ResumoEste artigo discute o atendimento a mulheres em situações de violência por serviços de saúde e de segurança pública. Tem como pressuposto que as atuais políticas de enfrentamento da violência contra as mulheres preveem ações dessas duas instituições. Baseia-se na análise de três elementos que compõem a prática: o espaço físico, o fluxo dos serviços e a percepção dos profissionais em relação às usuárias. Seus dados foram obtidos em estudo qualitativo realizado em unidades básicas de saúde, serviços de emergência de hospitais públicos, delegacias especializadas no atendimento a mulheres e distritos policiais de uma região da cidade de São Paulo. A coleta de dados incluiu observação não participante e entrevistas com profissionais. Os resultados apontam que o atendimento às mulheres que sofrem violência é marcado por ambiguidades e contradições; os espaços e fluxos de trabalho são pouco adequados à tarefa tão sensível e a percepção dos profissionais é permeada por estereótipos de gênero. Isso sugere que o enfrentamento da violên-cia contra as mulheres exige a reconfiguração das práticas de trabalho, com educação permanente para os profissionais e mudanças nos processos de trabalho. Palavras-chave: Violência Institucional; Violência contra as Mulheres;

ObjectiveTo assess public services attending female victims of sexual violence in the city of Sao Paulo. Methods This is a qualitative study conducted in two public services attending female victims of sexual violence. Interviews with 42 women were conducted, 13 of whom had sought these services for assistance and 29 were professionals working in these services. Evaluation of the services was based on the categories: reception, access, resolvability and sanitary responsibility. ResultsThe analysis of the interviews per category has shown that there was reception in both services, problems with respect to access due to the lack of information concerning these services, and quality resolvability with a multi-professional team. As to the sanitary responsibility, it is present in these specialized services but is deficient in the emergency services and basic health care units. Many women are unaware of the rights they are entitled to with respect to specialized services. Frequently their late arrival compromises the efficacy of care. There are deficiencies both in terms of reference and counter reference. ConclusionsThe results ratify the importance of these services and the need for their decentralized expansion. Health courses should introduce the theme of sexual violence at the undergraduate level.

OBJECTIVE:The Family Health Program proposes a new dynamics for the structuring of health service, as well as for its relationship with the community in its different levels of care. The aim of the present study was to analyze the significance of teamwork for professionals working in the Family Health Program. METHODS:The study was carried out in the city of Conchas, Southeastern Brazil, in 2004. We used a qualitative approach based on phenomenology as an attempt to reveal the essence of the reality experienced by eight professionals from two Family Health Program teams. RESULTS:Themes revealed that teamwork is characterized by dedication to daily activities. Interaction among all members is required for integral action, although there are differences in ideology and conduct between professionals. Close contact with families has allowed for more efficient interventions, and integrated work is essential for efficacious, high-quality care. CONCLUSIONS:The phenomenon unveiled gives origin to a new perspective of action for professionals and furthers our understanding of multiprofessional teamwork.

RESUMO Objetivo Investigar o estresse emocional, o coping e burnout da equipe de enfermagem e a associação com fatores biossociais e do trabalho em Unidade de Terapia Intensiva (UTI). Método Estudo transversal, realizado em oito UTI de hospital-escola, do município de São Paulo, em 2012. Coletaram-se dados biossociais e de trabalho dos profissionais, juntamente com Escalas de Estresse no Trabalho, Coping Ocupacional, Lista de Sinais e Sintomas e Inventário Maslach de Burnout. Resultados Participaram da pesquisa 287 sujeitos, predominantemente mulheres, com companheiro e filhos. O nível médio de estresse e coping controle foram prevalentes (74,47% e 79,93%, respectivamente) e a presença de burnout em 12,54%. Fatores associados ao estresse referiram-se às condições de trabalho. Ter companheiro, atuar em UTI Clínica e gostar do trabalho foram fatores de proteção para coping prevalente, enquanto que horas de sono adequadas foi fator de proteção para burnout. Conclusão O controle do ambiente de trabalho e o sono adequado são fatores decisivos e protetores para enfrentamento das situações de estresse ocupacional.

Objective: to analyze the influence of workload, stress, Burnout, work satisfaction, the nursing team's perception of the care environment, and the presence of adverse events in a Trauma Intensive Care Units.Method: an observational study conducted at the Intensive Trauma Therapy Unit 195 patients were prospectively followed for the collection of incidents, and instruments were used to measure Nursing workload, stress, Burnout, job satisfaction and work environment assessment by the nursing team. Data were analyzed using appropriate statistics for the study.Results: we observed 1,586 incidents, predominantly no harm incidents (78.44%). Among the nursing staff, 77.40% had average levels of stress; 17.00% presented Burnout; 56.6% were dissatisfied and considered the environmental characteristics to be inadequate. Nursing workload was high (73.24%). An association between incident and length of stay was found. No harm incidents were associated with nursing workload. Método: estudio observacional en la Unidad de Cuidados Intensivos de Trauma. Para la recolección de los incidentes fueron seguidos prospectivamente 195 pacientes siendo utilizados instrumentos para medir la carga de trabajo de enfermería, el estrés, el Burnout, la satisfacción laboral y el trabajo de evaluación del entorno de trabajo por parte del personal de enfermería. Los datos se analizaron usando el estudio estadístico apropiado. ConclusionResultados: ocurrieron 1.586 incidentes predominantemente incidentes sin daño (78,44%). Entre el personal de enfermería, 77.40% tenían niveles medios de estrés; 17,00% mostró Burnout; y el 56,6% estaban insatisfechos y consideraron inadecuadas las características ambientales. La carga de trabajo de enfermería fue alta (73,24%). Se observó una asociación entre la incidencia y la duración de la estancia. Incidentes sin lesiones se asociaron con la carga de trabajo de enfermería.Conclusión: La identificación de factores asociados puede prevenir la aparición de incidentes. DESCRIPTORES:Seguridad del paciente. Unidades de cuidados intensivos. Carga de trabajo. Agotamiento profesional. Enfermería.

