Background: The Chinese Methadone Maintenance Treatment (MMT) Program was established in 2004 and has expanded rapidly to 28 provinces, autonomous regions, and municipalities with a total of 738 MMT clinics providing treatment for a cumulative total of more than 344,000 patients at the end of 2011. However, the total number of patients being treated daily accounted for less than 20% of all registered opiate users not counting the unregistered drug-using population. Coverage of the community-based MMT program is still low and the dropout rate among MMT patients remains high. The primary objective of this study is to identify barriers associated with detainees' unwillingness to participate in community-based MMT when released from compulsory drug detoxification centers in China.

Methods: This study was carried out in two compulsory drug detoxification centers in Mangshi City, Dehong Prefecture, Yunnan Province. Between July and November, 2012, in-depth interviews were conducted with 20 incarcerated drug users in one center. A total of 250 incarcerated drug users was also recruited to participate in a face-to-face cross-sectional survey using a convenient sampling method in the other center.

Results: The majority of our study participants expressed their unwillingness to initiate MMT enrollment post-release, which is of great concern. Most participants' reasons for unwillingness to take part were: no perceived needs to participate in MMT; misconceptions and lack of MMT-related knowledge; limited accessibility and financial difficulties. Moreover, side-effects, inconvenience, dosage and concurrent opiate and stimulant uses were indicated as reasons for dropping out. We also documented that ethnic disparities existed in this culturally and geographically diverse population. Lastly, a surprisingly high proportion of our study participants reported using stimulants, specifically ephedrine, as their primary drug of choice.

Conclusions: There is an urgent need to revamp the current practices inside the compulsory drug detoxification and rehabilitation centers as well as the community-based MMT programs in China. A comprehensive Pre-release Relapse Prevention Program needs to be established to prepare those soon-to-be released detainees for life after incarceration. The community-based MMT program needs to be expanded to include psychological counseling and behavioral modification in order to retain patients and prevent high dropouts. In addition, testing for non-opiate drugs as part of the urine-monitoring program at MMT clinics needs to be implemented. Ethnic disparities need to be considered when designing future educational campaigns and prevention programs. And educational materials regarding the danger of stimulants addiction should be developed and disseminated among drug users and the general public as soon as possible. Further training on drug addiction as a chronic disease and methadone related knowledge should be provided for compulsory drug detoxification and rehabilitation center staff. Cooperation between public security and health sectors also needs to be strengthened.

