Features

It was never going to be an easy experience. Getting to meet Pope Francis on his Holy Land trip, that is. The Amman International Stadium was packed to capacity, as I jostled with thousands of the gathered faithful, at one of the many entrances. 

The sunlight was bright and unrelenting and tempers were threatening to rise with the rising temperatures. But the many volunteers handing complimentary water bottles and peak caps helped to calm the nerves. Once inside the lavish grounds, a carnival type scenario awaited us all. 

A stage was erected at one end of the field with two huge screens on either side where live video recordings could be played. Young schoolchildren, in white costumes, walked in a line, with their teachers issuing smiling instructions at them. All around one could see families with infants in strollers, and the amazing thing was that the babies were not bawling, but sleeping peacefully in anonymous silence. 

The carols like songs emanating from the loudspeakers were in Arabic, welcoming the Pope to Amman. The lyrics were easy to follow and within moments I joined in with the clapping and singing crowd. It was high noon and though the breeze was cool in the shade, under the scorching sun, my face was turning a dark shade of tomato and my skin was baking to a chocolate brown colour. 

But these were small discomforts. Pope Francis was 77 years old and had only one full lung. He had battled a cold and fatigue that forced him to cancel some recent appointments, to make an appearance. There was no way sunburn could deter me. Besides, if rank newborns could handle the heat and dust, who was I to complain? 

Suddenly, a huge mass of gas balloons appeared at various spots in the large arena. Pink, blue and white, they trailed one after another as they were let off into the sky. A drone of helicopters, which signified aerial security surveillance, followed this. Everyone craned their necks to see what was happening. Before I could understand what was going on, an enthusiastic helper handed me a huge Jordanian flag and asked me to wave it. I was more than happy to pass off for a local. Balancing my parasol and the flag together was a bit of a challenge, but I managed it soon enough. 

White doves, as symbols of peace were released into the sky and then everybody turned away from the stage as a large vehicle made its appearance, from the opposite side. Standing upright in this roofless vehicle, the Pope embraced small children who were lifted and presented to him by their eager parents. The slow procession, lined by masses of humanity on all sides, made its way gradually to the raised platform. 

Subsequently, the open air mass started where he spoke of “putting aside our grievances and divisions” for the sake of unity. Peace was not something that could be bought, he emphasised. It was a gift to be crafted by our daily actions.

There must be some magic to his sermon. On the way back the same guards who were yelling at the teeming millions earlier, smilingly opened the exit gates for us. 

“Your face is so red!” one security policeman exclaimed. 

“Yes,” I agreed.

“You got sun burned?” he asked. 

“Yes,” I repeated. 

“Ah, tomorrow the skin will peel off,” he warned.

“But till then I will radiate a holy glow,” I smiled.

SAN FRANCISCO/SYDNEY – Multiple users on Apple Inc.’s online support forum and Twitter have reported an unusual smartphone and tablet hack in which cyber attackers were said to have locked Australian users’ smartphones and demanded payment in return for unlocking them.

The alleged cyber attackers, first reported by The Sydney Morning Herald, appeared to use Apple’s “Find My Phone” feature to lock the devices’ screens and send a message demanding money be sent to a PayPal account, according to multiple users. The anti-theft feature locks phones that are reported lost.

Apple, in response to inquiries about the hacking, confirmed there had been an incident. The technology giant said in an e-mailed statement it “takes security very seriously and iCloud was not compromised during this incident”.

It recommended affected users change their passwords as soon as possible and avoid using the same username and password for multiple services.

An Apple spokeswoman in Sydney said by telephone Apple did not have any details on how widespread the incident was or whether it was contained to Australia.

Multiple users requested information on Apple’s support forum about how to reset their phones or otherwise circumvent the lock, while other users also tweeted their concerns.

“I went to check my phone and there was a message on the screen saying that my device(s) had been hacked by ‘Oleg Pliss’ and he/she/they demanded $100 USD/EUR,” said “veritylikestea”, a user from the Australian city of Melbourne, on an Apple discussion board.

Other users replied that they had received the same message.

Telstra Corp Ltd., Australia’s largest telecommunications provider, said it was aware of the issue, while Vodafone Hutchison Australia said it was encouraging worried customers to contact Apple.

