An Unhealthy Relationship?:The Reputational Risks of Europe’s Health Focused Public Diplomacy in Africa

The article assesses the reputational risks associated with health focused EU public diplomacy (PD) in Africa in the closing years of the Cotonou Agreement. Focussing on the COVID-19 pandemic, it assesses Europe’s PD strategy in Africa in the wake of the virus. It explains health focused European PD stories – as well as aid delivery – in Africa in terms of the EU’s self-image as a normative power, its concern for reputation management, and its power plays vis-à-vis rival donors, notably China. However, the article argues that the EU’s PD focus on health narratives bears severe reputational risks for Europe in terms of opening-up wider interrogations of the health impacts of Africa-EU ties. Notably, the health risks for African citizenries of Europe’s neo-colonial commercial policies far outweigh any benefits associated with the ‘Team Europe’ pandemic response. The article concludes by considering African agency to contest EU PD discourse on its health terrain, and to leverage the EU’s reputational risks to challenge Europe’s unhealthy relationship with African countries

Metrics of student dissatisfaction and disagreement: longitudinal explorations of a national survey instrument

This study explores dissatisfaction and neutrality metrics from 12 years of a national-level undergraduate student survey. The notion of dissatisfaction is much less prevalent in the narratives surrounding student survey outcomes, and the underpinning metrics are seldom considered. This is despite an increasingly vociferous debate about ‘value for money’ of higher education and the positioning of students as consumers in a marketised sector. We used machine learning methods to explore over 2.7 million national survey outcomes from 154 institutions to describe year-on-year stability in the survey items that best predicted dissatisfaction and neutrality, together with their similarity to known metric predictors of satisfaction. The widely publicised annual increases in student ‘satisfaction’ are shown to be the result of complex reductions in the proportions of disagreement and neutrality across different survey dimensions. Due to the widespread use of survey metrics in university league tables, we create an anonymised, illustrative table to demonstrate how UK institutional rankings would have differed if dissatisfaction metrics had been the preferred focus for reporting. We conclude by debating the tensions of balancing the provision of valuable information about dissatisfaction, with perpetuating negative impacts that derive from this important subset of the survey population

National student survey metrics: where is the room for improvement?

The purpose of this study is to use machine learning and exploratory data analysis to interrogate patterns of metrics from a national-level student survey. Analysis of over 1.8 million returns detected long-term stability of the predictors of student satisfaction, with survey items relating to course management and teaching being consistently most influential. All metric outputs increased over the survey period, however the rates of increase of several dimensions including Overall Satisfaction decreased markedly in the most recent years to a point of levelling off. There was also a growing similarity in institutional of outcomes at a national level. This study contributes new insights into the influential survey instrument, through rigorous determination of the most influential survey items, descriptions of the changes in variability between institutions and exploration of the importance of patterns of outliers at the extremes of the metric outputs. We also identify a rapidly growing spike in total satisfaction at a broad course level and highlight how this is inconsistent with a customer satisfaction model. We conclude by considering the value of the survey instrument for informing the management of student satisfaction in higher education

Preliminary joint X-ray and neutron protein crystallographic studies of ecDHFR complexed with folate and NADP\u3csup\u3e+\u3c/sup\u3e

A crystal of Escherichia coli dihydrofolate reductase (ecDHFR) complexed with folate and NADP+ of 4 x 1.3 x 0.7 mm (3.6 mm3) in size was obtained by sequential application of microseeding and macroseeding. A neutron diffraction data set was collected to 2.0 A resolution using the IMAGINE diffractometer at the High Flux Isotope Reactor within Oak Ridge National Laboratory. A 1.6 A resolution X-ray data set was also collected from a smaller crystal at room temperature. The neutron and X-ray data were used together for joint refinement of the ecDHFR–folate–NADP+ ternary-complex structure in order to examine the protonation state, protein dynamics and solvent structure of the complex, furthering understanding of the catalytic mechanism

Extraversion and the West African EPA Development Programme: realising the development dimension of ACP–EU trade?

