Complete and Voluntary Starvation of 50 days

A 34-year-old obese male (96.8 kg; BMI, 30.2 kg m⁻¹) volitionally undertook a 50-day fast with the stated goal of losing body mass. During this time, only tea, coffee, water, and a daily multivitamin were consumed. Severe and linear loss of body mass is recorded during these 50 days (final 75.4 kg; BMI, 23.5 kg m⁻¹). A surprising resilience to effects of fasting on activity levels and physical function is noted. Plasma samples are suggestive of early impairment of liver function, and perturbations to cardiovascular dynamics are also noted. One month following resumption of feeding behavior, body weight was maintained (75.0 kg; BMI, 23.4 kg m⁻¹). Evidence-based decision-making with the fasting or hunger striking patient is limited by a lack of evidence. This case report suggests that total body mass, not mass lost, may be a key observation in clinical decision-making during fasting and starvation.

The potential for neighbourhood regeneration in a period of austerity: changing forms of neighbourhood governance in two cities

Localism is an active political strategy, developed in a period of austerity by the UK's coalition government as a justification for the restructuring of state-civil society relationships. The deprived neighbourhood has long been a site for service delivery and a scale for intervention and action, giving rise to a variety of forms of neighbourhood governance. Prior international comparative research indicated convergence with the US given the rise of the self-help conjuncture and the decline of neighbourhood governance as a medium of regeneration. The subsequent shift in the UK paradigm from ‘big’ to ‘small state’ localism and deficit-reducing cuts to public expenditure confirm these trends, raising questions about the forms of neighbourhood governance currently being established, the role being played by local and central government, and the implications for neighbourhood regeneration. Two emerging forms of neighbourhood governance are examined in two urban local authorities and compared with prior forms examined in earlier research in the case study sites. The emerging forms differ significantly in their design and purpose, but as both are voluntary and receive no additional funding, better organised and more affluent communities are more likely to pursue their development. While it is still rather early to assess the capacity of these forms to promote neighbourhood regeneration, the potential in a period of austerity appears limited. Reduced funding for local services increases the imperative to self-help, while rights to local voice remain limited and the emerging forms provide little scope to influence (declining) local services and (still centralised) planning decisions, especially in neighbourhoods with regeneration needs which are likely to lack the requisite capacities, particularly stores of linking social capital. Initial conclusions suggest greater polarity and the further containment of deprived neighbourhoods.

Housing at the neighbourhood level: a review of the initial approaches to neighbourhood development plans under the Localism Act 2011 in England

The Localism Act 2011 created an opportunity for local communities to form neighbourhood forums and to prepare their own neighbourhood development plans in urban and rural areas in England. Initial reactions suggested that, rather than leading to the development of more housing, these initiatives would confirm all the stereotypes of local residents blocking unwanted development in their defined neighbourhoods. However, neighbourhood plans need to be in general conformity with the core strategies of higher-tier plans and often make provision for more new homes than planned before 2011. This article discusses the role and purpose of neighbourhood plans, the evidence base on which they are founded and some of the legal challenges which have helped clarify procedures. It then identifies two types of plan based on the ways housing strategies and evidence of need are reflected in a sample of 10 plans which have been made to date. It concludes that the voluntary nature of localism to date tends to favour more rural and affluent areas and ends with an assessment of the impact of neighbourhood plans on the planning process. It suggests that the implications for spatial planning may be far-reaching.

National Policies for Local Urban Sustainability: A New Governance Approach?

Cities have become a focal point for efforts to transition towards a more sustainable, low-carbon society, with many municipal agencies championing ‘eco city’ initiatives of one kind or another. And yet, national policy initiatives frequently play an important – if sometimes overlooked – role, too. This chapters provides comparative perspectives on four recent national sustainable city programmes from France, India, Japan, and the United Kingdom. The analysis reveals two key insights: first, national policy is found to exercise a strong shaping role in what sustainable development for future cities is understood to be, which helps explain the considerable differences in priorities and approaches across countries. Second, beyond articulating strategic priorities, national policy may exercise a ‘soft’ governance function by incentivising and facilitating wider, voluntary governance networks in the effort to implement sustainable city projects locally. This innovative role, however, depends on the ability of national policy to produce resonance among societal actors and on its effective interaction with formal planning processes.