Preventive medicine
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Preventive medicine · Feb 2023
Case ReportsAppraisal of Kenya's excisable goods management system using interrupted time series analysis: A case of cigarettes and cigars excise tax revenue.
The government of Kenya introduced the Excisable Goods Management System (EGMS) in November 2013, which is a form of Track and Trace Systems (TTSs) for excisable goods, including cigarettes and cigars. This study appraised the EGMS with a focus on its impact on cigarette and cigars excise tax revenue and possibly control of related illicit trade in Kenya. Illicit trade in cigarettes and cigars pose significant health risks owing to increased access to tobacco products, besides contributing to loss of government revenues. ⋯ The results show that the difference between the pre-intervention and post-intervention slopes of the real excise tax revenue was positive and statistically significant, suggesting a change in excise tax revenue trends. The hypothesis of an immediate level change in excise tax revenue was however not supported, possibly due to the initial implementation challenges that dampened a 'jump' in real excise tax revenue. These findings suggest that TTSs need to be complemented by sustained efforts to achieve maximum compliance levels and impact in both the short term and the long term.
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Preventive medicine · Feb 2023
Concurrent participation in breast, cervical, and colorectal cancer screening programmes in Denmark: A nationwide registry-based study.
Women in Denmark are invited to breast, cervical, and colorectal cancer screening in their fifties and sixties. We determined the patterns of concurrent participation in the three programmes. Participation in organised cancer screening was determined using the highly complete Danish population and health care registers for all women aged 53-65 years on 31 March 2018 who continuously resided in Denmark since 1 April 2012. ⋯ Cancer-specific patterns were highly heterogeneous across the population but changed little after accounting for women's medical history. A significant proportion of women who are screened for a specific cancer remain unscreened for other cancers. The consistency of these data at the international level requires a reconsideration of invitational practices for organised screening.
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The concept of well-being offers researchers an alternative to understanding inequality and poverty primarily through income and consumption, and recent research has emphasized the importance of examining well-being inequality. Food insecurity has been identified as an important driver of average levels of well-being; in this paper, we show it also predicts changes in the distribution of well-being. We use individual-level data from the Gallup World Poll for 135 countries between 2014 and 2017 (N = 446,741) and apply a flexible moments-based approach. ⋯ Findings indicate that higher food insecurity is associated with higher inequality in well-being in middle- and high-income countries, but not in low-income countries. We also find that being severely food insecure correlates with peoples' well-being inequality in every income group. Understanding disparities in peoples' lives offers important, policy-relevant information that cannot be inferred from mean values alone and offers important insights to achieve SDG Goals 2 and 3 for all people.
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Preventive medicine · Jan 2023
Digital screen time and suicidality during high school: How important is cyberbullying? A mediation analysis using the youth risk behavioral surveillance survey, 2011-2019.
Elevated digital screen time (i.e., 2+ hours per day) is associated with suicidal ideations, planning, and attempts during adolescence. Recent studies suggest quality, rather than duration, of digital screen time is most impactful on adolescent mental health. We investigate the role of cyberbullying victimization on the relationship between elevated digital screen time and risk factors for completed suicide. ⋯ Similar mediating effects were observed in models stratified by sex. Findings reinforce prior research demonstrating that the quality of leisure, digital media strongly influences the relationship between digital screen time and mental health during adolescence. Findings need replication via longitudinal designs.