Self-Perceived Barriers and Facilitators to Dietary Approaches to Stop Hypertension Diet Adherence Among Black Americans With Chronic Kidney Disease: A Qualitative Study.

OBJECTIVE: The Dietary Approaches to Stop Hypertension (DASH) eating plan improves hypertension in Black individuals and is associated with favorable chronic kidney disease (CKD) outcomes. Yet, adherence to DASH is low among US adults in general, particularly among Black Americans. We assessed perceptions about DASH, its cultural compatibility, and barriers and facilitators to DASH adherence in Black adults with CKD. DESIGN AND METHODS: We conducted focus groups and semistructured individual interviews involving 22 Black men and women with CKD Stages 3-4 from outpatient clinics at a US academic medical center. Transcripts of audio-recorded interviews were analyzed using thematic analysis. RESULTS: Among participants (2 focus groups [N = 8 and 5] and 9 individual interviews), 13 (59%) had CKD Stage 3, 13 (59%) were female, the median age was 61 years, and 19 (90%) had hypertension. After receiving information about DASH, participants perceived it as culturally compatible based on 3 emergent themes: (1) Black individuals already eat DASH-recommended foods ("Blacks eat pretty much like this"), (2) traditional recipes (e.g., southern or soul food) can be modified into healthy versions ("you can come up with decent substitutes to make it just as good"), and ( 3) diet is not uniform among Black individuals ("I can't say that I eat traditional"). Perceived barriers to DASH adherence included unfamiliarity with serving sizes, poor cooking skills, unsupportive household members, and high cost of healthy food. Eleven (52%) reported after paying monthly bills that they "rarely" or "never" had leftover money to purchase healthy food. Perceived facilitators included having local access to healthy food, living alone or with supportive household members, and having willpower and internal/external motivation for change. CONCLUSIONS: Black adults with CKD viewed DASH as a healthy, culturally compatible diet. Recognizing that diet in Black adults is not uniform, interventions should emphasize person-centered, rather than stereotypically culture-centered, approaches to DASH adherence.

Characteristics Associated with Burnout among Cardiologists in an Academic Medical Setting: Baseline Survey Results from a Communication Coaching RCT.

OBJECTIVES: Clinician burnout poses risks not just to clinicians but also to patients and the health system. Cardiologists might be especially prone to burnout due to performing high-risk procedures, having to discuss serious news, and treating diseases that incur significant morbidity and mortality. Few have attempted to examine which cardiologists might be at higher risk of burnout. Knowing at-risk cardiologists can help frame resilience interventions. METHODS: We enrolled 41 cardiologists across five ambulatory cardiology clinics into a randomized controlled trial where we assessed the Maslach Burnout Inventory at baseline. We used bivariate analyses to assess associations between cardiologist demographics and burnout. RESULTS: Cardiologists reported low burnout for depersonalization and personal accomplishment and moderate levels for emotional exhaustion. Female cardiologists reported emotional exhaustion scores in the "low" range (M = 12.3; SD = 10.06), compared to male cardiologists whose score was in the "moderate" range 19.6 (SD = 9.59; p = 0.113). Cardiologists who had greater than 15 years in practice reported higher mean scores of emotional exhaustion, indicating moderate burnout (M = 20.0, SD = 10.63), compared to those with less than 15 years in practice (M = 16.6, SD = 9.10; p = 0.271). CONCLUSIONS: In this sample, unlike prior studies, male cardiologists reported more burnout. Consistent with prior work, mid-level cardiologists might be at highest risk of emotional exhaustion.

LATIN-19: A Grassroots Coalition to Mitigate the Effect of COVID-19 on the Latinx Community in North Carolina.

