Self-management of cancer treatment-related fatigue, nausea, vomiting and oral mucositis in Chinese cancer patients

Background: Treatment-related symptoms continue to place a significant burden on many cancer patients. Many side effects require patients to engage in a range of self-management actions. While some studies have explored self-management of treatment-related side effects in Western settings, very few studies were identified that described the self-management practices of cancer patients in China. Objective: The purposes of this study are to: (1) Investigate Chinese cancer patients. self-management behaviours in dealing with the fatigue, nausea/vomiting and oral mucositis that result from treatment, as well as the perceived effectiveness of these behaviours and related self-efficacy in performing them. (2) Explore factors influencing symptom self-management behaviours using the Cancer Symptom Self-management Framework based on Grey, Knafl and McCorkle.s (2006) self-management framework as a guide. Methods: This study was divided into two phases. Phase One consisted of the translation and modification of two instruments. The adaptation of these instruments to ensure applicability in the Chinese context was achieved through semi-structured interviews with six cancer patients, and content evaluation with eight experienced oncology nurses. A pilot study was conducted with nine cancer patients to trial the questionnaire set in the Chinese context. Based on the results of Phase One, Phase Two involved a cross-sectional survey of Chinese cancer patients undergoing cancer treatment using these instruments. A total of 277 chemotherapy patients with fatigue and/or nausea and vomiting, and 100 radiotherapy patients with oral mucositis were surveyed. Results: Participants in this study reported a variety of self-management behaviours to cope with fatigue, nausea, vomiting and oral mucositis. There are some consistencies as well disparities between strategies that are frequently used and those rated as effective. For fatigue self-management, participants were more likely to use strategies related to rest and sleep, while activity enhancement strategies were rated as achieving higher relief. For nausea and vomiting self-management, dietary modification and taking medication were most frequently used and rated as moderately effective. Psychological strategies were used by more than a third of participants and were rated as mildly effective. Some other infrequently used strategies, such as distraction by keeping busy and acupressure, were rated as moderately effective. For oral mucositis self-management, having soft, bland food and keeping the mouth moisturised were most frequently reported and they were rated as achieving moderate relief. A prescribed mouthwash was used by most but not all participants and brought moderate relief. In general, patients had low-to-moderate self-efficacy in nausea and vomiting self-management behaviours, moderate self-efficacy in fatigue self-management behaviours, and low-to-moderate self-efficacy in oral mucositis self-management behaviours. In terms of the factors influencing symptom self-management, different predictors were identified affecting engagement in fatigue, nausea/vomiting and oral mucositis self-management behaviours. Self-efficacy scores of different behaviours were consistently found to be a positive predictor of the relief level from corresponding behaviours, after controlling for other variables. Perceived social support from health care professionals was identified as an important factor influencing nausea and vomiting self-management behaviours, while neighbourhood support was important for fatigue self-management. In addition, symptom distress was identified as an important factor influencing nausea and vomiting self-management. Conclusion: Similar to reports from overseas, Chinese cancer patients initiate a wide range of self-management behaviours in response to treatment-related side effects. While some behaviours were reported to provide relief, many did not. Given these results, this study has a number of practical implications for health care professionals, particularly in relation to developing tailored self-management programs for fatigue, nausea, vomiting and oral mucositis. Additionally, this study suggests a number of theoretical implications and directions for future research. It is envisaged that these recommendations may pave the way for further studies understanding and promoting cancer symptom self-management in Chinese people affected by cancer.

Learning from episodes of degradation and recovery in variable Australian rangelands

Land-change science emphasizes the intimate linkages between the human and environmental components of land management systems. Recent theoretical developments in drylands identify a small set of key principles that can guide the understanding of these linkages. Using these principles, a detailed study of seven major degradation episodes over the past century in Australian grazed rangelands was reanalyzed to show a common set of events: (i) good climatic and economic conditions for a period, leading to local and regional social responses of increasing stocking rates, setting the preconditions for rapid environmental collapse, followed by (ii) a major drought coupled with a fall in the market making destocking financially unattractive, further exacerbating the pressure on the environment; then (iii) permanent or temporary declines in grazing productivity, depending on follow-up seasons coupled again with market and social conditions. The analysis supports recent theoretical developments but shows that the establishment of environmental knowledge that is strictly local may be insufficient on its own for sustainable management. Learning systems based in a wider community are needed that combine local knowledge, formal research, and institutional support. It also illustrates how natural variability in the state of both ecological and social systems can interact to precipitate nonequilibrial change in each other, so that planning cannot be based only on average conditions. Indeed, it is this variability in both environment and social subsystems that hinders the local learning required to prevent collapse.

