Organization and Information in the Fight against Crime: An Evaluation of the Integration of Police Forces in the State of Minas Gerais, Brazil

This paper explores the experience of information sharing, coordination, and integration of actions of the Civil and Military Polices in the state of Minas Gerais, Brazil, in the context of the IGESP program. The IGESP is based on the introduction of information management systems and organizational changes akin to those associated with COMPSTAT. All the evidence presented points to a causal effect of the IGESP on crime. The most conservative estimates indicate a reduction of 24% in property crimes and 13% in personal crimes. There is also evidence that the IGESP is associated with improved police response, measured by apprehension of weapons and clearance rates. We present one of the first set of causal estimates – with a clear identification strategy – of the impact of COMPSTAT-like programs. The results suggest that the coordination and informational gains represented by the program may constitute a first-order factor in a successful policy for fighting crime.crime, police, Brazil, COMPSTAT, impact evaluation

Organization and Information in the Fight against Crime: An Evaluation of the Integration of Police Forces in the State of Minas Gerais, Brazil

This paper explores the experience of information sharing, coordination, and integration of actions of the Civil and Military Polices in the state of Minas Gerais, Brazil, in the context of the IGESP program. The IGESP is based on the introduction of information management systems and organizational changes akin to those associated with COMPSTAT. All the evidence presented points to a causal effect of the IGESP on crime. The most conservative estimates indicate a reduction of 24% in property crimes and 13% in personal crimes. There is also evidence that the IGESP is associated with improved police response, measured by apprehension of weapons and clearance rates. We present one of the first set of causal estimates – with a clear identification strategy – of the impact of COMPSTAT-like programs. The results suggest that the coordination and informational gains represented by the program may constitute a first-order factor in a successful policy for fighting crime.crime, police, Brazil, COMPSTAT, impact evaluation JEL Codes: H11, K00, K42

Organization and information in the fight against crime: the integration of police forces in the state of Minas Gerais, Brazil

This paper analyzes the experience of information sharing, coordination, and integration of actions of the civil and military police forces in the state of Minas Gerais, Brazil, in the context of the IGESP program. The IGESP was based on the introduction of information management systems and organizational changes akin to those associated with the CompStat system originally developed in New York City. The evidence points to a causal effect of the IGESP on crime. The most conservative estimates indicate a reduction of 23 percent in violent property crimes due to the introduction of the program. There is also evidence that the IGESP is associated with improved police response, measured by apprehension of weapons and clearance rates. We present one of the few estimates available with a clear identification strategy of the impact of CompStat-like programs. The results suggest that coordination of actions and efficient use of information may constitute first-order factors in the fight against crime

Eficiência do setor hospitalar nos municípios paulistas

O objetivo deste artigo é avaliar o grau de eficiência produtiva do setor público hospitalar em 366 municípios do estado de São Paulo entre os anos de 1998 e 2003. Para tanto é utilizado o método de fronteira estocástica de produção. O modelo estimado com a forma flexível de Fourier usa o complemento da taxa de mortalidade hospitalar como produto e o gasto público com profissionais e o número de leitos por município como insumos. Os resultados sugerem que os municípios mais eficientes são aqueles que contratam mais leitos de hospitais privados, que realizam o maior número de internações (efeito de economia de escala), que possuem menor população (efeito congestionamento) e que apresentam menor tempo médio de internação.The purpose of this article is to assess the degree of productive efficiency of public sector hospitals in 366 municipalities of the state in São Paulo between the years 1998 and 2003. In2003. In order to do so we use the stochastic frontier of production approach. The model is estimated using the flexible form of Fourier and uses the complement of the rate of hospital mortality as output and public spending with professionals and the number of beds per municipality as inputs. The results suggest that the most efficient municipalities are those that hire more beds in private hospitals, the ones which perform the highest number of admissions (economies of scale effect), the ones with smaller population (congestion effect), and the ones which show lower average time of hospitalization

Reajuste de preços na indústria farmacêutica brasileira e o fator X: uma avaliação usando o método de fronteiras estocásticas

O objetivo deste artigo é propor uma metodologia alternativa aquela apresentada pela resolução da CMED para calcular a produtividade da indústria farmacêutica durante o período 2000-2006. Utiliza-se o índice de produtividade total dos fatores (PTF) de Malmquist proposto por Caves, Christensen e Diwert (1982). Para a obtenção do índice é aplicada a metodologia de fronteiras estocásticas desenvolvida por Battese e Coelli (1995). Esta metodologia permite a separação da PTF em variação na eficiência técnica (uso da melhor tecnologia disponível) e variação tecnológica (mudanças na fronteira de produção propriamente dita). Utiliza-se uma base de dados única obtida através de pesquisa feita pela FIPE junto a empresas da indústria farmacêutica. Os resultados indicam uma perda de produtividade em 2005 e 2006, ao contrário do que estabelece o governo

Contribution of Efflux to the Emergence of Isoniazid and Multidrug Resistance in Mycobacterium tuberculosis

