Thursday, December 26, 2013

"To Grandmother's House We Go" - Winter Driving Safety

Statistics indicate that of the more than 6 million vehicle crashes each year, 24% are weather-related.  Weather-related crashes are defined as those that occur in adverse weather (i.e., rain, sleet, snow, and/or fog) or on slick pavement (i.e., wet pavement, snowy/slushy pavement, or icy pavement).  Data compiled by the National Highway Traffic Safety Administration (NHTSA) indicates that on average, 7,130 people are killed and over 629,000 people are injured in weather-related crashes each year.
A large percentage of the U.S. population faces winter driving condition each year.  Over 70 percent of the nation’s roads are located in snowy regions that receive more than five inches average snowfall annually.  Additionally, many people travel from warmer to colder climates each winter for business or pleasure. It pays to have knowledge of the special challenges posed by winter driving and to be prepared for the unexpected.

Here are some of the most important tips for safe winter driving:
  1. Slow down.  Allow extra time to reach your destination. Stopping, turning, accelerating--- practically every driving function takes longer on snow-covered roads, so leave extra distance between you and other cars.
  2. Brake earlier. It takes at least twice as long to stop on icy or snowy roads than on dry pavement.  With anti-lock brakes, apply constant, firm pressure to the pedal and never pump the brakes.
  3. Check your tires. Replace them if you are getting close to the wear bars. If you are unsure if you need new or a different type of tire, consult your local tire dealer. Make sure your tires are inflated to the correct pressure. Tires that were at the proper pressure in summer could be low with the colder temperatures of winter.
  4. Remove snow from the entire car, not just the windows. This will keep snow from blowing onto your windshield or the windshields of other drivers. Side-view mirrors and all lights should be cleared as well.
  5. Service your car. You should make that it is in top operating condition. This includes checking the battery, charging system, belts, anti-freeze level, windshield wipers and the washer reservoir.
  6. Use caution on bridges and overpasses. Without the heat provided by the earth, freezing can occur on these structures even when the road is relatively clear.
  7. Avoid using cruise control on icy or snowy roads.
     
  8. Watch weather reports prior to a long-distance drive. Delay trips if bad weather is expected. If you do travel when the weather is suspect, let someone know your route and when you expect to arrive.
  9. Stay home. Sometimes the best option, particularly if you don’t really have to get out, is to stay off the roads.
What if you become snow bound?  The American Automobile Association (AAA) advises that if you become stuck, stay with your vehicle. It provides temporary shelter and makes it easier for rescuers to locate you. You should not try to walk in a severe storm since you could become lost and unable to return to your car.  The AAA also recommends that drivers have the following equipment in a winter emergency kit:
  • A cell phone
  • Flashlight with extra batteries
  • Small snow shovel and brush
  • Traction mats/non-clumping kitty litter
  • Ice scraper
  • Battery booster cables
  • Warm blanket
  • Flares/triangle warning devices     
  • Heavy gloves
  • Windshield washer fluid
  • First aid kit
  • Bottled water
  • Non-perishable food items
  • Tire chains
Additional information regarding winter driving can be found at the American Automobile Association (AAA) website or from Click and Clack, the Tappet brothers, at CarTalk.com
In the wintertime, a number of factors can cause skin to dry out, leading to uncomfortable scaling, cracking and itching.   Lower outdoor humidity along with exposure to forced air heating, wood-burning stoves, space heaters and fireplaces can all cause skin to lose moisture.  Additionally, taking long, hot showers or baths and use of deodorant and antibacterial soaps can contribute to dry skin.  Here are a few suggestions to help address this problem: 

Modify bathing habits:

  • Limit your bath or shower time to around 15 minutes in order to avoid removing moisturizing oils from your skin.
     
  • Bath or shower with comfortably warm, rather than hot water.
  • Use mild soaps such as Neutrogena, Basis or Dove.  Try using as little soap as possible as even the best “moisturizing” soaps can have a drying effect. Deodorant and antibacterial soaps can be particularly harsh and drying to the skin.
  • Pat your skin dry with a towel rather than rubbing. 
Moisturize skin regularly:
  • The best moisturizers, particularly for the body, hands and feet, are those that are oil-based, rather than water-based.
     
