Service providers' adherence to methadone maintenance treatment protocol in China.

BACKGROUND:Methadone maintenance treatment (MMT) programs have expanded rapidly in China during the last decade. However, variance in service providers' practice may have an impact on the quality of care received by the patients. This study examined Chinese service providers' adherence to the MMT protocol and its associated factors. METHODS:The study used baseline data from a randomized intervention trial implemented in MMT clinics in five provinces of China. The data were collected from January 2012 to August 2013. A total of 418 service providers from 68 MMT clinics participated in the study. Demographic and job-related characteristics were collected. The providers' adherence to the MMT protocol, MMT knowledge, negative attitudes towards people who use drugs (PWUD), and perceived institutional support were assessed. RESULTS:The average adherence score was 36.7 ± 4.3 (out of 9-45). Fewer providers adhered to the protocol items where communications with patients or families were required. After controlling for potential confounders, adherence to the MMT protocol was positively associated with perceived institutional support (standardized β = 0.130; p = 0.0052), and negatively associated with prejudicial attitudes towards PWUD (standardized β = -0.357; p < 0.0001). Reception of national-level MMT training was not associated with higher level of adherence to protocol. CONCLUSION:The findings suggest the potential benefits of providing institutional support to MMT providers to enhance their level of adherence to the MMT protocol. Intervention effort is needed to reduce negative attitudes towards PWUD among MMT service providers to achieve greater consistency with best-practice recommendations

Antiretroviral Therapy Initiation Following Policy Changes: Observations From China.

China's HIV/AIDS treatment policies have been evolving over the preceding decade. This study describes patterns of antiretroviral therapy (ART) initiation for a sample of people living with HIV/AIDS (PLHIV) in rural Anhui, China, where most PLHIV were infected via paid plasma donation during the 1990s. A total of 481 PLHIV who were receiving ART were included in our analyses. Times between HIV diagnosis and the initiation of ART were examined relative to the time points when major ART-related policies changed in China. More than half (53%) of PLHIV who had been diagnosed by 2003 received ART within 6 months, whereas 93% of PLHIV who had been diagnosed in 2010 or later received ART within 6 months. The study results provide additional support that the "Four Frees and One Care" policy in 2003 and the relaxation of ART eligibility in 2010 have facilitated the initiation of treatment for PLHIV in China

Relativistic Heavy Quark Effective Action

We study the fermion action needed to accurately describe the low energy physics of systems including heavy quarks in lattice QCD even when the heavy fermion mass $m$ is on the order of, or larger than, the inverse lattice spacing: $m \ge 1/a$. We carry out an expansion through first order in $|\vec p| a$ (where $\vec p$ is the heavy quark momentum) and all orders in $ma$, refining the analysis of the Fermilab and Tsukuba groups. We demonstrate that the spectrum of heavy quark bound states can be determined accurately through $|\vec p| a$ and $(ma)^n$ for arbitrary exponent $n$ by using a lattice action containing only three unknown coefficients: $m_0$, $\zeta$ and $c_P$ (a generalization of $c_{SW}$), which are functions of $ma$. In a companion paper, we show how these three coefficients can be precisely determined using non-perturbative techniques.Comment: 40 pages, 1 figur

Mandatory Corporate Social Responsibility? Legislative Innovation and Judicial Application in China

Corporate social responsibility (CSR) is often understood as voluntary corporate behavior beyond legal compliance. The recent emergence of CSR legislation is challenging this typical understanding. A number of countries including China, Indonesia and India have expressly stated in corporate law that companies shall undertake CSR. The CSR law is controversial. Critics of CSR see the law as an unwise effort to challenge profit maximization as the only social responsibility of the corporation. Even CSR advocates welcome the CSR law with great caution. Given the vague statutory language of CSR, the practical application of the law places high demands on the judiciary. However, as the countries that have adopted the CSR law are mainly developing countries with rather weak legal institutions, it raises a common concern that the law is simply an innovation without implementation. This article conducts an empirical study on China, an early adopter of the CSR legislation. The empirical analysis of Chinese court cases reveals what the CSR law means in judicial practice, whether CSR is in fact mandatory and in what types of disputes CSR is relevant or outcome determinative. Among various findings, this article shows that the CSR law is by no means as useless as commonly expected. The meaningful application of the law is attributable to the law’s fit with China’s legal infrastructure and socio-political institutions. Chinese courts have innovatively applied CSR in various contexts far beyond the traditionally Western-led focus on directors’ fiduciary duties. The Chinese experience suggests that the significance of the CSR law is more of a judicial review standard than a corporate behavior standard, which further confirms the importance of judicial capacity in implementing the vague law. This article concludes with insights for the corporate purpose debate in comparative perspective and policy suggestions for adopting the CSR legislation