Papers by Heather Jeffery
2017 IEEE Life Sciences Conference (LSC), 2017
In low and middle income settings, there is a pressing need for simple, low-cost and robust ways ... more In low and middle income settings, there is a pressing need for simple, low-cost and robust ways of determining infant body composition. Measuring and monitoring body composition plays an important role in addressing the burden of child deaths under five, where depleted fat stores may put infants at risk of mortality, morbidity in later life and delayed cognitive development. In a subset of 41 infants aged between 2 and 8 months, we develop and evaluate a potential model for using near-infrared interactance (NIR) features for the estimation of infant fat mass and the deuterium dilution method as the reference method. Model evaluation demonstrates the potential of NIR to capture variability in body composition, with a correlation of R = 0.90 and Bland-Altman agreement (mean bias with 95% confidence intervals) of −8 (−553, 536) g with fat mass estimated by a four-compartment (4C) model. With continued development in the larger dataset, this model may enable simple and low-cast body composition assessment of infants in low and middle incomes settings where the burden of infant deaths is greatest.
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Sensors (Basel, Switzerland), 2021
Undernutrition in infants and young children is a major problem leading to millions of deaths eve... more Undernutrition in infants and young children is a major problem leading to millions of deaths every year. The objective of this study was to provide a new model for body composition assessment using near-infrared reflectance (NIR) to help correctly identify low body fat in infants and young children. Eligibility included infants and young children from 3–24 months of age. Fat mass values were collected from dual-energy x-ray absorptiometry (DXA), deuterium dilution (DD) and skin fold thickness (SFT) measurements, which were then compared to NIR predicted values. Anthropometric measures were also obtained. We developed a model using NIR to predict fat mass and validated it against a multi compartment model. One hundred and sixty-four infants and young children were included. The evaluation of the NIR model against the multi compartment reference method achieved an r value of 0.885, 0.904, and 0.818 for age groups 3–24 months (all subjects), 0–6 months, and 7–24 months, respectively. ...
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Introduction: There is a significant gap between health outcomes in Indigenous and non-Indigenous... more Introduction: There is a significant gap between health outcomes in Indigenous and non-Indigenous children, which may relate to inequity in health service provision, particularly in remote areas. We aim to review the literature to describe health services and their use by children living in remote Australia, comparing them to best practice models to identify opportunities for improvements.Methods: Electronic-databases of medical literature were searched from Jan 1990 to Dec 2013. Grey literature was identified through investigation of websites, including local, state and national health departments. Essential information was extracted and summarised for papers meeting inclusion criteria for the review.Results: A total of 45 titles was identified in a strategic search of electronic medical databases and 47 in the grey literature. Strict inclusion and exclusion criteria applied. Data were extracted from 92 documents.Conclusions: Barriers exist to effective child health service deliver...
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Background Aboriginal leaders invited us to examine the frequency and reasons for children presen... more Background Aboriginal leaders invited us to examine the frequency and reasons for children presenting to Fitzroy Crossing Hospital emergency department (ED), Western Australia.Methods ED presentations (2007-11 inclusive) were examined for children born in the Fitzroy Valley in 2002-03.Results ED data were examined for 127/134 (94.7%) eligible children, with 1058 presentations for 1743 conditions in children aged 3-9 over 5 years. Most (81%) had at least one ED presentation (median 9.0, range 1-50). There were no differences by sex or season but numbers of presentations increased over time. Common presentations included: injury (15.1%), diseases of the ear (14.9%), skin (13.8%), respiratory tract (13.4%), infectious and parasitic diseases (9.8%), screening, follow up, and social reasons (16.0%). Household over-crowding, financial and food insecurity were common socio-economic factors recorded at ED presentation. Prenatal alcohol exposure (PAE) was significantly associated with high-f...