West African elites have successfully argued for an Economic Partnership Agreement Development Programme (EPADP) as part of free trade negotiations with the European Commission. ECOWAS officials state that the EPADP is necessary to realise the ‘development dimension’ of trade. In particular, they have (re)articulated Europe’s own narratives relating to Aid for Trade and private sector development – insisting that the European Commission delivers on its promises. Accordingly, European negotiators have conceded the principle of the EPADP, stating that around €· billion will be delivered. This article, however, examines the likely (in)capacity of the EPADP to meaningfully marry trade and development in the context of premature liberalisation under Economic Partnership Agreements (EPAs). Crucially, it argues that West African extraversion in terms of EPADP resources may entrench predatory elites while locking-in ECOWAS states into inequitable trade structures that re-embed poverty in the region

Ultra-low temperature structure determination of a Mn12 single-molecule magnet and the interplay between lattice solvent and structural disorder

We have determined the ultra-low temperature crystal structure of the archetypal single-molecule magnet (SMM) [Mn12O12(O2CMe)16(H2O)4]·4H2O·2MeCO2H (1) at 2 K, by using a combination of single-crystal X-ray and single-crystal neutron diffraction. This is the first structural study of any SMM in the same temperature regime where slow magnetic relaxation occurs. We reveal an additional hydrogen bonding interaction between the {Mn12} cluster and its solvent of crystallisation, which shows how the lattice solvent transmits disorder to the acetate ligands in the {Mn12} complex. Unusual quantum properties observed in 1 have long been attributed to disorder. Hence, we studied the desolvation products of 1, in order to understand precisely the influence of lattice solvent on the structure of the cluster. We present two new axially symmetric structures corresponding to different levels of desolvation of 1, [Mn12O12(O2CMe)16(H2O)4]·4H2O (2) and [Mn12O12(O2CMe)16(H2O)4] (3). In 2, removal of acetic acid of crystallisation largely resolves positional disorder in the affected acetate ligands, whereas removal of lattice water molecules further resolves the acetate ligand disorder in 3. Due to the absence of acetic acid of crystallisation, both 2 and 3 have true, unbroken S4 symmetry, showing for the first time that it is possible to prepare fully axial Mn12–acetate analogues from 1, via single-crystal to single-crystal transformations

Case Report: Effect of low energy availability and training load on sleep in a male combat sport athlete

PurposeThe aim of this case report was to describe the sleep responses in a male combat sport athlete, who was engaging in both chronic (CWL) and acute (AWL) weight loss practices in order to reduce body mass for a national competition.MethodsDuring the first seven weeks of training (Phases 1 and 2), the athlete adhered to a daily energy intake (EI) equating to their resting metabolic rate (1700 kcal·day−1) followed by a reduction in EI (915–300 kcal·day−1) in the 5 days before weighing in (Phase 3). Nocturnal sleep was monitored throughout the 8-week training period using wristwatch actigraphy and frequent measurements of body mass/composition, daily exercise energy expenditure and training load (TL) were taken.ResultsThe athlete was in a state of low energy availability (LEA) during the entire training period. There was a very large decrease in LEA status during phase 3 compared with phases 1 and 2 (3 vs. 20 kcal·kgFFM·day−1) and there was a small decrease in TL during phase 3 compared with phase 2 (410 vs. 523 AU). The athlete's sleep efficiency increased throughout the training period, but total sleep time displayed a small to moderate decrease in phase 3 compared with phases 1 and 2 (386 vs. 429 and 430 min). However, correlational analysis demonstrated trivial to small, non-significant relationships between sleep characteristics and the athlete's LEA status and TL.ConclusionThese findings suggest that CWL and AWL practices that cause fluctuations in LEA and TL may be implemented without compromising the sleep of combat sport athletes

Preoperative clinical factors predict postoperative functional outcomes after major lower limb amputation: An analysis of 553 consecutive patients