Investigation of methods for increasing the energy efficiency on unmanned aerial vehicles (UAVS)

In recent years, development of Unmanned Aerial Vehicles (UAV) has become a significant growing segment of the global aviation industry. These vehicles are developed with the intention of operating in regions where the presence of onboard human pilots is either too risky or unnecessary. Their popularity with both the military and civilian sectors have seen the use of UAVs in a diverse range of applications, from reconnaissance and surveillance tasks for the military, to civilian uses such as aid relief and monitoring tasks. Efficient energy utilisation on an UAV is essential to its functioning, often to achieve the operational goals of range, endurance and other specific mission requirements. Due to the limitations of the space available and the mass budget on the UAV, it is often a delicate balance between the onboard energy available (i.e. fuel) and achieving the operational goals. This thesis presents an investigation of methods for increasing the energy efficiency on UAVs. One method is via the development of a Mission Waypoint Optimisation (MWO) procedure for a small fixed-wing UAV, focusing on improving the onboard fuel economy. MWO deals with a pre-specified set of waypoints by modifying the given waypoints within certain limits to achieve its optimisation objectives of minimising/maximising specific parameters. A simulation model of a UAV was developed in the MATLAB Simulink environment, utilising the AeroSim Blockset and the in-built Aerosonde UAV block and its parameters. This simulation model was separately integrated with a multi-objective Evolutionary Algorithm (MOEA) optimiser and a Sequential Quadratic Programming (SQP) solver to perform single-objective and multi-objective optimisation procedures of a set of real-world waypoints in order to minimise the onboard fuel consumption. The results of both procedures show potential in reducing fuel consumption on a UAV in a ight mission. Additionally, a parallel Hybrid-Electric Propulsion System (HEPS) on a small fixedwing UAV incorporating an Ideal Operating Line (IOL) control strategy was developed. An IOL analysis of an Aerosonde engine was performed, and the most efficient (i.e. provides greatest torque output at the least fuel consumption) points of operation for this engine was determined. Simulation models of the components in a HEPS were designed and constructed in the MATLAB Simulink environment. It was demonstrated through simulation that an UAV with the current HEPS configuration was capable of achieving a fuel saving of 6.5%, compared to the ICE-only configuration. These components form the basis for the development of a complete simulation model of a Hybrid-Electric UAV (HEUAV).

Development and validation of novel methods for microbial source tracking based on Escherichia coli as an indicator of water quality

Microbial pollution in water periodically affects human health in Australia, particularly in times of drought and flood. There is an increasing need for the control of waterborn microbial pathogens. Methods, allowing the determination of the origin of faecal contamination in water, are generally referred to as Microbial Source Tracking (MST). Various approaches have been evaluated as indicatorsof microbial pathogens in water samples, including detection of different microorganisms and various host-specific markers. However, until today there have been no universal MST methods that could reliably determine the source (human or animal) of faecal contamination. Therefore, the use of multiple approaches is frequently advised. MST is currently recognised as a research tool, rather than something to be included in routine practices. The main focus of this research was to develop novel and universally applicable methods to meet the demands for MST methods in routine testing of water samples. Escherichia coli was chosen initially as the object organism for our studies as, historically and globally, it is the standard indicator of microbial contamination in water. In this thesis, three approaches are described: single nucleotide polymorphism (SNP) genotyping, clustered regularly interspaced short palindromic repeats (CRISPR) screening using high resolution melt analysis (HRMA) methods and phage detection development based on CRISPR types. The advantage of the combination SNP genotyping and CRISPR genes has been discussed in this study. For the first time, a highly discriminatory single nucleotide polymorphism interrogation of E. coli population was applied to identify the host-specific cluster. Six human and one animal-specific SNP profile were revealed. SNP genotyping was successfully applied in the field investigations of the Coomera watershed, South-East Queensland, Australia. Four human profiles [11], [29], [32] and [45] and animal specific SNP profile [7] were detected in water. Two human-specific profiles [29] and [11] were found to be prevalent in the samples over a time period of years. The rainfall (24 and 72 hours), tide height and time, general land use (rural, suburban), seasons, distance from the river mouth and salinity show a lack of relashionship with the diversity of SNP profiles present in the Coomera watershed (p values > 0.05). Nevertheless, SNP genotyping method is able to identify and distinquish between human- and non-human specific E. coli isolates in water sources within one day. In some samples, only mixed profiles were detected. To further investigate host-specificity in these mixed profiles CRISPR screening protocol was developed, to be used on the set of E. coli, previously analysed for SNP profiles. CRISPR loci, which are the pattern of previous DNA coliphages attacks, were considered to be a promising tool for detecting host-specific markers in E. coli. Spacers in CRISPR loci could also reveal the dynamics of virulence in E. coli as well in other pathogens in water. Despite the fact that host-specificity was not observed in the set of E. coli analysed, CRISPR alleles were shown to be useful in detection of the geographical site of sources. HRMA allows determination of ‘different’ and ‘same’ CRISPR alleles and can be introduced in water monitoring as a cost-effective and rapid method. Overall, we show that the identified human specific SNP profiles [11], [29], [32] and [45] can be useful as marker genotypes globally for identification of human faecal contamination in water. Developed in the current study, the SNP typing approach can be used in water monitoring laboratories as an inexpensive, high-throughput and easy adapted protocol. The unique approach based on E. coli spacers for the search for unknown phage was developed to examine the host-specifity in phage sequences. Preliminary experiments on the recombinant plasmids showed the possibility of using this method for recovering phage sequences. Future studies will determine the host-specificity of DNA phage genotyping as soon as first reliable sequences can be acquired. No doubt, only implication of multiple approaches in MST will allow identification of the character of microbial contamination with higher confidence and readability.

