The European Refugee Crisis

[removeduser_487563287433]

As we know, the European Refugee Crisis rumbles on. In Western Europe this week the French are set to clear "The Jungle" - the illegal migrant camp outside Calais where migrants hope to make the crossing to the UK, living in squalid conditions. There are known to be accompanied child refugees living in the camp, the documentation of whom has been passed to the British Government this week, who have agreed to take them in. Some 500 unaccompanied child refugees have already made the crossing on their own and are cared for by the local Government in Kent - my home county.

http://www.bbc.com/news/uk-england-36714617
http://www.bbc.com/news/uk-england-kent-35403862

Unfortunately, despite the large numbers of unaccompanied child refugees arriving in Europe and the trials they undergo during their journeys (female child refugees are disproportionally less likely to successfully make the journey, and fall victims to sex trafficking), there is a persistent accusation that these are not in fact under-age individuals. In response to this David Davies, Brexit supporting Tory MP, has demanded they have their teeth checked to check their age.

http://www.bbc.com/news/uk-37700074

The British Dental Association has obviously objected immediately based on the practice being unethical. Worth rememinding that there are some genuinely trying to keep even minors from shelter.

[Fanest]

Rename this to UK migrant trading or migrant teeth inspection because based on OP we have nothing else to discuss about.

[Incontinenta Buttox]

"The British Dental Association has obviously objected immediately based on middle class virtue-signalling"

Fixed that for you. Most of these "children" look older than me. "Shave the children" ...how apt!

[Prodromos]

Sorry, how reliable is this teeth thing? Can it tell the difference between a 19 year old and a 16 year old? The effects of malnutrition on growth are well-documented. Since most of these people are malnourished beyond belief, their "medical age" (bone age for example) could be a decade below their chronological age.

[Ludicus]

their "medical age" (bone age for example) could be a decade below their chronological age.

Nope, sorry.There is a delay in bone maturation, but it is does not significantly affect the bone age. (11-18 months, no more. Not a decade)

[Prodromos]

Nope, sorry.There is a delay in bone maturation, but it is does not significantly affect the bone age. (11-18 months, no more. Not a decade)

In more severe cases, bone age can trail chronological age by years. In cases of long-term anorexia nervosa, for instance, people in their mid 20s often have a bone age of 15 or even less, depending on when the illness started. If you're severely malnourished, your growth essentially halts. And I don't think most refugee-producing countries are known for having excellent nutrition.

The British definition of a child seems to be any <18 year old, regardless of physical, psychological or other development. There is no way they will be able to tell a 19 year old, or maybe even 21 or 23, from a 17 year old. Many of these tests were designed with healthy, well-nourished Western children in mind. They are utterly useless on other populations.

And I don't see why 17 year olds deserve protection more than 19 year olds. Probably a PR stunt, as always. They're saving "the children", you see.

[Pinarius]

Swedish pediatrician: Some 'children' nearly 40

[Heinz Guderian]

when i was at school, we had this new kid called Akhmed start with us one september. we were 14 at the time, and Akhmed was also officially 14 but the thing is Akhmed was built like one of those guardtowers in Balkh which kept the Mongols out. we obv deployed him as a back row in our 1st XV and other schools would complain and ask to see a record of his birth certificate. he had a full beard and arms like Hulk Hogan from the 90s when he was proper doing coke and roids not like Hogan from the noughties when he was fat. we'd give the egg to Akhmed and he would just plough through these children all elbows and knees. we'd have code words for our line outs and scrums, but the opposition quickly caught on that we would just give the ball to Akhmed and point him north. we won the national trophy that year by beating Leeds Grammar in the final. I will always love Akhmed even if he was actually 34 with 5 kids. Couldnt speak a lick of english but affable and loving.

[Harith]

In more severe cases, bone age can trail chronological age by years. In cases of long-term anorexia nervosa, for instance, people in their mid 20s often have a bone age of 15 or even less, depending on when the illness started. If you're severely malnourished, your growth essentially halts.

There's a difference between growth stunt and bone age. Two fundamentally different things.