BackgroundDespite being a major determinant of functional independence, ambulation after major limb amputation has not been well studied. The purpose, therefore, of this study was to investigate the relationship between a variety of preoperative clinical characteristics and postoperative functional outcomes in order to formulate treatment recommendations for patients requiring major lower limb amputation.MethodsFrom January 1998 through December 2003, 627 major limb amputations (37.6% below knee amputations, 4.3% through knee amputations, 34.5% above knee amputations, and 23.6% bilateral amputations) were performed on 553 patients. Their mean age was 63.7 years; 55% were men, 70.2% had diabetes mellitus, and 91.5% had peripheral vascular disease. A retrospective review was performed correlating various preoperative presenting factors such as age at presentation, race, medical comorbidities, preoperative ambulatory status, and preoperative independent living status, with postoperative functional endpoints of prosthetic usage, survival, maintenance of ambulation, and maintenance of independent living status. Kaplan-Meier survival curves were constructed and compared by using the log-rank test. Odds ratios (OR) and hazard ratios (HR) with 95% confidence intervals were constructed by using multiple logistic regressions and Cox proportional hazards models.ResultsStatistically significant preoperative factors independently associated with not wearing a prosthesis in order of greatest to least risk were nonambulatory before amputation (OR, 9.5), above knee amputation (OR, 4.4), age >60 years (OR, 2.7), homebound but ambulatory status (OR, 3.0), presence of dementia (OR, 2.4), end-stage renal disease (OR, 2.3), and coronary artery disease (OR, 2.0). Statistically significant preoperative factors independently associated with death in decreasing order of influence included age ≥70 years (HR, 3.1), age 60 to 69 (HR, 2.5), and the presence of coronary artery disease (HR, 1.5). Statistically significant preoperative factors independently associated with failure of ambulation in decreasing order of influence included age ≥70 years (HR, 2.3), age 60 to 69 (HR, 1.6), bilateral amputation (HR, 1.8), and end-stage renal disease (HR, 1.4). Statistically significant preoperative factors independently associated with failure to maintain independent living status in decreasing order of influence included age ≥70 years (HR, 4.0), age 60 to 69 (HR, 2.7), level of amputation (HR, 1.8), homebound ambulatory status (HR, 1.6), and the presence of dementia (HR, 1.6).ConclusionsPatients with limited preoperative ambulatory ability, age ≥70, dementia, end-stage renal disease, and advanced coronary artery disease perform poorly and should probably be grouped with bedridden patients, who traditionally have been best served with a palliative above knee amputation. Conversely, younger healthy patients with below knee amputations achieved functional outcomes similar to what might be expected after successful lower extremity revascularization. Amputation in these instances should probably not be considered a failure of therapy but another treatment option capable of extending functionality and independent living

Hormonal contraceptive use, menstrual cycle characteristics and training/nutrition related profiles of elite, sub-elite and amateur athletes and exercisers: one size is unlikely to fit all

The aim of the present study was to simultaneously audit hormonal contraceptive (HC) use, menstrual cycle characteristics and training/nutrition related profiles in pre-menopausal women from varying athletic and exercise backgrounds. Elite (n = 51), sub-elite (n = 118) and amateur (n = 392) female athletes and exercisers were examined via an anonymous quantitative/qualitative survey tool. All analyses for ratio data were conducted utilising one- and two-way ANOVA/ANCOVA and odds ratio models, with ordinal data analysed via Pearson's Chi-squared tests. HC use was similar across elite, sub-elite and amateurs (34–44%). Menstrual cycle length was not different (P = 0.08) between competitive levels (28 ± 13 days), but 66% of respondents reported cycle variability (10 ± 11 days). Training profiles were not different based on contraceptive status (P > 0.05) yet were across competitive groups (P 0.05), though elite and sub-elite groups reported a higher daily meal consumption compared to amateurs (P < 0.01). Forty percent of all respondents skipped meals, attributed to lack of time, schedule and alterations in appetite, with reported changes in taste preferences during pre-menses (14–35%) and menses (15–25%) towards sweet foods (60%), with cravings for chocolate and other confectionary (25%). Prevalence of dietary supplement use was not influenced by contraceptive status (P = 0.31), though elites (76%) reported higher use (P = 0.04) than amateurs (63%). Data demonstrates that in female athletes and exercisers, competitive level appears to affect simple markers of training and nutrition practice, yet contraceptive status does not