BACKGROUND: Social inequity is a primary driver of health disparities, creating multiple barriers to good health. These inequities were exacerbated during the coronavirus disease 2019 (COVID-19) pandemic, with Latinx communities suffering more than others. Grassroots collaborations have long existed to address disparities. OBJECTIVE: We describe the creation and work of the Latinx Advocacy Team and Interdisciplinary Network for COVID-19 (LATIN-19; http://latin19.org/), a multisector coalition in North Carolina created to address the unique challenges of COVID-19 in the Latinx community. METHODS: We discuss challenges and solutions that LATIN-19 addressed and the impact of LATIN-19 on community partners and members. RESULTS: LATIN-19 learned of challenges including, lack of awareness, need for data systems to track disparities, the need to increase access to resources, the need for policy changes, and the need to coordinate services by community organizations. CONCLUSIONS: LATIN-19 represents a grassroots organization that has had an impact on community and community organizations that spans beyond COVID-19.

Biological, Behavioral, and Ethical Considerations of Prader-Willi Syndrome: A Primer for Behavior Analysts.

Prader-Willi syndrome (PWS) is a rare genetic disorder typically characterized by hyperphagia, hypotonia, intellectual disabilities, insistence on routines, and obsession and compulsion related to food. Although current medical interventions primarily include growth hormones to address the biological symptoms of the individual, behavioral therapy is an alternative option for skill acquisition and decreasing problem behaviors. There is a growing need for applied behavior analysis (ABA) research on targeting problem behaviors and teaching requisite skills to individuals with this syndrome. This article reviews the current literature on PWS, highlights treatments and their limitations, suggests how ABA providers can provide ethical services, and proposes future research needs with this syndrome.

Effects of Smoking Reduction and Cessation on Birth Outcomes in a Scheduled Gradual Reduction Cessation Trial.

INTRODUCTION: Smoking during pregnancy can affect infant birthweight. We tested whether an intervention that promoted scheduled gradual reduction improved birth outcomes among pregnant women who smoked. We also examined race differences in birth outcomes. METHODS: We conducted a 2-arm randomized controlled trial where pregnant women who smoked received either SMS text-delivered scheduled gradual smoking reduction (SGR) program plus support texts or support messages only throughout their pregnancy. The outcomes for this paper were birth outcomes including birth weight and gestational age obtained from chart review. Analyses were conducted using chi-square and t-tests in SAS. RESULTS: We approached 2201 pregnant women with smoking history. Of the 314 women recruited into the study, 290 completed a medical release form (92%). We did not find any significant differences in birth outcomes by arm or race. The majority of participants reduced smoking by the 80%. Women who reduced more than 50% of their baseline cigarettes per day had a birth weight increase of 335 g compared to those that did not (p = 0.05). The presence of alcohol/drug use in prenatal visit notes was associated with low infant birth weight (p = 0.05). DISCUSSION: The scheduled gradual reduction intervention did not improve birth outcomes. Additional research is needed to help improve birth outcomes for pregnant women who engage in tobacco and illicit substance use. CLINICAL TRIAL #: NCT01995097.

Trajectories of Situational Temptations in Pregnant Smokers participating in a Scheduled Gradual Reduction Cessation Trial.

OBJECTIVE: The purpose of this paper was to examine changes in situational temptations to smoke among women in early to late pregnancy enrolled in a texting trial to help them quit smoking. We compared changes between (1) intervention arms, (2) those who quit, (3) those who reduced by 50% or more, and (4) those who reduced by less than 50%. We also examined cravings overtime in the intervention arm and the relationship between real-time cravings assessed via text message and situational temptations. METHODS: This was a secondary analysis of the Baby Steps trial, a randomized controlled trial testing the efficacy of a text-based scheduled gradual reduction (SGR) intervention on cessation. We used t-tests to examine changes across intervention arms and repeated measured proc mixed to explore changes in situational temptations and cravings. RESULTS: Among all women, situational temptations decreased from early to late pregnancy for the positive, negative, and habitual subscales, (ps < 0.001). We found no difference in situational temptations across arms. We found a positive relationship between negative situational temptation and average craving during the Weeks 2 and Weeks 3 of the intervention. Negative ST increased by 0.11 for each unit increase of craving at Week 2. CONCLUSIONS: As women progress through pregnancy their temptation to smoke reduces. A different relationship might exist, however with negative affect situations in which women reported higher craving but not in response to other temptations. Future work might have a particular focus on the intersection of negative affect with cravings and temptations to promote cessation during pregnancy. CLINICAL TRIAL: NCT01995097.

