AgX-based hybrid coordination polymers: mechanochemical synthesis, structure and luminescence property characterization.

Hybrid coordination polymers are interesting for their ability to converge the properties of both inorganic and organic systems in one single compound and recently attention has been focused on silver based hybrid coordination polymers due to their luminescence properties. We searched the CSD to establish the propensity of AgXL (X = Cl-, Br- and I-) with L as an organic ligand to form hybrid coordination polymers. About 800 AgXL structures are deposited in the CSD, with huge structural variability: indeed, it is possible to recognize some structural preferences based on the halide nature. The formation of an inorganic polymeric unit is favoured by iodide but it is also possible with the other halides. This research continues with the synthesis of AgX (X = I-, Br-) based coordination polymers with 2-, 3- and 4-picolylamine (n-pica) as ligands. By mechanochemical synthesis five new hybrid coordination polymers and one coordination polymer have been obtained and their structures determined. While [(AgI)(n-pica)]n are not luminescent, [(AgBr)(n-pica)]n emit and their profile depends on the crystallinity of the sample.

Healthcare professionals' assumptions as barriers to LGBTI healthcare.

Lesbian, gay, bisexual, trans and intersex (LGBTI) people experience significant healthcare inequalities and barriers to healthcare services. Contextualised within six Member States of the European Union (EU), this paper discusses efforts to identify and explore the nature of barriers to healthcare as part of Health4LGBTI, a 2-year pilot project funded by the EU. Data were generated through focus groups and interviews with LGBTI people and healthcare professionals and analysed using thematic analysis. Findings reveal that barriers to healthcare are underpinned by two related assumptions held by healthcare professionals: first, the assumption that patients are heterosexual, cisgender and non-intersex by default; second, the assumption that LGBTI people do not experience significant problems (and therefore that their experience is mostly irrelevant to healthcare). On the other hand, it is notable that responding healthcare professionals were broadly 'LGBTI-friendly'. Thus, we argue that efforts to improve LGBTI healthcare should not be limited to engaging with healthcare professionals with negative views of LGBTI people. Rather, such efforts should also tackle these assumptions amongst LGBTI-friendly healthcare professionals.

Training healthcare professionals in LGBTI cultural competencies: Exploratory findings from the Health4LGBTI pilot project.

OBJECTIVES: Lesbian, gay, bisexual, trans and intersex (LGBTI) people experience health inequalities and barriers to accessing healthcare at a greater rate than the general population. This paper aims to present the Health4LGBTI training course for healthcare workers and the results of its pilot implementation. METHODS: Funded by the European Parliament, the training course was developed by a multidisciplinary team including LGBTI organisations as part of the Health4LGBTI Project. 110 healthcare professionals from diverse medical fields attended the pilot training in six European Member States. Knowledge and attitudes were compared on the basis of a pre-post evaluation design utilising an ad hoc questionnaire. RESULTS: Knowledge scores increased after the training, irrespective of age and sexual orientation of participants. Attitudes scores generally improved, particularly in terms of inclusivity and a greater acknowledgement of LGBTI health needs and self-competence. CONCLUSION: The Health4LGBTI training course is both feasible and effective in training healthcare professionals and support staff to improve cultural competence and thereby promoting inclusive healthcare practice. PRACTICE IMPLICATIONS: The Health4LGBTI training course can be implemented in different healthcare contexts. Piloting of the course provided an opportunity for healthcare professionals and for support staff to improve their knowledge of, and attitudes towards, LGBTI people.

Co-producing knowledge of lesbian, gay, bisexual, trans and intersex (LGBTI) health-care inequalities via rapid reviews of grey literature in 27 EU Member States.

BACKGROUND: The health inequalities experienced by lesbian, gay, bisexual, trans and intersex (LGBTI) people are well documented with several reviews of global research summarizing key inequalities. These reviews also show how the health-care needs of LGBTI people are often poorly understood whilst suggesting that targeted initiatives to reduce inequalities should involve LGBTI people. OBJECTIVES: To determine what is known about the health-care inequalities faced by LGBTI people? What are the barriers faced by LGBTI people whilst accessing health care, and health professionals when providing care? What examples of promising practice exist? DESIGN: Rapid reviews of grey literature were co-produced with LGBTI people in 27 countries followed by a thematic analysis and synthesis across all data sets. The review included grey literature from each country that might not otherwise be accessible due to language barriers. MAIN RESULTS: Rapid reviews showed that LGBTI people faced various inequalities and barriers whilst accessing health care. Where heterosexuality, binary gender and assumed male/female sex characteristics were upheld as the norm, and where LGBTI people differed from these norms, discrimination could result. In consultations where LGBTI people feared discrimination and did not disclose their LGBTI status, health professionals lacked the information required for appropriate assessments. CONCLUSION: With greater understanding of sexual orientation (LGB people), gender identity (trans people) and sex characteristics (intersex people), combined with access to contemporary knowledge and training, health professionals can work in collaboration with researchers, policymakers and LGBTI people to develop systems that are better attuned to the needs of all service users.

