By Jessica Snyder Sachs

If you're religious about what really matters, you can take shortcuts with the rest. Check out our guide to being a sensible slacker.

1. Work Out 5 Days a Week?

It's not your imagination: Our bodies simply become higher maintenance after 40. Indulgences of food or drink are quicker to take revenge. Muscles require more maintenance. Screening tests become more important. So there's a lot to remember -- and yet the wellness precautions keep coming, with new dos and don'ts every passing year. Can anyone do it all?

Actually, no. And if you try, say experts, you may end up throwing in the towel on some of the essentials, as well as what's helpful but optional. So find out where you can settle for good enough and still enjoy great health.

Rule 1: Work out 30 to 60 minutes a day, five days a week. 
The Midlife Shortcut: Catch up when you miss workouts.

To reduce the risk of heart disease, cancer, and osteoporosis -- all big concerns for women over 40 -- experts urge us to exercise at least 30 minutes a day, five days a week (and for maximum health benefits, make that an hour rather than half an hour). But daily workouts can be difficult to fit into a life crammed with work and family responsibilities. Then there's the knee and joint pain that many women experience after years of pounding their way through "healthful" exercise.

Why there's wiggle room: The cumulative hours -- the total time you clock each week -- is what really counts. In fact, the weekend warrior has gotten a bad rap, says exercise physiologist Jane Roy, PhD, of the University of Alabama at Birmingham. If you're too busy Monday through Friday, weekends are a great time for getting in two or more hours of enjoyable exercise a day. You can catch up by spending a weekend morning or afternoon playing tennis with girlfriends, taking back-to-back aerobic and Pilates classes, or going for a long walk or run.

Then, during the week, concentrate on interspersing sedentary activities such as computer work with small but frequent movement breaks, Roy adds.

2. Get a Pap Smear Yearly?

Rule 2: Get a Pap smear every year.
The Midlife Shortcut: Get tested every two to three years.

Sexually active women under 40 should be tested every year, but women over 40 can stretch it out to once every two to three years once they've had three or more normal results in a row, as long as they're in a long-term, mutually monogamous relationship or are not sexually active, and they're still getting annual pelvic exams.

Why there's wiggle room: When a woman is either not having sex or always has it with the same person (and that person is not having it with anyone else), she's not being exposed to new strains of the human papillomavirus, explains gynecologist Stacy Tessler Lindau, MD, of the University of Chicago Medical Center.

The majority of people who have ever been sexually active have been exposed to one or more strains of HPV. Most women clear the symptoms of the virus within a few months. But in a small minority, the infection causes cells to become precancerous over the course of several years. These are the abnormalities that show up on Pap tests.

What that means is the risk of precancerous changes (and ultimately cervical cancer) becomes very low once women pass through this latency period without being exposed anew by having sex with someone different. Even if you don't have a new partner, says Lindau, "You can be exposed to new sexual partners through your own sexual partner." That's why your relationship has to be mutually monogamous; if you're not sure it is, continue to be tested every year.

3. Eat 5 Servings of Veggies a Day?

Rule 3: Eat your veggies: five servings a day.
The Midlife Shortcut: Aim to include veggies in most meals.

Five servings a day add up to a heck of a lot of vegetables. Using USDA food guide serving sizes, you'd need to swallow up to 17 cups of salad or solid veggies a week to meet that goal -- that on top of the four daily servings of fruit you're supposed to get.

Admittedly, as the over-40 metabolism slows, substituting produce for higher-calorie foods and snacks can help with weight control. But as our lives grow exponentially busier, getting down all those veggies can become overwhelming.

"Five servings a day remains an admirable goal," says registered dietitian Christine Gerbstadt, MD, of the American Dietetic Association. And she argues that meeting it can be a lot easier than you think. "Potatoes count," she notes. "Just don't make it french fries every day." You can also add salsa, tomato sauce, or any kind of bean to the list.

But she's also willing to compromise. "A decent daily plan is to include some vegetables in most meals, then concentrate on rounding out the rest of your diet by pumping up the fibrous whole grains and healthy fats."

Why there's wiggle room: If you look at the big nutrition picture and aim for moderate goals, success may encourage you to surpass your quota. But if you don't hit the mark every single day, Gerbstadt says, you can get by with a daily multivitamin -- that will ensure you get the vitamins and minerals that are naturally abundant in fresh vegetables.

4. Brush After Every Meal?

Rule 4: Brush after every meal. 
The Midlife Shortcut: Put down the toothbrush and grab some gum.

Or a toothpick. Or gum. Or a glass of water. It's not necessary to brush your teeth after every meal if you do something else to remove the food debris.

Why there's wiggle room: Brushing when you get up and before you go to bed is just fine, according to Edmond Hewlett, DDS, of the UCLA School of Dentistry. In fact, Hewlett says it's a bad idea to brush right after consuming acidic foods or beverages such as wine, orange juice, and most soft drinks. "The acidity slightly softens tooth enamel," he explains. So habitually brushing right after eating these foods can contribute to tooth sensitivity and cavities.

Chewing sugarless gum has other benefits besides removing food residue. It also increases saliva, which contains minerals that help replace the enamel lost to acidic food and acid-producing mouth bacteria. That's particularly important after age 40, when your natural saliva production starts to decrease. And if the gum contains xylitol, you'll get an added bonus: This sugar substitute inhibits the growth of cavity-causing tooth bacteria.

5. Sleep for 8 Hours?

Rule 5: Eight hours of sleep every night -- no sleeping in. 
The Midlife Shortcut: Sleep late on weekends.

Yes, the human body does need eight hours of sound sleep each night, says Joanne Getsy, MD, of Drexel University College of Medicine, in Philadelphia. "It's a fallacy that you need less sleep as you get older," she says. "You don't need less; you simply get less." Anyone dealing with hot flashes and sleep disturbances knows this too well. But whereas many experts insist that "catch-up sleep" isn't as good as the real thing, Getsy says there's room for deviating from your normal wakeup and going-to-bed times.

Why there's wiggle room: "The aim should be to pay back your sleep debt as soon as you can," Getsy says. Specifically, she recommends scheduling twice-a-week catch-up nights. "Pick one weeknight and one weekend night, and don't plan anything on those evenings," she advises. "Let them be your nights to recover." Daytime napping is okay too, she adds: "Just keep it under an hour so it doesn't interfere with a solid night's sleep."

As for sleep-bingeing on weekends, Getsy advises staying in bed as late as you like on Saturday. Then on Sunday, split the difference between when you'd like to get up and when you have to get up on Monday. That will help ease you back into your weekday schedule.

Even better news: Getsy says that when it comes to sleep debt, it's okay to pay back less than you borrowed. Usually one full night's sleep is enough to make up for a couple of shortchanged ones, she says. "If you feel better in the morning, you've slept enough."

6. Lift Weights 3 Times a Week?

Rule 6: Lift weights three times a week.
The Midlife Shortcut: Try for one or two sessions a week.

On top of encouraging us to meet aerobic exercise quotas, the health gurus tell us to get to the gym and pump iron at least three days a week. Strength training is especially important after menopause, at which point a woman's body tends to lose both muscle mass and bone strength.

"When you make the muscle grow, you strengthen the bone that's attached to it," explains Felicia Cosman, MD, of the National Osteoporosis Foundation. Aerobic exercise such as jogging works only about 20 percent of muscle fibers, she says, while strength training with weights engages up to 90 percent.

Why there's wiggle room: There's no magic number as to how often you need to strength train. Aim for regularity, Cosman says, even if it's just twice a week. Nor do you have to schlep to a gym. "Weight machines and free weights are good," Cosman says, "but so are equipment-free Pilates and yoga moves, and push-ups."

7. Do a Breast Self-Exam?

Rule 7: Do a breast self-exam every month.
The Midlife Shortcut: Do it often enough to notice changes.

We came of age being trained to search for lumps every month. The mandate feels even more compelling now, given how greatly the incidence of breast cancer increases after 40.

As it turns out, however, there's little evidence that obsessively examining yourself really helps women catch more life-threatening lumps.

Why there's wiggle room: After years of urging women to perform monthly self-exams, the American Cancer Society recently deemed them optional. But what's still important, says ACS spokesperson Debbie Saslow, PhD, is that women become familiar with how their breasts feel and what's normal for them. "For a lot of women, that's still a monthly exam. For others, it's the occasional self-exam or simply paying attention when getting dressed or showering."

Where Not to Cheat

Here's where our health gurus draw the line. Follow these three rules, they say, as scrupulously as you can.

Keep Moving 
Yes, you get brownie points for working out on weekends, but you lose out on lots of benefits if you just sit in a chair the rest of the week, says Jane Roy, PhD, of the University of Alabama at Birmingham. So get up for a stretch break at least once an hour at work (you could walk down the hall to talk to a colleague instead of sending an e-mail), and a few times a day, catch some fresh air with a quick five-minute stroll outside.