Multidrug resistant (MDR) tuberculosis is caused by Mycobacterium tuberculosis resistant to isoniazid and rifampicin, the two most effective drugs used in tuberculosis therapy. Here, we investigated the mechanism by which resistance towards isoniazid develops and how overexpression of efflux pumps favors accumulation of mutations in isoniazid targets, thus establishing a MDR phenotype. The study was based on the in vitro induction of an isoniazid resistant phenotype by prolonged serial exposure of M. tuberculosis strains to the critical concentration of isoniazid employed for determination of drug susceptibility testing in clinical isolates. Results show that susceptible and rifampicin monoresistant strains exposed to this concentration become resistant to isoniazid after three weeks; and that resistance observed for the majority of these strains could be reduced by means of efflux pumps inhibitors. RT-qPCR assessment of efflux pump genes expression showed overexpression of all tested genes. Enhanced real-time efflux of ethidium bromide, a common efflux pump substrate, was also observed, showing a clear relation between overexpression of the genes and increased efflux pump function. Further exposure to isoniazid resulted in the selection and stabilization of spontaneous mutations and deletions in the katG gene along with sustained increased efflux activity. Together, results demonstrate the relevance of efflux pumps as one of the factors of isoniazid resistance in M. tuberculosis. These results support the hypothesis that activity of efflux pumps allows the maintenance of an isoniazid resistant population in a sub-optimally treated patient from which isoniazid genetically resistant mutants emerge. Therefore, the use of inhibitors of efflux should be considered in the development of new therapeutic strategies for preventing the emergence of MDR-TB during treatment

Emergence of multidrug-resistant Mycobacterium tuberculosis of the Beijing lineage in Portugal and Guinea-Bissau: a snapshot of moving clones by whole-genome sequencing.

The Beijing genotype comprises a highly disseminated strain type that is frequently associated with multidrug resistant (MDR) tuberculosis (TB) and increased transmissibility but, countries such as Portugal and Guinea-Bissau fall outside the regions phylogeographically associated with this specific genotype. Nevertheless, recent data shows that this genotype might be gradually emerging in these two countries as an underlying cause of primary MDR-TB. Here, we describe the emergence of Mycobacterium tuberculosis Beijing strains associated with MDR-TB in Portugal and Guinea-Bissau demonstrating the presence of the well described superclusters 100-32 and 94-32 in Portugal and Guinea-Bissau, respectively. Genome-wide analysis and comparison with a global genomic dataset of M. tuberculosis Beijing strains, revealed the presence of two genomic clusters encompassing isolates from Portugal and Guinea-Bissau, GC1 (n = 121) and GC2 (n = 39), both of which bore SNP signatures compatible with the 100-32/B0/W148 and 94-32/Central Asia Outbreak clades, respectively. Moreover, GC2 encompasses a cross-border cluster between Portugal, Guinea-Bissau and Brazil thus supporting migration-associated introduction of MDR-TB and subsequent clonal expansion at the community-level. The comparison with global Beijing datasets demonstrates the global reach of the disease and its complex dissemination across multiple countries while in parallel there are clear microevolutionary trajectories towards extensively drug resistant TB

Organization and Information in the Fight against Crime: An Evaluation of the Integration of Police Forces in the State of Minas Gerais, Brazil *

Abstract This paper explores the experience of information sharing, coordination, and integration of actions of the Civil and Military Polices in the state of Minas Gerais, Brazil, in the context of the IGESP program. The IGESP is based on the introduction of information management systems and organizational changes akin to those associated with COMPSTAT. All the evidence presented points to a causal effect of the IGESP on crime. The most conservative estimates indicate a reduction of 24% in property crimes and 13% in personal crimes. There is also evidence that the IGESP is associated with improved police response, measured by apprehension of weapons and clearance rates. We present one of the first set of causal estimates -with a clear identification strategy -of the impact of COMPSTAT-like programs. The results suggest that the coordination and informational gains represented by the program may constitute a first-order factor in a successful policy for fighting crime

Clonal expansion across the seas as seen through CPLP-TB database: A joint effort in cataloguing Mycobacterium tuberculosis genetic diversity in Portuguese-speaking countries.

Tuberculosis (TB) remains a major health problem within the Community of Portuguese Language Speaking Countries (CPLP). Despite the marked variation in TB incidence across its member-states and continued human migratory flux between countries, a considerable gap in the knowledge on the Mycobacterium tuberculosis population structure and strain circulation between the countries still exists. To address this, we have assembled and analysed the largest CPLP M. tuberculosis molecular and drug susceptibility dataset, comprised by a total of 1447 clinical isolates, including 423 multidrug-resistant isolates, from five CPLP countries. The data herein presented reinforces Latin American and Mediterranean (LAM) strains as the hallmark of M. tuberculosis populational structure in the CPLP coupled with country-specific differential prevalence of minor clades. Moreover, using high-resolution typing by 24-loci MIRU-VNTR, six cross-border genetic clusters were detected, thus supporting recent clonal expansion across the Lusophone space. To make this data available to the scientific community and public health authorities we developed CPLP-TB (available at http://cplp-tb.ff.ulisboa.pt), an online database coupled with web-based tools for exploratory data analysis. As a public health tool, it is expected to contribute to improved knowledge on the M. tuberculosis population structure and strain circulation within the CPLP, thus supporting the risk assessment of strain-specific trends