Ten years after Copenhagen: Reimagining climate change governance in urban areas

In this review, we take stock of the last decade of research on climate change governance in urban areas since the 2009 conference in Copenhagen. Using a systematic evaluation of academic publications in the field, we argue that the current moment of research has been shaped by two recent waves of thought. The first, a wave of urban optimism, which started in 2011 and peaked in 2013, engaged with urban areas as alternative sites for governance in the face of the crumbling international climate regime. The second, a wave of urban pragmatism, which started in 2016, has sought to reimagine urban areas following the integration of the “sub-national” as a meaningful category in the international climate regime after the 2015 Paris Agreement for Climate Action. Four themes dominate the debate on climate change governance in urban areas: why there is climate action, how climate action is delivered, how it is articulated in relation to internationally reaching networks, and what implications it has to understand environmental or climate justice within urban settings. Calls to understand the impacts of climate change policy have fostered research on climate change politics, issues of power and control, conflicts, and the inherently unjust nature of much climate policy. What is largely missing from the current scholarship is a sober assessment of the mundane aspects of climate change governance on the ground and a concern with what kind of cultural and socio-economic change is taking place, beyond comparative analyses of the effectiveness of climate policies

Myocardial damage due to hypokalaemia and hypophosphataemia.

A case of severe hypokalaemia with stupor, skeletal muscle and heart muscle damage is reported. An initial infusion of glucose-insulin and potassium (GIK) produced a temporary clinical improvement with reduction of creatine kinase (CKMB) and elevation of serum K+. On the 4th day of treatment, neuromuscular and cardiovascular deterioration occurred accompanied by a further rise of CKMB. This deterioration was coincident with a serum phosphate of 0.26 mmol/l. The impaired left ventricular (LV) function was measured using echocardiography and detecting the ejection fraction (EF). GIK was stopped and a potassium phosphate infusion commenced. As the phosphate and potassium deficiencies were corrected, the neuromuscular and cardiac abnormalities resolved, CKMB fell to normal and LVEF rose from 40% to 72%. We suggest that additional cardiac damage due to hypophosphataemia may have occurred in this patient, who already had cardiac impairment as a result of profound hypokalaemia. Possible mechanisms are discussed