If you need extra motivation, consider this: Five one-minute stretch breaks over the course of a day burn just 15 to 20 calories. But over the course of a year, that adds up to over two pounds of fat.

Get a Mammogram Every Year 
When cancer strikes women in their 40s, the tumors tend to be aggressive, which means fast-growing -- so the early detection offered by mammograms is crucial, says the American Cancer Society's Debbie Saslow. After menopause, women tend to have slower-growing cancers, she adds, but the incidence increases. "So going longer than a year just isn't worth the risk," she says.

Maintain a Healthy Weight 
Overweight women are more likely to develop heart disease, diabetes, and many types of cancer than normal-weight women are.

In fact, a recent analysis estimates that 20 percent of all cancer deaths in American women are linked to excess weight. In general, cancer rates increase when a woman's body mass index exceeds 25, says Colleen Doyle of the American Cancer Society. The risk rises more dramatically when the BMI passes 30. Abdominal fat appears to be closely associated with postmenopausal breast cancer and cancers of the colon and pancreas. And some experts say that the risk increases when a woman's waistline exceeds 32 inches.

Originally published in MORE magazine, February 2009.

Unbridled development and pollution threaten the Chattahoochee's ability to be all things to the millions who use and abuse the fabled river

Copyright Jessica Snyder Sachs, as originally appeared in National Wildlife magazine

GRIDLOCK seizes metro Atlanta by 8:00 am most weekdays, as traffic grinds to a halt along hundreds of miles of urban highway. Ironically, it's from this road-rage-inducing vantage point that millions have fallen under the spell of the river the Creek Indians called Chattahoochee--"the river of painted rocks." For as the waterway dips and weaves beneath dozens of the city's thoroughfares, an ethereal mist rises from its waters, broken only by the herons and kingfishers that dive from its wooded banks. Look long enough and you can imagine an ancient hunter in a dugout canoe slipping through the billowing vapor. Look again and imagine it's you, disappearing downriver, far away from the exhaust and blaring horns.

Ask anyone who lives in this sprawling metropolis of 3.5 million and you'll be hard pressed to hear a negative word about their beloved 'Hooch. They boat and fish in its waters, picnic and play on its banks, draw power from its dams and drink from its spigots. Even as the river passes through the most industrialized sections of this city, its banks remain cloaked in the river birch, sycamore and tulip poplar that inspired southern author Pat Conroy to describe Atlanta as "where they built a city and left the forest."

But despite its serene appearance, this same river also flushes metro Atlanta's toilets and silently accepts the equivalent of a major oil spill in polluted runoff each year. As a result, the 70-mile section of river south of Atlanta ranks among the five most polluted waterways in the nation. Meanwhile, the metro area's breakneck growth continues to devour the Chattahoochee's watershed--the smallest to supply a major American city--at the unprecedented rate of 50 acres a day.

Not that Atlantans stand alone in loving the Chattahoochee to death. Over the last decade, the state governments of Georgia, Alabama and Florida have remained locked in a water war over their competing rights to use the river as both water source and sewer. So great are the demands that not only water quality but water quantity--an issue more often associated with the arid West--has become a severe regional problem. So much water is being drawn from the Chattahoochee along its 540-mile journey to sea that its declining volume threatens one of the world's most productive estuaries: Apalachicola Bay in the Gulf of Mexico.

"We are at the crossroads," says Sally Bethea, director of the Upper Chattahoochee Riverkeeper, a river advocacy group founded in 1994 by Laura and Rutherford Seydel, daughter and son-in-law of Atlanta media mogul Ted Turner. "We have already changed this river forever, with 15 dams from one end to the other," adds Bethea. "But it still supports an immense diversity of wildlife. The crucial issue now is whether our leaders will insist the river be protected as a healthy ecosystem or whether we continue using it as a toilet and dump."

This workhorse of a river begins as a weeping-rock spring in the Blue Ridge Mountains, 80 miles north of Atlanta and a stone's throw from the Appalachian Trail. Surrounding the headwaters is the lush, 750,000-acre Chattahoochee National Forest, home to some 500 species of animals.

Several miles downstream, after the river tumbles out of federal land, it flows south through poultry farms and fertilized fields, picking up a heavy load of agricultural runoff. This section of the upper Chattahoochee is a magnet for construction of new, luxurious retirement communities. The development increases downstream as the river widens to form the aquatic playground of Lake Lanier, created with the completion of Buford Dam in 1956. By releasing water from the chilly bottom of its reservoir, the dam transformed the section of river below its turbines into the nation's southernmost cold-water trout stream.

Lanier itself has become the country's most-visited federal reservoir. As a result, the 38,000-acre lake is now visibly filling with tons of silt. Add to this mix the discharge of high-phosphorus wastewater from poorly regulated treatment plants and the tainted runoff from oil-slicked roads and chemically pampered lawns.

Concluding that the lake can cope with the onslaught, Georgia's Environmental Protection Division last year signaled a willingness to permit the rapidly growing counties bordering the lake to increase their wastewater discharges, contingent on enforcement of water-treatment standards. "That the state is finally setting water-quality standards for the lake is a step in the right direction," says Russ England, assistant chief of fisheries with the Georgia Department of Natural Resources. But the environmental pressures on Lanier won't abate as long as the region's unbridled growth continues, he cautions. "If they halfway try, a lot of upstream communities can learn from Atlanta's mistakes," adds England. "But their interests remain with rapid growth and against anything that would drive up the cost of that growth."

Existing regulations include a prohibition on disrupting a 25- to 50-foot buffer zone along the riverbank and requirements for erosion-control barriers on construction sites within the watershed. But enforcement is lax, claims Bethea. Part of the problem is lack of manpower. Though Georgia is the largest state east of the Mississippi River, its Environmental Protection Division staff is disproportionately small.

Between Lake Lanier and Atlanta, the Chattahoochee winds for 48 miles through the metro area's affluent suburbs. The riverfront here lies protected from further development by dozens of municipal parks and the 4,000-acre Chattahoochee River National Recreation Area, a string of 13 riverfront units. Even private homes on this stretch of the river remain largely hidden by the resilient vegetation that typifies Georgia's Piedmont region.

But just 50 feet back from the river begins a sea of impervious pavement and brick. During rainstorms, runoff that would naturally filter through vegetation-bound soil instead collects on hot surfaces and slaloms down streets to pour into the river and its tributary creeks. The unnatural wallop of sediment and heated water has already exterminated the Chattahoochee's native shellfish and now endangers temperature- and sight-sensitive fish such as trout, says naturalist Henning von Schmeling of the Chattahoochee Nature Center, a 130-acre riverfront educational facility north of Atlanta.

Over the next ten miles, as the river flows through Atlanta proper, it absorbs more than 250 million gallons of treated sewage and nearly a billion gallons of heated power-plant discharge a day. Even worse are the millions of gallons of raw sewage that spill into the river when rainstorms swamp the city's overburdened treatment plant.

From 1995 to 1997, the Riverkeeper spearheaded a lawsuit against the city for its sewer system's long-standing violations of the federal Clean Water Act. As a result, Atlanta was forced to pay $2.5 million in fines and comply with a strict eight-year timetable for improving water quality that included spending $360 million to upgrade its main sewage plant and committing another $25 million for watershed restoration.

A greater problem remains in polluted runoff from roads, construction sites and other nonpoint sources. The longstanding provisions of the federal Clean Water Act require the state of Georgia to reduce such pollution to a level that the river can absorb without threatening wildlife. "But the state has yet to determine the level of pollutants going into the river, let alone what it can safely handle," says biologist Andrew Schock, director of NWF's Southeastern Natural Resources Center. NWF has become particularly involved in training community activists in Atlanta's poorer neighborhoods to lobby for the restoration of the heavily polluted waters where their children fish, swim and play.

"Success," adds Schock, "means having the people who live in those neighborhoods involved in the decisions that affect their daily lives."

South of the city, the Chattahoochee opens up for a slow, 40-mile meander through floodplain farmland to West Point Lake on the Georgia-Alabama border. West Point's quiet waters--a stark contrast to Lanier's buzz of activity--have become a settling pond for Atlanta's tainted runoff. But even as pollution levels dampen the lake's popularity for swimming, the high load of nitrogen and phosphorous has made West Point one of the nation's most fertile bass hatcheries. Bald eagles, osprey, and heron share the world-class fishing with sports anglers, though the humans know better than to eat what they catch.

