Severe Disadvantage Research Articles

The City of Cork Food Policy Council – Inter-agency collaboration towards a fairer, healthier, more secure and sustainable local food system

Abstract Food has long played a significant part in Cork's identity and Cork regards itself as ‘the food capital of Ireland’. In contrast Cork city has areas of severe social disadvantage and, in line with other parts of the country, there are rising levels of diet-related ill-health and where up to one in eight households experiences food poverty (Kenny and Sage, 2019). To date, Cork City does not have an Urban Food Strategy. The Cork Food Policy Council is a partnership between representatives of the community, food retail, farming, fishing, restaurant/catering, education, environmental and health sectors and local authorities. It was established in 2012 to work towards the achievement of a fairer, healthier, more secure and sustainable food system within the City and throughout the region. As a multidisciplinary group that works closely with the Cork Healthy City initiative, it has pioneered innovative approaches to bring food systems thinking into the city, working at both local and policy levels. This recognises the position and value of food within the fabric of city life, and for its multifunctional benefits to health, community, infrastructure and spatial thinking. The presentation will focus on the interagency nature of this group and how a greater understanding and collaboration among local policy drivers has led to innovative actions in the city and the groundwork towards co-creating a food strategy for the City.

Choosing invisibility? Exploring service (dis)engagement of women experiencing multiple disadvantage

PurposeThe shift in policy discourse towards individualism is affecting service provision and access, which has become increasingly conditioned on individual agency and the “deservingness” of the recipient. Gendered and intersectional experiences of homelessness and excluded populations less likely to be living on the streets remain overlooked and unaddressed. This study thus aims to uncover what drives “invisibility” in services for women experiencing multiple disadvantage and the gendered constraints the women are facing when exiting and navigating multiple disadvantage.Design/methodology/approachThe paper draws on in-depth interviews with women who face severe and multiple disadvantage and their support staff. Data is also gathered through survey data and observations with a wide range of frontline service providers, as well as support notes and numerical progress data recorded by one of the service providers.FindingsContradicting the common assumption that people act as rational actors in their interaction with services, the author found that women’s decisions to (dis)engage may be blinded by forces of multiple disadvantage and mistrust. These are often developed as a result of systemic and gendered constraints that limit women’s capabilities and exercise of choice. Barriers in service access often amplified the personal barriers they were facing and reinforced women’s decisions to not engage with services.Research limitations/implicationsThe author hopes that this paper sheds light on the particular set of barriers women with multiple disadvantage face, which will be vital to reach women who face severe disadvantage and provide more effective policies, care and support.Originality/valueThis study gives voice to a particular hidden population: women with multiple disadvantage. It contributes to existing frameworks on agency and choice by understanding gendered barriers behind service engagement and how services themselves may be contributing to women’s invisibility.

Improving access to general practice for people with severe and multiple disadvantage: a realist review protocol (The Connection Study)

Introduction: Despite having high unmet health need, people with severe and multiple disadvantage (SMD, including combinations of homelessness, substance misuse, poor mental health and domestic violence and abuse) have poor access to general practice. This realist review will examine the existing evidence on interventions or aspects of routine care in general practice that are likely to increase or decrease access to general practice for people with SMD. Methods and analysis: he aim of this review is to identify how these interventions or aspects of routine care increase or decrease access to general practice for people with SMD, in which contexts and for which patients. This review will involve a process comprising five sequential phases: (1) identifying established theories, (2) conducting an extensive search for proof, (3) selecting appropriate articles, (4) gathering and organising relevant data, and (5) utilising a realist analytical approach to synthesise evidence and make conclusions. Local implementation documents, in addition to published research studies, will be incorporated to enrich the analysis. We will collaborate with a stakeholder group consisting of people with lived experience of SMD and those who support them to advise us throughout. Ethics and dissemination: Ethical approval is not required. Our findings will be disseminated through peer-reviewed publications, conference presentations and lay summaries and will be used to develop a complex intervention for improving access to general practice for and with people with severe and multiple disadvantage. PROSPERO registration number: CRD42023390495

Preparation and electrochemical characteristics of porous carbon composites originating from hyper-crosslinked polymers