Reuters could not immediately verify the identity of the users, or the accuracy of their claims.

LOS ANGELES (AP) — Google will build a car without a steering wheel.

It doesn’t need one because it drives itself.

The two-seater won’t be sold publicly, but Google said Tuesday it hopes by this time next year, 100 prototypes will be on public roads. Though not driving very quickly — the top speed would be 25 mph (40kph).

The cars are a natural next step for Google, which already has driven hundreds of thousands 

of miles in California with Lexus SUVs and Toyota Priuses outfitted with a combination of sensors and computers.

Those cars have Google-employed “safety drivers” behind the wheel in case of emergency. The new cars would eliminate the driver from the task of driving.

No steering wheel, no brake and gas pedals. Instead, buttons for go and stop.

“It reminded me of catching a chairlift by yourself, a bit of solitude I found really enjoyable,” Sergey Brin, co-founder of Google, told a Southern California tech conference Tuesday evening of his first ride, according to a transcript.

The electric-powered car is compact and bubble-shaped — something that might move people around a corporate campus or congested downtown.

Google is unlikely to go deeply into auto manufacturing. In unveiling the prototype, the company emphasised partnering with other firms.

The biggest obstacle could be the law.

Test versions will have a wheel and pedals, because they must under California regulations.

Google hopes to build the 100 prototypes late this year or early next and use them in a to-be-determined “pilot programme”, spokeswoman Courtney Hohne said. Meanwhile, by the end of this year, California’s Department of Motor Vehicles must write regulations for the “operational” use of truly driverless cars.

The DMV had thought that reality was several years away, so it would have time to perfect the rules.

That clock just sped up, said the head of the DMV’s driverless car programme, Bernard Soriano.

“Because of what is potentially out there soon, we need to make sure that the regulations are in place that would keep the public safe but would not impede progress,” Soriano said.

CALIFORNIA – Microsoft Corp. showed off a test version of a real-time, spoken-word translation service for Skype calls on Tuesday, the first time the world’s largest software company has demonstrated the breakthrough technology publicly in the United States.

Skype Translator, as it is currently called, allows speakers in different languages to hear the other’s words spoken in their own language, according to a demonstration introduced by Chief Executive Officer Satya Nadella at the Code Conference technology gathering in Rancho Palos Verdes, California.

“It is going to make sure you can communicate with anybody without language barriers,” said Nadella, who took over as Microsoft CEO in February and is keen to re-establish the company as a technology leader after a decade of slipping behind Apple Inc. and Google Inc. in mobile computing.

Nadella described the underlying technology as “magical”, but said the task now was turn it into a real product rather than just a research project, promising it would launch by the end of the year. He did not say if it would be a free add-on for Skype users or a paid extra.

Immediate reaction to the demo, featuring an English-speaking Microsoft executive chatting with a German counterpart, was mixed. One German-speaking audience member said the translation was good enough for vacation, but not for business.

The new technology, which Microsoft demonstrated in a rougher form 18 months ago in China, could represent a significant feature for its Skype online chat service, which boasts hundreds of millions of users. It is an advance on Microsoft’s current translation features that only work with written words on its Bing search engine and Internet Explorer browser.

Microsoft has been working hard on speech recognition technology for years. Earlier this year it showed off Cortana, its voice-activated “personal assistant” designed to rival Apple’s Siri.

TOKYO – Music legend Paul McCartney is over an illness that forced the cancellation of his Asian tour and has left Japan, the concert organiser said Tuesday.

McCartney “has recovered well enough to travel on an airplane”, said an official from Kyodo Tokyo, the organiser of the Japanese leg of the “Out There” global tour.

“According to the information that we have, he left Japan yesterday” for an undisclosed destination, he said.

The former Beatle arrived in Japan on May 15 and was due to play four sold-out dates in Tokyo and Osaka.

But the 71-year-old pop veteran cancelled all his gigs as well as the South Korean leg of the tour, saying he had been taken sick with an undisclosed virus.

The called-off concerts included one at Tokyo’s Nippon Budokan Hall that would have marked his first return to the venue since appearing there with The Beatles in 1966.

