Biomedical subjects

Silvana K Zavala

Publications and source records attributed to Silvana K Zavala.

3 recordsLinked to original sources

PubMed2005

Guidelines and challenges for estimating the economic costs and benefits of adolescent substance abuse treatments.

Many economic evaluations have been conducted for adult substance abuse treatments, but only a few have been conducted for adolescent-specific treatments. This is the first article to present rigorous methodological guidelines for estimating the economic costs and benefits of adolescent substance abuse treatments while also addressing the potential challenges associated with such research activities. A representative case study of two adolescent substance abuse treatment programs (one residential and one outpatient) is presented to show some of the initial steps of a comprehensive economic evaluation (e.g., cost analyses, selection of treatment outcome measures, and valuation of outcome measures via monetary conversion factors). Cost data were collected and analyzed using the Drug Abuse Treatment Cost Analysis Program. Monetary conversion factors were obtained and presented for a variety of treatment outcomes. The methodological guidelines, discussion of analytic challenges, and recommendations set forth in this article provide a foundation for future economic studies on adolescent substance abuse treatments.

Adolescent↗

PubMed2003

Dangerous to your health: the role of chronic drug use in serious injuries and trauma.

OBJECTIVES: This study estimated the differential risks of serious injury or trauma for a community-based sample of chronic drug users (CDUs; n = 926) and a matched group of nondrug users (NDUs; n = 553). The study also estimated whether CDUs and NDUs differed in their utilization of health care services for serious injury or trauma. MATERIALS AND METHODS: Data were collected in 1996 and 1997 through community outreach activities in Miami-Dade County, Florida. The analysis estimated the effects of drug use on (1) any lifetime serious injury or trauma, (2) any serious injury or trauma during the past 12 months, and (3) utilization of health care services for serious injury or trauma. All analyses were gender specific and the models were also estimated with a measure of problematic alcohol use in addition to CDU. To examine the potential endogeneity of drug use, various specification tests were conducted. RESULTS: For females, CDUs experienced significantly more serious injury, trauma, or both (both lifetime and past year) than nonusers. Drug use status was not a significant predictor of serious injury or trauma (lifetime and past year) for males. Regardless of gender, conditional on experiencing any serious injury or trauma during the past year, CDUs and NDUs did not differ in their utilization of health care services. Various statistical tests determined that CDU was exogenous in all specifications and the findings were largely unchanged when problematic alcohol use was included in the models. CONCLUSIONS: The elevated risk for serious injury or trauma for female CDUs renders these persons vulnerable to severe medical problems. Specific training in substance abuse issues may be necessary if health care providers are to identify, engage, knowledgeably serve, and refer CDUs for appropriate services.

Adult↗

PubMed2002

Decision latitude and workload demand: implications for full and partial absenteeism.

This research examined the relative importance of two components of job stress--decision latitude and workload demand--on employee absenteeism. The analysis was based on confidential self-reported data from employees at two worksites, which were collected in three independent cross-sections beginning in 1995. The negative binomial technique was used to estimate the effects of decision latitude and workload demand on employee attendance, while controlling for employee demographics and other workplace characteristics. Estimation results show that high decision latitude was negatively and significantly related to number of full days absent from work (full absenteeism) and number of days arriving late to work or leaving work early (partial absenteeism). Conversely, the coefficient estimates for low decision latitude were positive in every model and significantly related to partial absenteeism. Low workload demand was negatively and significantly related to partial absenteeism, but not full days absent. The interaction effects of decision latitude and workload demand on absenteeism were not statistically significant. Several recent studies have estimated a significant relationship between decision latitude, workload demand, and medical problems such as cardiovascular disease. The current findings suggest that decision latitude and workload demand are also related to workplace attendance. Employers and occupational hygienists should consider decision latitude and workload demand as a means to improve workplace productivity and employee health.

Absenteeism↗