Global health is never conducted in a detached, placeless laboratory. This dissertation delves into the overlooked history of Taiwan as a pivotal postcolonial laboratory for the U.S.-led global health campaign in the post-World War II era. How did this island, since the postwar period, become strategically significant yet historiographically neglected? Taking a postcolonial detour, this dissertation focuses on the marginalized aspects of the island, which served as a crucial hub for U.S.-led global health initiatives from the onset of the postwar period. Taiwan, along with other islands, played a role in shaping and sustaining the United States as a de-territorialized global power throughout the 20th century. To challenge prevailing historical narratives that primarily highlight expertise and success in Taiwan, a postcolonial feminist approach is adopted. The study centers around three marginalized actors, examining how powerlessness intersected with the U.S.-Sino cooperative regime in global health during postwar Taiwan. As Taiwan was already situated on the fringes of global health and academia, this dissertation further highlights the marginalized within the marginalized: children, monkeys, and female technicians of Taiwan, all involved in global trachoma campaigns in the postwar period. Their postcolonial trajectories are brought to light. Through the lens of marginalized actors, the argument is made that a logic of coloniality persisted on the island throughout this process, stemming from the Japanese colonial legacy, the Cold War agenda of Nationalist China and the United States, as well as the colonial conduct of U.S. scientists towards Native American children in the early 20th century. Primary sources include archival collections and historical documentation from the U.S., Taiwan, and Japan. The findings begin by examining the postcolonial imperial regime and the politico-economic power structure in Taiwan following the postwar transition from Japanese colonial rule to U.S.-Sino cooperation. In Chapter Two, the focus is on how Taiwanese children played a central role in the WHO-UNICEF trachoma program, transitioning from recipients of treatment to caregivers, health trainees, and financial donors over the course of nearly two decades. Chapter Three explores transnational connections between two marginalized groups of children in Taiwan and the Native American Nation, facilitated by global collaborative research on trachoma virus and vaccine in the postwar period. This chapter unveils layers of silence and exposes the logic of coloniality driven by imperial, racial, and capitalist objectives that sustained the intellectual and technical exchanges across countries, as well as the unethical practices and the dispossession experienced by marginalized communities across borders. Chapter Four shifts the focus to the encounters between the indigenous Taiwan Monkey and the imperial powers of the U.S., Japan, and the UK. It reveals how the Taiwan Monkey became subject to scientific study and incorporated into colonial projects, illustrating the imperial accumulation within the realm of modern science through the collection and utilization of animal species from the mountains, fieldwork, vaccine trials, urban pet stores, and zoological trades. Chapter Five centers around the life history of LIN Shou-Yin (林壽英), also known as Christine Yang (1943–Present), a Taiwanese-Hakka woman and former NAMRU-2 technician in the virology laboratory conducting trachoma virus research from 1965 to 1967. This chapter challenges conventional notions of significance and triviality concerning scientists and technicians, male and female, Whiteness and Yellowness, in historical writing and archiving. It responds to the fact that female technicians often left scant archival records of their lives and careers. Additionally, this chapter highlights how local Taiwanese women leveraged their temporary and often unseen scientific work at NAMRU-2, turning it into a steppingstone for professional migration to the U.S. during the martial law era in Taiwan when international travel was generally prohibited. The epilogue explores a postcolonial response to the imperial regime through the history of the Northern American Taiwanese Medical Association (NATMA). The current free clinic programs of NATMA in Latin America and the Caribbean have their roots in the overseas ethnic radical movements in the United States since the 1960s. The transnational identity of NATMA plays a pivotal role in shaping how Taiwanese medical diasporas perceive and engage in global health practices. The stories of postwar Taiwan will always be complex due to its significance as a hub for numerous global public health programs, research endeavors, and the political interests of various imperial powers. This complexity encourages critical examination of our own historical practices in terms of engaging with archives, narratives, perspectives, and cultivating connections that extend beyond borders, fostering a global solidarity rooted in justice with other historically marginalized and suffering communities.

In this dissertation, I computationally analyze the dynamic pattern for time series belonging to two distinct settings: rhythmic and arrhythmic, and resolving a Machine Learning topic: Multiclass Classification (MCC). The primary study of arrhythmic signals is carried out via change-point analysis on dynamics of various complex systems, while the study of rhythmic patterns is focused on gait dynamics. For arrhythmic time series with unknown and unspecified non-stationarity, an approach is proposed to partition the whole time span into homogeneous periods where the underlying distribution is identical. In contrast, for the rhythmic time series, the goal is to detect all rhythmic cycles precisely. Although an encoding-and-decoding technique is implemented from local to global, the methodologies and the information content under the two settings are rather different. Under the arrhythmic setting, the number and temporal locations of all identified change points are the primary parts of information. Especially, a group of time points is marked as events of interest for characterizing segments in high and low intensity. The number of change-points is determined by information criteria based on maximum likelihood functions derived based on Geometric distributions of recursive time between two successive events. While under the rhythmic setting, structural components constitute a rhythm, so the cyclic structures and rhythmic patterns are the major parts of information. The rhythmic time series is discretized by a set of symbols, and the deterministic pattern is embraced so that the symbolic trajectory is in low Kolmogorov or Lempel-Ziv complexity. So far, the homogeneous segments or rhythmic cycles are detected without explicit labeling. For the completeness of the study, geometric structure of structured data with labels is investigated as a basis of facilitating error-free classification with potential multiple candidate labels.