During armed conflict, the non-combative population, and particularly children, are susceptible to the effects of conflict from a variety of perspectives; psychological stress, loss of food and ...resources, loss of accommodation, occupation, income, death of family members, etc. The Lancet recently published a special issue entitled 'Maternal and child health and armed conflict' concluding that the ways in which health can be affected by conflict are protean but systematic evidence is sparse, whatever evidence exists is localised and of low to moderate quality, and that data on adolescents are sparse to non-existent. Whilst this may be true of the challenging environments of conflicts in developing countries, historically recent conflicts in Europe provide an alternative viewpoint that is frequently aired in the Auxological literature but is virtually unknown and/or unrecognised in health settings.
The current paper summarises three previously published studies based on repeated cross-sectional child growth surveys in London, Oslo, and Stuttgart covering the years of the Second World War. Taken together these studies provide extensive evidence of the response of children to armed conflict in the context of secular tends in growth of children living in industrialised nations during the twentieth century.
The conclusions to all three studies may be summarised, with regard to children in industrialised nations, as: (1) armed conflict adversely affects human growth and health, (2) armed conflict affects all age groups but adolescents more so, (3) all age groups recover from poor growth as conditions improve in relation to post-war health and welfare programmes, (4) pre-war differences in size between SES groups diminish during post-war recovery when accompanied by nutritional, welfare and reconstruction programmes.
Context: There is widespread concern over the use of maturity indicators to estimate chronological age in children.
Objective: To review the definition of maturity indicators, the criteria governing ...their identification and use and the problems of their interpretation.
Methods: The development of maturity indicators, the criteria for their selection and the relationship of maturity to chronological age is critically reviewed.
Results and Conclusions: Maturity indicators are not related to the passage of chronological time, but to the progression of the individual from an immature to a mature state. They are discrete events in a continuous process or a series of processes (e.g. skeletal, sexual, dental, etc.) that highlight uneven maturation within the individual, the independence of maturational processes, sexual dimorphism and the relationship of maturity to size. The use of a timescale of development causes considerable problems in translating biological maturity into a developmental scale. One "year" of maturational time does not equate to 1 year of chronological time and, thus, the passage of time determined by developmental rather than temporal landmarks is both variable and inconsistent. Chronological age determination was not the aim of maturational assessment and, thus, its widespread use as an age determinant poses considerable interpretive challenges.
Cohort studies are special forms of longitudinal studies that have long been accepted as the primary designs to acquire information on the interaction between the environment and health and the ...subsequent aetiology and progression of disease. Richard Doll, Regius Professor of Medicine at Oxford University from 1969-1979, was the 20th century's pre-eminent epidemiologist in the UK. He used cohort studies to establish the relationship between smoking and health (primarily cancer) in the 1960s at a time when over 80% of British males smoked. However, the development of cohorts as a means of studying health and wellbeing across the lifespan is rooted in research on tuberculosis in Europe and America in the 1920s and 1930s. Cohort studies were recognised as the primary research design for the study of human growth and development between and during the wars in the USA. Their natural legacy as longitudinal studies emerged in Europe after WWII through a series of growth studies coordinated by the Centre Internationale de L'Enfance in Paris from the 1960s onwards. The failure of two nationally representative birth cohort studies in the USA and UK between 2010 and 2015 has highlighted the previous success of smaller birth cohorts and the advantages gained from standardised methods of measurement and assessment that allow amalgamation and metanalysis of different datasets.
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