After West Point, the Chattahoochee continues south along the state border and over the fall line, where the hard rock and red clay of Piedmont Plateau give way to the soft sandstone of the coastal plain. Wildlife becomes even more abundant as the river fills its last reservoir, the shallow and reedy Lake Seminole. There, the waters of the Chattahoochee mingle with those of the Flint River before entering the Florida Panhandle under a new name: the Apalachicola. Over its final 100 miles, the meandering stream nourishes millions of acres of hardwood swamp, including the world's largest stands of tupelo trees.

The river's final act is to deliver some 16 billion gallons of fresh water a day into Apalachicola Bay, a protected estuary where fresh and salt water mix slowly to produce a world-class harvest of oysters, shrimp and fish valued at more than $100 million a year. Imperative to the health of this breeding ground is the massive influx of fresh water that keeps deep-ocean predators at bay. Declining volume and pollution have already begun to take their tolls.

"A lot of hip Atlantans love to eat Apalachicola oysters at the city's finest restaurants," comments von Schmeling. "They need to realize that the road grease from their commutes and the chemicals from their over-fertilized yards are ending up on their plates." In many ways, Atlanta's appreciation of fine Apalachicola oysters epitomizes the larger issues facing the Chattahoochee. The millions of Southeasterners who benefit from this river must now face the cost of ensuring its long-term welfare.

"The answers must come from a sense of wise stewardship," says Lindsay Thomas, the federal commissioner appointed to oversee the ongoing negotiations between the three states for the Chattahoochee-Flint-Apalachicola River Basin. But solutions have not come easily. Over the last three years, state negotiators have failed to meet four deadlines for a mutually satisfactory water-management plan. Georgia and Alabama want enough water to sustain another 50 years of booming development, without sacrificing irrigation for agriculture or river levels for commercial navigation. Florida remains desperate to stem the dwindling flow that threatens Apalachicola Bay and 90 percent of its oyster harvest.

Fighting to be heard above the fray is the 17-member TriState Conservation Coalition, which includes the Riverkeeper and two NWF affiliates, the Georgia Wildlife Federation and Florida Wildlife Federation. Lobbying for negotiators to go beyond sheer quantity, the coalition is raising complex "flow" issues that directly impact the wildlife that make southeastern rivers among the most biologically diverse on Earth. Many of the Chattahoochee's 170 species of fish, for example, rely on spring floods to reach their spawning grounds in surrounding wetlands. As withdrawals lower the river's flow, the careful timing of dam releases becomes crucial to these natural cycles. Cyclic flooding is even more pivotal to the Apalachicola Bay system, with its vast fishery nurseries.

The coalition's demands are bolstered by such federal laws as the U.S. Fish and Wildlife Coordination Act, which requires federal negotiators to consider ecological impacts; and the Clean Water Act, which mandates that waterways be kept clean enough to maintain wildlife.

Meanwhile, water-quality issues remain largely in the control of local communities, particularly metro Atlanta and its northern neighbors. Sensing the shift in mood, some of the region's developers have begun to go beyond the letter of the law to protect the Chattahoochee. "More developers are approaching us with a sincere attitude of wanting what's best for the community," says Bethea. "Other times, they're forced to work with us."

A recent case involved construction of the massive Mall of Georgia, the centerpiece of a sprawling retail complex that laid bare some 500 acres of red Georgia clay south of Lake Lanier. "The developers needed a variance to build within stream buffers and knew we could raise holy hell about it," explains Bethea. "As result we got a seat at the planning table." Specifically, the mall's developers consulted closely with Riverkeeper engineers to keep construction runoff from rolling into bordering creeks.

On the public side, Georgia Governor Roy Barnes recently budgeted 60 new positions in the state's Environmental Protection Division, primarily in programs focusing on water quality, with a promise of 140 more over five years. Barnes also vetoed a bill that would have allowed the state legislature to strike down environmental regulations set forth by the agency. Perhaps the most exciting opportunity on the horizon is the creation of a 180-mile greenway protecting riverbank from Helen to Columbus. Though it would leapfrog privately held land, the proposed Chattahoochee Riverway would become the longest river park in the nation--a project that will require $180 million to complete.

Clearly, the momentum for saving the Chattahoochee has never been greater. "What makes this river so remarkable is the fact that there are so many people who love it and depend on it," concludes England. "But the same environmental issues are being faced by great rivers across the nation." What happens here in the next few years, environmentalists agree, will largely determine whether the Chattahoochee becomes a national paradigm or a legacy lost.

Writer Jessica Snyder Sachs is the author of Good Germs, Bad Germs: Health & Survival in a Bacterial World (Hill&Wang/FSG) and Corpse: Nature, Forensics, and the Struggle to Pinpoint Time of Death (Perseus/Basic Books).

copyright Jessica Snyder Sachs, as first appeared in National Wildlife

FOR TENS OF MILLIONS of years, a corps of natural hydrologists ensured the continuous cleansing of our continent's water supplies. In woodlands across North America, some 200 million beavers slowed rivers and streams to a silt-dropping crawl with their semiporous dams. Moreover their relentless logging created an elaborate network of wetland meadows that absorbed and cleansed surface runoff.

Beyond the forests, tens of millions of bison and elk worked in tandem with wildfires to sustain the short-grass and tallgrass prairies that soaked up the torrential downpours of seasonal thunderstorms. Beneath these same grasslands, hundreds of thousands of prairie dogs dug vast networks of tunnels that channeled groundwater deeper, to feed and refresh underground rivers that, in turn, continually recharged the continent's lakes and above-ground streams.

In these ways, a network of keystone species helped maintain a clean supply of the continent's most vital, life-sustaining substance. For while many forms of life can survive without oxygen, none can do so without water. Indeed, 60 to 80 percent of every living cell consists of water, and all vital biological processes begin or end with this simple molecule.

So far as science can discern, life on this planet began in a watery cradle. And when astronomers scan other planets for the potential to support life, they look first for signs of the molecule H20.

As seen from space, the sparkling blue ball that is Earth reveals itself to be a paradise of wetness. Above the oceans and lakes that cover more than 70 percent of the planet's surface drifts an ever-shifting lace of water-vapor clouds. Water pours from our skies, courses down our mountains and flows across every continent, back to the seas where the warming sun sends it skyward again. In this manner, our planet continually recycles an estimated 370 quintillion gallons (18 zeros), most of it older than the oldest fossils.

As life in North America and elsewhere evolved around water's unique properties, elaborate ecosystems developed to ensure continual recycling and purification. In Water: A Natural History, environmental engineer Alice Outwater describes the consequences of disrupting these ecosystems, particularly the large-scale decimation of North America's pre-Columbian populations of beaver, bison, elk and prairie dogs. "By tampering with and in some cases eliminating the ecological niches where water cleans itself," she says, "we have simplified the pathways that water takes through the American landscape, and we have ended up with dirty water."

Without wetlands and prairie grasslands to absorb rainfall, water slaloms across the landscape, picking up and dumping sediment into streams and lakes. Without beaver dams to brake their flow, streams frequently deepen into brown-water gulleys, continually eating away at their own banks. In an even more dramatic manner, development that clears natural vegetation speeds sediment-laden runoff during rainstorms, while adding a potentially toxic load of pesticides and other chemicals. The U.S. Geological Survey's recently completed ten-year assessment of the nation's water resources found multiple pesticides and unnaturally elevated levels of phosphorus and nitrogen in virtually all streams and groundwater sampled outside undeveloped wilderness. The majority of these streams contained pesticides at levels that exceeded--and often far exceeded--federal guidelines for the protection of aquatic life. These same chemicals can likewise endanger humans if they enter the drinking water supply.

"Scientific studies have repeatedly shown that our ability to protect our water sources from pollutants--and there are many of them--relates closely to our ability to safeguard our own health, especially that of our children, with their growing bodies," observes Monty Fischer, National Wildlife Federation policy director of water resources. "As conservationists, we're also keenly aware of the crucial role an untainted and abundant water supply plays in sustaining wildlife."

Certainly, Fischer points out, part of the solution is increased water efficiency--from turning off the faucet when we brush our teeth to making sure that our municipalities repair leaky water mains and otherwise invest in efficient water-delivery systems. But more important, he says, "is a public understanding of the linkage between the water flowing out of your tap and the wild places where it comes from, both in terms of the quantity and quality of that water, and the commitment it takes to protect those water sources."

Outwater agrees, adding: "An undeniable symbiosis exists between our country's water, the land from which it springs and the life that the two support together. Safeguarding that symbiosis is a responsibility all of us must share."

New Jersey journalist Jessica Snyder Sachs wrote about the effects of pesticides on endangered species in the December/January issue.

SIDEBAR:

H₂O: The Incredible Molecule

What is it that makes H₂O the liquid of life itself?

In chemical structure, the water molecule could hardly be simpler: two hydrogen atoms stuck like Mickey Mouse ears onto a single atom of oxygen. But in that simplicity can be found water's unique properties.