If a person is malnourished, osteoclast activity is significantly higher, meaning that the body breaks down bones to supply itself with enough calcium. Often times this results in less bone density (hence why the elderly are prone to bone breaking), but if the malnourishment is severe, it can also stunt growth.

Bone's age doesn't change. Samples taken from mid points of the long bone should reliably tell use the age of that person. New bones only grow on the end points and on the inside of the bone (where the bone marrow is) to increase density.

[Prodromos]

There's a difference between growth stunt and bone age. Two fundamentally different things.

If a person is malnourished, osteoclast activity is significantly higher, meaning that the body breaks down bones to supply itself with enough calcium. Often times this results in less bone density (hence why the elderly are prone to bone breaking), but if the malnourishment is severe, it can also stunt growth.

Bone's age doesn't change. Samples taken from mid points of the long bone should reliably tell use the age of that person. New bones only grow on the end points and on the inside of the bone (where the bone marrow is) to increase density.

Bone age stunting and growth stunting usually go hand in hand, so that the potential for growth after the growth-stunting illness is gone [mostly] remains. Bone age doesn't refer to the bone's actual age, but merely how similar it looks to the bones of healthy, well-nourished children. The bones examined are usually those of the wrist or hand. If an XRAY examination shows the bones to look most similar to, say, the bones of a healthy 16 year old, the examined child is said to have a bone age of 16. This is useful for determining growth potential or the presence of growth-retarding illnesses, but it isn't a good way to determine chronological age in most human populations.

An XRAY of refugees will give a significantly lower bone age than their chronological age. This is quite common in adopted children from poor countries. All these refugees probably grew up on nutritionally-empty vegetarian food. Their growth patterns are not similar to those of Western children at all.

Unless you are referring to a different test on a different bone, then this method is very unreliable for non-Western populations. What specific bone exam are you referring to? I am not sure how reliable teeth exams are, but I am guessing they similarly don't account for variation caused by environmental factors or genetics.

[Harith]

Bone age stunting and growth stunting usually go hand in hand, so that the potential for growth after the growth-stunting illness is gone [mostly] remains.

Thats just.... not true at all.

An XRAY of refugees will give a significantly lower bone age than their chronological age. This is quite common in adopted children from poor countries. All these refugees probably grew up on nutritionally-empty vegetarian food. Their growth patterns are not similar to those of Western children at all.

Again, not true at all. X-rays of children bones show cartilage areas between the bone areas. These cartilages are, over time, calcified and turned into bone. If your growth is stunt or you are short, these areas will resemble an adult's area since the cartilage will disappear through calcification anyway and bone endpoints will start touching. The difference is that elongation of the end points will not take place.

So, to sum it up, a child's bone cannot be confused with an adult's bone. It's physiological impossible. The only case of confusion is if a child undergoes a growth sprout and hence calcifies all cartilage and is confused with an adult.

[Ludicus]

how reliable is this teeth thing?

The margin of error in determining age through dental age assessments or x-ray reports is approximately +- 2 years in protein energy malnutrition children. (PEM)
Evaluation of dental age in protein energy malnutrition children
--------
The most appropriate approach is to use a holistic evaluation.The Age Assessment Tool questionnaire has an accuracy within a range of approximately 2 years.
Table 5,
Age determination in refugee children

[DaniCatBurger]

It might be helpful to explain how relevant it is not to lie to officials and that they are just human beings that require a degree of cooperation to help.

It seems probable then that a good number of the underage refugees understand this and in consequence will provide the correct answer when they were asked.

[Prodromos]

Thats just.... not true at all.



Again, not true at all. X-rays of children bones show cartilage areas between the bone areas. These cartilages are, over time, calcified and turned into bone. If your growth is stunt or you are short, these areas will resemble an adult's area since the cartilage will disappear through calcification anyway and bone endpoints will start touching. The difference is that elongation of the end points will not take place.

So, to sum it up, a child's bone cannot be confused with an adult's bone. It's physiological impossible. The only case of confusion is if a child undergoes a growth sprout and hence calcifies all cartilage and is confused with an adult.

