Ah how does hand washing decrease the microbes present on your hands?

it kills microbes and then removes them.
it removes viruses but not bacteria from them.
it kills the microbes but does not remove them.
it removes the microbes but does not kill them.

Well, l think that some effective communication is, emotional barriers and lack of attention, interest distraction or irrelevance. also some physical disabilities such as hearing problems or speech difficulties.      l hope i am correct  and you good luck.