In essence, every water molecule is a tiny magnet, and its strong polar nature gives it the ability to dissolve an unparalleled range of substances, including a wide range of salts. In addition to the familiar sodium-chloride molecule we know as table salt, these include scores of biologically important substances such as potassium chloride, magnesium chloride and calcium sulfate. Indeed, all living beings--from plants to humans--depend on water to release the life-sustaining minerals contained in these salts.

Water's remarkable solvent powers provide the perfect medium for virtually every biological reaction that occurs inside a living cell--from energy-storing photosynthesis to energy-consuming respiration. And water has the remarkable ability to dissolve gases--most importantly, oxygen and carbon dioxide. It is water's oxygen-carrying capacity that sustains aquatic animal life.

A water molecule's mini-magnet configuration generates a host of other queer qualities, as well. Given its simple structure and small size, it should fly apart into gaseous form at extremely low temperatures. But water molecules cluster into tight groups, with each molecule's negatively charged oxygen atom lining up with the positively charged hydrogen on its neighbors. The considerable amount of energy needed to break these "hydrogen bonds" gives water the unusually high boiling point of 212 degrees F (100 degrees C). As a result, the planet's surface water never completely evaporates under the beating sun. Instead, oceans and lakes act as impressive energy sinks for storing and slowly releasing solar energy to temper seasons, and smooth out temperature differences between day and night.

As temperatures drop toward freezing, the hydrogen bonds between water molecules perform another impressive trick. They preassemble into the open-lattice structure that gives snowflakes their beautiful patterns and makes ice lighter than water. This bizarre quality of water being lighter as a solid than as a liquid has a huge consequence: It is the reason that lakes and oceans don't freeze from the bottom up, solidifying into a global ice block that even the hottest summer would never melt.--Jessica Snyder Sachs

Copyright Jessica Snyder Sachs, as first appeared in National Wildlife

THE EARLY MORNING SUN glints off the amber, "swamp tea" waters of Okefenokee National Wildlife Refuge, as an eager group of Sunday birders clamber up its wetland observation tower. For the last half mile of boardwalk, they've heard the croak of sandhill cranes above the rustling sound of the sawgrass blocking their view. "They'll be lifting off any day now," says refuge ranger Maggie O'Connell of the swamp's winter population of several thousand greater sandhill cranes. Though only mid-February, winter is already loosening its halfhearted grip on southern Georgia's Great Okefenokee, one of the largest intact freshwater ecosystems in the world.

Atop the 50-foot tower, O'Connell surveys her domain. "Seventeen miles to the horizon without a stitch of solid ground," she marvels. Indeed, the dense vegetation of this landscape grows atop floating peat-bog islands, the largest crowned by bald cypress draped in ghostly green Spanish moss. For good reason, the Creek Indians dubbed this Oguafenogua, the "land of the trembling earth." Stomp hard enough and even the trees shake.

Like the majority of the 539 units in America's National Wildlife Refuge System, the Okefenokee was protected to serve as sanctuary for migratory waterfowl such as the cranes, teals, mergansers, herons and egrets seen feeding across its open, wet "prairie." But the Georgia reserve has evolved far beyond its "duck factory" genesis.

This refuge's expanded purpose becomes clear as the sun rises high enough to banish the morning chill, and boaters begin paddling and motoring up the swamp's 120 miles of canals and slow-moving streams. Blinking back at them from the shore or half-submerged in the shimmering blackwater are the sleek American alligators that are among the Okefenokee's star attractions. Many of the visitors will linger after returning to dock--lunching on the refuge's grassy picnic grounds, touring its new million-dollar environmental education exhibit, and shopping for souvenirs in the gift shop. Some will spend the night, either in the state park easement on the refuge's west side or deep in the swamp, on one of seven overnight canoeing platforms.

In addition to playing host to more than 400,000 visitors a year, the staff of this national wildlife refuge have launched an ambitious long-term project to restore and expand the area's upland stands of rare longleaf pine and wiregrass habitat--home to endangered red-cockaded woodpeckers and threatened gopher tortoises, indigo snakes and Florida black bears. To this end, nearly half the refuge staff work on the fire crews that conduct prescribed burns to beat back the saw palmetto and slash pine that once were kept in check by seasonal wildfires. "We figure it'll take about 300 years of active management to restore the area," says O'Connell.

Now, as it prepares to celebrate its centennial year beginning in March, the National Wildlife Refuge System as a whole is experiencing an equally radical deepening and expansion of its purpose. Administered by the U.S. Fish and Wildlife Service, it is the world's only national network of public lands set aside specifically for wildlife. And for years, it struggled without any sense of unifying mission. Beginning with President Theodore Roosevelt's founding of the first refuge--Florida's Pelican Island in 1903--one unit after another has flickered into being with its own narrowly defined mission. Before Roosevelt left office in 1909, these included 56 big game preserves and bird reservations such as Idaho's Mindoka refuge for ducks and geese, Oklahoma's Wichita Mountains for bison and elk, and Alaska's Fire Island for moose.

In addition to playing host to more than 400,000 visitors a year, the staff of this national wildlife refuge have launched an ambitious long-term project to restore and expand the area's upland stands of rare longleaf pine and wiregrass habitat--home to endangered red-cockaded woodpeckers and threatened gopher tortoises, indigo snakes and Florida black bears. To this end, nearly half the refuge staff work on the fire crews that conduct prescribed burns to beat back the saw palmetto and slash pine that once were kept in check by seasonal wildfires. "We figure it'll take about 300 years of active management to restore the area," says O'Connell.

Now, as it prepares to celebrate its centennial year beginning in March, the National Wildlife Refuge System as a whole is experiencing an equally radical deepening and expansion of its purpose. Administered by the U.S. Fish and Wildlife Service, it is the world's only national network of public lands set aside specifically for wildlife. And for years, it struggled without any sense of unifying mission. Beginning with President Theodore Roosevelt's founding of the first refuge--Florida's Pelican Island in 1903--one unit after another has flickered into being with its own narrowly defined mission. Before Roosevelt left office in 1909, these included 56 big game preserves and bird reservations such as Idaho's Mindoka refuge for ducks and geese, Oklahoma's Wichita Mountains for bison and elk, and Alaska's Fire Island for moose.

Since 1934, the Migratory Bird Hunting and Conservation Stamp Act has funded the acquisition of millions of acres of additional waterfowl habitat, concentrated up and down North America's four major migratory flyways. Among the first, Montana's Red Rock Lakes refuge became the last-chance sanctuary for the highly endangered trumpeter swan in 1935.

In 1966, Congress passed the National Wildlife Refuge Administration Act, enlarging the refuge system further with several thousand small prairie pothole wetlands designated as "Waterfowl Production Areas." And in 1980, the Alaska National Interest Lands Conservation Act nearly tripled the refuge system's holdings with some 54 million acres of pristine arctic and subarctic habitat.

By the time the 500th refuge--West Virginia's Canaan Valley--was established in 1994, the system encompassed more units than the National Forest Service and more land (90 million acres) than the National Park Service's holdings. Yet much of the refuge system continued to be managed under a mishmash of policies and regulations that left its lands vulnerable to such strangely incompatible uses as jet skiing, dune-buggy racing, livestock grazing, oil drilling, even military war games and bombing runs. Refuge managers opposing such uses stood on shaky legal ground unless they could show that the activities directly threatened the specific purpose for which their refuges had been established.

A case in point: In 1990, the manager of Aransas National Wildlife Refuge on the Texas Gulf Coast tried to remove privately owned cattle from the preserve's wildlife-rich Matagorda Island. Biologists had determined that overgrazing had already degraded the island's otherwise pristine habitat, including nesting sites for endangered sea turtles and underbrush vital to wintering songbirds. The problem was that Congress had established the refuge in 1937 specifically as a sanctuary for the world's last wild population of whooping cranes.

"We could show that the cattle were definitely degrading the overall ecosystem of Matagorda Island," explains National Wildlife Refuge System Director Dan Ashe. "But technically, in order to deny the grazing permit, we had to show that it was incompatible with the refuge's original purpose." In the end, federal administrators stood behind the refuge manager's claim that cattle grazing constituted an incompatible use. "But a lot of people, including our own attorneys, thought we were stretching things," admits Ashe.

Such legalistic hand-tying came to an end in 1996, with an executive order by President Clinton, followed the next year by the bipartisan passage of the National Wildlife Refuge System Improvement Act. These two legal directives set forth "conservation" as the refuge system's singular and all-encompassing purpose--a purpose against which any proposed use had to be judged. The groundbreaking Improvement Act also required the staff at every refuge to create a 15-year comprehensive conservation plan--guided, in large part, by public input. Indeed, by placing an emphasis on "wildlife-compatible" uses such as observation, photography and limited hunting, the law acknowledged that refuges are for people too.

