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Steve Collins

Publications and source records attributed to Steve Collins.

6 recordsLinked to original sources

Community-based therapeutic care in HIV-affected populations.

Community-based therapeutic care (CTC) is a community-based model for delivering care to malnourished people. CTC aims to treat the majority of severely malnourished people at home, rather than in therapeutic feeding centres. This paper describes the potential of the CTC approach to provide effective care and support for people living with HIV and AIDS (PLWHA). CTC includes many of the components of a home-based care model for PLWHA. It provides outpatient treatment for common complications of HIV and AIDS, such as acute malnutrition and simple infections, and an energy-dense ready-to-use food that could be made with the appropriate balance of micronutrients for the HIV-infected patient. Through the de-centralisation of outpatient treatment sites, CTC improves accessibility by moving treatment closer to people's homes and helps to promote the sustainability of care by building on the capacity of existing health infrastructure and staff. The CTC model contains many features that are appropriate for the care and support of HIV-affected people and, in its present form, can provide effective physical care for many HIV-affected individuals. We are currently working to adapt the CTC model to make it more suitable for the support of PLWHA in the longer term.

AIDS-Related Opportunistic Infections↗

Efficient bipedal robots based on passive-dynamic walkers.

Passive-dynamic walkers are simple mechanical devices, composed of solid parts connected by joints, that walk stably down a slope. They have no motors or controllers, yet can have remarkably humanlike motions. This suggests that these machines are useful models of human locomotion; however, they cannot walk on level ground. Here we present three robots based on passive-dynamics, with small active power sources substituted for gravity, which can walk on level ground. These robots use less control and less energy than other powered robots, yet walk more naturally, further suggesting the importance of passive-dynamics in human locomotion.

Algorithms↗

A field trial of a survey method for estimating the coverage of selective feeding programmes.

OBJECTIVE: To test a survey method for estimating the coverage of selective feeding programmes in humanitarian emergencies. METHODS: The trial survey used a stratified design with strata that were defined using the centric systematic area sample method. Thirty 100 km2 quadrats were sampled. The communities located closest to the centre of each quadrat were sampled using a case-finding approach. FINDINGS: The method proved simple and rapid to implement and allowed overall and per-quadrat coverage to be estimated. Overall coverage was 20.0% (95% confidence intervals, 13.8-26.3%). Per-quadrat coverage ranged from zero (in nine quadrats) to 50% (in one quadrat). Coverage was highest in the quadrats closest to therapeutic feeding centres and in quadrats containing major roads leading to the towns in which therapeutic feeding centres were located. CONCLUSION: The method should be used, in preference to WHO Expanded Programme on Immunization (EPI)-derived survey methods, for estimating the coverage of selective feeding programmes. Its use should also be considered when evaluating the coverage of other selective entry programmes or when coverage is likely to be spatially inhomogeneous.

Altruism↗

Outpatient care for severely malnourished children in emergency relief programmes: a retrospective cohort study.

BACKGROUND: In emergency nutritional relief programmes, therapeutic feeding centres are the accepted intervention for the treatment of severely malnourished people. These centres often cannot treat all the people requiring care. Consequently, coverage of therapeutic feeding centre programmes can be low, reducing their effectiveness. We aimed to assess the effectiveness of outpatient treatment for severe malnutrition in an emergency relief programme. METHODS: We did a retrospective cohort study in an outpatient therapeutic feeding programme in Ethiopia from September, 2000, to January, 2001. We assessed clinical records for 170 children aged 6-120 months. The children had either marasmus, kwashiorkor, or marasmic kwashiorkor. Outcomes were mortality, default from programme, discharge from programme, rate of weight gain, and length of stay in programme. FINDINGS: 144 (85%) patients recovered, seven (4%) died, 11 (6%) were transferred, and eight (5%) defaulted. Median time to discharge was 42 days (IQR 28-56), days to death 14 (7-26), and days to default 14 (7-28). Median rate of weight gain was 3.16 g kg(-1) x day(-1) (1.86-5.60). In patients who recovered, median rates of weight gain were 4.80 g kg(-1) day(-1) (2.95-8.07) for marasmic patients, 4.03 g x kg(-1) x day(-1) (2.68-4.29) for marasmic kwashiorkor patients, and 2.70 g x kg(-1) x day(-1) (0.00-4.76) for kwashiorkor patients. INTERPRETATION: Outpatient treatment exceeded internationally accepted minimum standards for recovery, default, and mortality rates. Time spent in the programme and rates of weight gain did not meet these standards. Outpatient care could provide a complementary treatment strategy to therapeutic feeding centres. Further research should compare the effectiveness of outpatient and centre-based treatment of severe malnutrition in emergency nutritional interventions.

Ambulatory Care↗