A method of hyper-crosslinked polymers-derived carbon compounded with transition metal sulfides was employed in this study for suppressing the severe disadvantage of specific capacitance (SC) decay of transition metal sulfides due to volume variation and to enhancing supercapacitors' performance from the perspectives of power density and energy density, with the aim of addressing the challenge that carbon-based supercapacitors exhibit relatively lower energy density (ED). In this study, PNOC-800-3@NiS composites were well prepared based on the direct carbonization-chemical activation method with hyper-crosslinked polymer (PNO) as the precursor. Subsequently, PNOC-800-3@NiS composites were well prepared based on the hydrothermal approach with thiourea and PNOC-800-3 as the sulfur source and the substrate, separately. The effects exerted by different nickel-sulfur ratios and synthesis temperatures on the composites' electrochemical characteristics were studied. As revealed by the results, the surface area of PNOC-800-3@NiS-2-180 reached 1006.31 m2 g−1, and the pore diameter on average was 1.86 nm at the ratio of nickel to sulfur of 1:2 and the synthesis temperature of 180 °C. In the 6 M KOH electrolyte solution, composites exhibited the SC of 1051.2 F g−1 under a current density (CD) of 1 A g−1. With the rising CD in a range between 1 A g−1 and 10 A g−1, SC achieved a decay rate of 49.58 %. Under a power density (PD) of 700 W kg−1, a prominent ED was achieved by the assembled asymmetric supercapacitor, which was of 20.98 Wh kg−1. When 5000 cycles of discharging and charging was achieved, the composite PNOC-800-3@NiS-2-180 exhibited a capacitance retention rate of 72.63 %. Furthermore, as indicated by the result, the composite PNOC-800-3@NiS-2-180 exhibited prominent electrochemical characteristics, and can serve as one of the highly suitable electrode materials to be used in supercapacitors.

Disparate Impact: How Does Social Deprivation Affect Patient-reported Outcomes After ACL Reconstruction in Children and Adolescents?

Research has indicated that lower socioeconomic status is associated with delays in the treatment of anterior cruciate ligament (ACL) injuries; however, there is a paucity of literature evaluating its association with patient-reported outcomes (PROs). Using the Area Deprivation Index (ADI), a validated proxy for socioeconomic status, the study aimed to determine how relative socioeconomic disadvantage is related to PROs after primary ACL reconstruction (ACLR) in pediatric patients. This retrospective cohort study included all patients 18 years old or above who underwent primary ACLR at an academic institution between 2018 and 2021. Exclusion criteria included multiligament injury, congenital ACL absence, and absent outcomes data. The minimum follow-up was 6 months. A Patient-reported Outcomes Measurement Information System (PROMIS) 50 Pediatric self-report questionnaire was completed at postoperative visits, and domain scores for pain, physical function/mobility, fatigue, anxiety, depression, and peer relationships were generated. The National ADI percentile was calculated using the patients' addresses. Patients were divided into quartiles (low, moderate, moderate-severe, and severe ADI), and comparative analyses were performed to determine the relationship between ADI and PROMIS. A total of 413 patients were identified, including 49% (n=207), 33% (n=139), 11% (n=48), and 7% (n=30) from the low, moderate, moderate-severe, and severe deprivation areas, respectively. As compared with those in the low-deprivation quartile, patients in the severe deprivation quartile had delayed time to the first clinic visit (11 vs. 16.5d, P=0.044) and surgery (51 vs. 80d, P=0.004). There were no differences in the number of additional procedures required at index surgery. All quartiles had progressive improvements in physical function/mobility and pain scores throughout recovery, but at 9 months, there was significantly more pain in the severe deprivation cohort, despite no difference in self-reported physical function and mobility. Those with severe socioeconomic disadvantage had worse psychosocial outcomes, including significantly increased depression, fatigue, and anxiety and decreased peer relationship scores. Although there were no differences in preoperative PROMIS scores, pediatric patients living in areas with higher levels of socioeconomic deprivation/disadvantage had worse psychosocial PROs after ACLR. Level III-retrospective comparative study.