Intention, foresight and ending life : a response to "The Double Effect effect" by Charles Foster, Jonathan Herring, Karen Melham and Tony Hope, (CQ 20(1))

In this paper I examine the recent arguments by Charles Foster, Jonathan Herring, Karen Melham and Tony Hope against the utility of the doctrine of double effect. One basis on which they reject the utility of the doctrine is their claim that it is notoriously difficult to apply what they identify as its 'core' component, namely, the distinction between intention and foresight. It is this contention that is the primarily focus of my article. I argue against this claim that the intention/foresight distinction remains a fundamental part of the law in those jurisdictions where intention remains an element of the offence of murder and that, accordingly, it is essential ro resolve the putative difficulties of applying the intention/foresight distinction so as to ensure the integrity of the law of murder. I argue that the main reasons advanced for the claim that the intention/foresight distinction is difficult to apply are ultimately unsustainable, and that the distinction is not as difficult to apply as the authors suggest.

Points of convergence and divergence : normative, institutional and operational relationships between R2P and POC

As an international norm, the Responsibility to Protect (R2P) has gained substantial influence and institutional presence—and created no small controversy—in the ten years since its first conceptualisation. Conversely, the Protection of Civilians in Armed Conflict (PoC) has a longer pedigree and enjoys a less contested reputation. Yet UN Security Council action in Libya in 2011 has thrown into sharp relief the relationship between the two. UN Security Council Resolutions 1970 and 1973 follow exactly the process envisaged by R2P in response to imminent atrocity crimes, yet the operative paragraphs of the resolutions themselves invoke only PoC. This article argues that, while the agendas of PoC and R2P converge with respect to Security Council action in cases like Libya, outside this narrow context it is important to keep the two norms distinct. Peacekeepers, humanitarian actors, international lawyers, individual states and regional organisations are required to act differently with respect to the separate agendas and contexts covered by R2P and PoC. While overlap between the two does occur in highly visible cases like Libya, neither R2P nor PoC collapses normatively, institutionally or operationally into the other.

Helping undergraduate students across disciplines and cultures actively engage and collaborate as equal members of a community of scholars : peer review within an e-learning environment

