Alternative approach towards housing reform in China

Thesis (M.S.)--Massachusetts Institute of Technology, Dept. of Architecture, 1989.Includes bibliographical references (leaves 100-104).The thesis is a study on urban housing upgrading in China. The main objective is to look at upgrading, which has been widely used in many developing countries, as an alternative approach to solving the existing urban housing problems in China. It is argued that these problems are caused by two main factors: first, the unequal distribution system, under which, public housing can hardly reach those who lack access. Since most of this disadvantaged population group resides in old city neighborhoods, an effective housing upgrading program for these areas will effectively solve the overall housing problems. Second, the undergoing housing commercialization reform does little to help the disadvantaged group , because most urban residents cannot afford expensive commodity housing units. Therefore, a new approach is needed to break through the conventional housing system. China can learn valuable lessens from the international experience on providing low-cost housing to the urban poor. In the first part of the thesis, the basic housing background is introduced aiming at better understanding of what are the fundamental factors causing the housing problem; who suffer from these problems; and why upgrading is the crucial issue. The second part is to review the international upgrading experience in many developing countries. The valuable experiences on dealing with issues, such as affordability standard, self-help and effective management are what China lacks and should learn from the international paradigm. In the third part, the main focus of the thesis, I will examine the feasibility of applying the upgrading strategy in China. Based on some detailed analysis, A self-help and lowcost upgrading program will be developed. The suggested strategies involve a series changes on housing policy, design attitude, financial arrangement, as well as institutions.by Fang He.M.S

Pneumococcal Pneumolysin Induces DNA Damage and Cell Cycle Arrest

Streptococcus pneumoniae produces pneumolysin toxin as a key virulence factor against host cells. Pneumolysin is a cholesterol-dependent cytolysin (CDC) toxin that forms lytic pores in host membranes and mediates pneumococcal disease pathogenesis by modulating inflammatory responses. Here, we show that pneumolysin, which is released during bacterial lysis, induces DNA double strand breaks (DSBs), as indicated by ataxia telangiectasia mutated (ATM)-mediated H2AX phosphorylation (γH2AX). Pneumolysin-induced γH2AX foci recruit mediator of DNA damage checkpoint 1 (MDC1) and p53 binding protein 1 (53BP1), to sites of DSBs. Importantly, results show that toxin-induced DNA damage precedes cell cycle arrest and causes apoptosis when DNA-dependent protein kinase (DNA-PK)-mediated non-homologous end joining is inhibited. Further, we observe that cells that were undergoing DNA replication harbored DSBs in greater frequency during pneumolysin treatment. This observation raises the possibility that DSBs might be arising as a result of replication fork breakdown. Additionally, neutralizing the oligomerization domain of pneumolysin with monoclonal antibody suppresses DNA damage and also cell cycle arrest, indicating that pneumolysin oligomerization is important for causing DNA damage. Taken together, this study reveals a previously unidentified ability of pneumolysin to induce cytotoxicity via DNA damage, with implications in the pathophysiology of S. pneumoniae infection

Barriers and facilitators to implementing measurement-based care for depression in Shanghai, China: a situational analysis

Background Measurement-based care (MBC) is an evidence-based practice for depression, but its use by clinicians remains low. Enhanced MBC (eMBC), which uses digital technologies, can help to facilitate the use of MBC by clinicians and patients. Understanding factors that act as barriers and drivers to the implementation of MBC and eMBC is important to support the design of implementation strategies, promoting uptake by clinicians and patients. Objective This situational analysis identifies barriers and facilitators to the implementation of standard and eMBC at mental health centers in Shanghai, China. Methods We used mixed methods to develop a comprehensive understanding of the factors influencing MBC and eMBC implementation in Shanghai. This study took place across three mental health centers in Shanghai. We used situational analysis tools to collect contextual information about the three centers, conducted surveys with n = 116 clinicians and n = 301 patients, conducted semi-structured interviews with n = 30 clinicians and six focus groups with a total of n = 19 patients. Surveys were analysed using descriptive statistics, and semi-structured interviews and focus groups were analysed using framework analysis. Results Several potential barriers and facilitators to MBC and eMBC implementation were identified. Infrastructure, cost, attitudes and beliefs, and perceptions about feasibility and efficacy emerged as both challenges and drivers to MBC and eMBC implementation in Shanghai. Conclusions The results of this study will directly inform the design of an implementation strategy for MBC and eMBC in Shanghai, that will be tested via a randomized controlled trial. This study contributes to the emerging body of literature on MBC implementation and, to the best of our knowledge, is the first such study to take place in Asia. This study identifies several factors that are relevant to the equitable delivery of MBC, recognizing the need to explicitly address equity concerns in global mental health implementation research.Medicine, Faculty ofNon UBCPsychiatry, Department ofReviewedFacultyResearcherOthe