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Sleep, 1995
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Pathology, 2011
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Pediatric Research, 2016
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Journal of Nursing & Care, 2016
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Objetivos. Determinar el impacto de las respuestas inflamatorias maternas y fetales intrauterinas... more Objetivos. Determinar el impacto de las respuestas inflamatorias maternas y fetales intrauterinas (corioamnionitis y vasculitis umbilical) sobre el desarrollo del síndrome de dificultad respiratoria (SDR) neonatal en neonatos prematuros. Diseño, entorno y participantes. El estudio incluyó a todos los neonatos con menos de 30 semanas de gestación nacidos en el Royal Prince Alfred Hospital (Sidney, Australia) e ingresados en la Unidad de Cuidados Intensivos Neonatales entre 1991 y 2001. Se excluyeron los casos en que no se había realizado un examen de la placenta. Se extrajeron datos prenatales y perinatales de las bases de datos prospectivas del hospital y se correlacionaron con una base de datos neonatal central independiente. Las placentas fueron sometidas a un examen prospectivo con un método estandarizado semicuantitativo. Principal variable de resultado. Diagnóstico de síndrome de dificultad respiratoria neonatal. Resultados. 766 neonatos reunieron los requisitos y 724 (94,5%) p...
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Conference proceedings : ... Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual Conference, 2014
Using Monte Carlo simulations we optimized the wavelength and source-detector distance (SDD) of a... more Using Monte Carlo simulations we optimized the wavelength and source-detector distance (SDD) of a reflectance-based spectroscopic device used for measuring subcutaneous fat thickness. As the optical properties of muscle, fat and dermis are wavelength dependent, it is necessary to choose a wavelength that is highly sensitive to fat but insensitive to water and melanin. The SDD is important since it determines average photon penetration depth. With a tissue optics plug-in for the GEANT4/GAMOS system and published ex vivo tissue optical properties we were able to predict the behavior of different device configurations when used with varying thicknesses of fat, melanin concentrations or hydration levels. Our results indicate that the ideal wavelengths for fat measurement are 630-650 nm with an SDD of 2.6-29 cm. We also examined the potential of using near infrared (NIR) spectroscopy to determine tissue hydration levels, but concluded that this wavelength range was not ideal.
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Protocols, 2010
ABSTRACT Fetal growth restriction is defined as failure to reach growth potential and considered ... more ABSTRACT Fetal growth restriction is defined as failure to reach growth potential and considered one of the major complications of pregnancy. These infants are often, although not universally, small for gestational age (SGA). SGA is defined as a weight less than a specified percentile (usually the 10th percentile). Identification of SGA infants is important because these infants are at increased risk of perinatal morbidity and mortality. Screening for SGA is a challenge for all maternity care providers and current methods of clinical assessment fail to detect many infants that are SGA. Large observational studies suggest that customised growth charts may be better able to differentiate between constitutional and pathologic smallness. Customised charts adjust for physiological variables such as maternal weight and height, ethnicity and parity. To assess the benefits and harms of using population-based growth charts compared with customised growth charts as a screening tool for detection of fetal growth in pregnant women. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 September 2011), reviewed published guidelines and searched the reference lists of review articles. Randomised, quasi-randomised or cluster randomised clinical trials comparing customised versus population-based growth charts used as a screening tool for detection of fetal growth in pregnant women. Two review authors independently assessed trials for inclusion. No randomised trials met the inclusion criteria. There is no randomised trial evidence currently available. Further randomised trials are required to accurately assess whether the improvement in detection shown is secondary to customised charts alone or an effect of the policy change. Future research in large trials is needed to investigate the benefits and harms (including perinatal mortality) of using customised growth charts in different settings and for both fundal height and ultrasound measurements.
