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Tuesday, 7 February 2012

Planes window seats can up the risk of DVT

Window seat on an aeroplane (Fotolia)Sitting in a window seat of an aeroplane during long distance flights can increase the risk of deep vein thrombosis (DVT), doctors say.

A window seat is one of the risk factors for DVT in long distance travellers outlined in new guidelines by the American College of Chest Physicians (ACCP), which say that a person's individual risk factors for blood clots should be taken into account before being offered preventative medicines.

Other risk factors highlighted include being elderly, pregnant or taking oral contraceptives.
The experts also say that so-called '"economy class syndrome" is a myth, as the risk of developing a blood clot during a long haul flight is the same for those travelling in first or business class.

Deep vein thromboses are blood clots which usually develop in the legs. If a clot breaks away, it can cause a potentially fatal blockage in the lungs known as a pulmonary embolism.The new guidance, published in the journal Chest, says the risk of developing a blood clot on a long distance flight is "very small" for most people, but was strongest for flights taking longer than eight to ten hours, particuarly in those with other risk factors.

Prolonged sitting, such as in a window seat of a plane, where someone is less likey to get up and move around, can also increase the risk of DVT. Guidelines co-author Dr Mark Crowther from McMaster University, Ontario, said: "Travelling in economy class does not increase your risk for developing a blood clot, even during long-distance travel.

"However, remaining immobile for long periods of time will. Long distance travellers sitting in a window seat tend to have limited mobility, which increases their risk for DVT. This risk increases as other factors are present."Smoking and obesity were also identified as risk factors, but the doctors said they found no "definitive evidence" that either dehydration or drinking alcohol boosted the risk of DVT.

Medical conditions which can put a person at increased risk include having had recent surgery, a family history of blood clots and having heart disease.The guidelines recommend that all long-haul passengers should take preventative measures such as getting out of their seats and walking around, and calf muscle stretches.In addition to this, people at higher risk of DVT should sit in an aisle seat if possible and wear below-knee graduated compression stockings, they advised.

The doctors also advised against the use of aspirin or any other anti-coagulant medication to prevent DVT in long-distance travellers. Drugs which can prevent blood clotting should only be considered on an individual basis for those at a higher risk of DVT as the "adverse effects may outweigh the risks," they said.

Dr Gordon Guyatt, who chaired the panel of experts which drew up the guidelines, said: "There has been a significant push in health care to administer DVT prevention for every patient, regardless of risk.
"As a result, many patients are receiving unnecessary therapies that provide little benefit and could have adverse effects." "The decision to administer DVT prevention therapy should be based on the patients' risk and the benefits of prevention or treatment."

Thursday, 2 February 2012

Spending on business travel to increase in 2012

If you want an indication of where the economy is going, look for business travelers the next time you fly or check into a hotel.
The more companies spend on business travel, the more likely the economy is inching closer to a recovery, and a new report hints at that very possibility for 2012.
On Tuesday, the Global Business Travel Association (GBTA) released its latest Business Travel Quarterly Outlook, which monitors business travel spending among U.S. companies. According to the report, spending on business travel is expected to top $263 billion dollars this year, an increase of 4.6 percent over last year.
“We’ve hit the reset button from pre-recession levels,” said Michael McCormick, executive director and chief operating officer. “We’re back at the level we were at in 2007.”

Alas, it’s not all good news as most of the increase is expected to come from rising travel costs rather than an increase in the number of trips taken. While the number of trips business travelers took in 2011 was up 2.1 percent over the year before, GBTA predicts they’ll post a slight decline of 0.8 percent this year.
Nevertheless, says McCormick, the fact that businesses are spending money on travel is itself a positive sign — not just for businesses but for the travel industry and the nation.

“Business travelers are a big driver of the economy,” he told “The amount of revenue dollars and tax dollars that are created by business travelers being out there is a great way to measure the health of the economy.”

Recent research from Deloitte LLP provides some cause for optimism. In September, the market research and consulting company conducted a survey of 1,000 business travelers and 85 percent of respondents said they expected to take the same number or more trips in 2012 than in 2011.
According to Adam Weissenberg, vice chairman of global travel, hospitality and leisure at Deloitte LLP, much of that bullishness can be traced to Gen X and Gen Y business travelers. While only 16 percent of respondents ages 45 and older are planning more trips this year, 27 percent of those between 18 and 44 expect to travel for work.

