Experiences of Help from the Perspective of Parents Whose Adolescent Is Harming Themselves or Has Died by Suicide.

Adolescent self-harm or suicide are emotionally difficult for parents, thus also parents need help. This qualitative descriptive study aimed to produce knowledge on the experiences of help received by Finnish parents (n = 23) whose adolescent is harming themselves or has died by suicide. The parents received diverse help for themselves, and for their self-harming adolescent or the deceased adolescent's sibling. Parents described negative experiences, but also factors that promoted their experience of help. There are many barriers to help related to the parents themselves, the adolescent, or to the social support system. Professional help should be easier to obtain and be based on the parents' individual expectations.

Gamma-valerolactone biorefinery: Catalyzed birch fractionation and valorization of pulping streams with solvent recovery.

In this study, we propose a full gamma-valerolactone (GVL) organosolv biorefinery concept including the utilization of all pulping streams, solvent recovery, and preliminary material and energy balances. GVL is a renewable and non-toxic solvent that fractionates woody biomass. The silver birch chips were pulped (45-65 wt% GVL, 150 °C, 2 h) under a series of acid-catalyzed conditions (5-12 kg H2SO4/t), and the fully bleached pulp was spun into fibers by the IONCELL® process and knitted into the fabric. The dissolved lignin was precipitated by water from spent liquor (1:1) and processed into polyhydroxyurethane. Most of the dissolved hemicelluloses were in the form of xylose, therefore, the crystallization efficiency of xylose from spent liquor in the presence of residual GVL was studied. The GVL recovery rate in the lab column was 66%, however by increasing the number of equilibrium stages, 99% recovery could be achieved.

Depression and dissociation mediate the association between bullying victimization and self-cutting.

BACKGROUND: Bullying victimization is experienced by more than 10% of children and adolescents worldwide and has been associated with numerous negative mental health consequences, such as depression and dissociation. AIMS: We investigated the association between bullying victimization and self-cutting in a Finnish adolescent population and whether depression and dissociation act as mediators in this association. METHODS: We used cross-sectional questionnaire data from Finnish students (age 13-18; N = 3345; boys n = 1454; girls n = 1891). Logistic regression and mediation analyses were performed. RESULTS: Bullying victimized adolescents were younger, more likely to be afraid to go to school, had fewer friends, felt lonelier, and had a poorer relationship with family members, as well as higher level of depressive and dissociative symptoms compared to non-bullied adolescents. According to logistic regression analysis, the association between bullying and self-cutting remained significant despite all other adjustments besides those for depressive symptoms. In serial mediation analysis, depressive and dissociative symptoms mediated the effect of bullying victimization on self-cutting, regardless of their order in the model. CONCLUSIONS: Self-cutting is more common among bullying victimized adolescents than their peers. The association is mediated by depressive and dissociative symptoms. More studies are needed to clarify the exact mechanisms via which depressive and dissociative symptoms interact with the association between bullying and self-harm.

Willow Bark-Derived Material with Antibacterial and Antibiofilm Properties for Potential Wound Dressing Applications.

Tree stems contain wood in addition to 10-20% bark, which remains one of the largest underutilized biomasses on earth. Unique macromolecules (like lignin, suberin, pectin, and tannin), extractives, and sclerenchyma fibers form the main part of the bark. Here, we perform detailed investigation of antibacterial and antibiofilm properties of bark-derived fiber bundles and discuss their potential application as wound dressing for treatment of infected chronic wounds. We show that the yarns containing at least 50% of willow bark fiber bundles significantly inhibit biofilm formation by wound-isolated Staphylococcus aureus strains. We then correlate antibacterial effects of the material to its chemical composition. Lignin plays the major role in antibacterial activity against planktonic bacteria [i.e., minimum inhibitory concentration (MIC) 1.25 mg/mL]. Acetone extract (unsaturated fatty acid-enriched) and tannin-like (dicarboxylic acid-enriched) substances inhibit both bacterial planktonic growth [MIC 1 and 3 mg/mL, respectively] and biofilm formation. The yarn lost its antibacterial activity once its surface lignin reached 20.1%, based on X-ray photoelectron spectroscopy. The proportion of fiber bundles at the fabricated yarn correlates positively with its surface lignin. Overall, this study paves the way to the use of bark-derived fiber bundles as a natural-based material for active (antibacterial and antibiofilm) wound dressings, upgrading this underappreciated bark residue from an energy source into high-value pharmaceutical use.