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Obstetrics & Gynecology, 2015
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PLoS Medicine, 2012
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Midwifery, 2014
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Journal of Paediatrics and Child Health, 1998
Objective:To determine the interobserver reliability of the click test, a rapid bedside test of s... more Objective:To determine the interobserver reliability of the click test, a rapid bedside test of surfactant function.Methodology:One hundred samples (48 amniotic fluid, 28 gastric aspirates, 24 tracheal aspirates) were obtained from pregnant women, term and preterm infants managed at two perinatal centres. Gestational ages of the pregnancies or infants at time of sampling ranged from 24 to 40 weeks (mean±sd: 31±5). The click test was performed independently by two observers, with differing levels of experience, and blinded to each other’s results. Interobserver reliability was determined for samples classified as negative (no clicking bubbles), equivocal (a few clicking bubbles seen after 2 min of looking), and positive (clicking bubbles seen easily on first look). As negative and equivocal test results suggest surfactant dysfunction, these results were also combined to provide a dichotomised result.Results:For samples classified as negative, equivocal and positive the interobserver ...
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Journal of Paediatrics and Child Health, 2013
AimThis study aims to evaluate adherence to a clinical guideline for screening and prevention of ... more AimThis study aims to evaluate adherence to a clinical guideline for screening and prevention of neonatal hypoglycaemia on the post‐natal wards.MethodsRetrospective chart review of 581 healthy term neonates born at a tertiary maternity hospital. Indications for hypoglycaemia screening included small for gestational age (SGA), infants of diabetic mothers (IDM; gestational, Type 1 or 2), symptomatic hypoglycaemia, macrosomia and wasted (undernourished) appearance. Outcomes were protocol entry and adherence with hypoglycaemia prevention strategies including early and frequent feeding and timely blood glucose measurement.ResultsOf 115 neonates screened for hypoglycaemia, 67 were IDM, 19 were SGA (including two both IDM and SGA), and two were macrosomic. One IDM and one SGA were not screened. Twenty‐two neonates were screened for a reason not identifiable from the medical record, and 13 neonates were SGA by a definition different to the guideline definition, including five who were also ...
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Journal of Paediatrics and Child Health, 2013
AimThe study aims to assess accuracy of standard practice measurement of neonatal length compared... more AimThe study aims to assess accuracy of standard practice measurement of neonatal length compared with a gold‐standard length‐board technique.MethodsData were obtained from a population‐based, cross‐sectional study of 602 term babies at Royal Prince Alfred Hospital, Sydney, Australia, in 2010. Neonatal length was measured by standard clinical practice and by a length‐board (gold standard) and measurements compared. Standard growth curve percentiles were used to plot length measurements. The Bland and Altman method was used to assess agreement, and acceptable levels of agreement were set at ≤1 cm and ≤0.5 cm.ResultsThe limits of agreement were between −3.06 cm (95% CI −3.08 to −3.04) and 2.67 cm (95% CI 2.65 to 2.69). Neonates whose standard‐practice length fell within 0.5 cm of the gold standard totalled 41% (241 neonates), while 59% (342) were >0.5 cm. The change in length resulted in a change in the percentile range of 53% (309) on a standard growth curve percentile. When exami...
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Diabetes Care, 2012
OBJECTIVE We aimed to compare the discriminative power of prognostic models for early prediction ... more OBJECTIVE We aimed to compare the discriminative power of prognostic models for early prediction of women at risk for the development of gestational diabetes mellitus (GDM) using four currently recommended diagnostic criteria based on the 75-g oral glucose tolerance test (OGTT). We also described the potential effect of application of the models into clinical practice. RESEARCH DESIGN AND METHODS A prospective cross-sectional study of 2,772 pregnant women was conducted at a referral maternity center in Vietnam. GDM was determined by the American Diabetes Association (ADA), International Association of the Diabetes and Pregnancy Study Groups (IADPSG), Australasian Diabetes in Pregnancy Society (ADIPS), and World Health Organization (WHO) criteria. Prognostic models were developed using the Bayesian model averaging approach, and discriminative power was assessed by area under the curve. Different thresholds of predicted risk of developing GDM were applied to describe the clinical impa...
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Clinical Pediatrics, 1998
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Archives of Disease in Childhood - Fetal and Neonatal Edition, 1999
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Papers by Heather Jeffery