Protecting the Autonomy of Patients with Severe Mental Illness Through Psychiatric Advance Directive Peer-Facilitation

Protecting the Autonomy of Patients with Severe Mental Illness Through Psychiatric Advance Directive Peer-Facilitation

Improving access to general practice for people with severe and multiple disadvantage: a realist review protocol (the connection study)

Introduction: Despite having high unmet health need, people with severe and multiple disadvantage (SMD, including combinations of homelessness, substance misuse, poor mental health and domestic violence and abuse) have poor access to general practice. This realist review will examine the existing evidence on interventions or aspects of routine care in general practice that are likely to increase or decrease access to general practice for people with SMD. Methods and analysis: The aim of this review is to identify how these interventions or aspects of routine care increase or decrease access to general practice for people with SMD, in which contexts and for which patients. This review will involve a process comprising five sequential phases: (1) identifying established theories, (2) conducting an extensive search for proof, (3) selecting appropriate articles, (4) gathering and organising relevant data, and (5) utilising a realist analytical approach to synthesise evidence and make conclusions. Local implementation documents, in addition to published research studies, will be incorporated to enrich the analysis. We will collaborate with a stakeholder group consisting of people with lived experience of SMD and those who support them to advise us throughout. Ethics and dissemination: Ethical approval is not required. Our findings will be disseminated through peer-reviewed publications, conference presentations and lay summaries and will be used to develop a complex intervention for improving access to general practice for and with people with severe and multiple disadvantage.

Barriers Preventing Indigenous Women with Violence-related Head Injuries from Accessing Services in Australia

ABSTRACT Traumatic brain injury (TBI) is a serious yet commonly under-recognised injury sustained by women as a direct outcome of family violence. Although healthcare and support services are critical, many women do not access support services following this injury. At present, there are few relevant qualitative studies that have elevated the voices of Aboriginal and Torres Strait Islander women. This article describes the barriers that prevent Aboriginal and Torres Strait Islander women from accessing hospital and support services after experiencing a TBI from family violence in one regional (Queensland) and one remote location (Northern Territory). Interviews and focus-group discussions were conducted with 28 community members and 90 service professionals. Thematic analysis identified four key factors influencing women’s access to health care: all women fear child removal; fear of escalating violence; prioritisation of other competing demands; and insufficient awareness of the signs of brain injury. Given child protection systems perpetuate cycles of discrimination based on poverty and structural inequalities that have generated fear and contributed to the reluctance of women to engage with services, child protection processes and practices need to be transformed to consider the impact of head injury on the everyday lives of women. Pathways need to be implemented to assist women to access healthcare and support services as well as strengthen families to maintain the care of their children. Content warning: This article includes distressing information and may trigger trauma, especially for Aboriginal and Torres Strait Islander women. IMPLICATIONS Aboriginal and Torres Strait Islander women living with a head injury experience severe trauma, coercive control, disadvantage, and poverty, which prevents them from accessing healthcare and support services. Communities should be resourced to design, implement, and evaluate TBI prevention and intervention solutions as increased awareness and insight into the long-term consequences for the brain that can result from violence, including education for school-aged children, community campaigns, and targeted education for community members. TBI should be incorporated into child protection frameworks, workforce training, and assessment tools, along with training and education for community members.

Bridging gaps: improving access to primary care for and with marginalised patients.

People who experience severe and multiple disadvantage (SMD - including combinations of homelessness, substance misuse, violence and abuse, and poor mental health) have high health need and poor access to primary care. Access to care requires the 'human fit' between the patient and healthcare staff. This study aimed to co-produce service improvements in primary care to improve access for and with people with SMD and explore the perceptions of professionals and people with lived experience who contributed to these service improvements. Bridging Gaps is a collaboration between healthcare staff, women with lived experience, and a charity that supports them. We used a co-production approach, where people with lived experience are involved in decision-making throughout the process. A thematic analysis was performed of 12 observed collaborative service-improvement meetings, feedback from 3 GP trainees involved and interviews with 14 professional and lived experience collaborators on the project. Co-produced outcomes included a clinic designed for and with people with SMD; two Inclusion Health Care Coordinators, and a document for people with SMD to share information with their practice. Key themes from the data included protecting resource to enable cultural shift to proactive relationship-based care; and the benefits to marginalised patients, services, and professionals of having collaborative space to develop positive changes. Co-produced service-improvements to improve access to primary care for marginalised patients were valued, possible, and of benefit to patients, staff, and services. This study offers valuable insight into how we can better include and care for marginalised patients in primary care.