Assessing the feasibility and acceptability of a peer-based communication coaching model among hospital clinicians.

Objective: Communication coaching shows promise for improving clinician communication yet few have assessed the feasibility of having peers coach each other. We conducted a proof-of-concept study to test the feasibility and acceptability of a peer-based communication coaching program in an inpatient setting. Methods: We trained three clinician communication coaches (two physicians and one physician assistant) and randomized half of the 27 clinicians working on the general medicine floor to receive coaching. The coaching involved shadowing and providing feedback on real-time encounters with patients. We collected data on feasibility of providing the coaching, quantitative and qualitative ratings of acceptability of the coaching both from the clinician and the coach perspective, and clinician burnout. Results: We found the peer coaching to be feasible and acceptable. Quantitative and qualitative reports support the merit of the coaching; most clinicians who received the coaching reported making changes in their communication. Clinicians in the intervention arm reported less burnout than those who did not receive the coaching. Conclusions: This proof-of-concept pilot showed that peer coaches can provide communication coaching and that clinicians and coaches viewed the coaching as acceptable and might change communication. The coaching also seems to show promise on burnout. We provide lessons learned and thoughts about how to improve the program. Innovation: Teaching clinicians to coach each other is innovative. We conducted a pilot that shows promise for feasibility, acceptability of clinicians coaching each other to communicate better, and a signal that it can help improve clinician burnout.

Communication Coaching in Cardiology (CCC): A study protocol and methodological challenges and solutions of a randomized controlled trial in outpatient cardiology clinics.

Given the role of effective communication in improving patient adherence and satisfaction, high quality patient-clinician communication is critical. Building on previous communication interventions in oncology and pediatrics, we developed a tailored communication coaching intervention to improve empathic communication quality and patient-centered care. In this randomized controlled trial, cardiologists record their patient encounters for review by a communication coach who provides tailored feedback. We are recruiting 40 cardiologists and 400 patients, or 4 patients per cardiologist in the Pre-intervention phase and 6 patients per cardiologists in the Post-intervention phase, from outpatient cardiology clinics within the Duke Health System. The primary goal of the trial is to determine the efficacy of the clinician communication coaching versus usual care in the post-intervention phase (240 patient encounters). In this paper, we describe the development of the communication coaching intervention. We also describe the details of the methods and outcomes of the ongoing trial. Finally, we discuss the challenges, solutions, and lessons learned during the start-up phase of the study.

A Yet Unrealized Promise: Structured Advance Care Planning Elements in the Electronic Health Record.

Background: Electronic health records (EHRs) may help enable reliable, rapid data management for many uses, such as facilitating communication of advance care planning (ACP). However, issues with validity and accuracy of EHRs hinder the use of ACP information for practical applications. Design: We present a cross-sectional pilot study of 433 older adults with cancer from three large health care systems, participating in an ongoing multisite pragmatic trial (4UH3AG060626-02). We compared data extracted from dedicated structured EHR fields for ACP to a chart review of corresponding ACP documentation contained in the medical chart. Results: Structured ACP data existed for 43.2% of patients and varied by site (25.7% -48.9%). Of the identified structured ACP data elements, 59.2% of recorded elements were correct, 23.7% were incorrect, and 17.1% were duplicates with heterogeneity across sites. Conclusion: Structured ACP data in EHRs were frequently incorrect. This represents a problem for patients and their families, as well as quality improvement and research efforts. Clinical Trials Registration: NCT03609177.

Cue-based treatment for light smokers: A proof of concept pilot.