At the international level, the higher education sector is currently being subjected to increased calls for public accountability and the current move by the OECD to rank universities based on the quality of their teaching and learning outcomes. At the national level, Australian universities and their teaching staff face numerous challenges including financial restrictions, increasing student numbers and the reality of an increasingly diverse student population. The Australian higher education response to these competing policy and accreditation demands focuses on precise explicit systems and procedures which are inflexible and conservative and which ignore the fact that assessment is the single biggest influence on how students approach their learning. By seriously neglecting the quality of student learning outcomes, assessment tasks are often failing to engage students or reflect the tasks students will face in the world of practice. Innovative assessment design, which includes new paradigms of student engagement and learning and pedagogically based technologies have the capacity to provide some measure of relief from these internal and external tensions by significantly enhancing the learning experience for an increasingly time-poor population of students. That is, the assessment process has the ability to deliver program objectives and active learning through a knowledge transfer process which increases student participation and engagement. This social constructivist view highlights the importance of peer review in assisting students to participate and collaborate as equal members of a community of scholars with both their peers and academic staff members. As a result of increasing the student’s desire to learn, peer review leads to more confident, independent and reflective learners who also become more skilled at making independent judgements of their own and others' work. Within this context, in Case Study One of this project, a summative, peer-assessed, weekly, assessment task was introduced in the first “serious” accounting subject offered as part of an undergraduate degree. The positive outcomes achieved included: student failure rates declined 15%; tutorial participation increased fourfold; tutorial engagement increased six-fold; and there was a 100% student-based approval rating for the retention of the assessment task. However, in stark contrast to the positive student response, staff issues related to the loss of research time associated with the administration of the peer-review process threatened its survival. This paper contributes to the core conference topics of new trends and experiences in undergraduate assessment education and in terms of innovative, on-line, learning and teaching practices, by elaborating the Case Study Two “solution” generated to this dilemma. At the heart of the resolution is an e-Learning, peer-review process conducted in conjunction with the University of Melbourne which seeks to both create a virtual sense of belonging and to efficiently and effectively meet academic learning objectives with minimum staff involvement. In outlining the significant level of success achieved, student-based qualitative and quantitative data will be highlighted along with staff views in a comparative analysis of the advantages and disadvantages to both students and staff of the staff-led, peer review process versus its on-line counterpart.

Rebuilding housing after a disaster : factors for failure

Disasters, particularly those triggered by nature are often followed by a swift humanitarian relief response to address the resultant emergencies. These efforts are then transitioned through the medium recovery stage, eventually aimed at providing a long term post-disaster reconstruction solution. Emergency humanitarian relief focuses on responding to the immediate need for restoration of basic services, medical treatment and medical supplies, food and temporary shelter, and is a short term strenuous effort. Reconstruction of permanent houses, on the other hand, is a continuous process that often requires decades of effort to return a community to normality. Whilst emergency relief is generally perceived to be very effective, post-disaster housing reconstruction projects often fail to meet their set objectives. This paper outlines and discusses factors that contribute to the failure of post-disaster housing reconstruction projects and the subsequent immediate and long term negative impacts of failure on project outcomes.

Documentary as history, memory, dream and film

A century ago, as the Western world embarked on a period of traumatic change, the visual realism of photography and documentary film brought print and radio news to life. The vision that these new mediums threw into stark relief was one of intense social and political upheaval: the birth of modernity fired and tempered in the crucible of the Great War. As millions died in this fiery chamber and the influenza pandemic that followed, lines of empires staggered to their fall, and new geo-political boundaries were scored in the raw, red flesh of Europe. The decade of 1910 to 1919 also heralded a prolific period of artistic experimentation. It marked the beginning of the social and artistic age of modernity and, with it, the nascent beginnings of a new art form: film. We still live in the shadow of this violent, traumatic and fertile age; haunted by the ghosts of Flanders and Gallipoli and its ripples of innovation and creativity. Something happened here, but to understand how and why is not easy; for the documentary images we carry with us in our collective cultural memory have become what Baudrillard refers to as simulacra. Detached from their referents, they have become referents themselves, to underscore other, grand narratives in television and Hollywood films. The personal histories of the individuals they represent so graphically–and their hope, love and loss–are folded into a national story that serves, like war memorials and national holidays, to buttress social myths and values. And, as filmic images cross-pollinate, with each iteration offering a new catharsis, events that must have been terrifying or wondrous are abstracted. In this paper we first discuss this transformation through reference to theories of documentary and memory–this will form a conceptual framework for a subsequent discussion of the short film Anmer. Produced by the first author in 2010, Anmer is a visual essay on documentary, simulacra and the symbolic narratives of history. Its form, structure and aesthetic speak of the confluence of documentary, history, memory and dream. Located in the first decade of the twentieth century, its non-linear narratives of personal tragedy and poetic dreamscapes are an evocative reminder of the distance between intimate experience, grand narratives, and the mythologies of popular films. This transformation of documentary sources not only played out in the processes of the film’s production, but also came to form its theme.