Specifically, some 2 million hunters and 6 million anglers visit the refuge system each year. Twice that number--some 16 million visitors--come solely to watch wildlife or soak in the beauty and serenity of the nation's wildest places. Add busloads of students and tour groups taking advantage of environmental education programs and the tally swells to at least 35 million visitors a year. The importance of their input in setting the system's agenda for its second century can hardly be underestimated, says Jamie Rappaport Clark, former director of the U.S. Fish and Wildlife Service during the Clinton administration and now NWF senior vice president for conservation programs. "The pressures on the refuge system have grown tremendously in recent years," she explains. "We have more threatened and endangered species, more demands for human activity on the landscape, and more development and encroachment from the outside. As a result, the job of safeguarding these wild places and passing them on to new generations demands a high level of public engagement."

In fact, the most serious threats to refuge wildlife and habitat--urban sprawl, water depletion, pollution and invasive species--originate outside refuge borders and, therefore beyond the system's authority. Consequently, progress depends on activism on the part of local citizens and allied conservation organizations.

In recent years, for example, the Okefenokee National Wildlife Refuge has depended on a large coalition of conservation groups, including NWF and its affiliate, the Georgia Wildlife Federation, to stave off plans by the chemical giant DuPont to excavate a 30-mile-long, 50-foot-deep titanium strip mine a few feet from the refuge's eastern border. The proposed mining operations would generate a 24-hour-a-day onslaught of dust, smoke, exhaust, noise and light directly alongside the refuge's main wildlife observation drive. Worse, scientific studies indicate the mine could irrevocably alter the Okefenokee's delicate hydrology and ecology. With no authority to stop operations off refuge grounds, refuge managers continue to rely on sustained and vocal public opposition to keep DuPont's plans at bay.

Public opposition has, at least for the time being, helped play an even larger role in confronting what many people view as the greatest single threat to the refuge system in its 100-year history: the proposed opening of the coastal plain section of Alaska's 19.6 million-acre Arctic National Wildlife Refuge to oil drilling--a plan that the U.S. Senate voted down last year. Scientific studies by government wildlife biologists had confirmed that petroleum operations on the Arctic refuge would disrupt its vast caribou calving grounds and irreparably harm the region's delicate tundra ecosystem. More importantly, says Clark, "opening Arctic to drilling would totally blow apart the purpose of the entire refuge system. For if there's the will to violate a refuge as spectacular and ecologically unique as Arctic, what would stop the same from happening at the system's 75 million other acres?"

At the least, adds Clark, the 1997 Refuge Improvement Act makes doing so extremely difficult. "As there's no possible way to open up the heart of this refuge to drilling and call it 'compatible' with conservation," she says, "it would require Congressional legislation to literally set the Refuge Improvement Act aside."

More insidious threats to the system include a widening budget shortfall for staffing and maintenance, says Evan Hirsche, president of the National Wildlife Refuge Association, the umbrella organization for more than 200 local refuge volunteer "friends" groups. "Wildlife refuges have long been the black sheep of federal land holdings in terms of monetary support," he says. Specifically, the system must manage more than 94 million acres--and the welfare of more than 200 threatened or endangered species--with an annual budget of $370 million, or less than $4 an acre.

"As a result," says Hirsche, "a great deal of conservation objectives are not being met." Primary among these has been the refuge system's losing battle with invasive species such as the Australian pine and Brazilian pepper trees supplanting native habitat at Florida's Pelican Island National Wildlife Refuge; the zebra mussels and purple loosestrife crowding out native mollusks and wetland plant species in the Upper Mississippi National Fish and Wildlife Refuge; and nutria, a beaver-like Central American rodent, tearing up tidal marshes in Maryland's Blackwater National Wildlife Refuge. Also showing the strain of underfunding is the refuge system's aging infrastructure of access roads, buildings, water-management facilities and other assets.

The severe underfunding for maintenance and staff has also slowed the system's opening of new refuges, despite the annual influx of "Duck Stamp" money for land acquisition. "Before we acquire new areas, we have to ask ourselves whether we'll have the funds to manage them," explains Ashe. "Too often, I hear the argument, 'You don't have to do anything, just buy the land and protect it.' But 'protect' is an active verb."

Indeed, though much of the refuge system consists of wilderness where humans seldom tread, at a minimum, these places must be posted and patrolled. "In this day and age, even our most remote areas are no longer insulated from such illegal activities as drug trafficking, poaching and garbage dumping," says Ashe. "If we just left these places alone, I don't think anyone would be happy with what we'd find when we came back five years later." Moreover, a large percentage of the refuge system requires intensive management such as controlled burning to maintain ecosystem balance and active farming to provide grain for migratory waterfowl. "We need more maintenance workers, more equipment operators, more law-enforcement officers," says Ashe.

In particular, Ashe and conservation activists agree, the system needs more wildlife biologists. "The lack of biological expertise undermines any effort at strategic planning and wise management," says Clark. "Many of our refuges need extensive habitat restoration that can't be carried out because of this lack of biological expertise." At the very least, she explains, the system needs enough biologists to conduct wildlife surveys, monitor wildlife threats and prioritize spending at individual refuges.

For all these reasons, a coalition of 20 conservation groups, including the National Wildlife Federation, recently called on President Bush and Congress to nearly double the refuge system's budget. "Because of their strategic locations and acreage, our refuges provide safe havens for hundreds of threatened and endangered species, provide migratory stopover for millions of birds, while at the same time provide terrific areas for solace and enjoyment for people who want to experience nature," argues Clark. "But it's a system that desperately requires increased funding if it's going to address the needs of both wildlife and people."

The good news is that authorities in Washington, D.C., are finally getting the message. "We've seen sustained budget increases over recent years, including Secretary of the Interior Gale Norton's endorsement of a nearly $57 million increase for maintenance and operations in 2003," says Ashe, who credits conservation groups for their persistent lobbying on behalf of the refuge system. "Constituent organizations like the National Wildlife Federation have in the past five to six years rallied to our defense. It's in large part thanks to them that government leaders have been able to set aside political differences and support us."

Admittedly, recent federal funding increases fall far short of the refuge system's staggering maintenance backlog--currently estimated at more than $526 million, with another $700 million needed for high-priority projects such as restoring degraded habitats and promoting the recovery of endangered species.

Increasingly, refuges have come to rely on volunteers to pick up the slack. Every year some 30,000 volunteers donate more than a million hours of their time to driving heavy equipment, conducting habitat surveys, building boardwalks, running bookstores and nature programs, and lobbying for increased local, state and federal support. "That translates to about $13 million worth of services a year," notes Hirsche.

The need for volunteer support will only increase in the refuge system's second century. "These precious places are mere islands in the landscape, and we can't hope to ever acquire all the land we need," he explains. "As a result, the success of the system's conservation mission will depend on local volunteers becoming envoys to neighboring landowners and local governments, and in this way extending each refuge's wildlife objectives beyond its borders."

In the future that Hirsche envisions, "refuges will become shining examples for private landowners, state land managers and other federal land agencies of how they can all develop management policies consistent with species conservation."

New Jersey-based journalist Jessica Snyder Sachs visited the Okefenokee and Pelican Island National Wildlife Refuges while reporting for this article.

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FROM A DISTANCE, the oddly stunted mangrove trees of Florida's Pelican Island look dusted in snow. Approach closer, however, and the snowfall turns out to be hundreds of nesting egrets, herons, ibises, wood storks and downy young pelicans. The mangrove's dwarfed greenery likewise results from the birds, whose continual pruning for nesting material has produced an island-wide bonsai effect. Scientists estimate that this tiny islet, a stone's throw from the East Florida mainland on one side and barrier islands on the other, has provided the birds and their nestlings safe haven from predators for thousands of years.

Yet in the closing years of the 19th century, this ancient rookery came within a hair's breadth of extirpation. First came the winter tourists, shooting clouds of island birds for idle entertainment. Plume hunters followed, systematically raking the island for both nestlings and adults to feed the insatiable demand for fashionable feathered hats. Naturalists and scientists only added to the massacre in the late 1800s with their wholesale collection of eggs and specimens for display.

Watching it all from the mainland, boat builder Paul Kroegel cursed the mindless slaughter. In 1881, Kroegel established his boat shop across from Pelican Island in order to enjoy the sight of reeling birds. But by 1898, the herons, egrets, roseate spoonbills and white ibises were gone, the pelicans severely reduced. Over the next five years, Kroegel and pioneering wildlife conservationists William Dutcher and Theodore Palmer lobbied officials in Washington, D.C., for protection. In 1903, they finally convinced President Theodore Roosevelt to declare Pelican Island a wildlife sanctuary--the country's first national wildlife refuge.

