Strategic Spatial Planning in European City-Regions: Parallel Processes or Divergent Trajectories? (NIRSA) Working Paper Series No. 60

Drawing on recent experiences of strategic spatial planning in two city-regions in Europe, the paper seeks to challenge dominant narratives of the emergence of strategic spatial planning as a uni-dimensional process of policy convergence. Recognising a need for fine-grained analysis of practices of spatial planning in diverse territorial and institutional contexts, the paper presents a framework for contextualised comparative analysis, identifying multiple levels of differentiation. The application of this comparative framework is subsequently illustrated with reference to the two city-regions of Dublin and Erfurt. The paper concludes with an outline of an agenda for further research

Strategic Spatial Planning in European City-Regions: Parallel Processes or Divergent Trajectories? (NIRSA) Working Paper Series No. 60

Drawing on recent experiences of strategic spatial planning in two city-regions in Europe, the paper seeks to challenge dominant narratives of the emergence of strategic spatial planning as a uni-dimensional process of policy convergence. Recognising a need for fine-grained analysis of practices of spatial planning in diverse territorial and institutional contexts, the paper presents a framework for contextualised comparative analysis, identifying multiple levels of differentiation. The application of this comparative framework is subsequently illustrated with reference to the two city-regions of Dublin and Erfurt. The paper concludes with an outline of an agenda for further research

Discovery of biomarkers for glycaemic deterioration before and after the onset of type 2 diabetes: an overview of the data from the epidemiological studies within the IMI DIRECT Consortium

Background and aims: Understanding the aetiology, clinical presentation and prognosis of type 2 diabetes (T2D) and optimizing its treatment might be facilitated by biomarkers that help predict a person’s susceptibility to the risk factors that cause diabetes or its complications, or response to treatment. The IMI DIRECT (Diabetes Research on Patient Stratification) Study is a European Union (EU) Innovative Medicines Initiative (IMI) project that seeks to test these hypotheses in two recently established epidemiological cohorts. Here, we describe the characteristics of these cohorts at baseline and at the first main follow-up examination (18-months).Materials and methods: From a sampling-frame of 24,682 European-ancestry adults in whom detailed health information was available, participants at varying risk of glycaemic deterioration were identified using a risk prediction algorithm and enrolled into a prospective cohort study (n=2127) undertaken at four study centres across Europe (Cohort 1: prediabetes). We also recruited people from clinical registries with recently diagnosed T2D (n=789) into a second cohort study (Cohort 2: diabetes). The two cohorts were studied in parallel with matched protocols. Endogenous insulin secretion and insulin sensitivity were modelled from frequently sampled 75g oral glucose tolerance (OGTT) in Cohort 1 and with mixed-meal tolerance tests (MMTT) in Cohort 2. Additional metabolic biochemistry was determined using blood samples taken when fasted and during the tolerance tests. Body composition was assessed using MRI and lifestyle measures through self-report and objective methods.Results: Using ADA-2011 glycaemic categories, 33% (n=693) of Cohort 1 (prediabetes) had normal glucose regulation (NGR), and 67% (n=1419) had impaired glucose regulation (IGR). 76% of the cohort was male, age=62(6.2) years; BMI=27.9(4.0) kg/m2; fasting glucose=5.7(0.6) mmol/l; 2-hr glucose=5.9(1.6) mmol/l [mean(SD)]. At follow-up, 18.6(1.4) months after baseline, fasting glucose=5.8(0.6) mmol/l; 2-hr OGTT glucose=6.1(1.7) mmol/l [mean(SD)]. In Cohort 2 (diabetes): 65% (n=508) were lifestyle treated (LS) and 35% (n=271) were lifestyle + metformin treated (LS+MET). 58% of the cohort was male, age=62(8.1) years; BMI=30.5(5.0) kg/m2; fasting glucose=7.2(1.4)mmol/l; 2-hr glucose=8.6(2.8) mmol/l [mean(SD)]. At follow-up, 18.2(0.6) months after baseline, fasting glucose=7.8(1.8) mmol/l; 2-hr MMTT glucose=9.5(3.3) mmol/l [mean(SD)].Conclusion: The epidemiological IMI DIRECT cohorts are the most intensely characterised prospective studies of glycaemic deterioration to date. Data from these cohorts help illustrate the heterogeneous characteristics of people at risk of or with T2D, highlighting the rationale for biomarker stratification of the disease - the primary objective of the IMI DIRECT consortium

Strategic green infrastructure planning in Germany and the UK: a transnational evaluation of the evolution of urban greening policy and practice

