ABSTRACT. The present study was carried out with the objective of determining the requirements for digestible lysine in Nile tilapia during the 500 to 600 g live weight stage. Isocaloric and isonitrogenous diets were tested with increasing amounts of digestible lysine. L-lysine HCl (78%) were used to replace glutamic acid at increasing levels, resulting in treatments of 9.3, 12.3, 15.3, 18.3 and 21.3 g kg-1 of digestible lysine. Three hundred Nile tilapias with an average weight of 519 ± 27.23 g were used and distributed among 25 tanks. The physical and chemical parameters of the water were pH, dissolved oxygen, salinity, conductivity and temperature. The mortality rate was registered daily. Two slaughters were performed at 28 and 50 days after the beginning of the experiment. It was estimated that an amount of 13.1 g kg-1 of digestible lysine was ideal for obtaining higher WG. Fish slaughtered after 50 days, the digestible lysine requirements were determined to be 14.5 g kg-1 for the lowest carcass humidity and 14.6 g kg-1 for the greatest carcass ethereal extract. Nile tilapias with live weight between 500 and 600 grams require 13.1 g kg-1 of digestible lysine in the diet for greater WG (90.53 g) and better FCR (2.55).

ABSTRACT Two experiments were conducted using direct method to determine the standardized ileal phosphorus (P) digestibility coefficient (SIPDC) of meat and bone meal (MBM) and poultry byproduct meal (PBM) for broilers. In the first experiment, three MBM from different batches were evaluated, with four treatments (MBMI, MBMII, MBMIII, and a P-free diet) and nine replicates of seven birds each, totaling 252 birds distributed across a completely randomized design. The P-free diet was used to determine endogenous P losses. Titanium dioxide (5 g kg−1) was used as an indigestible indicator. In the second experiment, three PBM from different batches were evaluated, with 189 birds distributed over three treatments (PBMI, PBMII, and PBMIII) and nine replicates of seven birds each. These two experiments were conducted when birds were 19-22 days old. The birds were euthanized to collect the ileal content. Using the P-free diet, endogenous P losses were determined at 94.9 mg kg−1 dry matter intake. Standardized ileal P digestibility of MBMI (0.65) and MBMIII (0.69) was higher compared with MBMII (0.49). The SIPDC determined for three PBM sources were similar and 0.96, 0.96, and 0.93 for PBMI, PBMII, and PBMIII, respectively. The present study demonstrates that P in MBM is not as available as it is believed and that the variability between batches should be considered by nutritionists, while PBM can be considered an excellent P source to broiler diets.

OBJETIVO: A atenção integrada às doenças prevalentes da infância é uma estratégia desenvolvida para contribuir na redução das principais causas de mortalidade infantil. O objetivo do estudo foi avaliar o impacto da estratégia sobre a saúde infantil. MÉTODOS: Compararam-se a qualidade do atendimento à saúde infantil e os custos associados em quatro estados da região Nordeste do Brasil, em 2001. Foram estudadas 48 unidades de saúde onde havia implementação estável da estratégia por pelo menos dois anos antes do início do estudo e 48 unidades sem (controle) nos mesmos estados. O percentual de crianças doentes atendidas corretamente foi utilizado para avaliar a qualidade da atenção oferecida a crianças doentes. O custo total da atenção à saúde infantil foi avaliado a partir de dados coletados nos níveis nacional, estadual, municipal e de unidade de saúde. RESULTADOS: As unidades que adotam a estratégia obtiveram desempenho significantemente melhor no atendimento de crianças doentes, sem custos adicionais em relação aos municípios sem. Nas unidades com a estratégia, 72% das crianças avaliadas foram atendidas corretamente, comparado com 56% nas unidades controle. O custo por criança atendida corretamente foi de US$13.20 versus US$21.05 nos municípios com e sem a estratégia respectivamente, após os ajustes para o tamanho das populações municipais. CONCLUSÕES: A estratégia melhorou a eficiência das unidades de atenção primária de saúde da região estudada. Em unidades de atenção primária com a estratégia, a qualidade do tratamento foi melhor, sem aumento de custos.

OBJECTIVE: The Integrated Management of Childhood Illness is a strategy designed to address major causes of child mortality. The aim of this study was to assess the impact of the strategy on the quality of child health care provided at primary facilities. METHODS: Child health quality of care and costs were compared in four states in Northeastern Brazil, in 2001. There were studied 48 health facilities considered to have had stable strategy implementation at least two years before the start of study, with 48 matched comparison facilities in the same states. A single measure of correct management of sick children was used to assess care provided to all sick children. Costs included all resources at the national, state, local and facility levels associated with child health care. RESULTS: Facilities providing strategy-based care had significantly better management of sick children at no additional cost to municipalities relative to the comparison municipalities. At strategy facilities 72% of children were correctly managed compared with 56% in comparison facilities (p=0.001). The cost per child managed correctly was US$13.20 versus US$21.05 in the strategy and comparison municipalities, respectively, after standardization for population size. CONCLUSIONS: The strategy improves the efficiency of primary facilities in Northeastern Brazil. It leads to better health outcomes at no extra cost.

OBJETIVO: A atenção integrada às doenças prevalentes da infância é uma estratégia desenvolvida para contribuir na redução das principais causas de mortalidade infantil. O objetivo do estudo foi avaliar o impacto da estratégia sobre a saúde infantil. MÉTODOS: Compararam-se a qualidade do atendimento à saúde infantil e os custos associados em quatro estados da região Nordeste do Brasil, em 2001. Foram estudadas 48 unidades de saúde onde havia implementação estável da estratégia por pelo menos dois anos antes do início do estudo e 48 unidades sem (controle) nos mesmos estados. O percentual de crianças doentes atendidas corretamente foi utilizado para avaliar a qualidade da atenção oferecida a crianças doentes. O custo total da atenção à saúde infantil foi avaliado a partir de dados coletados nos níveis nacional, estadual, municipal e de unidade de saúde. RESULTADOS: As unidades que adotam a estratégia obtiveram desempenho significantemente melhor no atendimento de crianças doentes, sem custos adicionais em relação aos municípios sem. Nas unidades com a estratégia, 72% das crianças avaliadas foram atendidas corretamente, comparado com 56% nas unidades controle. O custo por criança atendida corretamente foi de US$13.20 versus US$21.05 nos municípios com e sem a estratégia respectivamente, após os ajustes para o tamanho das populações municipais. CONCLUSÕES: A estratégia melhorou a eficiência das unidades de atenção primária de saúde da região estudada. Em unidades de atenção primária com a estratégia, a qualidade do tratamento foi melhor, sem aumento de custos.

OBJECTIVE: The Integrated Management of Childhood Illness is a strategy designed to address major causes of child mortality. The aim of this study was to assess the impact of the strategy on the quality of child health care provided at primary facilities. METHODS: Child health quality of care and costs were compared in four states in Northeastern Brazil, in 2001. There were studied 48 health facilities considered to have had stable strategy implementation at least two years before the start of study, with 48 matched comparison facilities in the same states. A single measure of correct management of sick children was used to assess care provided to all sick children. Costs included all resources at the national, state, local and facility levels associated with child health care. RESULTS: Facilities providing strategy-based care had significantly better management of sick children at no additional cost to municipalities relative to the comparison municipalities. At strategy facilities 72% of children were correctly managed compared with 56% in comparison facilities (p=0.001). The cost per child managed correctly was US$13.20 versus US$21.05 in the strategy and comparison municipalities, respectively, after standardization for population size. CONCLUSIONS: The strategy improves the efficiency of primary facilities in Northeastern Brazil. It leads to better health outcomes at no extra cost.