Emulgel: An Effective Drug Delivery System

When emulgel comes to administering hydrophobic medications, many of the benefits of gels are also severe disadvantages. An emulsion-based strategy is adapted to bypass barriers, giving even a hydrophobic medicinal component to take advantage of the special features of gels. Emulgel is a dosage form that combines gels and emulsions. The utilization of novel polymers has sparked a lot of curiosity in recent years. The direct convenience of the skin as a target organ for diagnostic and therapeutic objectives distinguishes dermatological pharmacology. Both hydrophilic and hydrophobic chemicals are blocked by this barrier is created by combining hydrophilic horn cells with a hydrophobic intercellular medium. Within the primary group of semi-solid preparations, the use of opaque gels in cosmetics and pharmaceutical preparations has grown. By lowering surface and interfacial tensions while raising aqueous phase viscosity, these chemicals allow the formation of stable emulsions and creams. An emulgel is created by adding a gelling ingredient to a conventional emulsion's aqueous phase. In various ways, these emulsifiers exceed both novel vesicular systems and traditional systems. Using various permeation enhancers, emulsifiers could be used as better topical medication delivery systems than they are today. The use of emulsifiers can be expanded to include analgesics and antifungals. Analgesics and antifungals can both benefit from emulsifiers. We discuss the types, advantages, marked emulgel, formulation of emulgel, emulgel preparation, and characterization.

Patients' Perspectives on Life and Recovery 1 Year After COVID-19 Hospitalization.

Many patients hospitalized for COVID-19 experience prolonged symptoms months after discharge. Little is known abou t patients' personal experiences recovering from COVID-19 in the United States (US), where medically underserved populations are at particular risk of adverse outcomes. Toexplore patients' perspectives on the impact of COVID-19 hospitalization and barriers to and facilitators of recovery 1year after hospital discharge in a predominantly Black American study population with high neighborhood-level socioeconomic disadvantage. Qualitative study utilizing individual, semi-structured interviews. Adult patients hospitalized for COVID-19 approximately 1year after discharge home who were engaged in a COVID-19 longitudinal cohort study. The interview guide was developed and piloted by a multidisciplinary team. Interviews were audio-recorded and transcribed. Data were coded and organized into discrete themes using qualitative content analysis with constant comparison techniques. Of 24 participants, 17 (71%) self-identified as Black, and 13 (54%) resided in neighborhoods with the most severe neighborhood-level socioeconomic disadvantage. One year after discharge, participants described persistent deficits in physical, cognitive, or psychological health that impacted their current lives. Repercussions included financial suffering and a loss of identity. Participants reported that clinicians often focused on physical health over cognitive and psychological health, an emphasis that posed a barrier to recovering holistically. Facilitators of recovery included robust financial or social support systems and personal agency in health maintenance. Spirituality and gratitude were common coping mechanisms. Persistent health deficits after COVID-19 resulted in downstream consequences in participants' lives. Though participants received adequate care to address physical needs, many described persistent unmet cognitive and psychological needs. A more comprehensive understanding of barriers and facilitators for COVID-19 recovery, contextualized by specific healthcare and socioeconomic needs related to socioeconomic disadvantage, is needed to better inform intervention delivery to patients that experience long-term sequelae of COVID-19 hospitalization.

Sovereignty, Cyberspace, and the Emergence of Internet Bubbles

The cyber domain emerged as a perfect platform for international struggle over power and influence. International powers are actively engaged in cyber proxy warfare due to the relatively low risk of escalation, various enforcement challenges, and the vagueness of international law within this realm. These indirect conflicts might lead some global powers to close or restrict their virtual borders to avoid or reduce the plausibility of cyber proxy warfare or unwanted foreign influence in general. The formation of such restricted networks, articulated in this article as “internet bubbles,” is already shaping within the realm of actors like Russia, China, North Korea, and Iran. The authors argue that liberal democracies like the United States might be at a severe disadvantage to fight against cyber proxy warfare due to legal and constitutional barriers. But at the same time, the emergence of platform governance and self-regulation might be proven as a new force within these proxy wars and reshape its boundaries.

The dilution effects of healthy lifestyles on the risk of depressive symptoms attributed to life-course disadvantages among Chinese middle-aged and older adults

