922 resultados para Policy evaluation
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OBJECTIVE: To evaluate the current use of Australian Type 2 Diabetes Risk Assessment Tool (AUSDRISK) as a screening tool to identify individuals at high risk of developing type 2 diabetes for entry into lifestyle modification programs.
RESEARCH DESIGN AND METHODS: AUSDRISK scores were calculated from participants aged 40-74 years in the Greater Green Triangle Risk Factor Study, a cross-sectional population survey in 3 regions of Southwest Victoria, Australia, 2004-2006. Biomedical profiles of AUSDRISK risk categories were determined along with estimates of the Victorian population included at various cut-off scores. Sensitivity, specificity, positive predictive value (PPV), negative predictive value, and receiver operating characteristics were calculated for AUSDRISK in determining fasting plasma glucose (FPG) ≥6.1 mmol/L.
RESULTS: Increasing AUSDRISK scores were associated with an increase in weight, body mass index, FPG, and metabolic syndrome. Increasing the minimum cut-off score also increased the proportion of individuals who were obese and centrally obese, had impaired fasting glucose (IFG) and metabolic syndrome. An AUSDRISK score of ≥12 was estimated to include 39.5% of the Victorian population aged 40-74 (916 000), while a score of ≥20 would include only 5.2% of the same population (120 000). At AUSDRISK≥20, the PPV for detecting FPG≥6.1 mmol/L was 28.4%.
CONCLUSIONS: AUSDRISK is powered to predict those with IFG and undiagnosed type 2 diabetes, but its effectiveness as the sole determinant for entry into a lifestyle modification program is questionable given the large proportion of the population screened-in using the current minimum cut-off of ≥12. AUSDRISK should be used in conjunction with oral glucose tolerance testing, fasting glucose, or glycated hemoglobin to identify those individuals at highest risk of progression to type 2 diabetes, who should be the primary targets for lifestyle modification.
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Includes bibliography
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Includes bibliography
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Politicians, social scientists and general readers have noted in both Cuban and international academic forums and periodicals that the well-being enjoyed by the Cuban people in the 1980s has been seriously compromised since the economic crisis of the 1990s. Even for the most skeptical of observers it is clear that this worsening of conditions can be attributed not only to external factors, such as the breakup of the international socialist system, the tightening of the US blockade, and the worldwide economic crisis suffered by underdeveloped countries, but also to internal factors that have kept the country from taking full advantage of the human and material potential available on the island. Although Cuba is currently experiencing an economic recovery from the collapse in GDP in the mid 1990s following the collapse of its ties with the Socialist Bloc, it continues to maintain high import coefficients due to longstanding structural.
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Utah lacks a NEPA-equivalent environmental law for state funded projects. UDOT policies provide guidance on complying with NEPA but not on environmental reviews of state funded transportation projects. These projects are either not evaluated for impacts or are evaluated without a formal process, resulting in inconsistent and inadequate consideration of resources and project alternatives, with limited public involvement. This capstone provides a standard policy for UDOT. The policy incorporates elements from other state DOT polices and is based on federal NEPA, CEQ regulations, FHWA technical guidance, and existing UDOT procedures. Implementation will ensure consideration of project impacts to resources, analysis of project alternatives, encourage meaningful public involvement, and improve interagency coordination.
