Water is a critical resource necessary to support social and economic development. Economic growth and, in particular, the growth of urban and peri-urban areas, however results in declining water quality which threatens water-dependent industries. In developing countries this is a particular concern due to the rapid rate of urbanisation and the limited financial resources and technical capabilities to adequately maintain and upgrade wastewater treatment works. This is particularly relevant in catchments with a high dependence on export-orientated agriculture. This study considered water quality risks in the Breede River catchment as an area which experiences significant urban and peri-urban growth, focusing on economic risks associated with declining water quality, estimates of the costs needed to rehabilitate existing wastewater treatment works, and alternative strategies such as the use of artificial wetlands, the rehabilitation and protection of natural wetlands, as well as the clearing of invasive alien plants. A major conclusion is that the financial risk associated with a declining economy and social instability outweighs the costs that will be needed for rehabilitation of existing treatment plants. Together with more pronounced fluctuations in precipitation anticipated with climate change, these risks due to declining water quality are likely to increase in future with continued urban and peri-urban growth.

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Context: To aid prioritisation of funding for stroke research, a Stroke Priority Setting Partnership is being conducted in the UK by The Stroke Association using surveys and workshops with stroke survivors, stroke carers and health professionals. Another valuable source of information about topics that require research is the social media platform Twitter. Objective: To ascertain common topics of discussion in relation to stroke recovery on Twitter amongst stroke survivors, their carers, and the general public. Study design and analysis: Content analysis of public posts on Twitter. Dataset: An electronic search of Twitter was performed to analyse the content of two major stroke discussion tags: #strokesurvivor and #strokerecovery. Tweets were collected using NCapture, an open-source extension for the internet browser Chrome. Tweets spanning 5 weeks over the course of January to February 2021 were analysed. Population studied: Tweets made by stroke survivors and their carers or other interested members of the public were included and those made by health professionals or organisations (e.g. charities or health care providers) were excluded. All tweets were fully anonymised and edited where necessary to omit any identifying information. Outcome measures: The content of each tweet was analysed thematically using NVIVO, with tweets being coded by their content and sentiment to identify trends in discussion. Results: 486 tweets were analysed following the removal of duplicate and unrelated material. From these, 6 themes were identified: motivation & positivity; raising of stroke awareness; experience of the stroke rehabilitation process; symptomatic aspects of stroke recovery; sharing of stroke-related resources; and concerns about COVID-19. Conclusions: Twitter's role as a space for peersupport and motivation amongst survivors was evident, as was its potential for promoting awareness of stroke and its sequalae to the public. Amongst the most prominent aspects of recovery discussed was the psychological impact of stroke, with users expressing difficulty in addressing the emotional sequalae in comparison to the physical aspects. This may be addressed by targeted funding of mental health services, and recognition of the specialised needs of stroke survivors. It is hoped that the findings of this project will be useful in guiding the apportioning of funding, as well as complementing the findings of the James Lind Alliance's Priority Setting Partnership.