INTRODUCTION: Light smoking (smoking ≤ 10 cigarettes per day or on some days) has become increasingly prevalent in the US and increases morbidity and mortality. Many light smokers do not experience significant nicotine withdrawal but instead smoke in response to cues. Minimal evidence exists supporting interventions to help light smokers quit smoking. METHODS: We present results from a proof-of-concept pilot study designed to evaluate the feasibility and acceptability of a cue-based smoking cessation intervention targeted to light daily and intermittent smokers. Participants were randomized to one of two arms: Arm 1) standard smoking cessation treatment or Arm 2) standard smoking cessation treatment + enhanced cue-based treatment that included interactive texting to extend cue exposure treatment to real-world settings and cue management counseling.Outcomes included feasibility (number of participants who were recruited and who completed the intervention), acceptability (intervention ratings), and preliminary efficacy (7-day point prevalence abstinence). RESULTS: We randomized 24 English and Spanish-speaking light smokers, 13 to the treatment arm and 11 to the control arm. Across both arms, 77% attended all counseling sessions, 90% rated these sessions as very useful and 100% said that they would recommend the intervention to a friend. 15% in the treatment arm had biochemically-validated smoking abstinence compared to 0% in the standard counseling arm. CONCLUSIONS: Results from this proof-of-concept study demonstrated that a cue-based intervention is feasible and acceptable among light smokers and suggests the need for a fully powered study to assess this approach. TRIAL REGISTRATION: This study is registered at www.clinicaltrials.gov NCT03416621.

Pilot Test of Connecting Pregnant Women who Smoke to Short Message Service (SMS) Support Texts for Cessation.

INTRODUCTION: Most pregnant women know that smoking poses serious risks to baby and mother, yet many still smoke. We conducted a large randomized controlled trial and found that an SMS text-delivered program helped about 10% of these women quit smoking. In this paper, we describe the feasibility of disseminating a text-based intervention to pregnant women who smoke. METHODS: We tested dissemination in two ways from prenatal clinics and compared recruitment rates to those found in our large randomized controlled trial. The first method involved "direct texting" where study staff identified women who smoked and sent them a text asking them to text back if they wanted to receive texts to help them quit. The second involved "nurse screening" where clinic staff from county health departments screened women for smoking and asked them to send a text to the system if they wanted to learn more about the program. Our primary outcome was feasibility assessed by the number of women who texted back their baby's due date, which served as "enrolling" in the texting program, which we compared to the recruitment rate we found in our large trial. RESULTS: Over 4 months, we texted 91 women from the academic health system. Of those, 17 texted back and were counted as "enrolled." In the health departments, across the 4 months, 12 women texted the system initially. Of those, 10 were enrolled. This rate was similar to the rate enrolled in the randomized controlled trial. DISCUSSION: Two different methods connected pregnant women who smoke to a texting program. One of these methods can be automated further and have the potential of helping many women quit smoking with minimal effort. Clinical Trial # NCT01995097.

Revisiting a Previously Validated Temperament Test in Shelter Dogs, Including an Examination of the Use of Fake Model Dogs to Assess Conspecific Sociability.

This study assessed the feasibility and reproducibility of a previously validated temperament test (TT) for shelter dogs. The test was developed to measure dog behaviour in the kennel, and traits of sociability towards people and other dogs, docility to leash, playfulness, cognitive skills, and reactivity. We introduced the use of differently sized fake dogs to check their appropriateness in correctly assessing sociability to dogs to broaden its applicability (as the original study used real stimulus dogs). We hypothesised that dogs' responses may be modulated by the body size of the stimulus dog presented. The reduction analysis of the TT scores extracted five main dimensions (explaining 70.8% of variance), with high internal consistency (alpha > 0.65) and being broadly consistent with existing research. Behavioural components that were extracted from the fake dog experiment showed that dogs are likely to show signs of anxiety and fear toward both the real and fake dog. Dogs' responses towards a real vs. fake stimulus were significantly correlated (p < 0.05) and they were not affected by the size of the stimulus (p > 0.05). We discuss the importance of interpreting these data with caution and use behavioural tests as a partial screening tool to be used in conjunction with more extensive behavioural and welfare monitoring.

Pilot Study to Improve Goals of Care Conversations Among Hospitalists.