“Gen X and Gen Y travelers are making up more of the workforce and they’re also more optimistic,” said Weissenberg. Furthermore, their influence is becoming increasingly apparent, he told, as hotels renovate formal lobbies into friendlier, social venues; airlines offer more online and mobile services; and more “lifestyle” restaurants offer a middle ground between fast-food and waiter service.
Such changes, of course, won’t happen overnight, just as the improving economy is proving to be a slow-motion affair. In the meantime, both McCormick and Weissenberg maintain that as business travel goes, so goes the larger economy — at least eventually.
“There’s typically a lag between business travel and the economy,” said Weissenberg. “Historically, heading into a recession, [the drop in] business travel is about six months behind because people have already booked plane tickets, set up meetings, paid fees for conferences. That doesn’t change overnight.”

Conversely, as companies begin to see signs of economic growth, they gradually become more optimistic to the point that they start sending people back out on the road. According to GBTA, business travel typically lags the economy by a quarter (of a four-quarter year), which suggests the effects of that optimism will start to show up this spring or summer.
“What we’re seeing now is that 2012 is looking better than 2011,” said Weissenberg. "Clearly, it’s a good sign.”

Tips for taking a trip with toddlers

By Harriet Baskas, 

“How do you fly with two toddlers?”

That’s what Jessica White wants to know. She’s planning to travel soon with her two toddlers and wrote to Overhead Bin for advice.
“When I called Frontier Airlines,” said White, “they couldn't answer my questions about bringing aboard car seats and checking our large double stroller at the gate.”
We didn’t find anything to address gate-checking strollers under the Traveling with children section of the Frontier Airlines website, so we called the airline directly.

A cheery agent offered to make a note in a reservation record and assured us that White would be able to gate-check her stroller for free. “She could also check the stroller at the counter,” the agent told us, “but I suggest the mom take it to the gate so she doesn’t have to worry about chasing toddlers through the airport.”
The agent also took some time to run through the options for taking and using car seats on board the airplane. “Usually putting a car seat in the middle or aisle seat is not permitted,” she said. “But in this case, if both children have tickets for their own seats, the mom could put the seats side-by-side, in the window and middle seat, and take the aisle seat herself.”
Each airline has its own rules for gate-checking strollers, so it’s a good idea to call ahead or look on an airline’s website before traveling. And don’t assume that the rules you encountered last holiday season are still in force. This past June, for example, American Airlines announced it was changing its rules and only gate-checking collapsible or umbrella-style strollers under 20 pounds.
White also had a question about taking along drinks and snacks for her children.
“One child has severe food allergies and I want to bring aboard soy milk in sippy cups and snacks from home that are milk, peanut, tree nut & egg free. Will security let me through with these items?”
The TSA does not restrict non-liquid snacks taken through the checkpoint. Guidelines about baby formula, breast milk, juice and other liquids are posted in the Traveling with Kids page of the TSA's website.

“Parents traveling with children may pass through a security checkpoint with a reasonable amount of milk or baby formula in containers larger than 3.4 ounces after it is screened,” said TSA spokesperson Greg Soule. “We encourage parents carrying larger amounts of liquids for their children to declare the items to one of our officers in front of the checkpoint, so it can be screened properly.”

Tips from well-traveled families

By Colleen McBrinn,
Sean Runnels and his wife, Diane, with children Abby, right, 7; Elise, 4; and Rhys, 1, in front of the Angkor Wat temple in Cambodia.

Most of us travel with our kids a few times a year at most. We stress about all the gear to pack, the change in routines, and how to keep our tots entertained en route.
But some folks raise their kids traveling, and have it down to an art. Their tips and tricks — some learned the hard way in such remote places as Croatia or the Cascade mountains — can perhaps help us “regular” traveling parents ease up a bit and enjoy the ride more.
Three families — two sets of physicians and a couple that lives and works on Oregon’s Mount Hood — share what they’ve learned on various adventures.
Sean Runnels, an anesthesiologist in Salt Lake City, and his wife, Diane Ellis, an obstetrician/gynecologist, have worked and traveled around the world with their three kids, ages 12, 8 and 5. After they complete an upcoming two-year volunteer stint in Africa on the Mercy Ship floating hospital, their kids will have circled the globe on its surface.
“I think it’s a good way for them to get the idea of how big the Earth really is, something you can’t get an appreciation of when flying,” Runnels said, referring to their plan to travel to Africa by boat, rail and hiking trail, starting with sailing from New York to England on the Queen Mary 2.
Runnels shares his thoughts…
On gear …“Less is more,” Runnels said. “You can always get more if you need it when you arrive, but most likely, you’ll not miss it.”
They pack one pair of shoes per child, and earth-tone-colored clothes (“to hide stains”) as well as tie-dye shirts to quickly spot the kids in a crowd. After watching their middle child nearly drown in a lake in Croatia, they now travel with life jackets if they plan to be near water. They favor backpacks over suitcases, after finding that wheeled suitcases leave no hands for controlling children.

