Hallinto-oikeuksien suorituskyvynmittauksen ja tavoiteasetannan kehittämismahdollisuudet

Suomen hallintotuomioistuinten mittaristotyöryhmä on laatinut oikeusasioiden hallintaa parantavan käsittelyn viivästymisestä varoittavan hälytysjärjestelmän sekä luokitellut asiat työmäärään perustuen. Luokille on laadittu työmäärää kuvaavat painokertoimet. Tämän diplomityön tavoitteena on tutkia asiahallintajärjestelmään tehtyjen uudistusten mahdollistamia suorituskyvynmittauksen ja tavoiteasetannan kehittämismahdollisuuksia asiavirtauksen näkökulmasta. Tavoitteeseen pääsemiseksi selvitetään työmääräpainotuksen vaikutuksia hallinto-oikeuksien suorituskyvyn tunnuslukuihin sekä analysoidaan hallinto-oikeuksien suorituskykyä työmääräpainotuksella vuosina 2009-2012. Raportti sisältää tutkimuksen aihetta käsittelevän teoriakatsauksen ja kohdeorganisaatiota tutkivan empiirisen osuuden. Empiirinen osuus perustuu vahvasti kvantitatiiviseen tutkimukseen. Tutkimuksen tuloksena havaittiin, että työmääräpainotus kaventaa hallintooikeuksien välisiä suorituskykyeroja, mutta huomattavia eroja esiintyy myös työmääräpainotuksilla tarkasteltuna. Hallinto-oikeuksien suorituskyvyissä esiintyy eroja sekä oikeuksien välillä että oikeuksien sisällä eri vuosina. Analysoimalla nykyisiä suorituskyvyn mittauksen ja tavoiteasetannan käytäntöjä, voidaan esittää neljä kehittämisen painopistettä: 1) tavoiteasetannan tekeminen pidemmälle tähtäimelle, 2) mittauksen ja seurannan painopiste toteutuneesta ennakointiin, 3) suorituskyvyn tunnusluvut vastaamaan työmääräpainotusta ja 4) tavoitetasojen yhdenmukaistaminen. Näiden havaittujen kehittämispainopisteiden ja suorituskykyanalyysien pohjalta luotiin vaihtoehtoinen tapa mitata suorituskykyä ja asettaa tavoitteita. Kehittämisehdotusta havainnollistettiin erilaisten skenaarioiden avulla. Työ tarjoaa hyödyllistä tietoa hallinto-oikeuksien suorituskyvystä ja siitä millaisia mahdollisuuksia asianhallinnan uudistukset tuovat hallinto-oikeuksien suorituskyvyn kehittämiseen ja seurantaan.

Tiedolla johtaminen henkilöstöhallinnossa - Empiirinen tutkimus

Yritysten syvällinen ymmärrys työntekijöistä vaatii yrityksiltä monipuolista panostusta tiedonhallintaan. Tämän yhdistäminen ennakoivaan analytiikkaan ja tiedonlouhintaan mahdollistaa yrityksille uudenlaisen ulottuvuuden kehittää henkilöstöhallinnon toimintoja niin työntekijöiden kuin yrityksen etujen mukaisesti. Tutkielman tavoitteena oli selvittää tiedonlouhinnan hyödyntämistä henkilöstöhallinnossa. Tutkielma toteutettiin konstruktiivistä menetelmää hyödyntäen. Teoreettinen viitekehys keskittyi ennakoivan analytiikan ja tiedonlouhinnan konseptin ymmärtämiseen. Tutkielman empiriaosuus rakentui kvalitatiiviseen ja kvantitatiiviseen osiin. Kvalitatiivinen osa koostui tutkielman esitutkimuksesta, jossa käsiteltiin ennakoivan analytiikan ja tiedonlouhinnan hyödyntämistä. Kvantitatiivinen osa rakentui tiedonlouhintaprojektiin, joka toteutettiin henkilöstöhallintoon tutkien henkilöstövaihtuvuutta. Esitutkimuksen tuloksena tiedonlouhinnan hyödyntämisen haasteiksi ilmeni muun muassa tiedon omistajuus, osaaminen ja ymmärrys mahdollisuuksista. Tiedonlouhintaprojektin tuloksena voidaan todeta, että tutkimuksessa sovelletuista korrelaatioiden tutkimisista ja logistisesta regressioanalyysistä oli havaittavissa tilastollisia riippuvuuksia vapaaehtoisesti poistuvien työntekijöiden osalta.