Hired as the sanctuary's first manager, Kroegel earned $1 a month to keep his eye on the island rookery. He kept a ten-gauge shotgun in his dockside skiff to help persuade trespassers to move on. The mild-mannered conservationist started the island on its slow recovery.

A century later, refuge manager Paul Tritaik continues the fight to protect Pelican Island and its spectacular diversity of nesting birds. Instead of a gun, Tritaik faces the island's modern-day threats with an impressive array of bureaucratic wrangling and artfully harnessed public activism. "I try every angle I can," says Tritaik of his ten years managing a refuge that until recently didn't so much as provide him with his own budget, let alone a wildlife biologist or other full-time help.

When he arrived at the refuge in 1993, Tritaik realized that Pelican Island was literally disappearing. "I noticed it when I was looking at old aerial photos of the island," he explains. "The shape of the island was dramatically different than it is today." A survey confirmed Tritaik's worst fears: Over the course of the 20th century, the island had eroded from a 5.5-acre triangle to a 2.2-acre comma.

Part of the problem, Tritaik realized, was the island's location--dead center in Florida's busy Intracoastal Waterway. The wakes generated by the heavy boat traffic had been pounding on the fragile islet for decades. "At some point, I knew the island would simply be too small to support a viable rookery," he says. But Tritaik remained powerless to stop or even slow the traffic.

Though the refuge had acquired some 4,700 acres of surrounding water from the state of Florida in 1963, the additional territory came with the precondition that no restrictions be placed on fishing or boating. Tritaik first turned to volunteer labor to try to stabilize the islet's battered shore. When that made little headway, he finagled Pelican Island's designation as a National Historic Landmark into getting money for hiring a helicopter to dump 250 tons of oyster shell.

Similarly, Tritaik has wrangled Environmental Protection Agency funds to help clean and restore the surrounding Indian River Lagoon, even as he gleaned other restoration money based on its status as a National Wilderness Area. Most importantly, perhaps, Tritaik continues to network with Pelican Island's many passionate local supporters, who stand ready to wield their lobbying clout as well as their physical labor.

A sea change in government support arrived in 1999, says Tritaik, when U.S. Fish and Wildlife Service Director Jamie Rappaport Clark committed her agency to transforming this, the nation's first wildlife refuge, into a showcase for the system's upcoming centennial. Within three years, the refuge had acquired more than 150 acres of neighboring barrier island. The newly acquired acreage will allow the refuge to welcome the public for the first time with hiking trails, boardwalk, rookery observation tower and visitors' center. "Pelican Island today," says Tritaik, "stands as a monument to the National Wildlife Refuge System that it spawned."

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Are you doing what you can to protect your child from sexual abuse? The standard advice is wrong: Here's what you need to know.

 copyright Jessica Snyder Sachs, as first published in PARENTING magazine

When I was 11, I kept a terrible secret from my parents. I feared their reaction if they found out what a neighbor and family friend had done in his home after turning off the lights and saying he loved me. Besides, it took me months to figure it out myself. Even then, I doubt that the term "molestation" had become part of my vocabulary.

My story wouldn't bear mentioning except that it continues to be horribly common. Although studies show a small but steady decline in substantiated child molestations over the past decade, conservative estimates still place the number of children who are sexually abused each year at around 200,000. Only about half of cases are reported, experts believe. And the problem extends into younger age groups than most people realize. In a national survey of adults molested as children, the median age of first abuse was 9 years, with one-fourth being violated before age 8 and nearly 15 percent before age 6.

Scarier still, conventional notions on how to protect kids is wrong. We rush to teach them about "stranger danger," but more than 80 percent of molesters know their victims, according to a study by the University of New Hampshire's Crimes Against Children Research Center. We instruct our children to "Yell and Tell," but such simplistic advice can backfire when youngsters face the typical offender  -- the outwardly caring teacher, coach, friend, or relative who's worked hard to win your child's trust  -- not to mention yours.

"In no other area do we give children the responsibility to stop or change the behavior of the adults in their life," says Elizabeth Ralston, Ph.D., executive director of Dee Norton Lowcountry Children's Advocacy Center, in Charleston, South Carolina. "The result is that often, kids who've been molested feel guilty for not having prevented the abuse and ashamed to tell anyone about what's happened to them."

Even lessons on "good touch/bad touch" can backfire because molestation doesn't always start out feeling "yucky." Nor does it necessarily involve physical contact, as is the case when adults expose children to sexually explicit pictures, talk, and behavior, or when they get them to expose themselves for photographs.

You're probably cringing right about now, but that discomfort is a part of the problem. "It's natural for parents to cling to the myth of the child molester as the dirty old man in the wrinkled raincoat," says Anna Salter, Ph.D., author of Predators: Pedophiles, Rapists, and Other Sex Offenders. "It's disturbing to think that people we know, or even love, could harm our children."

Your first line of defense, then, is to minimize the situations in which your child is left alone with an adult you don't thoroughly know and wholly trust  -- even if it's Grandpa. "This isn't about being paranoid," says Anne Lee, founder of the national child-protection campaign Darkness to Light and a survivor of sexual abuse herself. "Just as we're not being paranoid about the risk of an accident, so we buckle our kids into their car seats or hold their hands crossing the street, it's not paranoid to eliminate one-on-one situations that may put them at risk of abuse." These age-specific guidelines can help you keep your child safe.

Protecting Infants and Toddlers

It was the grandma who noticed. While diapering her 14-month-old granddaughter, she felt a roughened area between the baby's buttocks. The pediatrician said it was too calloused to be diaper rash and concluded it had been caused by chronic rubbing over a long period of time. It turned out, says Ralston, that the teenage boy who babysat the child had been masturbating against her.

Yes, babies get abused. A molester may masturbate against an infant or toddler, stimulate the child for self-gratification, or even attempt penetration. Red flags for possible abuse include abrasions, swelling, and skin tears around the genitals, anus, or mouth. If you notice such an injury, see your doctor immediately.

Ralston urges parents to screen any adult they're considering as a regular caregiver for criminal offenses through local law-enforcement agencies and the FBI. You'll need the person's birth date, social security number, and a list of the counties and states in which she's lived.

After you hire someone, make it clear to her that you're vigilant about your child's safety and then check in unannounced periodically. "If she complains, find somebody else," says Ralston.

Protecting preschoolers and grade-schoolers

"See. You're a dirty little girl. You like it." That's what Anne Lee's great-uncle told her when he began fondling her during summers at the family's vacation house. She was 4 years old.

"The tragedy is, I believed him and felt too ashamed to tell my parents," says Lee, who's now the mom of a 10-year-old daughter. At the same time, Lee's behavior was a cry for help: "Here we had this wonderful place on a beautiful crystal lake, and I was begging not to go."

Although there are no numbers available regarding boys, the incidence of molestation and sexually motivated abductions of girls more than triples by the time children reach grade school. This isn't surprising, considering that as kids get older, they're out of their parents' sight more often. To protect them despite this change:

Reduce accessibility
There's no substitute for direct supervision. "Offenders look for ease of approach and ease of retreat," says Monique Boudreaux, Ph.D., a consultant with the Child Abduction and Serial Murder Investigative Resources Center, in Quantico, Virginia, and a mom of two. So plop down on a lawn chair when your kids play outside; take the phone along or let the voicemail pick up to avoid having your attention diverted.

Before your child visits a friend's home, get to know the parents or try to spend time there. If you're not comfortable, have them play at your house.

At your child's daycare or school, find out if there's an "open-door policy"  -- that is, an open door or unobstructed window should allow any classroom to be visible from the hallway at all times.

If you've chosen family daycare for your child, make it clear that she should never be left with anyone other than the primary caregiver without your prior approval. When babysitters come into your home, establish ground rules as to who else is allowed in the house while you're away.

Attend your child's practices, lessons, and other extracurricular activities, or send someone you trust. Relax on the sidelines, but be aware of how coaches and instructors interact with your child.

Never ignore the protests of a child who expresses reluctance or fear about spending time with a particular adult, even a relative or close family friend. Avoid leading questions, but assure your child that he won't get in trouble for telling you what's going on.

Reduce desirability
Advertising your child's name on the outside of backpacks and other personal items can draw unwanted attention. "We know that some offenders literally stalk children to gain information about them," says Boudreaux. "Knowing your child's name helps them." At the very least, it can make it easier for a molester to directly gain a child's trust.

In a more literal sense, reducing desirability means not dressing young children in alluring clothing, accessories, or makeup. Interviews with convicted child molesters suggest that a provocative appearance plays a significant role in the selection of victims.