On planning …Runnels said they try not to plan more than one step ahead so they can remain flexible. They stay in one location for at least two days for every day of travel, and have learned to slow their pace and lower expectations, gravitating toward smaller towns where the environment is typically safer and more interesting for kids.
The Runnels’ youngest child took his first steps while on a month-long, 250-mile trek in Nepal, in which their 7-year-old daughter walked the entire way and their 4-year-old daughter walked a quarter of the way. They took frequent breaks, often hiking one day and resting the next.
“We went from village to village, stopping at tea shops where there were chickens to chase and goats to play with,” he said. “It’s hard to have that kind of down time in big cities.”
Runnels said success when traveling with kids comes when you have realistic expectations and learn to plan just one activity in the morning and one in the evening.

“If you put kids in the right environment where you’re not having to say no all the time, and they’re seeing and doing new things, they’re going to have fun,” he said. “They’re kids — that’s what they do."

On lessons learned the hard way …In addition to the life-jacket lesson, they’ve learned:
  • to spend a bit more when traveling, if necessary, versus “taking a midnight ferry in Croatia to save $10.”
  • that high-end hotels are no place for kids.
  • that when changing time zones, stay at hotels with pools since it’s impossible for kids to sleep when it’s their day time.
  • to pay attention to what your kids are eating before “a monk tells you the nuts they just grabbed in a Thai temple are powerful laxatives.”
On go-to travel spots with kids …Runnels swears by Asia. “Everyone loves kids, lots of great street food, and eye candy everywhere.” He also recommends trekking inn-to-inn in Europe, where there are “cheap hostels with good food, castles and medieval cities — it’s all a fairy tale to them.”

Rafting around the world
Jenny Blechman, a family physician in Bend, Ore., and her husband, Tim Carney, an anesthesiologist, make the most of weekends away to the coast and longer raft trips around the Northwest. With their two sons, ages 8 and 5, they have traveled to Mexico, Alaska, New Zealand and Spain.
Blechman shares her thoughts…

On gear …They pack light, bring books and occasionally hand over Blechman’s iPad for movies and games. They never leave home without Zack’s favorite stuffed dog and Alex’s blue blanket.

On planning …“We started traveling with them early so it made it normal for them,” Blechman said. “They don’t mind sleeping in strange beds or waking up somewhere else.”
They took Zack on a week-long raft trip down the John Day River in eastern Oregon when he was just a few months old, and Alex to Spain when he was 5 weeks.

On lessons learned the hard wayBring (or rent) car seats! When traveling in Mexico four years ago, they were in a car crash caused by a hit-and-run driver. Blechman’s husband, Tim, was arrested for questioning and held in jail for 24 hours, along with the other drivers involved. Blechman had almost let the car-rental employee talk her out of needing a car seat for her oldest child, then 3 1/2, but then rented one, “thankfully,” she says. Both boys suffered significant skin burns from the crash’s impact.

On go-to travel spots with kids …“We go rafting!” she said. “It’s a lot of prep work bringing your own food and gear, but the kids love it — there’s nothing to entertain them but just being outside, and we all have a lot of fun.”

Adventure travel for the whole family
Tammy Villali, catering manager at Timberline Lodge on Oregon’s Mount Hood, and her husband, David Villali, wine program manager, do a lot of day-tripping with their 9- and 3-year-old sons to hike, ski and kayak around Mount Hood where they live. They also travel to Florida, California, Maui and southern Oregon.
Villali shares her thoughts:
On gear …In addition to snacks and books, the Villalis now pack a portable DVD player, something they resisted for years because they permit only a half-hour of screen time a day at home.
“But for long trips over 2 hours,” she said, “it was worth the lower stress levels and enjoyment level for all and I wish we had bought it sooner.”

On planning …Villali said her biggest hurdle traveling with kids has been changing her expectations of how long and how far they would go.
“I had to go from ‘Let’s go ski six miles or snowboard today’ to ‘Let’s have fun getting there, getting gear on, playing in the snow,’ " she said. “It’s not about the distance we cover as much as the time spent making it fun to get outside and spend time outside.”

On lessons learned the hard way …The only routine they stick to now when traveling is meal times and bed times, having found that naps don’t happen when they want them to.
“I also learned that a hungry and tired child is close to impossible to reason with … a fed but tired child can buy you the extra 15 minutes you need to pack your gear, car or them!” she said.

On go-to travel spots with kids …They often hit Trillium Lake and Frog Lake around Mount Hood for frog-catching, hiking and kayaking in summer, and cross-country skiing and snowshoeing in winter.
“Stash a plastic garbage bag in your pack to slide down a hill here and there to keep it fun for the kids and again,” she said, “pack lots of snacks.”