Fast and quantitative compositional analysis of hybrid cellulose-based regenerated fibers using thermogravimetric analysis and chemometrics.

Cellulose can be dissolved with another biopolymer in a protic ionic liquid and spun into a bicomponent hybrid cellulose fiber using the Ioncell® technology. Inside the hybrid fibers, the biopolymers are mixed at the nanoscale, and the second biopolymer provides the produced hybrid fiber new functional properties that can be fine-tuned by controlling its share in the fiber. In the present work, we present a fast and quantitative thermoanalytical method for the compositional analysis of man-made hybrid cellulose fibers by using thermogravimetric analysis (TGA) in combination with chemometrics. First, we incorporated 0-46 wt.% of lignin or chitosan in the hybrid fibers. Then, we analyzed their thermal decomposition behavior in a TGA device following a simple, one-hour thermal treatment protocol. With an analogy to spectroscopy, we show that the derivative thermogram can be used as a predictor in a multivariate regression model for determining the share of lignin or chitosan in the cellulose hybrid fibers. The method generated cross validation errors in the range 1.5-2.1 wt.% for lignin and chitosan. In addition, we discuss how the multivariate regression outperforms more common modeling methods such as those based on thermogram deconvolution or on linear superposition of reference thermograms. Moreover, we highlight the versatility of this thermoanalytical method-which could be applied to a wide range of composite materials, provided that their components can be thermally resolved-and illustrate it with an additional example on the measurement of polyester content in cellulose and polyester fiber blends. The method could predict the polyester content in the cellulose-polyester fiber blends with a cross validation error of 1.94 wt.% in the range of 0-100 wt.%. Finally, we give a list of recommendations on good experimental and modeling practices for the readers who want to extend the application of this thermoanalytical method to other composite materials. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s10570-021-03923-6.

Identification of cellulose textile fibers.

Distinguishing different textile fibers is important for recycling waste textiles. Most studies on non-destructive optical textile identification have focused on classifying different synthetic and natural fibers but chemical recycling requires more detailed information on fiber composition and polymer properties. Here, we report the use of near infrared imaging spectroscopy and chemometrics for classifying natural and regenerated cellulose fibers. Our classifiers trained on images of consumer textiles showed 100% true positive rates based on model cross-validation and correctly identified on average 8-9 out of 10 test set pixels using images of specifically made cotton, viscose and lyocell samples of known compositions. These results are significant as they indicate the possibility to monitor and control fiber dosing and subsequent dope viscosity during chemical recycling of cellulose fibers. Our results also suggested the possibility to identify fibers purely based on polymer chain length. This finding opens the possibility to indirectly estimate dope viscosity and creates entirely new hypotheses for combining imaging spectroscopy with classification and regression methods within the broader field of cellulose modification.

Social support may prevent self-cutting in adolescence: A 5-year follow-up study.

Self-cutting is common among adolescents. However, studies examining protective factors are rare. It has been suggested that social support may protect against self-cutting in adolescence. The aim of this study was to investigate the possible association of social relationships with the initiation of self-cutting. METHODS: The participants were community-dwelling Finnish adolescents (N = 4171) aged 13-18 years at baseline. The follow-up assessment was conducted 5 years later (N = 794). Those adolescents who had self-cut before the baseline assessment (N = 134) were excluded from the analysis, leaving a total of 660 participants to be analyzed. In this group, 37 adolescents initiated self-cutting during the 5-year follow-up period and 623 did not. Cox's proportional hazards models were used with several adjustments for possible confounding factors. FINDINGS: A higher age, male gender, good relationships with siblings, weekly meetings with friends, and personal experience of not being lonely associated with the noninitiation of self-cutting during the follow-up period. Good relationships with parents or peers had no association with the initiation of self-cutting. Depressive symptoms mediated the effect of subjective loneliness on initiating self-cutting. CONCLUSIONS: Social support produced by friends may have a protective effect against self-cutting.

Experiences of Help From the Perspective of Finnish People Who Self-Harmed During Adolescence.

