Facilitators and Barriers in Integrated Social Care for Families Facing Multiple and Complex Problems: A Scoping Review.

Introduction: Families with multiple and complex problems often deal with multiple professionals and organizations for support. Integrated social care supposedly prevents the fragmentation of care that often occurs.We identified facilitators and barriers experienced by families receiving integrated social care and by the professionals who provide it. Method: We performed a scoping review following Arksey and O'Malley's framework, using the following databases: PsycINFO, Web of Science Core Collection, Psychology and Behavioral Sciences Collection, CINAHL, PubMed, and Medline. Furthermore, conducted a thematic analysis. The results were divided into facilitators and barriers of integrated social care. Results: We identified 278 studies and finally included sixteen in our scoping review. We identified facilitators, including: linking formal care with informal networks, promoting collaboration among professionals e.g., working in pairs, and professionals autonomy. We identified barriers, including: time constraints, tasks outside professionals' expertise, along with resistance to integrated collaboration among organizations. These findings can enhance the advancement of social integrated care as a promising approach to support families facing multiple and complex problems. Conclusion: To empower families, integrated social care requires a systematic approach based on trust. It involves coordinated care, shared decision-making, informal networks and the participation of all family members, including children.

Closed-Loop Recyclable and Nonpersistent Polyethylene-like Polyesters.

ConspectusAliphatic polyesters based on long-chain monomers were synthesized for the first time almost a century ago. In fact, Carothers' seminal observations that founded the entire field of synthetic polymer fibers were made on such a polyester sample. However, as materials, they have evolved only over the past decade. This is driven by the corresponding monomers becoming practically available from advanced catalytic conversions of plant oils, and future prospects comprise a possible generation from third-generation feedstocks, such as microalgae or waste. Long-chain polyesters such as polyester-18.18 can be considered to be polyethylene chains with a low density of potential breakpoints in the chain. These do not compromise the crystalline structure or the material properties, which resemble linear high-density polyethylene (HDPE), and the materials can also be melt processed by injection molding, film or fiber extrusion, and filament deposition in additive manufacturing. At the same time, they enable closed-loop chemical recycling via solvolysis, which is also possible in mixed waste streams containing polyolefins and even poly(ethylene terephthalate). Recovered monomers possess a quality that enables the generation of recycled polyesters with properties on par with those of the virgin material. The (bio)degradability varies enormously with the constituent monomers. Polyesters based on short-chain diols and long-chain dicarboxylates fully mineralize under industrial composting conditions, despite their HDPE-like crystallinity and hydrophobicity. Fundamental studies of the morphology and thermal behavior of these polymers revealed the location of the in-chain groups and their peculiar role in structure formation during crystallization as well as during melting. All of the concepts outlined were extended to, and elaborated on further, by analogous long-chain aliphatic polymers with other in-chain groups such as carbonates and acetals. The title materials are a potential solution for much needed circular closed-loop recyclable plastics that also as a backstop if lost to the environment will not be persistent for many decades.

Polymorphism and Stretch-Induced Transformations of Sustainable Polyethylene-Like Materials.

Herein we demonstrate that polyethylene-like bioderived, biodegradable, and fully recyclable unbranched aliphatic polyesters, such as PE-2,18, develop hexagonal crystal structures upon quenching from the melt to temperatures <∼50 °C and orthorhombic-like packing at higher quenching temperatures or after isothermal crystallization. Both crystal types are layered. While all-trans CH2 packing characterizes the structure of the orthorhombic-like form, there is significant conformational disorder in the staggered long CH2 sequences of the hexagonal crystals. On heating, the hexagonal crystals transform to the orthorhombic type at ∼60 °C via melt recrystallization, but no change is apparent during heating samples with the orthorhombic form up to the melting point (∼95 °C). The hexagonal structure is of interest not only because it develops under very rapid quenching from the melt but also because under uniaxial tensile deformation it undergoes a stretch-induced transformation to the orthorhombic structure. Compared to deformation of orthorhombic specimens that maintain the same crystal type, such transformation results in larger strains and enhanced strain hardening, thus representing a desired toughening mechanism for this type of polyethylene-like materials.

Waxes from Long-Chain Aliphatic Difunctional Monomers.