The cancellations generated an outpouring of good wishes from fans of the Liverpool-born musician — one of two living members of The Beatles.

A combined 170,000 people had been due to see his shows in Japan, according to local media, some paying as much as 100,000 yen ($1,000) for a ticket. 

A statement from New York-based public relations company Nasty Little Man said last week that McCartney had “received successful medical treatment at a hospital in Tokyo”.

“He will make a complete recovery and has been ordered to take a few days rest” before leaving the country, the agency said at the time.

Japanese tabloid paper Nikkan Gendai, citing an unnamed person close to the musician, said Tuesday that McCartney had a laparoscopy — surgery using a thin tube inserted into his belly.

A viral disease had been “suspected for nausea, vomiting and stomachache but his case was diagnosed as an intestinal obstruction”, the source told the paper.

The operation to resolve the obstruction was successful, the report said.

The Kyodo Tokyo official could not confirm the report.

NEW YORK – Worries, conflicts and demands in relationships with friends, family and neighbours may contribute to an earlier death suggests a new Danish study.

“Conflicts, especially, were associated with higher mortality risk regardless of whom was the source of the conflict,” the authors write. “Worries and demands were only associated with mortality risk if they were related to partners or children.”

Men and people without jobs seemed to be the most vulnerable, Rikke Lund, a public health researcher at the University of Copenhagen, and her colleagues found.

The health-protecting effects of support from a social network and close connections with family and friends are widely recognised, Lund’s team writes in the Journal of Epidemiology and Community Health.

“Less is known about the health consequences of stressful aspects of social relations, such as conflicts, worries and demands,” they write.

To examine the influence of relationship stress on all causes of death, the researchers looked at data from a long-term study in Denmark. They included 9,870 adults in their 1930s, 1940s and 1950s when the study began and tracked their health from 2000 to the end of 2011.

The researchers measured stressful social relations by comparing answers to questions about who — including partners, children, relatives, friends and neighbours — caused worry and conflicts in the participants’ lives.

They also looked at answers to questions about emotional support and symptoms of depression. 

During the study period, 4 per cent of the women and 6 per cent of the men died. Almost half the deaths were from cancer; other causes included cardiovascular disease, liver disease, accidents and suicide. 

About one in every 10 participants said that their partner or children were always or often a source of demands and worries. Six per cent said they always or often experienced conflicts with other members of their families and 2 per cent reported always or often having conflicts with friends.

The researchers also found that 6 per cent of participants had frequent arguments with their partner or children, 2 per cent with other relatives and 1 per cent with friends or neighbours.

People who always or often experienced worries or demands because of their partners had double the risk of dying compared to those who seldom had those experiences. 

Participants who always or often experienced worries and demands from their children had about a 50 per cent increase in risk of death.

Frequent conflicts also were linked to an increased risk of dying. 

Participants who always or often experienced conflicts with their partners or friends had more than double the risk of dying, and if they argued with neighbours, the risk more than tripled.

Having conflicts or worries and demands, and not being part of the labour force was linked to a risk of death about 4.5 times that of a person without those problems.

“I think it really adds to our broader understanding of the influence of relationships, not only on our overall health, but on our longevity — how long we actually live,” Julianne Holt-Lunstad told Reuters Health. 

Holt-Lunstad, a psychology researcher at Brigham Young University in Provo, Utah, was not involved in the study.

“There are a couple of other studies that have shown that negativity in relationships actually is associated with greater risk of mortality, and this study looks specifically across different types of relationships as well and also looks at the gender effect which adds to our understanding,” she said.

Hold-Lunstad explained that just like exercise and eating a healthy diet is good for health, fostering the positive aspects of a relationship can be protective.

“But not all relationships are equal — we need to be careful about the negative aspects as well,” she said.

Holt-Lunstad doesn’t want people to get the impression from this study that ending all imperfect relationships is the right thing to do.

“We know that social isolation is bad for us as well,” she said. “They’re probably both bad and that’s why it might be important to foster the positive aspects rather than just focusing on cutting people out of your life.”