Luottamuksen lähteet. Vertaileva tutkimus yleistynyttä luottamusta synnyttävistä mekanismeista

Tutkimuksen aiheena on yleistynyt luottamus. Väitöskirjassa tutkitaan mistä tuntemattomien kansalaisten toisiinsa kohdistama luottamus kumpuaa ja haetaan vastauksia tähän kysymykseen sekä maakohtaisen että vertailevan tutkimuksen avulla. Tutkimus koostuu yhteenvedon lisäksi viidestä tutkimusartikkelista, joissa luottamuksen syntyä tarkastellaan sekä yksilöiden mikrotason vuorovaikutuksen että maiden välisten eroavaisuuksien näkökulmasta. Yleistyneen luottamuksen synnystä on esitetty useita eri teorioita. Tässä tutkimuksessa tarkastellaan näistä kahta keskeisintä. Osa tutkijoista korostaa kansalaisyhteiskunnan ja ruohonjuuritason verkostojen roolia yleistyneen luottamuksen synnyn taustalla. Tämän hypoteesin mukaan kansalaiset, jotka viettävät aikaansa yhdistyksissä tai muissa sosiaalisissa verkostoissa, oppivat muita helpommin luottamaan paitsi täysin tuntemattomiin ihmisiin myös yhteiskunnallisiin instituutioihin (kansalaisyhteiskuntakeskeinen hypoteesi). Toiset taas painottavat yhteiskunnan julkisten instituutioiden merkitystä. Tämä hypoteesi korostaa instituutioiden reiluutta ja oikeudenmukaisuutta (instituutiokeskeinen hypoteesi). Ihmiset pystyvät luottamaan toisiinsa ja ratkaisemaan kollektiivisia ongelmiaan yhdessä silloin kun esimerkiksi poliittiset ja lainsäädännölliset instituutiot pystyvät luomaan tähän tarvittavan toimintaympäristön. Aineistoina käytetään kansallisia (Hyvinvointi- ja palvelut) sekä kansainvälisiä vertailevia kyselytutkimuksia (European Social Survey ja ISSP). Yksilö- ja makrotason analyyseja yhdistämällä selvitetään yleistynyttä luottamusta selittäviä tekijöitä sekä mekanismeja joiden kautta yleistynyt luottamus muodostuu. Väitöskirjan tulokset tukevat suurimmaksi osaksi instituutiokeskeiseen suuntaukseen sisältyviä hypoteeseja yleistyneen luottamuksen kasautumisesta. Kuitenkin myös esimerkiksi yhdistystoiminnalla havaittiin olevan joitakin yhdistysjäsenien ulkopuolelle ulottuvia myönteisiä vaikutuksia kansalaisten luottamukseen, mikä taas tukee kansalaisyhteiskuntakeskeistä hypoteesia. Tutkimuksen keskeinen tulos on, että kaiken kaikkiaan luottamus näyttäisi kukoistavan maissa, joissa kansalaiset kokevat julkiset instituutiot oikeudenmukaisina sekä reiluina, kansalaisyhteiskunnan roolin luottamuksen synnyttämisessä ollessa tälle alisteinen. Syyksi tähän on oletettu, että näissä maissa (erityisesti pohjoismaiset hyvinvointivaltiot) harjoitettu universaali hyvinvointipolitiikka ja palvelut ovat keskeisiä korkeaa yleistynyttä luottamusta selittäviä tekijöitä. Toisaalta maavertailuissa tätä yhteyttä on selitetty myös sillä, että näissä yhteiskunnassa ei ole paikannettavissa selkeää kulttuurisesti erottuvaa alaluokkaa. Tämän tutkimuksen tulokset tukevat enemmän universaalin hyvinvointivaltion oikeudenmukaisuuteen liittyviä ominaisuuksia alaluokkaistumishypoteesin sijaan. Toisaalta mikrotasolla tarkasteltuna yleistyneen luottamuksen ja hyvinvointipalvelujen välinen yhteys liittyy enemmän palveluiden riittävyyteen kuin niiden universaalisuuden asteeseen. Niin ikään maavertailuissa esimerkiksi verotuksen oikeudenmukaisena kokeminen näyttäisi olevan palvelujen saatavuutta tai niihin liittyviä oikeudenmukaisuuden kokemuksia tärkeämpi seikka yleistyneen luottamuksen kannalta.