Not sure where you are getting this. We are talking about people with growth abnormalities, not healthy, well-nourished people, with normal bone growth. If bone age progression does not halt along with growth retardation, then catch-up growth after a growth-retarding illness is treated is impossible. But it isn't, at all. It happens to millions of children and young adults every year. Various types of studies, from adoption studies, to studies of people with hormonal or malabsorption problems, or genetic traits such as constitutional growth delay, confirm this. Your information sources are either 50 years outdated, or are talking only about healthy children.

As an example:



It's from the book, "Anorexia Nervosa and Related Eating Disorders in Childhood and Adolescence"

By Bryan Lask

page 145

on Google Books.

Can't post the URL for some reason. It just messes up the entire post.

[Prodromos]

The margin of error in determining age through dental age assessments or x-ray reports is approximately +- 2 years in protein energy malnutrition children. (PEM)
Evaluation of dental age in protein energy malnutrition children
--------
The most appropriate approach is to use a holistic evaluation.The Age Assessment Tool questionnaire has an accuracy within a range of approximately 2 years.
Table 5,
Age determination in refugee children

Thanks. I had a suspicion that it was 2 years. Very similar to bone age exams. I wonder if the MoE is larger for older children.

[Harith]

Not sure where you are getting this.

Honours double major in physiology and neuroscience from a top 25 university (globally). The picture is a direct snapshot from my lecture slides. This is general, basic physiology information which you can access and verify via wikipedia.

We are talking about people with growth abnormalities, not healthy, well-nourished people, with normal bone growth. If bone age progression does not halt along with growth retardation, then catch-up growth after a growth-retarding illness is treated is impossible. But it isn't, at all. It happens to millions of children and young adults every year. Various types of studies, from adoption studies, to studies of people with hormonal or malabsorption problems, or genetic traits such as constitutional growth delay, confirm this. Your information sources are either 50 years outdated, or are talking only about healthy children.

Ok let me start over, and hopefully make my point clear.

Bone age refers to the maturity of bones. This maturity can be determined through X-rays where they look at bone endpoints and see if it is sealed or not. If it is sealed, then the bone has reached it's maturity level. The sealing happens when the endpoints join together. In children, these areas are cartilage not bones. Cartilage is soft-ish material and does not light up in X-rays just like flesh. In adults, there is no cartilage between bone parts because it is transformed into bones.

So, a bone age test cannot confuse a child with an adult regardless of the circumstances. If a person suffers from growth stunt, then these areas will still be bones and not cartilage because otherwise he will experience growth. Anyone above the age of 18 is very, very unlikely to experience any growth since their cartilage is entirely sealed and x-ray will show that.

The source you cited talks about bone age delay in children and yet goes to say

No appreciable difference was found between the two groups in their final adult height, as the prolonged growth period seemed to have compensated for the slower skeletal growth

This is because the majority of calcium is internally generated and malnutrition affects bone density more often than stunning growth.

Conclusion is, you cannot confuse an adult with a child. You can only confuse children with adults if they have advanced growth rates.

[removeduser_487563287433]

Sorry, how reliable is this teeth thing? Can it tell the difference between a 19 year old and a 16 year old? The effects of malnutrition on growth are well-documented. Since most of these people are malnourished beyond belief, their "medical age" (bone age for example) could be a decade below their chronological age.

It's not. As per the source (yet still the only ones provided) it would give inconclusive results.

[fkizz]

Debated to death. Previous thread closed for a reason.

[removeduser_487563287433]

German police have been shot by a member of an anti-refugee far-right group. Attacks by far-right activists have been rising in Europe alongside reactionism towards the refugee crisis:

http://www.bbc.com/news/world-europe-37705054

The Home Office has ruled out dental checks on arriving unaccompanied minor migrants:

http://www.bbc.com/news/uk-37706862

Some quarters have been questioning the age of these migrants, with the Daily Mail using face recognition software on pictures. This has been prompted a reaction from the developer Microsoft, desperately pointing out their app cannot be used as a reliable age checker.

https://www.theguardian.com/uk-news/...ld-refugee-row

[Prodromos]

Honours double major in physiology and neuroscience from a top 25 university (globally). The picture is a direct snapshot from my lecture slides. This is general, basic physiology information which you can access and verify via wikipedia.



