Applying Failure Modes and Effects Analysis to Public Health Models: The Breathe Easy at Home Program

Failure Modes and Effects Analysis (FMEA) is a structured process used to identify and prioritize risks by ranking them based on severity, occurrence, and detectability. Historically, FMEA has been used within industries, including automotive and health care. This project explored the adaption of the FMEA template to a small public health program designed to improve asthma outcomes. The Breathe Easy at Home (BEAH) program is a multi-sector partnership that uses a web-based system to link clinical sites with housing code inspections and enforcement for patients with asthma. In July and August 2014, an FMEA was conducted to uncover risks within the BEAH process, and failures were prioritized for corrective action. The FMEA team prioritized risk based on severity, occurrence, and detectability to apply the FMEA process to a public health program. The FMEA team developed an action plan to improve failure modes that received the highest rankings. To fit the needs of a relatively small public health program, Joint Health Commission and U.S. Veterans Administration rating scales were adapted. The FMEA process can be adapted to a public health systems evaluation framework in order to prioritize areas for improvement

Asthma and Social Justice How to Get Remediation Done

Given the compelling evidence that conditions within the home can worsen asthma symptoms, creating access to housing inspections and other legal services in the healthcare setting can be an effective way of addressing asthma risks related to the home. The systematic review 1 published in this supplement to the American Journal of Preventive Medicine found that multicomponent, home-based interventions with an environmental focus might be effective in improving overall quality of life for children with asthma. Health issues relating to housing conditions require a multidisciplinary approach, and we suggest that this approach stretch beyond the scope of traditional medicine. Partnerships among the healthcare, legal, public health, and housing community can effectively reduce asthma-related hazard

Combination of Heparin Binding Peptide and Heparin Cell Surface Coatings for Mesenchymal Stem Cell Spheroid Assembly

Microtissues containing multiple cell types have been used in both <i>in vitro</i> models and <i>in vivo</i> tissue repair applications. However, to improve throughput, there is a need to develop a platform that supports self-assembly of a large number of 3D microtissues containing multiple cell types in a dynamic suspension system. Thus, the objective of this study was to exploit the binding interaction between the negatively charged glycosaminoglycan, heparin, and a known heparin binding peptide to establish a method that promotes assembly of mesenchymal stem cell (MSC) spheroids into larger aggregates. We characterized heparin binding peptide (HEPpep) and heparin coatings on cell surfaces and determined the specificity of these coatings in promoting assembly of MSC spheroids in dynamic culture. Overall, combining spheroids with both coatings promoted up to 70 ± 11% of spheroids to assemble into multiaggregate structures, as compared to only 10 ± 4% assembly when cells having the heparin coating were cultured with cells coated with a scrambled peptide. These results suggest that this self-assembly method represents an exciting approach that may be applicable for a wide range of applications in which cell aggregation is desired

Near-term climate change:Projections and predictability

This chapter assesses the scientific literature describing expectations for near-term climate (present through mid-century). Unless otherwise stated, ‘near-term’ change and the projected changes below are for the period 2016-2035 relative to the reference period 1986-2005. Atmospheric composition (apart from CO2; see Chapter 12) and air quality projections through to 2100 are also assessed. Decadal Prediction. The nonlinear and chaotic nature of the climate system imposes natual limits on the extent to which skilful predictions of climate statistics may be made. M.del-based ‘predictability’ studies, which probe these limits and investigate the physical mechanisms involved, support the potential for the skilful prediction of annual to decadal average temperature and, to a lesser extent precipitation. Predictions for averages of temperature, over large regions of the planet and for the global mean, exhibit positive skill when verified against observations for forecast periods up to ten years (high confidence). Predictions of precipitation over some land areas also exhibit positive skill. Decadal prediction is a new endeavour in climate science. The level of quality for climate predictions of annual to decadal average quantities is assessed from the past performance of initialized predictions and non-initialized simulations. {11.2.3, Figures 11.3 and 11.4}. In current results, observation-based initialization is the dominant contributor to the skill of predictions of annual mean temperature for the first few years and to the skill of predictions of the global mean surface temperature and the temperature over the North Atlantic, regions of the South Pacific and the tropical Indian Ocean for longer periods (high confidence)