Currency Carry Trades – Excess Returns and Performance Optimization of G10 Currency Carry Trade Strategies during the Euro Era

This study examines the excess returns provided by G10 currency carry trading during the Euro era. The currency carry trade has been a popular trade throughout the past decades offering excess returns to investors. The thesis aims to contribute to existing research on the topic by utilizing a new set of data for the Euro era as well as using the Euro as a basis for the study. The focus of the thesis is specifically on different carry trade strategies’ performance, risk and diversification benefits. The study finds proof of the failure of the uncovered interest rate parity theory through multiple regression analyses. Furthermore, the research finds evidence of significant diversification benefits in terms of Sharpe ratio and improved return distributions. The results suggest that currency carry trades have offered excess returns during 1999-2014 and that volatility plays an important role in carry trade returns. The risk, however, is diversifiable and therefore our results support previous quantitative research findings on the topic.

Factors associated with the development of renal complications of diabetes mellitus in São Paulo city

The incidence of diabetic end-stage renal failure (ESRF) varies worldwide and risk factors have been demonstrated in several populations. The objective of the present study was to identify possible factors associated with the risk of development of ESRF in patients with diabetes mellitus (DM). Two groups of diabetic subjects were included in a case-control study: 1) one group was submitted to renal replacement therapies, attending dialysis centers in São Paulo city and 2) the same number of controls without clinical nephropathy (two negative dipstick tests for urine protein), matched for duration of DM, were obtained from an outpatient clinic. A standardized questionnaire was used by a single investigator and additional data were obtained from the medical records of the patients. A total of 290 diabetic patients from 33 dialysis centers were identified, and 266 questionnaires were considered to contain reliable information. Male/female ratios were 1.13 for ESRF and 0.49 for the control group. A higher frequency of men was observed in the ESRF group when compared with controls (53 vs 33%, P<0.00001), although logistic regression analysis did not confirm an association of gender and diabetic nephropathy (DN). Similar proportions of non-white individuals were found for both groups. Patients with insulin-dependent diabetes mellitus (IDDM) were less common than patients with non-insulin-dependent diabetes mellitus (NIDDM), particularly in the control group (3.4 vs 26.3%, P<0.00001, for controls and ESRF patients, respectively); this type of DM was associated with a higher risk of ESRF than NIDDM, as determined by univariate analysis or logistic regression (OR = 4.1). Hypertension by the time of the DM diagnosis conferred a 1.4-fold higher risk of ESRF (P = 0.04), but no difference was observed concerning the presence of a family history. Association between smoking and alcohol habits and increased risk was observed (OR = 4.5 and 5.9, respectively, P<0.001). A 2.4-fold higher risk of ESRF was demonstrated in patients with multiple hospitalizations due to DM decompensation, which suggested poor metabolic control. Photocoagulation and neuropathy were found to be strongly associated with ESRF but not with macrovascular disease. Data collected in our country reinforce the higher risk attributable to IDDM and the association between hypertension and the progression of DN. Indirect evidence for an association with metabolic control is also suggested

Analysis of the DF508 mutation in a Brazilian cystic fibrosis population: comparison of pulmonary status of homozygotes with other patients

Sixty-one cystic fibrosis patients admitted for check-up or antibiotic treatment were enrolled for genetic and clinical evaluation. Genetic analysis was performed on blood samples stored on neonatal screening cards using PCR techniques to determine the presence of DF508 mutations. Clinical evaluation included Shwachman and Chrispin-Norman scores, age at onset of symptoms and diagnosis, spirometry, awake and sleep pulse oximetry, hyponychial angle measurement and presence of chronic Pseudomonas aeruginosa colonization. Eighteen patients (29.5%) were homozygous for the DF508 mutation, 26 (42.6%) had one DF508 mutation and 17 (27.9%) were noncarriers, corresponding to a 50.8% prevalence of the mutation in the whole population. Analysis by the Kruskal-Wallis test for comparison of genetic status with continuous variables or by the chi-square test and logistic regression for dichotomous variables showed no significant differences between any two groups for a = 0.05. We conclude that genetic status in relation to the DF508 mutation is not associated with pulmonary status as evaluated by the above variables

Differences between remaining ability and loss of capacity in maximum aerobic impairment