CONTEXT: Many hospitalized patients receive care that is not concordant with their goals. Teaching communication skills that better align goals and treatment can improve the care that patients receive. OBJECTIVE: To develop and test an innovative approach that encourages hospitalists to engage in goals of care (GOC) conversations with their patients. METHODS: We recruited 14 hospitalists and randomized half to receive electronic health record alerts for patients who might benefit most from a goals-of-care conversation, as well as communication coaching. The coaching required an initial meeting, then audio recording of two GOC conversations and feedback from the coach. Outcomes were the presence of GOC conversations (primary), the quality of the GOC conversations, physician perceptions of the intervention, and hospital metrics (e.g., 30-day readmissions, referrals to palliative care). RESULTS: We did not increase the frequency of GOC conversations but did improve the quality of the conversations. Patients of physicians who received the intervention had fewer 30-day readmission rates and were less likely to die 90 days after admission than patients of physicians in the control arm. Patients of intervention physicians also had fewer palliative care consults than patients of control physicians. CONCLUSIONS: Teaching hospitalists to have GOC conversations translated into better skills and outcomes for patients. This pilot study shows promise and should be tested in a larger trial.

Understanding Pediatric Caretakers' Views on Obtaining Medical Care for Low-acuity Illness.

BACKGROUND: A significant proportion of low-acuity emergency department (ED) visits are by patients under 18 years of age. Results from prior interventions designed to reduce low-acuity pediatric ED use have been mixed or poorly sustained, perhaps because they were not informed by patient and caretakers' perspectives. The objective of this study was to explore caretaker decision-making processes, values, and priorities when deciding to seek care. METHODS: We conducted semistructured interviews of caretakers in both emergency and primary care settings, incorporating stimulated recall methodology. We also explored receptiveness to two care delivery innovations: use of community health workers (CHWs) and video teleconferencing. RESULTS: Interviews of 57 caretakers identified multiple barriers to accessing primary care for their children's acute illness, including transportation, work constraints, and childcare. Frequent ED users lacked reliable social supports to overcome barriers. Fear of unforeseen health outcomes and a lack of trust in unfamiliar providers also influenced decision-making, rather than lack of general knowledge about minor illness. Receptiveness to CHWs was mixed, reflecting concerns for privacy and level of expertise. The option of video teleconferencing for low-acuity care was well received by caretakers. CONCLUSIONS: Caretakers who used the ED frequently had limited social support and reported difficulty accessing care when compared to other caretakers. Fear also motivated care seeking and a desire for immediate medical care. Teleconferencing for low-acuity visits may be a useful health care delivery tool to reduce access barriers and provide rapid reassurance without engaging the ED.

The Role of Mental Health Disease in Potentially Preventable Hospitalizations: Findings From a Large State.

BACKGROUND: Preventable hospitalizations are markers of potentially low-value care. Addressing the problem requires understanding their contributing factors. OBJECTIVE: The objective of this study is to determine the correlation between specific mental health diseases and each potentially preventable hospitalization as defined by the Agency for Healthcare Research and Quality. DESIGN/SUBJECTS: The Texas Inpatient Public Use Data File, an administrative database of all Texas hospital admissions, identified 7,351,476 adult acute care hospitalizations between 2005 and 2008. MEASURES: A hierarchical multivariable logistic regression model clustered by admitting hospital adjusted for patient and hospital factors and admission date. RESULTS: A total of 945,280 (12.9%) hospitalizations were potentially preventable, generating $6.3 billion in charges and 1.2 million hospital days per year. Mental health diseases [odds ratio (OR), 1.25; 95% confidence interval (CI), 1.22-1.27] and substance use disorders (OR, 1.13; 95% CI, 1.12-1.13) both increased odds that a hospitalization was potentially preventable. However, each mental health disease varied from increasing or decreasing the odds of potentially preventable hospitalization depending on which of the 12 preventable hospitalization diagnoses were examined. Older age (OR, 3.69; 95% CI, 3.66-3.72 for age above 75 years compared with 18-44 y), black race (OR 1.44; 95% CI, 1.43-1.45 compared to white), being uninsured (OR 1.52; 95% CI, 1.51-1.54) or dual-eligible for both Medicare and Medicaid (OR, 1.23; 95% CI, 1.22-1.24) compared with privately insured, and living in a low-income area (OR, 1.20; 95% CI, 1.17-1.23 for lowest income quartile compared with highest) were other patient factors associated with potentially preventable hospitalizations. CONCLUSIONS: Better coordination of preventative care for mental health disease may decrease potentially preventable hospitalizations.

