Agregação familiar e resultados maternos e perinatais da pré-eclâmpsia severa em população do Rio Grande do Norte

To determine whether there is familiar aggregation of severe preeclampsia in a Brazilian population from Rio Grande do Norte and to characterize the maternal and perinatal outcomes in the studied population. Methods: A case control study was performed with 412 participants who were admitted at Maternidade Escola Januário Cicco (MEJC) for medical care. Of these, 264 subjects presented normal blood pressure and 148 were cases. Cases were composed of eclampsia (n=47), HELLP Syndrome (n=85) and Eclampsia associated with HELLP syndrome (n=16). The diagnosis of these illness were based on the citeria developed by National High Blood Pressure Education Program Working (2000). An interview was performed with each subject and questions related to personal and familiar history of hypertension, preeclampsia, HELLP syndrome and eclampsia. Statistical analysis was performed and comparison of median and mean between cases and controls were performed, with the level of significance of 5%. The Odds-Ratio was determined to estimate the risk of preeclampsia within the families. Results: There were no difference in the demographic data between cases and controls. Previous history of chronic hypertension and preeclampsia was more frequent in the case group. Headaches were more frequent in eclampsia and epigastric pain in the HELLP syndrome cases. Bleeding and oliguria were more frequently found in the eclampsia associated with HELLP syndrome cases. Acute Renal insufficiency was a common complication in the case group, but these cases did not evolve to chronic renal insufficiency. The maternal mortality was 0.4% and the perinatal mortality was high, 223 per 1,000 live births. The 111 risk of a woman to develop preeclampsia whose mother has hypertension or had preeclampsia was respectively 2.5 and 3.5. This risk was increased 5 times, when a sibling has hypertension and 6 times when both sibling and mother had previous history of preeclampsia. Conclusions: This study confirms that there is familiar aggregation of preeclampsia in this Brazilian population. The potential for cardiovascular complications due to development of chronic hypertension indicates the need of closely follow up of women who develop preeclampsia

A concepção de humanização no contexto da formação médica: o caso da UFRN

This thesis aims at understanding the aspects related to the concept of humanization that contribute to a humanized education in the pedagogical project of the medicine graduation course of the Federal University of Rio Grande do Norte (UFRN). It has been used a qualitative research through non - structured interviews to six professors and through the focus group technique with participant observation of 30 students of the 2 nd , 4 th and 6 th terms of the med program. The data has been analyzed through the cate gorical thematic subject analysis technique from which two categories have emerged: tendency changes and initial changes. In the former we ’ ve identified aspects related to the social reality based in the experiences of professors and students in their work field; the competencies such as stimulation to the students ’ critical and reflexive knowledge through professors ’ encouragements and learning to learn as a way of developing professors ’ education towards the process of learning and evaluation of students. In the latter, we ’ ve noticed positive and negative aspects. While in the positive aspects we ’ ve testified actions and attitudes that were crucial for the development of the curricular proposals, in the negative ones we ’ ve verified controversial arguments between the students and teachers ’ speeches regarding the process of medical education in a humanized approach. For last, we ’ ve got large different results within the period investigated. However, we understand that the data found in the study has contribu ted to reach the proposed objectives regarding what has been perceived between the professors and students ’ point of views in relation to a humanized based education. Even if it ́s an initial perception, it is moving towards a medical education more humaniz ed and centered in the human being.

Prevalence of the metabolic syndrome and its components in Brazilian women with polycystic ovary syndrome

SOARES, Elvira Maria Mafaldo et al. Prevalence of the metabolic syndrome and its components in Brazilian women with polycystic ovary syndrome. Fertility and Sterility, v.89, n.3, p.649-655, mar. 2008

A Humanização e a Formação Médica na Perspectiva dos Estudantes de Medicina da Universidade Federal do Rio Grande do Norte

The aim of this study is to understand the perception of medical students at the Federal University of Rio Grande do Norte (UFRN) about humanization in the context of their medical formation, using a qualitative approach. The focus group and participant observation techniques were used, involving a multidisciplinary team composed of professionals from the areas of anthropology and psychology, as well as professors from the medical course, who studied two groups of nine students in their final year. The data were analyzed using the categorical thematic content analysis technique, from which emerged three categories: student/patient relationship, teaching/learning and student/professor relationship. The first allows us to identify that student-patient contact is an essential experience for adopting a more humanized view of the disease process. The second category shows that unqualified professors in the pedagogic practices inherent to the teaching profession and the theory the practical dichotomy hinder the autonomous and holistic formation of knowledge. Similarly, the lack of practices outside the academic environment and the absence of multiprofessional stimulation interfere in the construction of an integral view of the individual. From the third category, the student/professor relationship, emerge two opposing subcategories (professor model and assymetric relationships), which reflect the importance of the professor`s ethical humanist position, as opposed to an authoritarian attitude, to form the professional attitude of the student. The results point important aspects of the medical formation that may open a discussion about humanization, in the context of new national curricular guidelines