Melbourne on film dossier: 'Ghost Rider'

Despite being set in an unnamed Texan city, Ghost Rider (Mark Steven Johnson, 2007) was a landmark film for Melbourne. It was the first international production to be made at the Central City (now Docklands) Studios, much to the relief of the heavily-invested state government. And it demonstrated to the world (or more importantly, to producers resident in a small part of southern California), that the city was willing and available to be made over and made up to fit even (especially!) the most stupid filmmaking fantasies. Announcing the imminent arrival of the production in October 2004, the Herald Sun boldly predicted that '[c]ity lanes, Telstra Dome and the Yarra River will be the stars of the new action film'. In fact Melbourne is, as the filmmakers intended, (virtually) unidentifiable onscreen. For the Victorian State government, Ausfilm, Film Victoria and the Melbourne Film Office, this lack of specificity was something to be celebrated; a few months before Ghost Rider went in to production, the then State Minister for Innovation, John Brumby, declared that 'it's almost inconceivable that [Ghost Rider] won't put Melbourne on the map internationally'.

Submarine pyroclastic deposits formed during the 20th May 2006 dome collapse of the Soufrière Hills Volcano, Montserrat

The 20th May 2006 lava dome collapse of the Soufrière Hills Volcano, Montserrat, had a total non-dense rock equivalent (non-DRE) collapse volume of approximately 115 × 10 6 m 3. The majority of this volume was deposited into the ocean. The collapse was rapid, 85% of the mobilized volume being removed in just 35 min, giving peak pyroclastic flow flux of 66 × 10 3 m 3 s -1. Channel and levee facies on the submarine flanks of the volcano and formation of a thick, steep-sided ridge, suggest that the largest and most dense blocks were transported proximally as a high concentration granular flow. Of the submerged volume, 30% was deposited from the base of this granular flow, forming a linear, high-relief ridge that extends 7 km from shore. The remaining 70% of the submerged volume comprises the finer grain sizes, which were transported at least 40 km by turbidity currents on gradients of <2°. At several localities, the May 2006 distal turbidity currents ran up 200 m of topography and eroded up to 20 cm of underlying substrate. Multiple turbidites are preserved, representing current reflection from the graben margins and deflection around topography. The high energy of the May 2006 collapse resulted in longer submarine run out than the larger (210 × 10 6 m 3) Soufrière Hills dome collapse in July 2003.

How important is length? : mechanical testing and measurement of a cemented, polished, tapered femoral implant

Total hip arthroplasty (THA) has a proven clinical record for providing pain relief and return of function to patients with disabling arthritis. There are many successful options for femoral implant design and fixation. Cemented, polished, tapered femoral implants have been shown to have excellent results in national joint registries and long-term clinical series. These implants are usually 150mm long at their lateral aspect. Due to their length, these implants cannot always be offered to patients due to variations in femoral anatomy. Polished, tapered implants as short as 95mm exist, however their small proximal geometry (neck offset and body size) limit their use to smaller stature patients. There is a group of patients in which a shorter implant with a maintained proximal body size would be advantageous. There are also potential benefits to a shorter implant in standard patient populations such as reduced bone removal due to reduced reaming, favourable loading of the proximal femur, and the ability to revise into good proximal bone stock if required. These factors potentially make a shorter implant an option for all patient populations. The role of implant length in determining the stability of a cemented, polished, tapered femoral implant is not well defined by the literature. Before changes in implant design can be made, a better understanding of the role of each region in determining performance is required. The aim of the thesis was to describe how implant length affects the stability of a cemented, polished, tapered femoral implant. This has been determined through an extensive body of laboratory testing. The major findings are that for a given proximal body size, a reduction in implant length has no effect on the torsional stability of a polished, tapered design, while a small reduction in axial stability should be expected. These findings are important because the literature suggests that torsional stability is the major determinant of long-term clinical performance of a THA system. Furthermore, a polished, tapered design is known to be forgiving of cement-implant interface micromotion due to the favourable wear characteristics. Together these findings suggest that a shorter polished, tapered implant may be well tolerated. The effect of a change in implant length on the geometric characteristics of polished, tapered design were also determined and applied to the mechanical testing. Importantly, interface area does play a role in stability of the system; however it is the distribution of the interface and not the magnitude of the area that defines stability. Taper angle (at least in the range of angles seen in this work) was shown not to be a determinant of axial or torsional stability. A range of implants were tested, comparing variations in length, neck offset and indication (primary versus cement-in-cement revision). At their manufactured length, the 125mm implants were similar to their longer 150mm counterparts suggesting that they may be similarly well tolerated in the clinical environment. However, the slimmer cement-in-cement revision implant was shown to have a poorer mechanical performance, suggesting their use in higher demand patients may be hazardous. An implant length of 125mm has been shown to be quite stable and the results suggest that a further reduction to 100mm may be tolerated. However, further work is required. A shorter implant with maintained proximal body size would be useful for the group of patients who are unable to access the current standard length implants due to variations in femoral anatomy. Extending the findings further, the similar function with potential benefits of a shorter implant make their application to all patients appealing.