Understanding the Effect of Solvent Structure on Organic Reaction Outcomes When Using Ionic Liquid/Acetonitrile Mixtures.

The rate constant for the reaction between hexan-1-amine and 4-methoxybenzaldehyde was determined in ionic liquids containing an imidazolium cation. The effect on the rate constant of increasing the length of the alkyl substituent on the cation was examined in a number of ionic liquid/acetonitrile mixtures. In general it was found that there was no significant effect of changing the alkyl substituent on the rate constant of this process, suggesting that any nanodomains in these mixtures do not have a significant effect on the outcome of this process. A series of small-angle X-ray scattering and wide-angle X-ray scattering experiments were performed on mixtures of the ionic liquid 1-butyl-3-methylimidazolium bis(trifluoromethanesulfonyl)imide ([Bmim][N(CF3SO2)2]) and acetonitrile; this work indicated that the main structural changes in the mixtures occur by about a 0.2 mole fraction of ionic liquid in the mixture (χIL). This region at which the main changes in the solvent structuring occurs corresponds to the region at which the main changes in the rate constant and activation parameters occur for SN2 and condensation reactions examined previously; this is the first time that such a correlation has been observed. To examine the ordering of the solvent about the nucleophile hexan-1-amine, WAXS experiments were performed on a number of [Bmim][N(CF3SO2)2]/acetonitrile/hexan-1-amine mixtures, where it was found that some of the patterns featured asymmetric peaks as well as additional peaks not observed in the [Bmim][N(CF3SO2)2]/acetonitrile mixtures; this suggests that the addition of hexan-1-amine to the mixture affects the bulk structure of the liquid. The SAXS/WAXS patterns of mixtures of 1-butyl-2,3-dimethylimidazolium bis(trifluoromethanesulfonyl)imide ([Bm2im][N(CF3SO2)2]) and acetonitrile were also determined, with the results suggesting that [Bm2im][N(CF3SO2)2] is more ordered than [Bmim][N(CF3SO2)2] due to an enhancement in the short-range interactions.

Factors Associated With Potentially Preventable Pediatric Admissions Vary by Diagnosis: Findings From a Large State.

OBJECTIVES: The objective of this study was to determine characteristics associated with potentially preventable pediatric admissions as defined by the Agency for Healthcare Research and Quality. METHODS: The Texas Inpatient Public Use Data File, an administrative database of hospital admissions, identified 747 040 pediatric admissions ages 0 to 17 years to acute care facilities between 2005 and 2008. Potentially preventable admissions included 5 diagnoses: asthma, perforated appendicitis, diabetes, gastroenteritis, and urinary tract infection. A hierarchical multivariable logistic regression model clustered by admitting hospital and adjusted for admission date estimated the patient and hospital factors associated with potentially preventable admission. RESULTS: An average of 71 444 hospital days per year and 14.1% (N = 105 055) of all admissions were potentially preventable, generating $304 million in hospital charges per year in 1 state. Younger age (odds ratio [OR]: 2.88 [95% confidence interval (CI): 2.80-2.96]), black race (OR: 1.48 [95% CI: 1.45-1.52]) or Hispanic ethnicity (OR: 1.06 [95% CI: 1.04-1.08]), lower income (OR: 1.11 [95% CI: 1.02-1.20]), comorbid substance abuse disorder (OR: 2.03 [95% CI: 1.75-2.34]), and admission on a weekend (OR: 1.05 [95% CI: 1.03-1.06]) or to a critical access hospital (OR: 1.61 [95% CI: 1.20-2.14]) were high-risk factors for potentially preventable admission, whereas Native American race (OR: 0.91 [95% CI: 0.85-0.98]), government insurance (OR: 0.83 [95% CI: 0.89-0.96]) or no insurance (OR: 0.93 [95% CI: 0.89-0.96]), and living in a rural county (OR: 0.70 [95% CI: 0.68-0.73]) were associated factors. However, most factors varied from high to low odds depending on which of the 5 potentially preventable diagnoses was examined. CONCLUSIONS: Potentially preventable admissions represent a high burden of time and costs for the pediatric population, but strategies to reduce them should be tailored to each diagnosis because the associated factors are not uniform across all potentially preventable admissions.