Síndrome metabólica e risco cardiovascular na pós- menopausa: avaliação por diferentes critérios diagnósticos e influência de fatores sócio-econômicos

The metabolic syndrome (MetS) involves a group of risk factors and is associated with a significantly higher risk of developing cardiovascular diseases (CVD) and type 2 diabetes. Recent studies have shown the importance of preventing CVD through early diagnosis and treatment of patients with MetS. The objective of our study was to determine the prevalence of MetS by different diagnostic criteria in postmenopausal women and analyze the influence of socioeconomic factors on cardiovascular risk in this sample of the population. A cross-sectional study involving 127 postmenopausal women (45 to 64 years) from Natal and Mossoró, Brazil. The study was approved by the Research Ethics Committee of the Federal University of Rio Grande do Norte. The experimental protocol consisted of applying structured interview, clinical examination and implementation of dosages blood. The diagnosis of MetS was based on NCEP-ATP III (National Cholesterol Education Program-Adult Treatment Panel III) and IDF (International Diabetes Federation) criteria. The research was accomplished with the participation of an interdisciplinary team in their several phases. The result of the sample studied had mean age of 53.9 ± 4.6 years and per capita income of 54.5 dollars. The prevalence of MetS, according to NCEP-ATP III and IDF criteria, was 52.8% and 61.4$, respectively. The agreement rate between NCEP-ATP III and IDF criteria was 81.9%, with a kappa value of 0.63 (CI 95%, 0.49-0.76), indicating good agreement between the two definitions. The most prevalent cardiovascular risk factor was HDL < 50 mg/dl, observed in 96.1% of the women analyzed, followed by increased waist circumference (≥ 80 cm) in 78.0%, elevated blood pressure in 51.2%, triglycerides ≥ 150 mg/dl in 40.9% and glycemia ≥ 100 mg/dl in 37.0% of the women. The occurrence of MetS was significantly associated with schooling and body mass index (BMI). High blood pressure was significantly associated with low family income, low schooling and weight gain. There was no significant association between the intensity of climacteric symptomatology and the occurrence of MetS. The conclusions of the research were that MetS and its individual components show a high prevalence in postmenopausal Brazilian women, and significant associations with weight gain and low socioeconomic indicators. The data point to the need for an interdisciplinary approach at the basic health care level, directed toward the early identification of risk factors and the promotion of cardiovascular health of climacteric women.

Avaliação do conhecimento e de habilidades clínicas em saúde sexual e reprodutiva na graduação de medicina

No Brasil, a despeito das conquistas obtidas a partir da implantação do Sistema Único de Saúde e dos avanços legais e institucionais na atenção a diversos problemas relacionados ao gênero, a incorporação de temas relacionados aos direitos humanos, sexuais e reprodutivos no contexto da formação profissional em saúde permanece deficiente. Este trabalho teve como objetivos avaliar a inserção da temática saúde sexual e reprodutiva no currículo do curso de graduação em Medicina, por meio do emprego de avaliações de conteúdo cognitivo, procedimental e atitudinal. Trata-se de estudo de intervenção educacional envolvendo alunos do internato do curso de Medicina da UFRN. Foram utilizados os seguintes métodos avaliativos: prova escrita, exame clínico objetivo estruturado (OSCE) e Mini-CEX. Como variáveis explicativas foram consideradas o sexo, idade e participação prévia no componente curricular optativo Saúde Reprodutiva . A avaliação do processo constou da aplicação de questionários de satisfação e entrevistas acerca dos métodos avaliativos utilizados. Considerando os três métodos avaliativos empregados, 183 estudantes participaram do estudo, com média de idade de 24,5 ± 2,2 anos, sendo 52,5% do sexo masculino e 47,5% do sexo feminino. No contexto geral, observamos concordância entre os desempenhos dos estudantes nas avaliações de conteúdo cognitivo, procedimental e atitudinal. A participação dos estudantes no componente curricular eletivo Saúde Reprodutiva mostrou-se associada com melhor desempenho em algumas dimensões da avaliação cognitiva e na avaliação com o Mini-CEX, em relação às competências de anamnese, profissionalismo e qualidades humanísticas, relação médico paciente e desempenho global. A análise da fidedignidade entre os avaliadores na avaliação com o método OSCE mostrou-se adequada (alfa de Cronbach superior a 70%) em relação ao desempenho global e aos aspectos técnicos das competências avaliadas, observando-se baixa confiabilidade na avaliação da comunicação médico-paciente. O presente trabalho constitui-se numa experiência educacional inovadora e pioneira no âmbito da educação médica brasileira no que tange à inserção da temática de saúde sexual e reprodutiva na graduação, sugerindo-se um impacto positivo da iniciativa na formação do médico generalista na UFRN. A avaliação de conhecimentos, habilidades e atitudes em saúde sexual e reprodutiva na graduação de Medicina mostrou-se factível, com alta concordância entre os diferentes métodos empregados. Os métodos OSCE e Mini-CEX podem ser aplicados ao contexto da saúde sexual e reprodutiva, possibilitando a avaliação de competências clínicas relevantes para a formação do médico generalista e que habitualmente não são contempladas nas avaliações rotineiramente realizadas na graduação