Petrochemical polyethylene waxes (Mn = 800-8000 g/mol for commercial Ziegler waxes) as additives, lubricants, and release agents are essential to numerous products and production processes. The biodegradability of this class of compounds when unintentionally released to the environment is molar mass dependent and subject to ongoing discussions, and alternatives to conventional polyethylene waxes are desirable. By employing bottom-up and top-down approaches, that is nonstoichiometric A2 + B2 polycondensation and chain scission, respectively, linear waxes with multiple in-chain ester groups as biodegradation break points could be obtained. Specifically, waxes with 12,12 (WLE-12,12, WLE = waxes linear ester) and 2,18 (WLE-2,18) carbon atom linear ester repeat unit motifs were accessible over a wide range of molar masses (Mn ≈ 600-10 000 g/mol). In addition to the molar mass, the type of end group functionality (i.e., methyl ester, hydroxy, or carboxylic acid end groups) significantly impacts the thermal properties of the waxes, with higher melting points observed for carboxylic acid end groups (e.g., Tm = 83 °C for carboxylic acid-terminated WLE-12,12 with Mn,NMR = 1900 g/mol, Tm = 92 °C for WLE-2,18 with Mn,NMR = 2200 g/mol). A HDPE-like orthorhombic crystalline structure and rheological properties comparable to a commercial polyethylene wax suggest WLE-12,12 and WLE-2,18 are viable biodegradable and biosourced alternatives to conventional, petrochemical polyethylene waxes.

Polyethylene-Like Blends Amenable to Abiotic Hydrolytic Degradation.

Long-chain aliphatic polyester-18,18 (PE-18,18) exhibits high density polyethylene-like material properties and, as opposed to high density polyethylene (HDPE), can be recycled in a closed loop via depolymerization to monomers under mild conditions. Despite the in-chain ester groups, its high crystallinity and hydrophobicity render PE-18,18 stable toward hydrolysis even under acidic conditions for one year. Hydrolytic degradability, however, can be a desirable material property as it can serve as a universal backstop to plastic accumulation in the environment. We present an approach to render PE-18,18 hydrolytically degradable by melt blending with long-chain aliphatic poly(H-phosphonate)s (PP). The blends can be processed via common injection molding and 3D printing and exhibit HDPE-like tensile properties, namely, high stiffness (E = 750-940 MPa) and ductility (εtb = 330-460%) over a wide range of blend ratios (0.5-20 wt % PP content). Likewise, the orthorhombic solid-state structure and crystallinity (χ ≈ 70%) of the blends are similar to HDPE. Under aqueous conditions in phosphate-buffered media at 25 °C, the blends' PP component is hydrolyzed completely to the underlying long-chain diol and phosphorous acid within four months, as evidenced by NMR analyses. Concomitant, the PE-18,18 major blend component is partially hydrolyzed, while neat PE-18,18 is inert under identical conditions. The hydrolysis of the blend components proceeded throughout the bulk of the specimens as confirmed by gel permeation chromatography (GPC) measurements. The significant molar mass reduction upon extended immersion in water (M n(virgin blends) ≈ 50-70 kg mol-1; M n(hydrolyzed blends) ≈ 7-11 kg mol-1) resulted in embrittlement and fragmentation of the injection molded specimens. This increases the surface area and is anticipated to promote eventual mineralization by abiotic and biotic pathways of these HDPE-like polyesters in the environment.

Biodegradable High-Density Polyethylene-like Material.

We report a novel polyester material generated from readily available biobased 1,18-octadecanedicarboxylic acid and ethylene glycol possesses a polyethylene-like solid-state structure and also tensile properties similar to high density polyethylene (HDPE). Despite its crystallinity, high melting point (Tm =96 °C) and hydrophobic nature, polyester-2,18 is subject to rapid and complete hydrolytic degradation in in vitro assays with isolated naturally occurring enzymes. Under industrial composting conditions (ISO standard 14855-1) the material is biodegraded with mineralization above 95 % within two months. Reference studies with polyester-18,18 (Tm =99 °C) reveal a strong impact of the nature of the diol repeating unit on degradation rates, possibly related to the density of ester groups in the amorphous phase. Depolymerization by methanolysis indicates suitability for closed-loop recycling.

Closed-loop recycling of polyethylene-like materials.

Plastics are key components of almost any technology today. Although their production consumes substantial feedstock resources, plastics are largely disposed of after their service life. In terms of a circular economy1-8, reuse of post-consumer sorted polymers ('mechanical recycling') is hampered by deterioration of materials performance9,10. Chemical recycling1,11 via depolymerization to monomer offers an alternative that retains high-performance properties. The linear hydrocarbon chains of polyethylene12 enable crystalline packing and provide excellent materials properties13. Their inert nature hinders chemical recycling, however, necessitating temperatures above 600 degrees Celsius and recovering ethylene with a yield of less than 10 per cent3,11,14. Here we show that renewable polycarbonates and polyesters with a low density of in-chain functional groups as break points in a polyethylene chain can be recycled chemically by solvolysis with a recovery rate of more than 96 per cent. At the same time, the break points do not disturb the crystalline polyethylene structure, and the desirable materials properties (like those of high-density polyethylene) are fully retained upon recycling. Processing can be performed by common injection moulding and the materials are well-suited for additive manufacturing, such as 3D printing. Selective removal from model polymer waste streams is possible. In our approach, the initial polymers result from polycondensation of long-chain building blocks, derived by state-of-the-art catalytic schemes from common plant oil feedstocks, or microalgae oils15. This allows closed-loop recycling of polyethylene-like materials.