Development, population growth and climate change have pressurized water stress in the world. Being an urbanized coastal city, Hong Kong has adopted a dual water supply system since the 1950s for seawater toilet flushing for 80% of its 7 million inhabitants. Despite its success in saving 750,000 m(3)/day of freshwater, the saline sewage (consisting of about 20-30% of seawater) appears to have sacrificed the urban water cycle in terms of wastewater reuse and recycling. Can seawater toilet flushing be applied without affecting the urban water cycle with respect to sustainable water resource management? To address this issue, we examined the entire urban water cycle and developed an innovative water resource management system by integrating freshwater, seawater and reclaimed grey water into a sustainable, low-freshwater demand, low-energy consumption, and low-cost triple water supply (TWS) system. The applicability of this novel system has been demonstrated at the Hong Kong International Airport which reduced 52% of its freshwater demand.

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Purpose: Phantom limb syndrome (PLSd) is a frequent chronic complication post amputation and is difficult to manage with conventional medicine. Acupuncture has been shown to be effective in the management of other chronic pain conditions but little is known about the effectiveness of acupuncture for the management of PLSd. The study is nested in a larger study evaluating the feasibility of acupuncture for treating PLSd and aimed to explore the experience of PLSd and establish the acceptability of acupuncture intervention to treat PLSd.Methods: Study design comprised of a case study approach using multiple cases. One off semi-structured interviews were conducted with a purposive sample of 15 lower limb amputees 1-3 months post-surgery, with past or current experience of PLSd. Interviews explored participants' experience of PLSd and perceived acceptability of acupuncture intervention. Framework analysis was used to analyse data.Results: 6 key themes were identified during analysis; suffering (prior to amputation), acceptance and coping with the loss of a limb, real and physical phantoms, living with a phantom, being informed about PLSd, acupuncture acceptability. Additionally, outcome measures for the feasibility study were substantiated for ease of completion and relevance. Acupuncture was generally considered an acceptable intervention regardless of positive or negative past experience and few concerns were expressed. Local needling of the residual limb was considered acceptable. PLSd was perceived as a real and physical pain and participants used numerous and often metaphorical descriptions. PLSd frequently disrupted sleep and negatively affected wellbeing and mood.Conclusion: The study contributes to existing evidence exploring the experience of PLSd and identified that PLSd is a bothersome and annoying condition which affects quality of life. Findings suggest that amputees suffering from PLSd would be willing to try a complementary medicine (acupuncture) approach to help manage this condition.Contact: Esme Trevelyan, trevelye@lsbu.ac.uk / Nicola Robinson, nicky.robinson@lsbu.ac.uk http://dx.