The evolution of Green Infrastructure (GI) planning has varied dramatically between nations. Although a grounded set of principles are recognized globally, there is increasing variance in how these are implemented at a national and sub-national level. To investigate this the following paper presents an evaluation of how green infrastructure has been planned for in England and Germany illustrating how national policy structures facilitate variance in application. Adopting an evaluative framework linked to the identification of GI, its development and monitoring/ feedback the paper questions the impacts on delivery of intersecting factors including terminology, spatial distribution and functionality on effective GI investment. This process reviews how changing policy structures have influenced the framing of green infrastructure policy, and subsequent impact this has on the delivery of green infrastructure projects

Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults

Background Underweight and obesity are associated with adverse health outcomes throughout the life course. We estimated the individual and combined prevalence of underweight or thinness and obesity, and their changes, from 1990 to 2022 for adults and school-aged children and adolescents in 200 countries and territories. Methods We used data from 3663 population-based studies with 222 million participants that measured height and weight in representative samples of the general population. We used a Bayesian hierarchical model to estimate trends in the prevalence of different BMI categories, separately for adults (age ≥20 years) and school-aged children and adolescents (age 5–19 years), from 1990 to 2022 for 200 countries and territories. For adults, we report the individual and combined prevalence of underweight (BMI <18·5 kg/m2) and obesity (BMI ≥30 kg/m2). For schoolaged children and adolescents, we report thinness (BMI <2 SD below the median of the WHO growth reference) and obesity (BMI >2 SD above the median). Findings From 1990 to 2022, the combined prevalence of underweight and obesity in adults decreased in 11 countries (6%) for women and 17 (9%) for men with a posterior probability of at least 0·80 that the observed changes were true decreases. The combined prevalence increased in 162 countries (81%) for women and 140 countries (70%) for men with a posterior probability of at least 0·80. In 2022, the combined prevalence of underweight and obesity was highest in island nations in the Caribbean and Polynesia and Micronesia, and countries in the Middle East and north Africa. Obesity prevalence was higher than underweight with posterior probability of at least 0·80 in 177 countries (89%) for women and 145 (73%) for men in 2022, whereas the converse was true in 16 countries (8%) for women, and 39 (20%) for men. From 1990 to 2022, the combined prevalence of thinness and obesity decreased among girls in five countries (3%) and among boys in 15 countries (8%) with a posterior probability of at least 0·80, and increased among girls in 140 countries (70%) and boys in 137 countries (69%) with a posterior probability of at least 0·80. The countries with highest combined prevalence of thinness and obesity in school-aged children and adolescents in 2022 were in Polynesia and Micronesia and the Caribbean for both sexes, and Chile and Qatar for boys. Combined prevalence was also high in some countries in south Asia, such as India and Pakistan, where thinness remained prevalent despite having declined. In 2022, obesity in school-aged children and adolescents was more prevalent than thinness with a posterior probability of at least 0·80 among girls in 133 countries (67%) and boys in 125 countries (63%), whereas the converse was true in 35 countries (18%) and 42 countries (21%), respectively. In almost all countries for both adults and school-aged children and adolescents, the increases in double burden were driven by increases in obesity, and decreases in double burden by declining underweight or thinness. Interpretation The combined burden of underweight and obesity has increased in most countries, driven by an increase in obesity, while underweight and thinness remain prevalent in south Asia and parts of Africa. A healthy nutrition transition that enhances access to nutritious foods is needed to address the remaining burden of underweight while curbing and reversing the increase in obesit

Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults

Background Underweight and obesity are associated with adverse health outcomes throughout the life course. We estimated the individual and combined prevalence of underweight or thinness and obesity, and their changes, from 1990 to 2022 for adults and school-aged children and adolescents in 200 countries and territories. Methods We used data from 3663 population-based studies with 222 million participants that measured height and weight in representative samples of the general population. We used a Bayesian hierarchical model to estimate trends in the prevalence of different BMI categories, separately for adults (age ≥20 years) and school-aged children and adolescents (age 5–19 years), from 1990 to 2022 for 200 countries and territories. For adults, we report the individual and combined prevalence of underweight (BMI 2 SD above the median). Findings From 1990 to 2022, the combined prevalence of underweight and obesity in adults decreased in 11 countries (6%) for women and 17 (9%) for men with a posterior probability of at least 0·80 that the observed changes were true decreases. The combined prevalence increased in 162 countries (81%) for women and 140 countries (70%) for men with a posterior probability of at least 0·80. In 2022, the combined prevalence of underweight and obesity was highest in island nations in the Caribbean and Polynesia and Micronesia, and countries in the Middle East and north Africa. Obesity prevalence was higher than underweight with posterior probability of at least 0·80 in 177 countries (89%) for women and 145 (73%) for men in 2022, whereas the converse was true in 16 countries (8%) for women, and 39 (20%) for men. From 1990 to 2022, the combined prevalence of thinness and obesity decreased among girls in five countries (3%) and among boys in 15 countries (8%) with a posterior probability of at least 0·80, and increased among girls in 140 countries (70%) and boys in 137 countries (69%) with a posterior probability of at least 0·80. The countries with highest combined prevalence of thinness and obesity in school-aged children and adolescents in 2022 were in Polynesia and Micronesia and the Caribbean for both sexes, and Chile and Qatar for boys. Combined prevalence was also high in some countries in south Asia, such as India and Pakistan, where thinness remained prevalent despite having declined. In 2022, obesity in school-aged children and adolescents was more prevalent than thinness with a posterior probability of at least 0·80 among girls in 133 countries (67%) and boys in 125 countries (63%), whereas the converse was true in 35 countries (18%) and 42 countries (21%), respectively. In almost all countries for both adults and school-aged children and adolescents, the increases in double burden were driven by increases in obesity, and decreases in double burden by declining underweight or thinness. Interpretation The combined burden of underweight and obesity has increased in most countries, driven by an increase in obesity, while underweight and thinness remain prevalent in south Asia and parts of Africa. A healthy nutrition transition that enhances access to nutritious foods is needed to address the remaining burden of underweight while curbing and reversing the increase in obesity. Funding UK Medical Research Council, UK Research and Innovation (Research England), UK Research and Innovation (Innovate UK), and European Union

Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults

Background Underweight and obesity are associated with adverse health outcomes throughout the life course. We estimated the individual and combined prevalence of underweight or thinness and obesity, and their changes, from 1990 to 2022 for adults and school-aged children and adolescents in 200 countries and territories. Methods We used data from 3663 population-based studies with 222 million participants that measured height and weight in representative samples of the general population. We used a Bayesian hierarchical model to estimate trends in the prevalence of different BMI categories, separately for adults (age ≥20 years) and school-aged children and adolescents (age 5–19 years), from 1990 to 2022 for 200 countries and territories. For adults, we report the individual and combined prevalence of underweight (BMI 2 SD above the median). Findings From 1990 to 2022, the combined prevalence of underweight and obesity in adults decreased in 11 countries (6%) for women and 17 (9%) for men with a posterior probability of at least 0·80 that the observed changes were true decreases. The combined prevalence increased in 162 countries (81%) for women and 140 countries (70%) for men with a posterior probability of at least 0·80. In 2022, the combined prevalence of underweight and obesity was highest in island nations in the Caribbean and Polynesia and Micronesia, and countries in the Middle East and north Africa. Obesity prevalence was higher than underweight with posterior probability of at least 0·80 in 177 countries (89%) for women and 145 (73%) for men in 2022, whereas the converse was true in 16 countries (8%) for women, and 39 (20%) for men. From 1990 to 2022, the combined prevalence of thinness and obesity decreased among girls in five countries (3%) and among boys in 15 countries (8%) with a posterior probability of at least 0·80, and increased among girls in 140 countries (70%) and boys in 137 countries (69%) with a posterior probability of at least 0·80. The countries with highest combined prevalence of thinness and obesity in school-aged children and adolescents in 2022 were in Polynesia and Micronesia and the Caribbean for both sexes, and Chile and Qatar for boys. Combined prevalence was also high in some countries in south Asia, such as India and Pakistan, where thinness remained prevalent despite having declined. In 2022, obesity in school-aged children and adolescents was more prevalent than thinness with a posterior probability of at least 0·80 among girls in 133 countries (67%) and boys in 125 countries (63%), whereas the converse was true in 35 countries (18%) and 42 countries (21%), respectively. In almost all countries for both adults and school-aged children and adolescents, the increases in double burden were driven by increases in obesity, and decreases in double burden by declining https://researchonline.ljmu.ac.uk/images/research_banner_face_lab_290.jpgunderweight or thinness. Interpretation The combined burden of underweight and obesity has increased in most countries, driven by an increase in obesity, while underweight and thinness remain prevalent in south Asia and parts of Africa. A healthy nutrition transition that enhances access to nutritious foods is needed to address the remaining burden of underweight while curbing and reversing the increase in obesity

