Kristen E Downs

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The purpose of this study is to estimate the level of healthcare use and costs incurred by postmenopausal women overall and for these selected conditions: cardiovascular disease, osteoporosis, breast cancer, and gynecological cancers. National healthcare survey and discharge data were used to estimate healthcare use by women aged 45 and older. Clinical(More)
OBJECTIVES The aim of this study was to describe the current issues surrounding Coverage with Evidence Development (CED). CED is characterized by restricted coverage for a new technology in parallel with targeted research when the stated goal of the research or data collection is to provide definitive evidence for the clinical or cost-effectiveness impact(More)
Currently, one of every 13 U.S. residents is foreign born. A 1991 survey of certified nurse-midwives (CNMs) indicated that 51% of the respondents serve immigrant women. Using a case study approach, this article illustrates barriers to health care experienced by foreign-born women and demonstrates how cultural competence increases provider effectiveness in(More)
OBJECTIVE The objective of this study was to describe health-related productivity losses in nonsmokers, former smokers, and current smokers using a large, cross-sectional database of U.S. employees. METHODS Volunteers completed the Wellness Inventory, an instrument measuring productivity losses related to 11 health conditions affecting employee health.(More)
Evidence suggests that migraine is associated with decreased productivity. This article describes the results of a systematic literature review of peer-reviewed publications that measured the impact of migraine on workplace productivity in the United States and provides recommendations for future research. A MEDLINE search was conducted from January 1, 1990(More)
OBJECTIVE To collect workplace productivity and healthcare utilization data from subjects with bipolar I disorder and compare the results with those from normative subjects. METHODS A cross sectional survey was administered to patients and recruiting physicians. Data collected included employment status, Endicott Workplace Productivity Scale (EWPS)(More)
The terms sustainability, scaling up, and enabling environment are inconsistently used in implementing water supply projects. To clarify these terms we develop a framework based on Normalization Process Theory, and apply the framework to a hypothetical water supply project in schools. The resulting framework provides guidance on how these terms could be(More)
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