  • Use a skin moisturizer once or twice a day.  Eucerin, Lubriderm, Keri Lotion and Vaseline Intensive Care Lotion are examples of relatively inexpensive but effective moisturizers.
  • Before purchasing a moisturizer, be sure and read the label to make sure that it does not contain alcohol.
     
  • Apply the moisturizer shortly after bathing to help “seal” in moisture.
  • Hands and feet may be particularly troublesome. Bert’s Bees Hand Repair Creme, Udder Cream, and Bag Balm are examples of moisturizers designed specifically for these areas.
  • For very dry hands, apply a thin layer of petroleum jelly and wear thin cotton gloves to bed.
  • For splits in the skin around fingertips, try Lanolin Hydrous.
  • Lips are more prone to drying and chapping in the wintertime also. Resist the temptation to lick your lips if they feel dry. Saliva removes oil and makes your lips even drier. Instead use lip balm or petroleum jelly.
Address lifestyle issues: 
  • Make sure to stay well hydrated.  This will help to moisturize your skin from the "inside".
     
  • A portable home humidifier or one attached to your furnace adds moisture to the air inside your home.
       
  • Turn down the thermostat in the house to help avoid the drying effect of heat and forced air movement.
Wintertime is a particularly challenging time to keep skin from drying out.  For best results, start your skin moisturizing regimen early in the season and stay consistent with these measures to maintain skin hydration.

Monday, December 16, 2013

What is in Hand Sanitizers and How Do They Work?

Plastic containers of hand sanitizer are appearing everywhere---at restaurant counters, offices, gyms, even in campground pit toilets. And no wonder, keeping hands clean through proper hand hygiene is a proven way to avoid getting sick and to prevent spreading germs. According to the Centers for Disease Control (CDC), the standard for this is washing with soap and clean running water for at least 20 seconds. But what about hand sanitizers---do they work as well as soap and water, what are they made of, and how are they most appropriately used?


What's in hand sanitizer? The most effective sanitizers have a form of alcohol, such as ethyl alcohol, that serves as an antiseptic. To be effective, though, hand sanitizers should contain at least 60% alcohol. Two of the most popular brands of hand sanitizers, Germ-X and Purell, each contain ethyl alcohol at a concentration above this level. Other ingredients may include water, vitamin E, fragrance, and glycerin.

How effective are hand sanitizers? Popular hand sanitizers advertise that they are effective at eliminating "over 99.99%" of common germs and bacteria. At appropriate concentrations, alcohol-based sanitizers are effective against most bacteria, viruses, and fungi. This includes the virus that causes the flu as well as the bacteria responsible for causing methicillin-resistant staph infections (MRSA). Unfortunately, with too little volume of sanitizer or an insufficient amount or contact time, the 0.01% of "germs" not reliably killed includes noroviruses. These are the viruses that have been responsible for causing a number of epidemics of gastrointestinal illness on cruise ships. In this setting, the CDC recommends that washing hands with warm water and soap is still the best way to prevent spread of germs.

What is the proper way to use sanitizers? Hand sanitizers are packaged in a variety of ways including plastic pump bottles, personal size bottles, and soft wipes. The amount necessary for sanitizing varies among products but is usually one or two pumps from a bottle or enough to thoroughly cover the hands. Once applied to the palm of the hand, the product should be rubbed over all surfaces of the hands and fingers until dry. It's important to remember that alcohol-based sanitizers kill germs on contact, but has no residual germ-killing effect. Once it has evaporated, the germ-killing action stops. If re-exposed to germs, as for example after caring for someone who is sick, the sanitizer would need to be used again.

Are hand sanitizers as effective as hand washing? The CDC considers washing hands with soap and water to be the best way to reduce the spread of disease-causing germs. Even the manufacturers of hand sanitizers point out that they are designed to kill germs when access to soap and water is not available. Also, the effectiveness of hand sanitizers if greatly reduced if the hands are visibly dirty. If soap and water are not available, however, sanitizers that contain at least 60% alcohol are the next best way to kill disease-causing germs.