Adolescent self-harm is a widespread phenomenon, and a significant problem worldwide. This study describes the experiences of help from the perspective of Finnish people who have suffered self-harm during adolescence. Data were collected from 27 participants as essays and interviews. Participants included both females and males with different backgrounds and treatment experiences. The data were analysed using inductive content analysis. Participants described having received help from other people in informal and formal ways, and they had both positive and negative experiences of help. The results show that several barriers exist for self-harming adolescents to access help, thus improvement in this area are necessary.

Green Conducting Cellulose Yarns for Machine-Sewn Electronic Textiles.

The emergence of "green" electronics is a response to the pressing global situation where conventional electronics contribute to resource depletion and a global build-up of waste. For wearable applications, green electronic textile (e-textile) materials present an opportunity to unobtrusively incorporate sensing, energy harvesting, and other functionality into the clothes we wear. Here, we demonstrate electrically conducting wood-based yarns produced by a roll-to-roll coating process with an ink based on the biocompatible polymer:polyelectrolyte complex poly(3,4-ethylenedioxythiophene):poly(styrene sulfonate) (PEDOT:PSS). The developed e-textile yarns display a, for cellulose yarns, record-high bulk conductivity of 36 Scm-1, which could be further increased to 181 Scm-1 by adding silver nanowires. The PEDOT:PSS-coated yarn could be machine washed at least five times without loss in conductivity. We demonstrate the electrochemical functionality of the yarn through incorporation into organic electrochemical transistors (OECTs). Moreover, by using a household sewing machine, we have manufactured an out-of-plane thermoelectric textile device, which can produce 0.2 µW at a temperature gradient of 37 K.

Hyperspectral near infrared image calibration and regression.

Reference materials are used in diffuse reflectance imaging for transforming the digitized camera signal into reflectance and absorbance units for subsequent interpretation. Traditional white and dark reference signals are generally used for calculating reflectance or absorbance, but these can be supplemented with additional reflectance targets to improve the accuracy of reflectance transformations. In this work we provide an overview of hyperspectral image regression and assess the effects of reflectance calibration on image interpretation using partial least squares regression. Linear and quadratic reflectance transformations based on additional reflectance targets decrease average measurement errors and make it easier to estimate model pseudorank during image regression. The lowest measurement and prediction errors were obtained with the column and wavelength specific quadratic transformations which retained the spatial information provided by the line-scanning instrument and reduced errors in the predicted concentration maps.

Competences in Social Media Use in the Area of Health and Healthcare.

In today's life, social media offer new working ways. People are increasingly expanding interactions from face-to-face meetings to online ways of communication, networking, searching, creating and sharing information, and furthermore taking care of patients/citizens via tweeting care, Facebook care, blogging care, vlogging care, infotainment care, gamification-care, infographic care, for instance. This chapter discusses the utilisation of social media in the healthcare domain including nursing education, practice and research. When in the current healthcare era, social media is used effectively and purposefully, it can give all of us a greater choice in how we live, how we take care of our health and how we learn and build both our professional competences and produce evidence-based, qualified data. Nurses need continuous education and proper tools to take the most of the benefits of social media, not forgetting privacy and ethical issues. This use of social media in professional nursing generates the need for new competences.

Effect of rheological properties of dissolved cellulose/microfibrillated cellulose blend suspensions on film forming.

Enzymatically treated cellulose was dissolved in a NaOH/ZnO solvent system and mixed together with microfibrillated cellulose (MFC) in order to find the threshold in which MFC fibers form a percolation network within the dissolved cellulose solution and in order to improve the properties of regenerated cellulose films. In the aqueous state, correlations between the rheological properties of dissolved cellulose/MFC blend suspensions and MFC fiber concentrations were investigated and rationalized. In addition, rheological properties of diluted MFC suspensions were characterized and a correlation with NaOH concentration was found, thus partly explaining the flow properties of dissolved cellulose/MFC blend suspensions. Finally, based on results from Dynamic Mechanical Analysis (DMA), MFC addition had strengthening/plasticizing effect on regenerated cellulose films if low concentrations of MFC, below the percolation threshold (5.5-6 wt%, corresponding to 0.16-0.18 wt% of MFC in the blend suspensions), were used.

Factors helping adolescents to stop self-cutting: descriptions of 347 adolescents aged 13-18 years.