Turkey Reframed: Constituting Neoliberal Hegemony

Edited by Ismet Akca, Ahmet Bekman & Baris Alp Ozden

London: Pluto Press, 2014, 292 pp

The rise to power of the AKP (Justice and Development Party), which had its origins in the Islamist movement, initially elicited much speculation about whether Islam is compatible with democracy. However, the more poignant question posed by “Turkey Reframed” is whether neoliberalism is compatible with democracy — a question with relevance for many countries in the world today. As such, besides providing an incisive analysis of modern Turkey, this book touches on a number of salient issues on the current regional and international scene. 

The fifteen contributors, mostly professors at various Turkish universities, concur that “the almost 30-year history of developing a neoliberal hegemony in Turkey reached a state of relative stabilisation during the successive governments of the AKP.” (p. 48) Only shortly before the book’s publication did events challenge this stability, with the outbreak of the Gezi uprising in Taksim Square, blowback from the state’s Syria policy, and growing tension with the AKP’s erstwhile ally, the Gulen movement (which has since erupted into open confrontation). In an afterword, the editors provide a fascinating commentary on the Taksim events, but most of the book focuses on the period following the 1980 military coup—how it paved the way for the AKP’s rise and implementation of the IMF structural adjustment programme after other political forces had failed, decisively putting Turkey on the neoliberal track. 

In successive chapters, the contributors explore the factors that allowed the AKP to impose its hegemony, as well as the political, economic and social repercussions of the neoliberal order on Turkey’s state and society. Rather than focusing on the AKP’s piety credentials, they explain how the party gained the allegiance of Turkey’s major capital groups, promoting “Islamic capitalists” in the provinces (the so-called Anatolian Tigers) and integrating them with the Istanbul-based industrial bourgeoisie. Generally, the AKP is judged to be successful in promoting economic growth and expansion, but neoliberal reforms entailed dismantling the former social regime, thus endangering the economic security of the working class and the poor. In this light, “The most significant achievement of the AKP has been to forge a coalition of both the winners and losers of neoliberalism: the rising Anatolian bourgeoisie and the urban poor.” (p. 97) 

To this end, the party has pursued diverse strategies combining populism, authoritarianism and conservatism with a neo-Ottoman vision, a new form of nationalism which overlaps with Muslim identity, and widening formal democracy. Yet, while the AKP presents itself as fighting for the people against the old bureaucratic elite, its policies have actually disempowered broad sectors of the population. Inequality and unemployment are on the rise, but the government keeps these social problems off the political agenda, in a paternalistic drive to depoliticise the citizenry. The consensus among the contributors is that the AKP government is becoming more authoritarian. In this sense, its “neoliberal-conservative populism has failed… when confronted with collective and popular protests, it has opted for repressive measures.” (p. 40)

AKP policies are not presented as the only factor in recent developments. Great attention is accorded to how economic factors, whether local or global, set the stage for what the AKP is able to accomplish. Particularly striking is the massive migration to the cities of the 1990s, as farmers were made redundant by the increasing mechanisation of agriculture, and in the case of Kurds, made homeless by the army’s destruction of thousands of villages. These developments radically altered the demography of the working class and of poor urban neighborhoods, fragmenting the working class and minimising the trade unions in a way that made it easier to impose neoliberal measures, like privatisation, ending job security and the widespread use of sub-contracting in industry. 

The book includes a brilliant analysis of the effects of neoliberalism on social policy as well as on the media, housing, urban planning and the use of public space. It also explains how religiosity can be used to control workers and other social strata. Last, but not least, is a chapter on grass-roots politics that persuasively argues that the Kurdish movement has become the centre of opposition to AKP rule.

Sally Bland

TORONTO – Travellers who want to skip the hotel fitness centre in favour of local gyms that may offer better equipment, classes and amenities can turn to new apps on their smartphones to buy a day pass to a nearby gym.

“Most hotel gyms are just a small row of treadmills, and maybe a half-complete weight rack. For anyone serious about working out, it’s usually not enough,” said Kevin Bracken, chief executive officer of Gymsurfing based in San Francisco, California.

Gymsurfing, a new iPhone app, helps travellers book day passes to professional gyms with their smartphones, without needing to plan ahead.

Users open the app to see gyms nearby and the price of a day pass, as well as other offers.