In the evaluation of exercise intolerance of patients with respiratory diseases the American Medical Association (AMA) and the American Thoracic Society (ATS) have proposed similar classifications for rating aerobic impairment using maximum oxygen uptake (VO2max) normalized for total body weight (ml min-1 kg-1). However, subjects with the same VO2max weight-corrected values may have considerably different losses of aerobic performance (VO2max expressed as % predicted). We have proposed a new, specific method for rating loss of aerobic capacity (VO2max, % predicted) and we have compared the two classifications in a prospective study involving 75 silicotic claimants. Logistic regression analysis showed that the disagreement between rating systems (higher dysfunction by the AMA/ATS classification) was associated with age >50 years (P<0.005) and overweight (P = 0.04). Interestingly, clinical (dyspnea score) and spirometric (FEV1) normality were only associated with the VO2max, % predicted, normal values (P<0.01); therefore, in older and obese subjects the AMA/ATS classification tended to overestimate the aerobic dysfunction. We conclude that in the evaluation of aerobic impairment in patients with respiratory diseases, the loss of aerobic capacity (VO2max, % predicted) should be used instead of the traditional method (remaining aerobic ability, VO2max, in ml min-1 kg-1).

Prevalence and risk factors for HBV, HCV and HDV infections among injecting drug users from Rio de Janeiro, Brazil

Viral hepatitis constitutes a major health issue, with high prevalence among injecting drug users (IDUs). The present study assessed the prevalence and risk determinants for hepatitis B, C and D viruses (HBV, HCV and HDV) infections among 102 IDUs from Rio de Janeiro, Brazil. Serological markers and HCV-RNA were detected by enzyme immunoassay and nested PCR, respectively. HCV genotyping was determined by restriction fragment length polymorphism analysis (RFLP). HBsAg, anti-HBc and anti-HBs were found in 7.8, 55.8 and 24.7% of IDUs, respectively. In the final logistic regression, HBV infection was independently associated with male homosexual intercourse within the last 5 years (odds ratio (OR) 3.1; 95% confidence interval (CI) 1.1-8.8). No subject presented anti-delta (anti-HD). Anti-HCV was detected in 69.6% of subjects, and was found to be independently associated with needle sharing in the last 6 months (OR 3.4; 95% CI 1.3-9.2) and with longer duration of iv drug use (OR 3.1; 95% CI 1.1-8.7). These data demonstrate that this population is at high risk for both HBV and HCV infection. Among IDUs from Rio de Janeiro, unprotected sexual intercourse seems to be more closely associated with HBV infection, whereas HCV is positively correlated with high risk injecting behavior. Comprehensive public health interventions targeting this population and their sexual partners must be encouraged.

Evaluation of behavioral states among morning and evening active healthy individuals

The Horne-Östberg questionnaire partly covers some factors that may be important determinants of peak time and characterize patterns of behavior. We conducted a study for the evaluation of self-reported behavioral states (hunger sensation, availability for study, physical exercise, solving daily problems, and time preferences) as expressions of underlying cyclic activity. Three hundred and eighteen community subjects without history of medical, psychiatric, or sleep disorders were evaluated in a cross-sectional design. A self-report about daily highest level of activity was used to categorize individuals into morning, evening, and indifferently active. Time-related behavioral states were evaluated with 23 visual analog questions. The responses to most analogic questions were significantly different between morning and evening active subjects. Logistic regression analysis identified a group of behaviors more strongly associated with the self-reported activity pattern (common wake up time, highest subjective fatigue, as well as wake up, bedtime, exercise and study preferences). These findings suggested that the patterns of activity presented by normal adults were related to specific common behavioral characteristics that may contribute to peak time.

Factors associated with adherence to antiretroviral therapy in HIV/AIDS patients: a cross-sectional study in Southern Brazil

