Bibliometric trends of South African environmental health articles between 1998 and 2015: Making local research visible and retrievable

Background. South Africa (SA) has to grapple with multiple burdens of disease for which environmental factors have a role to play in both causation and prevention. This article describes a bibliometric review of environmental health indexed literature for SA over an 18-year period.Objectives. To provide an overview of the nature of SA-based published environmental health indexed research and to identify search challenges, frequently researched topics, and gaps and opportunities for future research.Methods. The Web of Science, PubMed and Science Direct were used to search for original, peer-reviewed and review articles with the inclusion criteria 'environmental health' and 'South Africa' available online and published between 1998 and 2015, inclusively.Results. A total of 230 journal articles were included in the bibliometric analysis. The highest number of articles (n=54) was published in 2015. The majority of the first authors were affiliated with SA institutions (n=160, 69.5%). For the articles where funding was explicitly declared (n=148), the three most frequently occurring agencies that funded the published research were the National Research Foundation in SA (n=17), the South African Medical Research Council (n=13) and the Water Research Commission (n=9). There was little inter-annual/environmental health category variation over time owing to the relatively small sample size. The largest number of retrieved journal articles was in the area of environmental pollution control (n=76), followed by environmental health lifestyle and behaviour-related topics (n=42) and then water monitoring (n=26).Conclusions. Despite the research needed to solve large environmental health challenges in SA, environmental health was only used as a keyword in title, author keywords or abstract for 230 SA-based studies over an 18-year period. This makes it extremely difficult for environmental health research to be located and used to inform the profession as well as the research agenda. Several issues that environmental health practitioners are typically tasked to implement and monitor are not indexed as environmental health topics. The need for authors to use 'environmental health' as a keyword is emphasised, particularly if research is to inform decision-making and policy support, as well as guide future research in the country

The influence of HIV infection on the age dependence of squamous cell carcinoma of the skin in South Africa

Background. Cancer incidence typically increases with age, but it is not known whether ethnic characteristics influence the age dependence of squamous cell carcinoma of the skin (SCC).Objectives. (i) To determine the age dependence of SCC in the black African, coloured and white population groups of South Africa (SA); and (ii) to show whether any differences in the rate of change of age dependence could be influenced by diversity in behaviour and lifestyle, especially with regard to the prevalence of HIV infection, rather than by a fundamental variation in cancer biology between the populations.Methods. Linear regression analysis was applied to the logarithm of the age-specific incidence rates for SCC v. the logarithm of age between 35 and 74 years. The slopes of the regression (age exponent) were compared for each subset of gender, population group and year of diagnosis (between 2000 and 2010).Results. The most notable feature was the low value of the age exponent in both male and female black African compared with the white and coloured populations. This finding could be explained in part by the difference in the prevalence of HIV infection in the black African population group compared with the white and coloured population groups.Conclusions. The prevalence of HIV infection in black Africans in SA tends to decrease the apparent age component in SCC compared with the white and coloured population groups. Other factors relating to lifestyle and behaviour that differ between the population groups are also likely to influence the age component in SCC

Compliance to Supervised and Home Based Diet and Exercise Weight Loss Programmes for Overweight Women with Breast Cancer Related Lymphoedema.

Background: Weight loss can improve breast cancer related lymphoedema [BCRL] (Shaw et al. [1]), but is not routinely advised in clinical practice which just involves standard arm mobility exercises. We are determining whether supervised or home based diet and exercise weight loss programmes are effective for reducing weight and lymphoedema in a feasibility study This abstract presents preliminary data on compliance to the weight loss interventions. Aims: To evaluate change in weight, body fat, waist circumference, dietary intake and physical activity in breast cancer survivors’ with lymphoedema who were randomised to either a 12 week supervised or home based diet and exercise weight loss programme or two comparison groups.Methods: Ethical approval was granted by North West 10 Research Ethics Committee – Greater Manchester North 11/H1011/2 .Fifty seven overweight breast cancer survivors’ with lymphoedema were randomly assigned: Supervised group, diet and exercise weight loss advice delivered during weekly sessions at the research facility (n= 12); Home- based group, diet and exercise weight loss advice via fortnightly phone calls and tailored mailings (n=16); Comparison group 1, arm mobility and standard written weight loss advice group (n=12); Comparison group 2, arm mobility advice only group who did not receive any weight loss advice (n= 17). Data Analysis: Weight and body fat, measured via DXA and waist circumference were assessed at baseline and 12 weeks. Seven day diet and physical activity diaries were analysed for changes in energy intake and cardiovascular activity. Changes in variables apply last observation carried forward analysis. There were no planned statistical analyses in this feasibility study. Results: Four participants from the home- based diet + exercise group and four from comparison group 2 dropped out of the study. The supervised and home based groups had numerically greater reductions in body weight and body fat than the comparison groups. Changes in body fat and waist circumference represent real reductions in general and central adiposity, which are independent of any changes in weight and body water which may occur in patients with lymphoedema. Discussion: The successful reductions in body weight and fat with the two lifestyle interventions show it is possible to reduce adiposity in overweight women with BCRL. Conclusion: Further analysis from this pilot trial will assess changes in lymphoedema between the groups. The longer term adherence and success of the home based and supervised interventions would need to be tested in a larger randomised trial.

Sexual and Menstrual Pratices : Risk for Cervix Cancer

Cervix cancer is the cancer that causes most female deaths in South Africa. Little is known about the sexual and menstrual practices in high-risk communities in South Africa. Knowledge of the risks inherent in these practices might lead to changed behaviour. The purpose of this study was to investigate if there are inherent risk factors for cervix cancer in the Black women's sexual and menstrual practices that could result in an increased incidence to provide an evidence base for future interventions. The design of the study was an exploratory; descriptive; contextual; quantitative survey. The context of the study was two urban areas in the Tshwane Metropolis. The target population was women from the age of 18 years in Ga-Rankuwa and Soshanguve extension 12. The sampling method used was convenient sampling (n = 279). A structured interview was conducted due to the high rate of illiteracy found amongst the women. The data were summarised using descriptive statistics. The results of the study highlight several risks that could increase the women's chance to develop cervix cancer. The identified risks are inherent in their socio-economic situation; knowledge and awareness of cervix cancer; and practices during menstruation