“You see a variety of gyms and amenities they offer, such as the type of equipment they have, and whether they have pools, saunas, or spas,” said Bracken.

The gyms available through the app range from corporate-style with state-of-the-art equipment to old-school body building and family-style establishments, with day passes costing between $5 to $20.

The app features passes for gyms in San Francisco, New York City, Los Angeles, Philadelphia, Miami and Toronto, with plans to include others.

“Our goal is make it so that as soon as you land in whatever city you’re going to, you can find a place to work out,” he said.

The company also plans to release a web app this week for Android phones and other devices.

Similar iPhone apps include OmFinder, which helps users find nearby yoga classes, and GymPoints to find US gyms that provide one-time day passes and drop-in classes for activities such as martial arts classes or Pilates.

A survey of 500 business travellers in the United States showed most try to maintain a healthy diet and exercise, and just under half use the hotel gym to keep in shape, according to an American Express Global Business Travel.

However, business travel expert Chris McGinnis, editor of the website TravelSkills, said that many business travellers often forgo the gym because they can’t fit workout clothes and shoes in their luggage.

“In the age of the carry-on bag, working out while on the road has kind of fallen to the wayside because there’s not enough room for their clothes, particularly their shoes,” he explained.

But he can see the appeal of the apps for travellers.

“Most hotels have gyms, but it may be a dank basement gym with no windows to the outside, or people might want the social experience of going to a gym, so in those cases an app might come in handy,” he said.

A product of the One Ford approach to developing cars for an ever more homogenised global car market, the Ford Fusion is an aptly named combination of Ford’s previously distinct American and European flavours, and serves as replacement for both its outgoing US and global predecessor and the European Mondeo — which continues selling under the same name. Sitting in the particularly tough automotive D-segment where buyers look for value and premium brand comfort, tech and safety, the new Fusion scores particularly well in design, safety, refinement and driving dynamics. A striking and accomplished gambit, the Fusion should be cause for consternation for even its best-selling competitors.

With moody browed and slim headlights slightly angled in and flanking its broad gaping trapezoidal grille and lower intake assembly, the Ford Fusion cuts a distinctly dramatic and assertive figure. Extending from the top of its current corporate-style grille, the Fusion’s ridged bonnet bulge extends to the base of the A-pillars and flows along a sleek and low roofline silhouette towards a rakish coupe-like rear slant and high rear deck. Aerodynamically slippery and with a stylishly urgent demeanor, the Fusion’s high waistline features lower and upper character lines to keep it interesting, while large optional 235/45R18 tyres aesthetically fills its wheel-arches and complements its relatively long wheelbase.

Smooth and refined

Offered with an all four-cylinder engine range including 1.5-, 1.6- and 2-litre turbocharged Ecoboost engines for some markets, the Middle East however gets the 2.5-litre naturally aspirated engine option, mated to a six-speed automatic gearbox, and returns 9L/100km combined cycle fuel efficiency. Developing 172BHP at 6,000rpm and 170lb/ft at 4,500rpm and with well-chosen gear ratios, the Fusion delivers respectable in-class off-the-line acceleration, with progressive power delivery and good mid-range flexibility. A quick and smooth-shifting gearbox complements the Fusion’s engine, and features electronic sequential manual shifting. Actuated by a small shift-lever mounted button, rather than lever movement, one found it more convenient to use accelerator pedal kick-downs shifting.

Where the Fusion excels is, however, in how it drives, and especially in terms of refinement and driving dynamics. With its aerodynamically efficient shape — including door mirrors that are extended away from the body for smoother airflow — and excellent in-class noise, vibration and harshness isolation, the Fusion remains refined and quiet as it slips through wind resistance, even at speed on track. Smooth riding and stable, the Fusion is comfortable with high speeds, while through simulated sudden lane change evasive manoeuvres it flicked to the next lane tidily and remained remarkably composed, with excellent body control, while secondary weight transfers were well suppressed.