Ok let me start over, and hopefully make my point clear.

Bone age refers to the maturity of bones. This maturity can be determined through X-rays where they look at bone endpoints and see if it is sealed or not. If it is sealed, then the bone has reached it's maturity level. The sealing happens when the endpoints join together. In children, these areas are cartilage not bones. Cartilage is soft-ish material and does not light up in X-rays just like flesh. In adults, there is no cartilage between bone parts because it is transformed into bones.

So, a bone age test cannot confuse a child with an adult regardless of the circumstances. If a person suffers from growth stunt, then these areas will still be bones and not cartilage because otherwise he will experience growth. Anyone above the age of 18 is very, very unlikely to experience any growth since their cartilage is entirely sealed and x-ray will show that.



The source you cited talks about bone age delay in children and yet goes to say



This is because the majority of calcium is internally generated and malnutrition affects bone density more often than stunning growth.

Conclusion is, you cannot confuse an adult with a child. You can only confuse children with adults if they have advanced growth rates.

Mate, I think you're under the impression that neuroscience and pediatric endocrinology are the same thing. Your main problem is that we're talking about two different populations. I am not talking about healthy populations with a normal growth pattern. It is well-known among pediatricians knowledgeable in catch-up growth, that bone maturation can be delayed by a number of factors. Obviously a 50 year old is highly unlikely to have a bone age of 16, but if the factors causing a delay in bone age progression persist into adulthood, a 19, 23, even a 26 year old man can maintain a bone age in the teens. There are numerous such recorded cases, caused by hormonal abnormalities, malnutrition, genetic factors, etc. Some studies detail cases where 26 year olds gained a foot, or more in height after growth-retarding illnesses were treated. I'd like to see proof that >18 year olds, cannot have a bone age lower than their chronological age. In a healthy, well-nourished population, that is certainly uncommon, but in a malnourished population exposed to various stresses, it is fairly normal.

And a delay in epiphyseal fusion doesn't necessarily result in continued growth. If malnutrition is present (or any other factor that causes abnormal growth), growth will be slow, almost unnoticeable, or will cease, until a favorable environment for growth is present. Neither growth or bone age progression are caused by time or chronological age, but by hormones, nutrition, genetics, etc. all working in concert. As I said before, delayed growth often goes hand in hand with delayed skeletal maturity. Not forever, but for quite a while. Look at the growth patterns of these Senegalese guys. If epiphyseal fusion always occurs by the age of 18, this would be impossible.



Mean height at follow-up survey in young Senegalese women (A) and men (B) by age and degree of preschool stunting (HAZ < −2, −2 to −1, and ≥−1, for marked stunting, mild stunting, and no stunting, respectively). All differences among groups of degree of stunting were significant, P < 0.0001.

The mean age at menarche has been estimated at 16.1 y in this population, compared with 12.5 y among girls of African origin living in the U.S. (2). In the present sample, 6.9% of women <20 y had still not experienced menarche, and this proportion was larger for women stunted in early childhood. Also, in the WHO/NCHS reference, mean height of both girls and boys increase by 6 mm from 17 to 18 y of age (23). Thus, stricto sensu, all subjects in this study had not reached final height, especially men, who may well pursue linear growth beyond the age of 20. However, it seems unlikely that subjects stunted in early childhood could manage a substantial catch-up in height compared with their nonstunted counterparts after follow-up, given the limited amount of growth left.

Preschool Stunting, Adolescent Migration, Catch-Up Growth, and Adult Height in Young Senegalese Men and Women of Rural Origin

Anyway, this is getting off-topic, and as Ferrets reminds us, the exam they are doing is a dental exam, which could be less unreliable, but apparently it still isn't reliable enough.

So thus endeth the lesson.