AIMS AND OBJECTIVES: To describe the factors contributing to the stopping of self-cutting among 13-18-year-old Finnish adolescents from the personal perspective of the adolescents. BACKGROUND: Self-cutting is quite common among adolescents. However, adolescents' personal descriptions of what helped them to stop self-cutting have not previously been investigated. DESIGN: Qualitative descriptive design with quantification. METHODS: The data were collected from 347 participants using structured self-rating questionnaires as a part of a larger research project focusing on the mental well-being of adolescents aged between 13-18 years in Finland. The participants were asked to write their own descriptions of how they had been able to stop self-cutting, if they had done so. The data were analysed using qualitative content analysis. Frequencies and percentages were calculated in relation to the total number of identified references to factors contributing to the stopping of self-cutting. This enabled the determination of the most important factors helping adolescents to stop self-cutting from their own perspective. RESULTS: Six main themes emerged: factors associated with self-cutting and meanings related to it (n = 173); personal factors (n = 126); factors associated with other people (n = 104); factors associated with care or therapy (n = 18); meanings related to the instruments used to cut (n = 1) and unidentified factors (n = 18). CONCLUSIONS: Factors associated with self-cutting and meanings related to it were the most important factors contributing to the stopping of self-cutting. Personal factors and those associated with other people were also important, while factors associated with care were of less importance in this study. RELEVANCE TO CLINICAL PRACTICE: The factors identified in this study could potentially be used in clinical practice to assist other adolescents in stopping their self-cutting.

Adolescent self-cutting elsewhere than on the arms reveals more serious psychiatric symptoms.

Self-cutting as a form of self-harm is a common and multifaceted phenomenon among adolescents. The aim of this study was to investigate whether the location of self-cutting (arms or other areas of the body) could help to assess the severity of the underlying psychiatric problems. A sample of adolescents who reported self-cutting (n = 440) was drawn from a large sample of community adolescents (n = 4,019). The majority of self-cutting adolescents, 296 (67.2%), reported cutting only the upper arms, while 144 (32.8%) also cut other parts of the body. The data included a structured self-rating questionnaire, questions about self-cutting, the Youth Self-Report (YSR) for adolescents aged 11-18 years, the Beck Depression Inventory, the Toronto Alexithymia Scale and the Adolescent Dissociative Experience Scale (A-DES). The results indicate that self-cutting on other parts of body than the arms was associated with female gender, a wide range of emotional and dissociative symptoms and suicidal ideation. In logistic regression analysis, the most pronounced association between self-cutting on other places than the arms was found with YSR subscales withdrawn/depressed, social problems and thought problems, and dissociation (A-DES). We conclude that self-cutting adolescents, mostly girls, with wounds elsewhere than on the arms present with the most serious psychiatric symptoms. It is important to perform a careful physical examination when an adolescent has unexplained wounds or scars on the arms or on other parts of the body. These adolescents also need a caring and conscientious psychiatric examination and possible psychiatric treatment.

Helping self-mutilating adolescents: descriptions of Finnish nurses.

This study focused on the views of Finnish nurses in regards to providing help for adolescents who self-mutilate. Nine nurses participated, and when the interviews and written descriptions were qualitatively analysed, four main categories of information emerged. The first category comprises the nurses' views on self-mutilation. The second category describes the people who are able to be helpers. The third category describes the content of help, which is made up of a variety of acts provided by non-health professionals that promote the healthy development of adolescents. The fourth category describes care provided by nurses to adolescents who self-mutilate. Guidelines for caring for self-mutilating adolescents are needed, including information on the phenomenon of self-mutilation.

A systematic literature review: self-mutilation among adolescents as a phenomenon and help for it-what kind of knowledge is lacking?

The aim of this review article is to present current knowledge of self-mutilation among adolescents as a phenomenon and to define what kind of knowledge is lacking based on existing literature. The literature searches were executed in the CINAHL and Medline databases in 2010. The analysed data consisted of 126 articles and inductive content analysis was carried out. Existing knowledge of self-mutilation was categorized into the following two classes: (1) self-mutilation as a phenomenon and (2) caring for persons who self-mutilate or self-harm.

Minimally-invasive implantation of living tissue engineered heart valves: a comprehensive approach from autologous vascular cells to stem cells.