Some of the most appropriate times to wash hands or use a hand sanitizer are:
  • Before, during and after handling or preparing food

  • Before eating

  • After using the bathroom

  • After handling animals or animal waste

  • When your hands are dirty

  • After sneezing, coughing or blowing your nose

  • Before dressing a wound, giving medicine or inserting contact lenses

  • After changing a diaper

  • When caring for someone who is sick
Hand sanitizers have provided a convenient way to clean your hands when conventional washing with soap and water is not possible. There are concerns related to their use, however, including the elimination of beneficial as well as harmful bacteria from the body, and the potential for producing antibiotic-resistant strains of bacteria. When used in appropriate circumstances, though, hand sanitizers can help to keep us from getting sick or spreading germs to others.

Friday, December 6, 2013

Treating the Common Cold - What Works, What Doesn't: Part 2

                                             Can the duration of a cold be shortened?

The common cold is a viral infection of the upper respiratory system. On average, children have six to eight colds per year, and adults have two to four. The common cold places a heavy burden on society, accounting for approximately 40% of time taken off work and millions of days of school missed by children each year. While medical science has yet to develop a cure for the common cold, many people take a variety of supplements in the hopes that they will prevent or shorten the duration of the illness. The most popular of these supplements are zinc, vitamin C, and Echinacea.

Let's look at some of the scientific evidence of the effectiveness of these supplements. Much of this information comes from the Cochran Group, an international network of scientists who compile the work of several researchers into larger studies known as "meta-analyses". By pooling data from a number of well-conducted studies, more robust and accurate conclusions can be drawn.

Zinc is commonly sold as a natural medicine for colds in tablet, lozenge, and liquid form. It is thought to decrease the ability of cold viruses to grow on or bind to the lining of the nose. While the results of studies have gone back and forth over the years regarding zinc's effectiveness in treating colds, a recent Cochran analysis supports the evidence for zinc supplementation in treating colds. After pooling the results of several well-conducted studies, the following conclusions were drawn:
  • 1. If started within 24 hours of the onset of cold symptoms, zinc supplementation was found to reduce the duration of colds on average, by about a day.
     
  • 2. People taking zinc were less likely to have their symptoms persist beyond seven days of treatment and had less severe symptoms than people taking a placebo.
     
  • 3. Although various dosages were of zinc were used in the studies evaluated, a dose of 75 mg/day (or higher) was thought to be best to use for treating colds.
In many of the studies, nausea as a side effect of taking zinc was reported. Also, in 2009, the U.S. Food and Drug Administration warned consumers to stop using intranasal zinc products (zinc-containing homeopathic cold remedies), because of reports of anosmia (loss of smell).

Except for vitamins and minerals, Echinacea is one of the most commonly used natural supplements. Advocates say that it is can boost the immune system and has antiviral properties, such as preventing colds. However, two 2006 meta-analyses evaluating this natural remedy drew conflicting conclusions. In the first analysis, extracts of Echinacea were found to be effective in preventing cold symptoms if someone had been clinically inoculated with the cold virus. The second, a Cochrane Systematic Review, found no evidence that Echinacea was any better than a placebo at preventing the common cold. Three clinical trials funded by the National Center for Complementary and Alternative Medicine also found no benefit from Echinacea for preventing or treating colds. Echinacea products vary widely, with different preparations using different species of the plant as well a different plant parts.

Vitamin C is an important micronutrient and antioxidant. The role of vitamin C in the prevention and treatment of the common cold has been a subject of controversy for decades. Nevertheless, it is widely used as both a preventive as well as therapeutic supplement. A 2007 meta-analysis of results from 30 clinical trials involving 11,350 participants taking vitamin C regularly (200 milligrams or more daily) found that:
  • 1. When taken after a cold starts, vitamin C supplements did not make a cold shorter or less severe.
     
  • 2. When taken on a daily basis as a preventive measure, vitamin C could slightly shorten the duration of a cold. In other words, the average adult who suffers with a cold for 12 days a year would still suffer for 11 days a year if that person took a high dose of vitamin C every day during that year.
     
  • 3. Vitamin C supplementation could be justified in people exposed to brief periods of severe physical exercise (e.g. running a marathon) or to cold environments. In those people, taking vitamin C appeared to cut their risk of catching a cold in half.
The final word regarding these and other supplements in the treatment of the common cold awaits further research. Obviously, a better approach would be to prevent the cold from developing in the first place. Currently, the best methods for doing this appear to be "behavioral" in nature, such as washing your hands regularly, getting plenty of rest, limiting exposure to people with colds, and avoiding touching your nose or eyes with potentially contaminated hands.