As average temperatures and occurrences of extreme heat events increase in the Southwest, the water infrastructure that was designed to operate under historical temperature ranges may become increasingly vulnerable to component and operational failures. For each major component along the life cycle of water in an urban water infrastructural system, potential failure events and their semi-quantitative probabilities of occurrence were estimated from interview responses of water industry professionals. These failure events were used to populate event trees to determine the potential pathways to cascading failures in the system. The probabilities of the cascading failure scenarios under future conditions were then calculated and compared to the probabilities of scenarios under current conditions to assess the increased vulnerability of the system. We find that extreme heat events can increase the vulnerability of water systems significantly and that there are ways for water infrastructure managers to proactively mitigate these vulnerabilities before problems occur.

The utilization of suicide risk assessment tools is a critical component of a comprehensive approach to suicide risk assessment. However, some professionals hesitate to utilize screening tools routinely in practice. A project was undertaken to determine if the utilization of the Columbia-Suicide Severity Scale (C-SSRS) improved staff confidence in assessing suicide risk. Professionals within a psychiatric urgent care in Scottsdale, Arizona were provided with
training on the C-SSRS. Participants then utilized the C-SSRS at triage with patients presenting with depression and/or suicidality over a two-month period.

Self confidence in assessing suicide risk was evaluated utilizing The Efficacy in Assessing and Managing Suicide Risk Scale (SETSP-S). The acceptability and usability of the C-SSRS was evaluated utilizing The System Usability Scale (SUS). Findings of the Wilcoxon Signed Ranks test indicated changes in pre and posttest assessment scores as significant in seven of the eight assessment parameters. In addition, Cohen's effect size value suggested medium or large clinical significance in these same assessment parameters.

Evidence suggests that efficient and effective assessment can improve staff confidence in assessing for suicidality and may improve morbidity and mortality rates for patients. The utilization of tools such as the C*SSRS could reduce health care costs associated with unnecessary hospital admissions as well as rehospitalizations. The routine utilization of assessment tools such as the C-SSRS many also be beneficial to healthcare specialties outside of behavioral health such as emergency departments and urgent care settings.