Reduce vulnerability
Although it's important not to lay the responsibility of protecting themselves solely on the tiny shoulders of preschoolers, they are old enough to learn that their bodies are their own and that the parts normally covered by underwear or a swimsuit shouldn't be touched or seen by others, with the exception of a parent or trusted caregiver at bathtime or a doctor examining them with a parent or nurse present. They should understand that others should not be exposing or showing pictures of private parts to them. This sense of "owning one's body" begins with the child's privilege of saying no when he doesn't feel like hugging or kissing, even if that person happens to be Granddad  -- or you.

Similarly, don't tell your child to be a good boy (or girl) and do whatever his sitter (teacher/coach/neighbor) says. Boudreaux teaches her own kids reasonable and acceptable behavior while letting them know they have the right to politely but firmly say no if they're told to do something that doesn't seem right. It can help to playact nonscary scenarios in which your child should "talk back" to an adult.

Instead of teaching fear of strangers, Boudreaux also instructs her children to look for "a mommy with kids or a grandma" if they get separated from her in a store or elsewhere. (Recognizing a store clerk or security guard can be difficult for little ones.)

Reducing vulnerability means making sure your child feels safe coming to you about a disturbing or confusing situation or emotion. Tell her, in terms she can understand, that some adults  -- not very many, but some  -- try to touch or otherwise interact with children in inappropriate ways.

Protecting tweens and up

My daughter's now 11, the age at which I was molested  -- and I've gone through many a heart-clenching moment when she's been out of my sight. To protect maturing kids without smothering them:

Continue to get to know your preteen's friends, and if possible visit their homes.

Encourage supervised activities with kids her own age, explaining that while relationships with adults and older teens may be fun and exciting, she may find herself in a vulnerable position that can lead to abuse. Pay special attention to friendships involving older persons, even a 14-year-old palling around with your 10-year-old.

Kids approaching and passing through puberty also need help managing their own sexual feelings, setting boundaries with boy- and girlfriends, and handling peer pressure regarding pornography. Look for opportunities to talk about these issues and brainstorm ways for your child to avoid or get out of uncomfortable situations.

Finding a balance

Protecting kids from molestation requires being vigilant while giving them freedom to learn about their world, make friends, and become independent adults. For me, that's meant choosing a preschool with two teachers in every class; sitting in on music lessons; and having quite a few frank talks with my daughter about sexuality and molestation. Not as much fun as chatting about her interest in Shakespeare or horses, but vital to making sure she never has to experience the kind of shame and confusion that I did as a child.

Parenting contributing editor Jessica Snyder Sachs is the author of Good Germs, Bad Germs: Health & Survival in a Bacterial World (Hill&Wang/FSG) and Corpse: Nature, Forensics, and the Struggle to Pinpoint Time of Death (Perseus/Basic Books).

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Antibiotic-resistant germs are showing up in hospitals, playrooms, and gyms around the country. Here's how to keep you and your family safe

By Jessica Snyder Sachs, as first appeared in PREVENTION magazine

One summer morning in 2004, Susanne Petrosky, 37, of Perkasie, PA, woke up feeling feverish. It was a month after she'd given birth to her third child, and one touch of her left breast--hot, swollen, tender--told her it was infected. She knew the drill, having been through it with her second baby. She called her doctor, picked up a prescription for the antibiotic clindamycin, and took it faithfully for the full 7 days. No more breast infection. 

Then the diarrhea started, with cramping so bad it made her recent labor pains seem mild. She made an appointment to see her doctor and got on the Internet. "I typed in clindamycin and side effects and it came right up--severe, sometimes fatal, diarrhea," she says. On the phone, her doctor was reassuring. That was on a Thursday. She spent much of the weekend lying on the bathroom floor; on Monday morning her sister drove her to the doctor. "He took one look at me," Petrosky says, "and told us to go straight to the emergency room."

Petrosky had picked up a dangerous new strain of an old bug: Clostridium difficile. The bacteria, which produces toxins in the intestine, is common--when people on antibiotics end up with diarrhea, C. difficile is often to blame. Generally, once they've finished taking the drugs, the diarrhea clears up on its own. But the new strain is much nastier than normal. It churns out 20 times the colon-damaging toxins as the older version, causing severe intestinal inflammation, or colitis, and is resistant to several important antibiotics. When Petrosky got sick, Canadian hospitals had already reported more than 200 deaths from C. difficile--toxins had eaten right through the walls of patients' colons. Many American hospitals were experiencing similar outbreaks, and the hypervirulent strain had begun to infect people in the general community. Since then, the situation has only gotten worse.

Experts have long warned against the overuse of antibiotics because of the possibility that bacteria would develop resistance to the drugs we use to kill them. Now, researchers say, some of their fears have come to pass. The CDC estimates that of the approximately 2 million bacterial infections Americans acquire in hospitals each year, 70% are resistant to at least one of the drugs commonly used against them. Why that's scaring the experts: If standard drugs don't work, doctors sometimes have to turn to more potent--and more toxic--alternatives. In some cases, those last-resort antibiotics have caused irreversible liver or kidney problems or lasting pain from nerve damage. In others, people have died for lack of an effective treatment. The CDC says that drug resistance kills 70,000 Americans each year--more than car accidents and homicides combined.

"The superbugs are here," says Martin J. Blaser, MD, president of the Infectious Diseases Society of America and the chair of New York University Medical School's department of medicine. "And it doesn't take a crystal ball to see that even more problems are coming." 

Scientists are trying to develop new bacteria-fighting drugs, but that process takes decades. In the meantime, we have to defend ourselves. It's crucial to be able to recognize the warning signs of a superbug infection, or, even better, prevent one. Here are four of the most dangerous of these germs and how leading experts say you can protect yourself.

Superbug C. difficile: A Toxic Intestinal Bug

When Petrosky got to the hospital, doctors immediately put her on extrapowerful antibiotics. She improved, but her right arm went numb from medicine-induced nerve damage; when her physicians switched drugs, she relapsed. It took more than 9 weeks to get her out of danger. After her recovery, her 4-year-old son and a neighbor went through similar bouts of illness. The neighbor had to be hospitalized.

The number of new cases of C. difficile-associated colitis among US hospital patients has doubled over the past 5 to 10 years, to as many as 500,000 a year, reports CDC medical epidemiologist L. Clifford McDonald, MD. The infection rate outside hospitals appears to have increased many times over, as well. And the death rate has skyrocketed: from less than 2% to as high as 17%.

Prevent It

Don't badger your doctor for unnecessary antibiotics. Remember: Antibiotics don't work against viral infections such as colds or flus.

Ask about alternatives if your doctor suggests long-term antibiotics for a chronic bacterial infection such as acne. (Try remedies like benzoyl peroxide cream instead.)

Avoid broad-spectrum antibiotics, if possible, when an illness requires an antibiotic. (Broad spectrum means they kill off good bacteria along with the bad.) The broad-spectrum antibiotics most associated with C. difficile infection are clindamycin (Cleocin), and the fluoroquinolones (Cipro, Floxin, and Levaquin).

Consider upping your intake of "friendly" bacteria, such as Lactobacillus and Bifidobacterium. They can be found in many brands of live-culture yogurt. Such a step can't hurt; research continues on whether it can help deny bad bugs a foothold in your system.

 Treat It

Contact your doctor if you have diarrhea or cramping and gas that lasts longer than a few days, and avoid antidiarrheal remedies, which can prevent your body from expelling C. difficile's tissue-damaging toxins. Instead, drink lots of fluids to stay hydrated and try the BRAT diet: bananas, rice, applesauce, and toast.

Superbug MRSA: Out of the Hospital and in your Community

On Christmas night, 2005, 14-month-old Bryce Smith had a stuffy nose and slight fever--his first cold, say his parents, Katie and Scott Smith of Santee, CA. Around midnight on New Year's Eve, Bryce began to struggle frighteningly for breath. The Smiths rushed him to the hospital, where a nurse checked his oxygen level. Within seconds, Katie recalls, at least 10 doctors and nurses had crowded around her baby, looking very scared.

X-rays and CT scans showed that Bryce's lungs were riddled with holes, and a team of surgeons hurried him into the operating room. Doctors told the Smiths that Bryce had the worst kind of lung infection, one caused by a particularly virulent variety of staph bacteria. Dubbed CA-MRSA, for community-acquired methicillin-resistant Staphylococcus aureus, the bacteria is resistant to penicillin, amoxicillin, and the other "cillins." And it produces poisons--which were chewing up Bryce's lungs.

Bryce lay in a medically induced coma for a month as doctors infused his body with a cocktail of antibiotics, sedatives, and other drugs. The medicines worked: After 40 days, the doctors brought him out of sedation and removed his tubes. But his parents have to be supervigilant now, because the treatment weakened his immune system, at least temporarily. "What would be an ordinary cold for us could prove deadly for him," his dad says.

