Age determination in asylum seekers: physicians should not be implicated

Sauer, Pieter; Nicholson, Alf J; Neubauer, David; Advocacy,

doi:10.1007/s00431-015-2628-z

Cited by 32 publications

(28 citation statements)

References 10 publications

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“…Although certain simple concepts can be directly observed (like a person's sex), there are cases where observation cannot be performed with precision (like in the case of age). In the case of young individuals applying for the international protection without proper birth documentations, for instance, physicians use measurements obtained through wrist radiographs and clavicle computerized tomography to estimate age (Sauer, Nicholson, & Neubauer, 2016).…”

Section: Measuring the Socialmentioning

confidence: 99%

Reconstructing the mixed mechanisms of health: the role of bio- and sociomarkers

Ghiara

Russo

2019

Longitudinal and Life Course Studies

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It is widely agreed that social factors are related to health outcomes: much research served to establish correlations between classes of social factors on the one hand and classes of disease on the other hand. However, why and how social factors are an active part in the aetiology of disease development is something that is gaining attention only recently in the health sciences and in the medical humanities. In this paper, we advance the view that, just as bio-markers help trace the causal continuum from exposure to disease development at the biological level, socio-markers ought to be introduced and studied in order to trace the social continuum from exposure to disease development. We explain how socio-markers differ from social indicators and how they can be used in combination with bio-markers in order to reconstruct the mixed mechanisms of health and disease, namely mechanisms in which both biological and social factors have an active causal role.

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Section: Measuring the Socialmentioning

confidence: 99%

Reconstructing the mixed mechanisms of health: the role of bio- and sociomarkers

Ghiara

Russo

2019

Longitudinal and Life Course Studies

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“…Unclear guidelines and arbitrary practices lead to shortcomings in the protection of this group of children and adolescents in Europe (Hjern et al, ). Medical participation, as well as non‐participation, in decisions based on these dubious methods raises a number of important ethical questions (Sauer, Nicholson, & Neubauer, ). Furthermore, given the nature of the health and safety risks of this group, it is questionable whether physical age is the best way to define the needs of this vulnerable population.…”

Section: High‐risk Groups: Unaccompanied Minors Pregnant Women and mentioning

confidence: 99%

ISSOP position statement on migrant child health

2017

Child

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Greater numbers of children are on the move than ever before. In 2015, the number of forcibly displaced people across the globe reached 65.3 million. Of the more than 1 million migrants, asylum seekers, and refugees who arrived in Europe in 2015, nearly one third were children, and 90,000 of these children were unaccompanied.Child migrants are among the most vulnerable, even after arriving at their destination. The health of migrant children is related to their health status before their journey, the conditions during their journey and at their destination, and the physical and mental health of their caregivers. These children may have experienced numerous forms of trauma including war, violence, separation from family, and exploitation. They may suffer from malnutrition and communicable diseases including vaccine-preventable diseases. Pregnant women, newborns, and unaccompanied minors are particularly vulnerable groups. Social isolation is a major risk factor for all migrant children that compound other health risks even after settlement in their new home. Lack of health information, language, and cultural differences serve as major barriers to adequate, timely, and appropriate healthcare. In spite the challenges they face, migrant children demonstrate remarkable resilience that can be nurtured to promote good mental and physical health.Migrant children, irrespective of their legal status, are entitled to healthcare of the same standard provided to children in the resident population, as stated in the UN Convention on the Rights of the Child. It is imperative that the health sector includes informed health workers who are able to identify the health risks and needs of these children and provide culturally competent care. In order to achieve this and promote the rights of migrant children to optimal health and well-being, ISSOP recommends that• Programmes and activities designed to promote and protect migrant child health and well-being must be designed in collaboration with all sectors involved, including the education and social sectors, and should always include the voices of migrant children and their families.• Health services should be readily available and easily accessible for preventive, maintenance, and curative care regardless of the child's legal status. Care should be of the same standard as care provided to the local population.• Health information should be provided that is culturally sensitive and readily available in a language that migrant children and families can understand.• Medical interpreters and cultural mediators should be available during healthcare encounters, and personnel working with migrants should receive training in cultural competence.• Health professionals should not participate in age determination until methods with acceptable scientific and ethical standards have been developed.• Professionals working with migrant children and families should have access to emotional support services.• Evidence-based best practices in the care of migrant children should be identifie...

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“…Bone age assessment is used in medicine to measure skeletal and biological maturity of children [1]. It can be used, among others, to estimate the final adult height [2], to measure therapeutic effect in patients with endocrine disorders [3] or to estimate the age of asylum seekers [4].…”

Section: Introductionmentioning

confidence: 99%

Automated Assessment of Bone Age Using Deep Learning and Gaussian Process Regression

Steenkiste

Ruyssinck

Janssens

et al. 2018

2018 40th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC)

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Bone age is an essential measure of skeletal maturity in children with growth disorders. It is typically assessed by a trained physician using radiographs of the hand and a reference model. However, it has been described that the reference models leave room for interpretation leading to a large inter-observer and intra-observer variation. In this work, we explore a novel method for automated bone age assessment to assist physicians with their estimation. It consists of a powerful combination of deep learning and Gaussian process regression. Using this combination, sensitivity of the deep learning model to rotations and flips of the input images can be exploited to increase overall predictive performance compared to only using the deep learning network. We validate our approach retrospectively on a set of 12611 radiographs of patients between 0 and 19 years of age.

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Age determination in asylum seekers: physicians should not be implicated

Cited by 32 publications

References 10 publications

Reconstructing the mixed mechanisms of health: the role of bio- and sociomarkers

Reconstructing the mixed mechanisms of health: the role of bio- and sociomarkers

ISSOP position statement on migrant child health

Automated Assessment of Bone Age Using Deep Learning and Gaussian Process Regression

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