A cross-sectional study was conducted on HIV-infected adults being treated with antiretroviral drugs at a reference service in Southern Brazil. Participants answered a sociodemographic questionnaire and were tested by scales assessing sociocognitive variables. Adherence to treatment was assessed by a self-report inventory developed for the study. Clinical information was obtained from the patients' records. Significance tests were conducted using univariate logistic regressions followed by multivariate logistic regression analysis. A total of 195 patients participated in the study and 56.9% of them reported > or = 95% adherence on the previous two days. In univariate analysis, the odds of adherence increased with self-efficacy (a person's conviction that he/she can successfully execute the behavior required to produce a certain desired outcome) in taking medications as prescribed (OR = 3.50, 95% CI 1.90-6.55), and decreased with perception of negative affect and physical concerns (OR = 0.71, 95% CI 0.53-0.95). The odds were lower for taking antiretroviral medications >4 times a day (OR = 0.44, 95% CI 0.20-0.94) and higher for patients with 8 years of schooling (OR = 2.28, 95% CI 1.12-4.66). In the multivariate analysis, self-efficacy (OR = 3.33, 95% CI 1.69-6.56) and taking medication >4 times a day (OR = 0.34, 95% CI 0.14-0.80) were independently associated with adherence. Self-efficacy was the most important predictor of adherence, followed by number of times antiretroviral medication was taken per day. Among sociodemographic and clinical variables, only the number of years of schooling was associated with adherence. Motivational interventions based on self-efficacy may be useful for increasing treatment adherence.

In vitro-induced antibody production in chronic hepatitis C virus infection

The objectives of the present study were to assess the in vitro-induced anti-hepatitis C virus (HCV) antibody production (IVIAP) in relation to the clinical, biochemical, virologic and histologic variables of patients with HCV infection. The study included 57 patients (60% males) with HCV infection (anti-HCV and HCV-RNA positive). Alanine aminotransferase (ALT) was elevated in 89% of the patients. Mean viral load was 542,241 copies/ml and histology of the liver showed chronic hepatitis in 27/52 (52%) and cirrhosis in 11/52 (21%) patients. IVIAP levels were determined by immunoenzymatic assay at median absorbance of 0.781 at 450 nm. IVIAP was negative in 14% of the patients. When groups with IVIAP levels above and below the median were compared, high IVIAP levels were associated with the male sex, elevated ALT levels and more advanced disease stage. After logistic regression analysis, advanced histologic damage to the liver remained as the only independent variable associated with elevated IVIAP levels. Using a receiver operator characteristic curve, the best cut-off level for IVIAP was established (= 1.540), with 71% sensitivity and 94% specificity for the detection of more advanced disease stages (grades 3 and 4). These findings are consistent with the participation of immunological mechanisms in the genesis of the hepatic lesions induced by HCV and indicate that the IVIAP test may be useful as a noninvasive marker of liver damage either alone or in combination with other markers.

The X-X-/E+E+ genotype of the XbaI/EcoRI polymorphisms of the apolipoprotein B gene as a marker of coronary artery disease in a Brazilian sample

Studies that consider polymorphisms within the apolipoprotein B (apo B) gene as risk factors for coronary artery disease (CAD) have reported conflicting results. The aim of the present study was to search for associations between two DNA RFLPs (XbaI and EcoRI) of the apo B gene and CAD diagnosed by angiography. In the present study we compared 116 Brazilian patients (92 men) with CAD (CAD+) to 78 control patients (26 men) without ischemia or arterial damage (CAD-). The allele frequencies at the XbaI (X) and EcoRI (E) sites did not differ between groups. The genotype distributions of CAD+ and CAD- patients were different (chi²(1) = 6.27, P = 0.012) when assigned to two classes (X-X-/E+E+ and the remaining XbaI/EcoRI genotypes). Multivariate logistic regression analysis showed that individuals with the X-X-/E+E+ genotype presented a 6.1 higher chance of developing CAD than individuals with the other XbaI/EcoRI genotypes, independently of the other risk factors considered (sex, tobacco consumption, total cholesterol, hypertension, and triglycerides). We conclude that the X-X-/E+E genotype may be in linkage disequilibrium with an unknown variation in the apo B gene or with a variation in another gene that affects the risk of CAD.

Detection of renal dysfunction based on serum creatinine levels in a Brazilian community: the Bambuí Health and Ageing Study