Staph causes problems only when it slips past the body's defenses, through a cut or scratch or into lungs weakened by a viral infection. Close contact--on playing fields, in locker rooms and showers, and between children in day care and preschool--has been the key to many outbreaks. (Young children appear to be particularly at risk.)

MRSA made headlines in 2005 when Miami Dolphins Junior Seau and Charles Rodgers were hospitalized with limb-threatening skin infections and college football player Ricky Lannetti of Philadelphia died suddenly of MRSA pneumonia on the heels of the flu. And a study in the New England Journal of Medicine startled physicians by revealing that the bug now causes more than half of all skin infections treated in US emergency rooms. It's crucial, say researchers, for doctors to keep the possibility of MRSA in mind--the study found that most cases of MRSA were treated with drugs that don't work against the superbug.

How To Avoid MRSA

Prevent It

* Wash cuts and scrapes thoroughly with soap and water.

* Don't share personal items such as towels and razors, and just in case you have a scratch that would offer entry to MRSA, always keep your clothing or a towel between your skin and any shared surfaces such as workout equipment or locker-room benches. *

* Get vaccinated against the flu--the disease clearly raises the risk of the most severe kind of staph infections.

Treat It

* Don't ignore an infected wound or a pus-filled boil--not even a scratch, if it seems to worsen over the course of a few days. MRSA skin infections tend to be very red, swollen, and painful, sometimes with a raised bump resembling a spider bite. Getting the right antibiotic is critical, so ask your doctor to consider the possibility of MRSA.

* Be particularly vigilant about any chest cold or flu that takes a sudden turn for the worse, or a fever that spikes over 102 degrees F. "Every major medical center is now on the alert for MRSA," says John Bradley, MD, chief of infectious disease at Rady Children's Hospital--San Diego, where Bryce was treated. "But there's still a problem with general practitioners and small community hospitals, where doctors may never have seen a case."

Superbug E. Coli: Food's Dangerous Hitchhiker

Frightening news stories recently about the damage done by tainted spinach made it horrifyingly clear: Produce, like meat, can harbor lethal germs. The culprit in spinach, E. coli 0157:H7, is not antibiotic resistant (in fact, antibiotics are not used to treat this infection), but is indisputably extratoxic; the poisons it produces can cause fatal kidney failure. Strains of other foodborne bugs, Salmonella and Campylobacter, turn out vicious toxins, as well--and these bugs shrug off many drugs that once could vanquish them. All told, these pathogens sicken 3 to 4 million Americans each year and kill several hundred.

Prevent It

Be scrupulous about washing hands after touching raw meat or eggs, and cook these foods thoroughly. (More than half of all cuts of raw supermarket chicken carry Salmonella and Campylobacter, studies show.)

Use hot, soapy water to wash cutting boards and other kitchen surfaces that come in contact with raw meat or eggs.

Rinse produce--even veggies and fruits with a thick rind, such as cantaloupe--with a strong spray of water. If produce is contaminated by irrigation water, as was the case with spinach, only thorough cooking will destroy the germs.

Wash your (and your kids') hands after handling pet rodents and reptiles or farm animals, which can spread Salmonella and Campylobacter.

Throw your kitchen sponges into the dishwasher daily and dishrags into the washing machine often; use hot water.

Treat It

 See a doctor for severe gastrointestinal distress that lasts more than a couple of days, especially if accompanied by fever. If your doctor prescribes an antibiotic, call back if symptoms worsen or don't get better within 24 hours.

Superbug UTI: Bladder Infections That Won't Quit

The first time Dena Kelley got a urinary tract infection, she ended up in the emergency room. It was the winter of 1999, and Kelley, now a 33-year-old store manager in Anchorage, was seeing what looked like tissue in the toilet bowl--the lining of her infected bladder. "It was unbelievably painful," she says, "and it scared the heck out of me."

The ER doc gave Kelley a powerful antibiotic--Cipro--to stop the infection fast, but 6 weeks later, Kelley got another UTI. Over the next year, she averaged an infection every 2 months. Finally, her doctors reluctantly turned to a drug to which she'd been allergic in childhood--amoxicillin, at four times the usual dose. Fortunately, Kelley had outgrown her sensitivity to the drug, which ended the agonizing bouts of UTIs. But she can no longer make it through the night without a trip to the bathroom. And her doctors have told her that permanent bladder damage may predispose her to chronic infections throughout her life.

Roughly half of all women get at least one UTI at some point in their lives. Until the late 1990s, doctors were able to treat the problem with trimethoprim-sulfamethoxazole (Bactrim), a narrowly targeted antibiotic with minimal side effects. But many UTIs have become resistant to Bactrim and other drugs. So doctors must use stronger antibiotics that can cause problems of their own.

"It's frustrating," says Gazala Siddiqui, MD, a urogynecologist at the University of Texas Medical School at Austin. "These powerful antibiotics increase the chances of a yeast infection, and also the chances that a woman's next bacterial infection--whether it's another UTI or pneumonia--will be drug resistant."

If a resistant UTI lingers, it can cause scarring--which predisposes a woman to even more UTIs. Some doctors try to stop the vicious cycle by keeping women on antibiotics for months at a time. But that virtually guarantees that any break-through infections will be impervious to antibiotics, says Siddiqui, who's sometimes had to admit patients to the hospital for intravenous treatment.

Prevent Antibiotic-Resistant Bladder Infections

Prevent It

Begin with good vaginal hygiene: Wipe from front to back after using the toilet and pee before and after sexual intercourse. Don't douche, and consider alternatives to spermicides; both can irritate the delicate tissue around the urethra, raising the odds of infection.

Discourage UTI-causing bacteria by making the urinary tract and vagina more acidic. "Cranberry juice is good at this. Cranberry capsules are better," says Siddiqui, who recommends two or three glasses or capsules a day for women who are prone to recurrent infection. Also helpful: acidifying vaginal jelly available by prescription (Acigel) or over the counter (RepHresh).

Try a low-estrogen vaginal cream if you're peri- or postmenopausal and getting lots of UTIs. It will keep the tissue of the urethra from thinning and becoming more vulnerable to infection.

Treat It

If you suspect a UTI, ask your doc to send a urine sample for analysis. Start antibiotics, but call back for results. If it turns out not to be a bacterial infection, stop the drugs and work with your doc to find the true cause. If a bacteria is at fault, check to make sure the drug you're on is effective against the bug you have.

3 Stay-Healthy Moves To Make Right Now

1. Scrubbing with old-fashioned soap and hot water is the best way to keep germs at bay. Do it before eating, after using the toilet or handling animals, and before and after preparing food. Wash vigorously for 20 seconds, experts say--about the time it takes to sing "Yankee Doodle Dandy."

 
2. If a sink isn't handy, clean up with an alcohol hand sanitizer. Studies show that when someone is sick in a household, classroom, or workplace, using a gel (between hand washings) reduces the spread of disease-causing bacteria and viruses. Be sure to choose a product containing 60 to 95% alcohol--some contain less and can actually help spread germs. Use a generous gob--enough so that hands still feel damp after rubbing them together for 20 seconds.

 3. Skip antibacterial soap. Household soaps and other products with antibacterial chemicals, such as triclosan and triclocarban, don't prevent infection any better than products without them, studies show. Worse, some experts worry that they may promote drug resistance. There's no proof yet that they do, admits resistance crusader Stuart B. Levy, MD, of Tufts University. "But why take the risk when they haven't been shown to be any more effective?"

Have A Healthy Hospital Stay

Ironically, "A hospital is not a good place to be when you're sick," says Curtis Donskey, MD, chief of infection control at the Cleveland VA Medical Center. Filled with the sickest patients on the strongest antibiotics, they're breeding grounds for superbugs. Unfortunately, many doctors neglect the steps that can reduce patients' risk of picking up nasty germs during their stay, says Donskey, who has spent a decade raising awareness among his colleagues. Enlist a friend or family member to help ensure that doctors and other medical personnel follow these guidelines.

* Ask your doctor to remove invasive devices such as catheters and IV lines as soon as it's safe--they provide a pathway into your body for dangerous bacteria.

* Request the most highly targeted antibiotic if you require one. Remind your doctor to take you off the drug as soon as possible.

* Demand to know more about infection rates. Few states now require hospitals to release this information, so it's next to impossible to "shop around" to avoid particularly risky facilities. That may be changing: New York recently passed a law requiring hospitals to make public their rates of hospital-acquired infection, and a number of other states are considering similar legislation.

Writer Jessica Snyder Sachs is the author of Good Germs, Bad Germs: Health & Survival in a Bacterial World (Hill&Wang/FSG) and Corpse: Nature, Forensics, and the Struggle to Pinpoint Time of Death (Perseus/Basic Books).

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