BackgroundLife-course disadvantages and unhealthy lifestyles are well-known to independently induce depressive symptoms, but whether adopting healthy lifestyles can dilute the depressive risks attributed to life-course disadvantages remain unknown in China. MethodsThis population-based cross-sectional study included 5724 middle-aged and older people from the China Health and Retirement Longitudinal Study (CHARLS). Depressive symptoms and healthy lifestyles (including regular exercise, reasonable sleep, never smoking, and no heavy alcohol consumption) were collected in 2018 while life-course disadvantages were collected in 2014. ResultsMultiple healthy lifestyles were associated with decreased depressive risks more significantly as the life-course disadvantages increased, with odds ratios (ORs) and 95 % confidence intervals (CIs) of 0.44 (0.25–0.80) and 0.33 (0.21–0.53) for 4 healthy lifestyles in participants with mild and severe life-course disadvantages, respectively. Life-course disadvantages and unhealthy lifestyles had enormous joint effects on depressive symptoms. Finally, adopting multiple healthy lifestyles can dilute the depressive risks attributed to life-course disadvantages and even mask some risks attributed to childhood disadvantages. LimitationsGiven that dietary data were not gathered by the CHARLS, diet was not included in this study. In addition, information on life-course disadvantages was primarily self-reported, which may lead to potential recall bias. Finally, the cross-sectional design of this study cannot capture causal associations well. ConclusionsAdopting multiple healthy lifestyles can well-dilute the depressive risks attributed to life-course disadvantages in middle-aged and older Chinese, which is of great importance for reducing the depressive burden and the construction of healthy aging in China.

Information encryption strategy for optical security authentication using phosphor-encapsulated poly(N-isopropylacrylamide) nanoparticles

Ultraviolet-induced fluorescence has proven an intriguing encoding strategy to increase the effectiveness of anti-counterfeiting measures for commercial materials. Recently, fluorescent inks showed severe disadvantages such as high costs, poor durability, and low efficiency. In this context, we present the development of a security encoding ink based on poly(N-isopropylacrylamide) (PNIPAM) nanoparticles immobilized with lanthanide-activated aluminate (LAA) nanoparticles (NPs), which can be used for advanced anticounterfeiting applications. LAA-encapsulated PNIPAM nanoparticles were prepared. Authentication inks based on LAA@PNIPAM nanoparticles provide a unique combination of photostability and endurance. Therefore, the composite ink containing LAA@PNIPAM nanoparticles exhibited strong reversible and photostable UV-induced fluorescence. Different composite inks with distinct emission properties were prepared by varying the concentration of LAA@PNIPAM nanoparticles. Paper sheets printed with a homogenous layer of the composite inks displayed a transparent appearance under visible lighting but became green beneath ultraviolet illumination, as proven by photoluminescence and CIE Lab tests. Using transmission electron microscopic (TEM) analysis, the morphological study of LAA particles displayed diameters of 3–8 nm, whereas LAA@PNIPAM nanoparticles displayed diameters in the range of 80–175 nm. Multiple methods were utilized to examine both structure and elemental composition of the fluorescent prints. The ink rheology and mechanical properties of prints were tested. The emission and excitation wavelength were detected at 519 (green color) and 365 nm (colorless), respectively. The present smart ink can be reported as a highly efficient technology for the production of anticounterfeiting commercial products.

A new Bihari inequality and initial value problems of first order fractional differential equations

We prove existence of solutions, and particularly positive solutions, of initial value problems (IVPs) for nonlinear fractional differential equations involving the Caputo differential operator of order alpha in (0,1). One novelty in this paper is that it is not assumed that f is continuous but that it satisfies an L^{p}-Carathéodory condition for some p>frac{1}{alpha } (detailed definitions are given in the paper). We prove existence on an interval [0, T] in cases where T can be arbitrarily large, called global solutions. The necessary a priori bounds are found using a new version of the Bihari inequality that we prove here. We show that global solutions exist when f(t, u) grows at most linearly in u, and also in some cases when the growth is faster than linear. We give examples of the new results for some fractional differential equations with nonlinearities related to some that occur in combustion theory. We also discuss in detail the often used alternative definition of Caputo fractional derivative and we show that it has severe disadvantages which restricts its use. In particular we prove that there is a necessary condition in order that solutions of the IVP can exist with this definition, which has often been overlooked in the literature.

Experimental and numerical investigations of the flexural behaviour ‎of Green - Ultra High Performance Fiber Reinforced Concrete ‎beams under repeated loads

There are various benefits to ultra-high-performance fiber-reinforced concrete ‎‎(UHPFRC). However, using a lot of cement in this type of concrete has a severe disadvantage since it causes pollution and several environmental concerns. Therefore, another type of concrete that achieves the same superior properties as UHPFRC while using less cement in the mixture should be considered. This research examined replacing cement with fly ash to produce environmentally friendly concrete called Green-UHPFRC. The impact of utilizing G-UHPFRC on the flexural behaviour of thirteen beams was investigated experimentally and numerically under repeated loads. The major parameters of the study were fly ash replacement ratios of 15%, 30%, and 45% and adding steel fiber to mixes with ratios of 1, 2, 3, and 4%. The tested beams were compared to the control beam in their backbone and hysteresis curves, failure load, crack propagation and failure modes, energy dissipation, stiffness degradation, and ductility index. From the results obtained, environmentally friendly concrete (G-UHPFRC) can be produced by replacing cement with fly ash up to 45% and adding 2% steel fiber without affecting the bending performance of beams made of G-UHPFRC compared to those made of UHPFRC.