Furthering the Flexibility of Contents of Formal Urban Development Plans

Der Flächennutzungsplan ist das zentrale Instrument der Gesamtplanung auf der gesamtstädtischen Ebene und kann gleichzeitig als Paradebeispiel für den – angesichts der in der Praxis zu lösenden Probleme nicht gerechtfertigten – Bedeutungsverlust formeller Pläne herangezogen werden. Mit der Bewältigung aktueller Herausforderungen der Stadtentwicklung konfrontiert, werden vor allem die seiner Aufstellung dienenden, zu langwierigen Verfahren und seine zu starren, Unsicherheiten in der tatsächlichen Entwicklung ungenügend berücksichtigenden Inhalte kritisiert. Folglich muss nach Möglichkeiten einer Weiterentwicklung des formellen Instrumentariums gesucht werden. Im Laufe der letzten Jahrzehnte wurden einige punktuelle Anpassungen im Modell des Flächennutzungsplanes vorgenommen. Des Weiteren sind Entwicklungen im benachbarten europäischen Ausland beachtenswert: Der im englischen Planungssystem neu eingeführte Local Development Framework soll sich durch Flexibilität und Modularität bei gleichzeitiger Stärkung der strategischen Steuerungswirkung seiner Inhalte auszeichnen. An einer systematischen Untersuchung der Erfordernisse, Potenziale und Grenzen einer Weiterentwicklung des Modells des Flächennutzungsplanes fehlt es bislang. Damit ein zukünftiges Modell die ihm zugedachten Wirkungen entfalten kann, ist zudem eine grundlegende Auseinandersetzung mit dem vorherrschenden Verständnis von gesamtstädtischer Planung und ihren Ergebnissen erforderlich. Vor diesem Hintergrund ist es das Ziel der vorliegenden Arbeit, das Modell des Flächennutzungsplanes systematisch abzuleiten und zu untersuchen, um es anschließend mit dem Ziel einer Erhöhung der Steuerungskraft der Inhalte des gesamtstädtischen Planes weiterentwickeln zu können. Hierbei fließen die Erkenntnisse aus einer Betrachtung des Local Development Framework mit ein. Die Arbeit kommt zu dem Ergebnis, dass trotz zahlreicher Anpassungen des Modells des Flächennutzungsplanes einige Charakteristika aus dessen Anfangszeit erhalten geblieben sind, die als nicht mehr angemessen bezeichnet werden müssen. Zu den Hauptschwächen des gegenwärtigen Modells zählen sein statischer Charakter und die unzureichende Berücksichtigung der Prozesshaftigkeit von Stadtentwicklung inklusive der Auseinandersetzung mit potenziellen Entwicklungsalternativen. Die Beschäftigung mit dem Local Development Framework zeigt, dass von einer Übertragbarkeit von Elementen auf das deutsche System auszugehen ist. Die erarbeiteten Vorschläge zu den Anpassungen am Modell des Flächennutzungsplanes eröffnen insgesamt die Möglichkeit, den Flächennutzungsplan zum modularen, dynamischen und strategischen Instrument gesamtstädtischer Planung weiterzuentwickeln. Im Fokus der Anpassungen stehen die neue Gesamtstruktur als Portfolio aus zeichnerischen und textlichen, formellen und informellen Bestandteilen, die Integration des Faktors „Zeit“ sowie sonstiger strategischer Aspekte von Stadtentwicklung – begleitet von einem neuen Verständnis vom Ergebnis gesamtstädtischer Planung, nach dem der Flächennutzungsplan nicht mehr als der eine Plan das kanonische Endprodukt darstellt, sondern kontinuierlich und mit seinen diversen Bestandteilen überprüft und fortentwickelt wird.The Flächennutzungsplan is the key instrument of land use planning at the local level in Germany. At the same time, and especially regarding current problems in planning practice, it can serve as a prime example for the unjustified loss of importance of formal plans in general. Facing the need for coping with present challenges of urban development, the Flächennutzungsplan is criticised because of its lengthy procedures and inflexible contents. Consequently, new approaches to revise its basic model have to be discovered. In the past decades, several selective amendments to the model of the Flächennutzungsplan were carried out. In addition to this, there exist remarkable developments in other European countries: Recently, for instance, in the English planning system the Local Development Framework has been introduced. It is characterised by its modular composition and is expected to be more flexible. Up to now, a comprehensive and systematic analysis of the current model of the Flächennutzungsplan has not been provided. Furthermore, and in order to enable a future model of the Flächennutzungsplan to be effective, a general debate on the understanding of local land use planning and its outcome is necessary. The goal of this thesis is the systematic deduction and analysis of the current model of the Flächennutzungsplan in order to identify how it can be further developed to enhance the governance capability of the formal plan contents. In this context, the results of an examination of the English Local Development Framework are integrated. The main findings of this thesis read as follows: Despite of several amendments to the model of the Flächennutzungsplan, some of its original drawbacks still remain and, thus, lead to a plan that is not able to handle the existing and future challenges of urban development. In particular, the current model does not sufficiently consider spatio-temporal aspects of urban development including the analysis of alternative directions of development. Furthermore, the analysis of local land use planning in England shows a basic transferability of various valuable elements to the German system. The resulting amendments to the model of the Flächennutzungsplan suggested in this thesis provide the opportunity to further develop the formal plan to a more modular, dynamic and strategic instrument of planning at the local scale. They focus on the new format of the plan as a portfolio of designed and written, formal and informal parts and the integration of spatio-temporal and strategic aspects of urban development. Last but not least, the understanding of local land use planning and its outcome is changed in a way that the plan and its contents do no longer represent the single canonic and final product of the formal planning process, but become subject of continuous review and evolvement