OBJECTIVES: The aim of this study was to demonstrate the feasibility of combining the novel heart valve replacement technologies of: 1) tissue engineering; and 2) minimally-invasive implantation based on autologous cells and composite self-expandable biodegradable biomaterials. BACKGROUND: Minimally-invasive valve replacement procedures are rapidly evolving as alternative treatment option for patients with valvular heart disease. However, currently used valve substitutes are bioprosthetic and as such have limited durability. To overcome this limitation, tissue engineering technologies provide living autologous valve replacements with regeneration and growth potential. METHODS: Trileaflet heart valves fabricated from biodegradable synthetic scaffolds, integrated in self-expanding stents and seeded with autologous vascular or stem cells (bone marrow and peripheral blood), were generated in vitro using dynamic bioreactors. Subsequently, the tissue engineered heart valves (TEHV) were minimally-invasively implanted as pulmonary valve replacements in sheep. In vivo functionality was assessed by echocardiography and angiography up to 8 weeks. The tissue composition of explanted TEHV and corresponding control valves was analyzed. RESULTS: The transapical implantations were successful in all animals. The TEHV demonstrated in vivo functionality with mobile but thickened leaflets. Histology revealed layered neotissues with endothelialized surfaces. Quantitative extracellular matrix analysis at 8 weeks showed higher values for deoxyribonucleic acid, collagen, and glycosaminoglycans compared to native valves. Mechanical profiles demonstrated sufficient tissue strength, but less pliability independent of the cell source. CONCLUSIONS: This study demonstrates the principal feasibility of merging tissue engineering and minimally-invasive valve replacement technologies. Using adult stem cells is successful, enabling minimally-invasive cell harvest. Thus, this new technology may enable a valid alternative to current bioprosthetic devices.

Adolescent dissociation and alexithymia are distinctive but overlapping phenomena.

Findings on the association between dissociation and alexithymia in adult populations are inconsistent. Dissociation has also been related to other types of psychopathology. Few studies have been published on these connections among adolescents. We examined the association between Adolescent Dissociative Experiences Scale (A-DES) scores and those for the Toronto Alexithymia Scale (TAS), the 21-item Beck Depression Inventory (BDI-21) and the Youth Self-Report (YSR), as well as subscales of the TAS and the YSR, in a sample of Finnish adolescents aged 13 to 18 years (n=4019). Factor analysis suggested that dissociation can be considered distinctive from other psychopathology. A-DES scores, however, associated strongly with several other scales and subscales measuring psychiatric symptoms. In logistic regression models the strongest associations were observable between the A-DES and TAS subscale 'difficulty identifying feelings' (DIF) and the YSR subscale 'thought problems'. Thus, dissociation and alexithymia can be considered distinctive but overlapping phenomena.

Helping adolescents who self-mutilate: parental descriptions.

AIM: The purpose of this qualitative descriptive study was to explore parental views on how to help adolescents who self-mutilate. BACKGROUND: Self-harm, including self-mutilation, is common among adolescents. However, parental conceptions of helping adolescents who self-mutilate have rarely been investigated in nursing science. DESIGN: Qualitative descriptive design. METHOD: Four parents of self-mutilating adolescents were interviewed in depth. Qualitative content analysis was applied. RESULTS: Three main categories emerged: a description of an adolescent who self-mutilates and descriptions of ways to help self-mutilating adolescents and ways to help their parents and family. An adolescent who self-mutilates appears externally to feel very well, but inside feels lonely and inferior to others. Help may include an adolescent helping herself by performing some activities alone or in relation to other people and an adolescent receiving help from a safe and trusting human relationship. Such a relationship can be with anyone who knows about the self-mutilation and is of utmost importance, but a caring attitude is particularly expected from adults. Factors that facilitate helping were identified as well as those considered help-hindering or helpful. Help that had been provided to parents and the family included factors considered helpful and unhelpful. CONCLUSION: Adolescents who self-mutilate try to help themselves, but are in need of external, probably professional help. Parents are in need of information about self-mutilation as a phenomenon to be able to help their children. Help for self-mutilating adolescents as perceived by their parents also includes help for the whole family. RELEVANCE TO CLINICAL PRACTICE: The findings of this study could assist health care professionals in approaching and helping both self-mutilating adolescents and their parents.

The essential elements of caring when building innovative service in South-African township.

When developing digital health care services there is a need for close cooperation between native and non-native developers. Via educating local people it is possible to find out health needs of families and develop an appropriate e-services.