Growth for Good: Reshaping Capitalism to Save Humanity from Climate Catastrophe

Terzi, an economist at the European Commission, describes his approach as follows: ‘Climate change is too important an issue to allow ideology to blind us to truth. I have worked hard to free myself from preconceptions taking as much as possible an open-minded approach, even to theories normally belittled by mainstream economics. This book carefully considers the points raised by those who criticise capitalism, its relation to nature, and therefore the mainstream strategy—green growth—being pursued to deal with climate change’ (p. xii). Alongside this promising start is the final chapter outlining a ‘Blueprint for Green Capitalism’, in which Terzi appears to recognise the scale of the transformation facing economy and society if we are to avoid climate catastrophe, noting that ‘full decarbonization will require a “whole-of-nation approach” akin to a wartime economy’ (p. 184). He repeatedly states that the green transition will require a much larger role for the state, and an even more urgent need to introduce a wide range of policies to reduce economic inequality. European Commissioner Frans Timmermans’s remark that there will either be a just green transition, or no transition, is endorsed with supporting arguments acknowledging that most forms of carbon pricing are regressive, and that some regions especially affected by the transition (such as coal mining areas) are often already suffering from severe economic disadvantage.

Desigualdade racial na assistência à saúde do adulto internado por COVID-19

Abstract: The objective was to analyze the association of race/skin color in health care, in adults hospitalized with severe acute respiratory syndrome (SARS)/COVID-19, between March 2020 and September 2022, with Brazil as the unit of analysis. This is a cross-sectional study that used the Influenza Epidemiological Surveillance Information System (SIVEP-Gripe) database and had a population composed of adults (≥ 18 years) and the final classification was SARS by COVID-19 or unspecified SARS. The direct effect of skin color on in-hospital mortality was estimated through logistic regression adjusted for age, gender, schooling level, health care system and period, stratified by vaccination status. This same model was also used to assess the effect of skin color on the variables related to access to health care services: intensive care unit (ICU), tomography, chest X-ray and ventilatory support. The results show that black, brown and indigenous people died more, regardless the schooling level and number of comorbidities, with 23%, 32% and 80% higher chances of death, respectively, when submitted to ventilatory support. Racial differences were observed in the use of health care services and in outcomes of death from COVID-19 or unspecified SARS, in which ethnic minorities had higher in-hospital mortality and lower use of hospital resources. These results suggest that black and indigenous populations have severe disadvantages compared to the white population, facing barriers to access health care services in the context of the COVID-19 pandemic.

Scars of War: The Politics of Paternity and Responsibility for the Amerasians of Vietnam by Sabrina Thomas

<i>Scars of War: The Politics of Paternity and Responsibility for the Amerasians of Vietnam</i> by Sabrina Thomas

A comparative study of the effects of chemical crosslinking agents on NBSK handsheet properties

Chemical crosslinking is an established method for improving the wet performance of paper. In the chemical crosslinking process, covalent bonds are formed between cellulosic surfaces. The formed intra- and inter-fiber bonds increase the paper’s wet strength and reduce its water absorptivity. The majority of published studies concern crosslinking treatments with glyoxal, citric acid (CA), or with 1,2,3,4-butanetetra-carboxylic acid (BTCA). The most severe disadvantage of the crosslinking treatments with glyoxal, CA, and BTCA is that the formed crosslinks make the fibers and the paper more brittle. This downside effect has largely impeded the utilization of crosslinking in paper and paperboard making. In the present study, handsheets made from Nordic bleached softwood kraft pulp (NBSK) were crosslinked with methylated 1,3-dimethylol-4,5-dihydroxyethylene urea (mDMDHEU), which is commonly used in cotton fabric finishing. Similar to using glyoxal and citric acid, crosslinking with mDMDHEU notably increased the handsheet wet strength and decreased the water absorption. Compared to the use of glyoxal or CA, the crosslinking with mDMDHEU did not make the handsheets that brittle. These results suggest that mDMDHEU could be a more viable crosslinking agent for improving the wet performance of paper products.