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A typical problem facing engineers when designing infrastructure to serve future demands is that those future demands are unknown, or at best uncertain. With respect to water supply systems, not only are future demands uncertain, so are the supplies that will be available to meet those demands. Traditionally engineers have based their design capacity estimates based in part on the statistical characteristics of past hydrological records. Today we recognize we can no longer make such assumptions. The past does not necessarily reflect what will happen in the future given the impacts of changes in climate and land cover and use. These changes together with changes in human populations, their age and spatial distributions, their standards of living, and their activities alter the demand for water along with the spatial and temporal distributions and amounts of runoff. Hence we face both demand and supply uncertainty where even the probability distributions of those possible values are unknown. Whatever those distributions will be, increased variability of supply is almost certain, and this in turn strengthens the argument for increased infrastructure capacities in advance of when they are needed. Some of this infrastructure, such as reservoirs and major water supply diversions, will be designed to last for the next 100 years or longer. The capacities of such projects are not easily expanded or reduced as the changes in stochastic nature of demand requirements and available supplies become more certain. One cannot monitor and then alter capacities accordingly in some adaptive framework as might be possible with respect to operating policies. How do we decide what capacities to build now that will affect our ability to serve those living in the next 100 years or so? Do we just apply engineering ‘safety factors’? This paper attempts to address this question.

A delayed cutaneous response to cold, characterized by areas of erythematous, edematous deep swelling at 9 to 18 hr after experimental ice challenge, was recognized in a 10-yr-old boy and several members of his family. Biopsy of the cold-induced lesion showed edema and an infiltrate of mononuclear cells; mast cells were normal, and immunoglobulins, complement factors, and fibrin were not detected by immunofluorescence techniques. Local cold challenge did not release histamine or induce alterations in the complement system or the enzymes, histaminase, and histamine methyl transferase. The delayed cutaneous response to cold could not be passively transferred with serum or tissue extracts to monkey skin. Family studies suggested an autosomal-dominant mode of inheritance.

This study evaluates an intervention program designed to reduce suicidal, self-destructive behavior among high-risk adolescents aged 13- to 17 years. The intervention combined a program of community education and direct service to youth who had required emergency care for self-inflicted injuries. The intervention program was effective in increasing subjects' compliance with medical regimen. To a lesser degree, the intervention also facilitated early help seeking among adolescents with suicidal thoughts and appeared to diminish slightly the overall occurrence of emergency room admissions for suicidal behaviors. However, the intervention program had no demonstrable effect on the occurrence of repeat suicidal episodes.

This article reviews use and depression in adolescents and explores the thesis that depressed mood and deviant actions represent deviant modes of coping and are the result of failed efforts to handle different and sometimes overlapping constitutional and social risk factors. Theories of drug use and depression and various studies in support of the theoretical framework are examined. Implications are suggested for public health interventions and clinical management as derived from the theoretic background and empiric evidence. Also provided are guidelines for assessment and intervention that can be useful for primary care physicians and other professionals working with troubled teenagers.

We report a case of an adolescent female with apparent agenesis of the uterus with chromosomally competent ovarian dysgenesis. In our case, the apparent absence of the uterus on the laparoscopy constituted a severe hypoplasia of the organ prior to estrogen stimulation, rather than aplasia. Following a year of estrogen/progesterone replacement, an infantile but otherwise normal uterus could be demonstrated by hysterosalpinogogram. In gonadal dysgenesis, therefore, it is not possible to differentiate the absence of the uterus from severe hypoplasia using laparoscopy.

Many myths exist concerning the needs and problems confronting adolescent fathers. Research on adolescent pregnancy has proliferated in the last decade. We now have a substantial body of empirically-based findings in this area. Unfortunately, few substantive findings are available on adolescent fathers, yet the magnitude of this problem has reached epidemic proportion. This article will provide an overview of current research on adolescent fathers and their needs and offer suggestions for appropriate intervention.An overview of current findings on and suggestions for appropriate intervention for adolescent fathers are discussed. Topics are identified as follows: adolescent pregnancy and demographic factors; adolescent fathers and sexuality ad contraception, attitudes toward abortion, psychological correlates, the role of and commitments and concerns, competency in parenting, infant development, problems, and needs; and needs for research and services. Adolescent fathers are trapped by low levels of educational attainment and family instability. Judgmental behavior of families, schools, and providers is a further hindrance. Minorities are prominently involved and their futures are not promising. In order to strengthen the role and position of minority men within the family, the community, and society, strategies need to be developed that must involve family members, peers, health care services, schools, and organizations such as the Urban League, Planned Parenthood, and churches. Important components of programs are the teaching and modeling of responsibility along with sustaining group identity. Research needs to be conducted to go beyond the limitations of prior studies which 1) are based on small, biased samples recruited through pregnant or parenting females, 2) are cross-sectional observations of social and psychological factors of only teen fathers in a crisis situation, and 3) lack standardized measurement of the social and behavioral characteristics. Suggested future research should emphasize studies 1) with a longitudinal format and adequate samples that have predictive value; 2) of sexual attitudes, contraceptive knowledge, and behavior; 3) of adolescent couples and contraceptive intentions; 4) of gender differences in parenting and responsibility; 5) of what constitutes competent functioning for the teenage male; 6) of the role and influence of parents in the adolescent decision to continue or not to continue the pregnancy; and 7) of the nature and extent of father and infant play which facilitates infant development. Since males receive most of their sexual and contraceptive information from schools and the media, schools adopt curricula on family planning and sexuality. comprehensive health care services and evaluation should be provided by schools in a manner that supports abstention and contraception. Service programs need to involve males in prenatal and parenting classes, and maternity wards must meet adolescent fathers' needs in basic caretaking. Infant development and caretaking training classes in some school or other location need to involve adolescent males. Paternity leave is a must.