Distinctly dynamic

Driven back-to-back against a 2,500km used example of the D-segment best-seller, the new Fusion had a distinct dynamic advantage, with better body roll and weight transfer control at high speed evasive maneuvers and medium speed slaloms. With superbly sporty, responsive and agile dynamics typical of contemporary Ford front-drive chassis platforms, the Fusion’s quick 2.7-turn steering sliced through the tight slaloms’ repetitive direction changes with quick wrist movements. With crisp front wheel grip, tidy body control, steering clarity and directness, the Fusion proved more agile and weaved through slaloms with greater concision and precision. Lining up to entering the Autodrome’s fast 180° sweeper at 140km/h, the Fusion was planted, stable and settled throughout the descending and slightly banked roller coaster-like curve. 

Reapplying the throttle by the sweeper’s apex, the Fusion’s front wheels dig in and pull through a clean cornering line and onto the straight. Though not noticeably faster in a straight line, the Fusion clearly had the upper hand through corners, and peeled away from the competition. Most evident through a 90° right hand corner followed by a tight ascending chicane segment, the Fusion remained composed and agile as it darted through with mere hints of under-steer and electronic stability control intervention if pushed too hard. Carrying similar speed, the competitor lurched through with noticeable body lean, stability control intervention and considerable understeer requiring excessive steering input and more throttle lift-off to follow an approximation of the desired line.

Sensibly safe

With its ride and cabin refinement a telltale sign of the precision, forethought, build quality, sound engineering and safety, the Ford Fusion earns the US Insurance Institute for Highway Safety’s (IIHS) coveted Top Safety Pick+ when first tested last year, which requires four “good” and at most just one “acceptable” ratings of five tests. Significantly, the test included the IIHS’ tough new “small overlap front” collision test, where it scored the second highest “acceptable” rating, while its prime competitor earned a “poor” rating — which has since been improved on — owing to some deformation of its A-pillar and because its front wheel intruded on the passenger cell’s foot well.

Well designed to absorb collision force by sacrificing the car’s deformable extremities and dissipate the impact throughout and along the structure, with the aim of maintaining passenger cell integrity, the Ford Fusion’s IIHS test videos attests to its crash safety. Demonstrably retaining A-pillar integrity as collision force was dissipated through along the roof, sides and floor, the Fusion front wheel was also safely torn off to the side, without compromising the passenger cell. In addition to its structural safety, the Fusion comes with an extensive range of passive safety features and optional driver assistance and semi-autonomous safety systems.

Technology and refinement

The first car in its segment with inflatable rear — and front — seatbelts to mitigate impact force, the Ford Fusion also features a Personal Safety System that tailors the deployment of various airbags according to both passenger size and position. Offered with rear view camera and rear cross-traffic sensors, the Fusion’s suite of driver assistance and semi-autonomous systems includes blind spot warning and driver alert systems. A Lane-Keeping System warns and then nudges the car back into lane if necessary, while Pull-Drift Compensation can apply subtle steering input to compensate for crosswinds. Adaptive cruise control can follow the car ahead at a safe distance and alert the driver of imminent collision.

Comfortable and refined inside, the Ford Fusion features good front space and seat adjustability, well-assembled interior construction and a quiet ambiance. With clean and contemporary styling and user-friendly layouts, the Fusion also features quality dash and console plastics and textures, while front visibility is also good. An accommodating mid-size saloon, the Fusion features good rear seat legroom and width, while headspace is generous for most passengers, but the rakishly slanted roofline does reduce headspace for taller passengers. Rear boot space is also accommodating at 453 litres. Well kitted with infotainment features, the Fusion also features a parallel parking assistance system that can automatically steer the wheels.