There are few population-based studies of renal dysfunction and none conducted in developing countries. In the present study the prevalence and predictors of elevated serum creatinine levels (SCr > or = 1.3 mg/dl for men and 1.1 mg/dl for women) were determined among Brazilian adults (18-59 years) and older adults (>60 years). Participants included all older adults (N = 1742) and a probabilistic sample of adults (N = 818) from Bambuí town, MG, Southeast Brazil. Predictors were investigated using multiple logistic regression. Mean SCr levels were 0.77 ± 0.15 mg/dl for adults, 1.02 ± 0.39 mg/dl for older men, and 0.81 ± 0.17 mg/dl for older women. Because there were only 4 cases (0.48%) with elevated SCr levels among adults, the analysis of elevated SCr levels was restricted to older adults. The overall prevalence of elevated SCr levels among the elderly was 5.09% (76/1494). The prevalence of hypercreatinemia increased significantly with age (chi² = 26.17, P = 0.000), being higher for older men (8.19%) than for older women (5.29%, chi² = 5.00, P = 0.02). Elevated SCr levels were associated with age 70-79 years (odds ratio [OR] = 2.25, 95% confidence interval [CI]: 1.15-4.42), hypertension (OR = 3.04, 95% CI: 1.34-6.92), use of antihypertensive drugs (OR = 2.46, 95% CI: 1.26-4.82), chest pain (OR = 3.37, 95% CI: 1.31-8.74), and claudication (OR = 3.43, 95% CI: 1.30-9.09) among men, and with age >80 years (OR = 4.88, 95% CI: 2.24-10.65), use of antihypertensive drugs (OR = 4.06, 95% CI: 1.67-9.86), physical inactivity (OR = 2.11, 95% CI: 1.11-4.02) and myocardial infarction (OR = 3.89, 95% CI: 1.58-9.62) among women. The prevalence of renal dysfunction observed was much lower than that reported in other population-based studies, but predictors were similar. New investigations are needed to confirm the variability in prevalence and associated factors of renal dysfunction among populations.

Social disability of Brazilian mood disorder patients

Mood disorders cause many social problems, often involving family relationships. Few studies are available in the literature comparing patients with bipolar, unipolar, dysthymic, and double depressive disorders concerning these aspects. In the present study, demographic and disease data were collected using a specifically prepared questionnaire. Social adjustment was assessed using the Disability Adjustment Scale and family relationships were evaluated using the Global Assessment of Relational Functioning Scale. One hundred patients under treatment for at least 6 months were evaluated at the Psychiatric Outpatient Clinic of the Botucatu School of Medicine, UNESP. Most patients were women (82%) more than 50 (49%) years old with at least two years of follow-up, with little schooling (62% had less than 4 years), and of low socioeconomic level. Logistic regression analysis showed that a diagnosis of unipolar disorder (P = 0.003, OR = 0.075, CI = 0.014-0.403) and dysthymia (P = 0.001, OR = 0.040, CI = 0.006-0.275) as well as family relationships (P = 0.002, OR = 0.953, CI = 0914-0.992) played a significant role in social adjustment. Unipolar and dysthymic patients presented better social adjustment than bipolar and double depressive patients (P < 0.001), results that were not due to social class. These patients, treated at a teaching hospital, may represent the severest mood disorder cases. Evaluations were made knowing the diagnosis of the patients, which might also have influenced some of the results. Social disabilities among mood disorder patients are very frequent and intensive.

Prevalence of retinopathy in Caucasian type 2 diabetic patients from the South of Brazil and relationship with clinical and metabolic factors

Diabetic retinopathy (DR) is a sight-threatening chronic complication of diabetes mellitus and is the leading cause of acquired blindness in adults. In this cross-sectional study, we investigated the prevalence of and the factors associated with DR in an analysis of 210 consecutive and unrelated Brazilian Caucasians with type 2 diabetes mellitus. Retinopathy was evaluated by ophthalmoscopy and/or biomicroscopy through dilated pupils. The relationship between clinical and metabolic variables and the presence of DR was assessed by logistic regression analysis. DR was detected in 99 of the 210 patients (47%). In the univariate logistic regression analyses, male sex, duration of diabetes, body mass index, glycated hemoglobin, C-peptide, LDL cholesterol, smoking, and albumin excretion rate were found to be associated with the presence of DR. However, the multiple logistic regression analysis showed that only duration of diabetes (odds ratio (OR) = 1.15, 95% CI = 1.09-1.22; P < 0.001), glycated hemoglobin (OR = 1.21, 95% CI = 1.01-1.46; P = 0.047) and albumin excretion rate >100 µg/min (OR = 12.72, 95% CI = 3.89-41.56; P < 0.001) were independently associated with DR. Although DR was found to be frequent among Brazilian type 2 diabetic patients, its prevalence was within the range observed in other Caucasian populations. Our findings emphasize the need for good glycemic control in order to prevent or delay the onset of DR, since the most well-known risk factors for the development of this complication in type 2 diabetes mellitus, such as duration of diabetes, glycated hemoglobin and albumin excretion rate were independently related to DR.