Structural accreditation of healthcare facilities: comparison of the requirements by Italian Presidential Decree 14/01/1997 and regional regulations. A proposal for updating the minimum environmental units at national level.

BACKGROUND AND AIM: The Decree of the President of the Italian Republic 14/01/1997 is the reference norm related to the accreditation of public and private healthcare structures. This guideline establishes the minimum structural, technological and organizational requirements that each structure operating in the Italian territory must comply with. METHODS: In occasion of the project work for the postgraduate training course in healthcare management by ALTEMS School, a team of researchers conducted a survey on the state of updating of the minimum structural requirements indicated in the norm-in particular those relating to hospital facilities- with those adopted by the individual regions through the analysis of the most up-to-date regional regulations. RESULTS: Precisely starting from the comparison of regional references and from the regulations on the subject of structural accreditation which suggest strategic environmental units and which address some key-aspects relating to the contemporary design of healing environments (i.e. semi-intensive care units, hybrid operating theatres, etc.), the outcome of the project work is to define a proposal to update the national reference document, also in the light of the currently changing needs in terms of hospital design. CONCLUSIONS: The research aims to become a starting milestone for future investigations. The team investigated - in this first phase - the functional areas listed in the norm, and the next step aims to extend the analysis also to the innovative functions (i.e. buffer spaces, hybrid operating theatres, sub-intensive care units, etc.) and/or introduced only the last years which have only been regulated in some regions.

Calcium carbonate as sorbent for lead removal from wastewaters.

Low-cost and largely available industrial by-products such as calcite (CaCO3) have been considered as sorbents to remediate wastewaters from toxic elements, such as lead, in compliance with the European circular economy strategy. To date few articles are reporting results on lead sorption at the calcite-water solution interface by X-ray photoelectron spectroscopy (XPS) and this investigation aims to clarifying the mechanism of the interaction of Pb2+ model solutions over a wide concentration range, from 0.1 µM to 80 mM, with commercial calcite. X-ray powder diffraction (XRPD), scanning electron microscopy (SEM, EDX) and XPS analysis indicate that when CaCO3 particles are soaked in Pb2+ 0.1 mM and 1 mM solutions, hexagonal platelets of hydrocerussite [(PbCO3)2 Pb(OH)2] precipitate on its surface. When the concentration of Pb2+ is equal or higher than 40 mM, prismatic acicula of cerussite [PbCO3] precipitate. Solution analysis by atomic emission spectroscopy (ICP-AES) and ICP-mass spectrometry (ICP-MS) indicate that Pb2+ removal efficiency is nearly 100%; when the initial Pb2+ concentration was equal to 0.1 µM it was below the limit of detection (LOD) and the efficiency could not be determined. The sorption capacity (qe) increases linearly with increasing initial Pb2+ concentration up to a value of 1680 (20) mg/g when the initial Pb2+concentration is 80 mM. These findings suggest that heterogeneous nucleation and surface co-precipitation occur and calcite can be well considered a very promising sorbent for Pb2+ removal from wastewaters within a wide initial concentration range.