SPECIFICATIONS

Engine: 2.5 litre, all aluminium, transverse 4-cylinders

Bore x stroke: 89 x 100mm

Compression ratio: 9.7:1

Valve-train: 16-valve, DOHC, variable valve timing

Gearbox: 6-speed automatic, front-wheel-drive

Gear ratios: 1st 4.58:1; 2nd 2.96:1; 3rd 1.91:1; 4th 1.45:1; 5th 1:1; 6th 0.75:1

Final drive: 3.07:1

Power, BHP (PS) [kW]: 172 (175) [127] @ 6,000rpm

Specific power: 68.3BHP/litre

Power-to-weight ratio: 109.4BHP/tonne

Torque, lb/ft (Nm): 170 (230) @ 4,500rpm

Specific torque: 92.4Nm/litre

Torque-to-weight ratio: 148Nm/tonne

Fuel economy, city / highway / combined: 10.6 / 6.9 / 9 litres/100km

Fuel capacity: 62.5 litres

Length: 4,869mm

Width: 1,852mm

Height: 1,476mm

Wheelbase: 2,850mm

Track, F/R: 1,593 / 1,585mm

Headroom, F/R: 995 / 960mm

Legroom, F/R: 1,125 / 972mm

Shoulder room, F/R: 1,468 / 1,445mm

Boot capacity: 453 litres

Kerb weight: 1,554kg

Suspension: MacPherson Struts / Multi-link, stabiliser bars

Steering: Electric power-assisted rack & pinion

Lock-to-lock: 2.7 turns

Brakes, F/R: Ventilated discs / discs

Tyres: 235/45R18 (optional)

NEW YORK – Children with asthma are no more likely than their peers to suffer mental health problems — provided their asthma is well-controlled, according to Dutch researchers.

“The original literature, mostly from America, suggested that kids with asthma were at risk for anxiety, depression and low self-esteem, but that’s not what we’ve encountered in our clinical practice,” said the lead author of a new study, Professor Paul Brand, who works with asthmatic children at Princess Amalia Childrens Centre at Isala Hospital in Zwolle, The Netherlands.

Earlier research probably included many children who did not take their daily medications as prescribed, he said. When kids take the necessary medicines, they don’t appear to be any worse off psychologically than other children.

He and his team compared 70 children from their clinic with mostly well-controlled asthma and aged 8 to 15 years old, to 70 of their friends, who were similar in many ways but did not have asthma.

All the children filled out age-appropriate questionnaires meant to assess depression, anxiety and self-esteem. They also answered questions about how well they controlled their wheezing and symptoms.

Hospital data included how long the children with asthma had the condition, their medication use and exposure to tobacco smoke. 

Only 10 of the children with asthma didn’t have it well controlled, meaning they had had an instance when asthma had worsened in the past year, less than healthy lung function and a low score on the asthma management scale.

On the whole, asthmatic kids and their healthy peers scored about the same on the psychological assessments, the authors write in the journal Archives of Disease in Childhood. Between 10 and 20 per cent of kids in both groups showed signs of depression, anxiety or low-self esteem.

But kids with poorly controlled asthma tended to score higher on the anxiety questionnaire than kids with well controlled asthma.

“It was sort of common sense that if you are doing well with any kind of chronic illness you won’t have the psychological risks,” Dr Andrew Ting told Reuters Health by phone.

Ting, who wasn’t part of the study, specialises in paediatric pulmonology at Mount Sinai Hospital in New York.

It is very possible to control asthma completely, Brand told Reuters Health by phone.

“If you can work with kids and their parents to agree on daily use of inhaled corticosteroids and appropriate use of rescue medications when necessary, you can really control most asthma,” he said.

A rescue inhaler, like Albuterol, helps to relax the airways during an asthma attack. Children with persistent asthma should also be using a corticosteroid inhaler, like Advair, every day to help reduce airway inflammation and lower mucous levels, he said.

But many children don’t use their daily inhaler, Brand said. “In order to insure adherence, you need to invest in the relationship with kids and their parents,” which is more common in western Europe than in the US, he noted.

“The question is, how do you do that in today’s medical economic climate; how do you carve out the time to make that kind of a relationship with the patients?” Ting said.

It’s impossible to really encourage patients to adhere to a good action plan in a five to ten minute doctor’s visit, he said. At Mount Sinai they have a social worker go over the asthma management plan with patients in more detail outside of a doctor’s appointment, but many places don’t have that resource.

“If parents find out that their kids have asthma symptoms that keep occurring it is possible that the child is not taking their medication at all,” Brand said. “If they deny the disease and don’t take the meds, they will be suffering more.”

Kids might be less likely to use their inhalers in front of friends because of the social stigma, Ting said, but if they take their corticosteroid every day it is less likely that they will have to do that.

With proper medication use, kids should be able to play sports and activities and be at no increased risk of anxiety or depression, he said.