A review of lesbian, gay, bisexual, trans and intersex (LGBTI) health and healthcare inequalities.

BACKGROUND: Lesbian, gay, bisexual, trans and intersex (LGBTI) people experience significant health inequalities. Located within a European Commission funded pilot project, this paper presents a review of the health inequalities faced by LGBTI people and the barriers health professionals encounter when providing care. METHODS: A narrative synthesis of 57 papers including systematic reviews, narrative reviews, meta-analyses and primary research. Literature was searched in Cochrane, Campbell Collaboration, Web of Science, CINAHL, PsychINFO and Medline. The review was undertaken to promote understanding of the causes and range of inequalities, as well as how to reduce inequalities. RESULTS: LGBTI people are more likely to experience health inequalities due to heteronormativity or heterosexism, minority stress, experiences of victimization and discrimination, compounded by stigma. Inequalities pertaining to LGBTI health(care) vary depending on gender, age, income and disability as well as between LGBTI groupings. Gaps in the literature remain around how these factors intersect to influence health, with further large-scale research needed particularly regarding trans and intersex people. CONCLUSION: Health inequalities can be addressed via changes in policy, research and in practice through health services that accommodate the needs of LGBTI people. With improved training to address gaps in their knowledge of LGBTI health and healthcare, health professionals should work in collaboration with LGBTI people to address a range of barriers that prevent access to care. Through structural change combined with increased knowledge and understanding, services can potentially become more inclusive and equally accessible to all.

Switching long acting antipsychotic medications to aripiprazole long acting once-a-month: expert consensus by a panel of Italian and Spanish psychiatrists.

INTRODUCTION: Aripiprazole long acting once-monthly (AOM) is a long acting atypical antipsychotic with proven efficacy in schizophrenia and with a pharmacological and a side effect profile that is different from other antipsychotics. These and other characteristics make AOM a possible alternative in patients requiring a change in long acting antipsychotic treatment due to issues such as lack of efficacy or persistent side effects. Both clinical and pharmacological factors should be considered when switching antipsychotics, and specific guidelines for long acting antipsychotic switching that address all these factors are needed. AREAS COVERED: A panel of Italian and Spanish experts in psychiatry met to discuss the strategies for the switch to AOM in patients with schizophrenia. Real life clinical experiences were shared and the clinical strategies to improve the likelihood of success were discussed. EXPERT OPINION: Due to its specific pharmacological and tolerability profile, AOM represents a suitable alternative for patients with schizophrenia requiring a switch to a new LAI treatment because of lack of efficacy or persistent side effects from another LAI. Possible strategies for the switch to AOM are presented in this expert consensus paper in an attempt to provide guidance throughout the entire switching process.

Mechanochemical preparation of copper iodide clusters of interest for luminescent devices.

The copper iodide complexes are known for their large variety of coordination geometries. Such diversity, while making it difficult to predict the final structure, permits the preparation of a great number of copper iodide complexes based on the same ligand. The target of the research was that of thoroughly exploring the chemistry of CuI and the ligand diphenyl-2-pyridyl phosphine (PN) by varying the stoichiometric ratio and/or the aggregation state. Six different compounds have been identified: [Cu4I4(PN)2], [Cu4I4(PN)2·(CH2Cl2)0.5], [CuI(PN)0.5]∞, [CuI(PN)3] whose structures have been determined during this study, CuI(PN)2 which was characterized by powder diffraction and [Cu2I2(PN)3] which has been already reported. The preparation routes are also different: synthesis in solution yielded [Cu4I4(PN)2·(CH2Cl2)0.5] and [CuI(PN)3] while [CuI(PN)0.5]∞ and CuI(PN)2 were obtained only via solid state reactions. These two latter examples confirmed that mechanochemistry is a valid route to explore the landscape of the possible structures of CuI derivatives. Crystallization by traditional solution procedures failed to give the desired crystal, so structure determination of the new compounds was tackled in two ways: by attempting crystal growth via solvothermal synthesis and by resolving the structure from X-ray powder diffraction data with "direct space" methods. What is more the photophysical properties of the complexes that could be obtained as sufficiently pure powders have also been investigated and are reported herein.