Implementation of a spark plasma sintering facility in a hermetic glovebox for compaction of toxic, radiotoxic, and air sensitive materials.

Spark plasma sintering (SPS) is a rapidly developing method for densification of powders into compacts. It belongs to the so-called "field assisted sintering techniques" that enable rapid sintering at much lower temperatures than the classical approaches of pressureless sintering of green pellets or hot isostatic pressing. In this paper, we report the successful integration of a SPS device into a hermetic glovebox for the handling of highly radioactive material containing radioisotopes of U, Th, Pu, Np, and Am. The glovebox implantation has been facilitated by the replacement of the hydraulic system to apply pressure with a compact electromechanical unit. The facility has been successfully tested using UO2 powder. Pellets with 97% of the theoretical density were obtained at 1000 °C for 5 min, significantly lower than the ∼1600 °C for 5-10 h used in conventional pellet sintering.

[The effect of two different methods of heel lancing on pain reaction in preterm neonates]. / L'efficacia di due diversi presidi per il controllo del dolore da puntura del tallone nel neonato pretermine.

Heel lancing is the most used method to obtain a blood sample in newborn and pre-term infants. The effectiveness on pain reduction of a new lancet, Tenderfoot was compared against the traditional Lancetta, randomizing 40 preterm newborns to have the heel lanced with one of the two instruments and observing overall 76 blood sampling episodes. Newborns were observed at baseline, when disinfected, during and at the end of the blood sampling procedure. Statistically different behavioural responses to the pain of the puncture were observed during the blood sampling, in the 'recovery time' after the procedure and in the number of pricks performed. When the Tenderfoot was used, less children cried during the first 5 seconds after the prick. The Tenderfoot is effective in reducing the heel prick pain, allows an easier collection of the blood, a reduction of the time necessary and of the need of squeezing the heel, therefore reducing the bruises and pain related to the squeezing itself. According to our data, its use is recommended for the obtainment of large quantities of blood, and in the severely ill newborns, that need frequent blood monitoring and several pricks. These characteristics render its use debatable because of the costs and of the bleeding for blood exams that require limited amount of blood (blood glucose, blood gas analysis) until its effects on the scarring time and outcome will be documented.

[Indicators of continuous improvement of the transfer of neonatal emergency cases in the Trento province]. / Indicatori di miglioramento continuo delle cure dopo valutazione dell'attività di trasporto primario d'emergenza neonatale in provincia di Trento.

The nursing personnel of the Neonatology Unit of Trento Hospital cares for the transportation of newborns in the Trento Province (more than 7500 transportations have been performed to date). Aim of the study is the evaluation of the quality of care as documented in the ad hoc neonatal transportation data-bank. A further goal is the formulation and validation of simple and easy to collect indicators of "improvement of care". Examples of indicators used to assess the activities of the years 1996 and 1997 were the number of transportations with functioning equipment; the number of newborns with body temperature registered; the number of transportation cards correctly filled out. These simple indicators allowed to identify areas where the quality of care could be improved. The cause-effect diagram used allowed the involvement of all the nursing personnel in the identification of problems and of possible solutions. An example of the process followed for identifying and preventing hypothermia is presented and discussed.

[Analysis of the utilization of the operating room using a computer]. / Análise da utilização de sala de cirurgia com apoio da informática.

With this study, we intended to verify the possibility of settling a time control of the activities developed at the operating room of an University Hospital, which has more than 500 beds, through the introduction of a computer program. The results indicate that this kind of systematic time control, which is used by nurses, anaesthesia and surgery staff is able to offer a more rational utility to human and material resources.

[Home care of children with chronic diseases: cooperation between hospital and home care workers]. / Assistenza domiciliare al bambino cronico: esperienze di integrazione fra operatori ospedalieri eterritoriali.

Newborns with chronic problems needing continuous and special care even after discharge are not very frequent but represent a challenge for the caring team. The discharge program of the Neonatal Care ward of Trento hospital includes several steps: discharge meetings of teh neonatologist and the nurse responsible for the child, the head nurse, the psychologist and, when possible, the social worker; a training program for the parents; the coordination of communications and interventions of the home-care nurses and a detailed post-discharge planning. From 1995 a home-hospital program, as an alternative to the hospital admission was started. To describe how the team functions and stress the need of a close integration among the team members, the case of Ahmed is presented. This case faced the team with several challenges, because of the lack of parent's knowledge of the italian language and of the severity of the child's problems. Every care plan is developed building on newborn's needs and patients' resources. Data on the patients-problems dealt with from 1991 to 1995 and the interventions and resources needed are presented.

[Overview of nosocomial infections in a neonatal intensive care unit (1989-1993)]. / Sorveglianza delle infezioni nosocomiali in unità di terapia intensiva neonatale (1989-1993).

Newborns admitted to any Intensive Care Unit (ICU) are more at risk for nosocomial infections. The author analyzed the incidence of nosocomial bacteriaemias occurred in the neonatal ICU of Trento, especially focusing on the relationship between weight at delivery, incidence of infections and mortality. The incidence of bacteriaemiae during the observation period (1.189-31.12.93) accounted for 3.5%, and 2.8% were classified as nosocomial. The most frequently involved organism was the Staphylococcus PCN (62% of bacteriaemiae). High risk newborns weighted < 1500 g; 10.7% were affected by nosocomial bactaeriaemia, representing the 56.1% of all the observed bacteriaemiae. A strong association (p < 0.05) was also observed between bactaeriaemiae and mortality, in newborns weighting less than 1000 g. Since low and very low birth weigh infants are particularly at risk for infections, special attention should be paid to the invasive techniques and a systematic reporting and documentation of epidemiology of infections, in order to monitor impact of modifications in caring techniques is warranted.