The tripeptide Hip-His-Leu was used to standardize a fluorimetric method to measure tissue angiotensin-converting enzyme (ACE) activity in rats. The fluorescence of the o-phthaldialdehyde-His-Leu adduct was compared in the presence and absence of the homogenate (25 µl) to determine whether the homogenate from different tissues interfered with the fluorimetric determination of the His-Leu product. Only homogenates from lung and renal medulla and cortex showed significantly altered fluorescence intensity. To overcome this problem, the homogenate from these tissues were diluted 10 times with assay buffer. The specificity of the assay was demonstrated by the inhibition of ACE activity with 3 µM enalaprilat (MK-422). There was a linear relationship between product formation and incubation time for up to 90 min for homogenates of renal cortex and medulla and liver, for up to 60 min for ventricles and adrenals and for up to 30 min for the aorta, lung and atrium homogenates. In addition, there was a linear relationship between product formation and the amount of protein in the homogenates within the following range: lung, 30-600 µg; renal cortex and medulla, 40-400 µg; atrium and ventricles, 20-200 µg; adrenal, 20-100 µg; aorta, 5-100 µg; liver, 5-25 µg. No peptidase activity against the His-Leu product (31 nmol), assayed in borate buffer (BB), was detected in the different homogenates except the liver homogenate, which was inhibited by 0.1 mM r-chloromercuribenzoic acid. ACE activity in BB was higher than in phosphate buffer (PB) due, at least in part, to a greater hydrolysis of the His-Leu product in PB. ACE activity of lung increased 20% when BB plus Triton was used. Enzyme activity was stable when the homogenates were stored at -20 o or -70 o C for at least 30 days. These results indicate a condition whereby ACE activity can be easily and efficiently assayed in rat tissue samples homogenized in BB using a fluorimetric method with Hip-His-Leu as a substrate. Correspondence

OBJETIVO: Conhecer a história de vida da mulher usuária de álcool, inserida em tratamento especializado para dependência química, auto-referida. MÉTODOS: Pesquisa qualitativa, utilizando como estratégia metodológica a "história de vida", realizada no período de maio a agosto de 2000. Participaram do estudo 13 mulheres em tratamento em ambulatório especializado de tratamento e pesquisa em álcool e drogas devido ao consumo alcoólico. Optou-se por uma abordagem focalizada/ temática do momento vivenciado pelas mulheres estudadas. Foram realizadas entrevistas semi-estruturadas e gravadas para a Análise de Conteúdo. RESULTADOS: As leituras das entrevistas transcritas permitiram identificar as seguintes categorias: 1) Trabalho e lazer antes do uso nocivo e a dependência ao álcool; 2) Perda do controle sobre a bebida e o surgimento de comprometimentos clínicos, sociais e familiares; 3) Percepção dos prejuízos e a busca de tratamento especializado; 4) Necessidade de voltar a acreditar em si mesma; 5) Acolhimento e respeito ao tratamento especializado e; 6) (Re)aprendendo a viver: lidando com a dependência. CONCLUSÕES: A mulher usuária de álcool necessita de atenção especial por parte dos profissionais de saúde e familiares, sobretudo no que se refere aos aspectos emocionais, aos comprometimentos clínicos e a promoção da auto-estima. Esse conjunto de atenções possibilitam o resgate da cidadania, objetivando melhor continuidade do processo de recuperação.

A continuous assay using internally quenched fluorescent peptides with the general sequence Abz-peptidyl-(Dnp)P-OH (Abz = ortho-aminobenzoic acid; Dnp = 2,4-dinitrophenyl) was optimized for the measurement of angiotensin I-converting enzyme (ACE) in human plasma and rat tissues. Abz-FRK(Dnp)P-OH, which was cleaved at the Arg-Lys bond by ACE, was used for the enzyme evaluation in human plasma. Enzymatic activity was monitored by continuous recording of the fluorescence (lambda ex = 320 nm and lambda em = 420 nm) at 37 degrees C, in 0.1 M Tris-HCl buffer, pH 7.0, with 50 mM NaCl and 10 microM ZnCl2. The assays can be performed directly in the cuvette of the fluorimeter and the hydrolysis followed for 5 to 10 min. ACE measurements in the plasma of 80 healthy patients with Hip-His-Leu and with Abz-FRK(Dnp)P-OH correlated closely (r = 0.90, P < 0.001). The specificity of the assay was demonstrated by the complete inhibition of hydrolysis by 0.5 microM lisinopril or captopril. Abz-FRK(Dnp)P-OH cleavage by ACE was monitored in rat lung, kidney, heart, and liver homogenates in the presence of a cocktail of inhibitors containing trans-epoxy-succinyl-L-leucylamido-(4-guanido)-butene, pepstatin, phenyl-methylsulfonyl fluoride, N-tosyl-L-phenylalanyl-chloromethyl ketone, and N-tosyl-lysyl-chloromethyl ketone to prevent undesirable hydrolysis. ACE activity in lung, heart and kidney homogenates, but not in liver homogenates, was completely abolished by 0.5 microM lisinopril or captopril. The advantages of the method are the procedural simplicity and the high sensitivity providing a rapid assay for ACE determinations.