Gas-separation membranes loaded with porous aromatic frameworks that improve with age.

Porosity loss, also known as physical aging, in glassy polymers hampers their long term use in gas separations. Unprecedented interactions of porous aromatic frameworks (PAFs) with these polymers offer the potential to control and exploit physical aging for drastically enhanced separation efficiency. PAF-1 is used in the archetypal polymer of intrinsic microporosity (PIM), PIM-1, to achieve three significant outcomes. 1) hydrogen permeability is drastically enhanced by 375% to 5500 Barrer. 2) Physical aging is controlled causing the selectivity for H2 over N2 to increase from 4.5 to 13 over 400 days of aging. 3) The improvement with age of the membrane is exploited to recover up to 98% of H2 from gas mixtures with N2 . This process is critical for the use of ammonia as a H2 storage medium. The tethering of polymer side chains within PAF-1 pores is responsible for maintaining H2 transport pathways, whilst the larger N2 pathways gradually collapse.

Lyotropic liquid crystal phases of phytantriol in a protic ionic liquid with fluorous anion.

The phase behaviour of phytantriol in the protic ionic liquid (PIL) 1-methylimidazolium pentadecafluorooctanoate (MImOF) and four different MImOF-water compositions was investigated by small- and wide-angle X-ray scattering (SAXS/WAXS), cross polarised optical microscopy (CPOM) and infrared spectroscopy (IR). MImOF is a distinct protic ionic liquid in that it contains a fluorocarbon anion and a hydrocarbon cation. This leads to MImOF having an unusual liquid nanostructure, such that it contains fluorocarbon, hydrocarbon and polar domains. No lyotropic liquid crystal phases were observed for phytantriol in neat MImOF. However, on addition of water, lamellar, cubic Ia3¯d and micellar phases were observed for specific MImOF-phytantriol-water compositions at room temperature, and up to 60 °C. The phase behaviour for phytantriol in the solvent mixture of 25 wt%-MImOF-75 wt%-water was the most similar to the phytantriol-water phase diagram. Only this MImOF-water composition supported the Ia3¯d cubic phase, which had a lattice parameter between 100-140 Å compared to 86-100 Å in deionised water, indicating significant swelling due to the MImOF. IR spectroscopy showed that a percentage of the water molecules were hydrogen bonded to the N-H of the MIm cation, and this water decreased the hydrogen bonding present between the cation and anion of the ionic liquid. This investigation furthers our understanding of the interaction of ionic liquids with solutes, and the important role that the different IL nanostructures can have on influencing these interactions.

Fluorous protic ionic liquids exhibit discrete segregated nano-scale solvent domains and form new populations of nano-scale objects upon primary alcohol addition.

Fluorous protic ionic liquids (FPILS) containing a perfluorinated anion and hydrocarbon cation have been observed to segregate into nano-scale fluorocarbon, hydrocarbon and polar domains. The solubility and interactions of ethanol and butanol in a series of FPILs has been investigated by synchrotron source small and wide angle X-ray scattering. Nano-scale objects were found to be present within the binary solutions from low concentrations of FPILs in alcohols to around 40 to 80 wt% FPIL. The FPILs retain their fluorocarbon, hydrocarbon and polar domains in binary mixtures with alcohols in addition to the formation of nano-scale alcohol associated objects. For comparison, the influence of alcohols on the nano-scale segregation of analogous protic ionic liquids (PILs) which contained hydrocarbon anions in place of the perfluorinated anions was also investigated. The ethanol and butanol were miscible with the PILs across the full concentration range, with no evidence for the formation of analogous nano-scale objects. The FPILs are prospective solvents which may enable simultaneous solubility of fluorocarbon, hydrocarbon and polar species.