From 'what' to 'how' : capacity building in health promotion for HIV/AIDS prevention in the Solomon Islands

This paper describes a capacity building process undertaken within the HIV/AIDS prevention project of the Adventist Development and Relief Agency (ADRA) in the Solomon Islands. ADRA HIV/AIDS has recently reoriented its project structure, moving beyond its awareness raising approach to incorporate health promotion frameworks, theories, strategies and assumptions. These have been used to inform project practice in project planning, delivery and evaluation. This paper shares what has worked and not worked in the capacity building process, including a project evaluation of the initial HIV/AIDS awareness raising project and the application of a number of capacity building strategies, including utilising a volunteer Australian Youth Ambassador for Development (AYAD) funded by the Australian Agency for International Development (AusAID). Existing and new projects are outlined. The underlying theme is that any capacity building exercise must include structural support (e.g. management, national frameworks) to ensure the incorporation of new initiatives and approaches. With time this enables ownership by counterparts and external partnerships to develop. The presence of an AYAD volunteer has been an effective strategy to achieve this. Reflections from the evaluators, the AYAD volunteer and the HIV/AIDS team are included.

Agronomic and economic evaluation of irrigation strategies on cotton lint yield in Australia

Cotton is one of the most important irrigated crops in subtropical Australia. In recent years, cotton production has been severely affected by the worst drought in recorded history, with the 2007–08 growing season recording the lowest average cotton yield in 30 years. The use of a crop simulation model to simulate the long-term temporal distribution of cotton yields under different levels of irrigation and the marginal value for each unit of water applied is important in determining the economic feasibility of current irrigation practices. The objectives of this study were to: (i) evaluate the CROPGRO-Cotton simulation model for studying crop growth under deficit irrigation scenarios across ten locations in New South Wales (NSW) and Queensland (Qld); (ii) evaluate agronomic and economic responses to water inputs across the ten locations; and (iii) determine the economically optimal irrigation level. The CROPGRO-Cotton simulation model was evaluated using 2 years of experimental data collected at Kingsthorpe, Qld. The model was further evaluated using data from nine locations between northern NSW and southern Qld. Long-term simulations were based on the prevalent furrowirrigation practice of refilling the soil profile when the plant -available soil water content is<50%. The model closely estimated lint yield for all locations evaluated. Our results showed that the amounts of water needed to maximise profit and maximise yield are different, which has economic and environmental implications. Irrigation needed to maximise profits varied with both agronomic and economic factors, which can be quite variable with season and location. Therefore, better tools and information that consider the agronomic and economic implications of irrigation decisions need to be developed and made available to growers.

Sustainable water provision : challenges, alternative strategies and sources in the ERA of climate change

As a result of rapid urbanisation, population growth, changes in lifestyle, pollution and the impacts of climate change, water provision has become a critical challenge for planners and policy-makers. In the wake of increasingly difficult water provision and drought, the notion that freshwater is a finite and vulnerable resource is increasingly being realised. Many city administrations around the world are struggling to provide water security for their residents to maintain lifestyle and economic growth. This chapter reviews the global challenge of providing freshwater to sustain lifestyles and economic growth, and the contributing challenges of climate change, urbanisation, population growth and problems in rainfall distribution. The chapter proceeds to evaluate major alternatives to current water sources such as conservation, recycling and reclamation, and desalination. Integrated water resource management is briefly looked at to explore its role in complementing water provision. A comparative study on alternative resources is undertaken to evaluate their strengths, weaknesses, opportunities and constraints, and the results are discussed.