Avaliação da prevalência de Síndrome Metabólica, Microalbuminúria e Risco Cardiovascular em mulheres com Síndrome dos Ovários Policísticos

Avaliar fatores de risco cardiovascular em mulheres brasileiras com síndrome dos ovários policísticos (SOP), através da utilização de múltiplos parâmetros, incluindo a determinação da prevalência de síndrome metabólica e seus componentes e pesquisa de microalbuminúria como marcador de um possível dano renal precoce nessas pacientes. Métodos: Foram avaliadas 102 mulheres de 20-34 anos de idade, com diagnóstico de SOP pelo Consenso de Rotterdam, tendo sido analisados parâmetros clínicos, antropométricos, bioquímicos e hormonais. Para diagnóstico de síndrome metabólica, foram adotados critérios do National Cholesterol Education Program s Adult Treatment Panel III (NCEP-ATP III). Para avaliação da microalbuminúria foi utilizada a relação albumina/creatinina (A/C), calculada a partir dos níveis de albumina e creatinina em amostra isolada de urina. Foram realizados testes estatísticos para avaliar associações e correlações entre variáveis, bem como comparação de médias ou medianas, adotando-se nível de significância de 5%. Resultados: A prevalência de síndrome metabólica foi de 28,4% (29 em 102 pacientes), estando associada ao aumento do índice de massa corporal (IMC). Quanto à análise da prevalência dos componentes individuais da síndrome metabólica, evidenciou-se: HDL-colesterol < 50 mg/dl em 69,6%, circunferência da cintura ≥ 88 cm em 57,9%, triglicerídeos ≥150 mg/dl em 31,7%, pressão arterial ≥130/85 mmHg em 18,6% e glicemia de jejum ≥110 mg/dl em 2,9%. Quando definida pelos limites convencionais para a relação A/C (3,5 35 mg/mmol), a microalbuminúria esteve presente em apenas três pacientes (3,3%). Entretanto, considerando diferentes limites de corte estabelecidos em recentes estudos que demonstraram aumento do risco cardiovascular associado a níveis muito baixos da relação A/C, a prevalência em mulheres com SOP foi alta, variando de 17,7 a 43,3% (para valores ≥ 0,58 e ≥ 0,37 mg/mmol, respectivamente). Mulheres com intolerância à glucose apresentaram nível significativamente mais elevado da relação A/C, quando comparadas às mulheres com normoglicemia. Os valores de microalbuminúria não apresentaram correlação significativa com IMC, níveis pressóricos, índices de sensibilidade insulínica ou perfil lipídico. Conclusões: Os dados evidenciam uma alta prevalência de síndrome metabólica e seus componentes individuais em mulheres brasileiras com SOP. Além do mais, observou-se elevado percentual de mulheres com níveis de excreção urinária de albumina em faixas significativamente associadas com aumento do risco para eventos cardiovasculares. Em conjunto, esses dados alertam para a necessidade da abordagem interdisciplinar e multidisciplinar das pacientes com SOP, visando à instituição de medidas voltadas para a prevenção primária cardiovascular

O domínio da leitura e da escrita : por que não eu?

The study and research field of Education is wide and rich, mainly when it goes towards the empirical area of social reality. This research focuses on young and adult subjects who cannot read or write, although they had had access to and attended schools in Natal/RN. The locus of the research are the Municipal Schools that develop the Youth and Adults Education program EJA, having representatives from the North, South, East and West zones of the city, in a total of 6 municipal schools. It analyzes these subjects' replies to the questions: "Why are there young and adults who attended school but still cannot read or write?", What are the exclusion situations they face by not being able to read or write?". From a dialectic view on the subject, the research's strategy for data collection is the semi-structured interview to collect the replies given by the interviewees; replies that are separated by analysis categories presented charts of ideas. The research's results are analyzed and lead us to the conclusion that the affective, organic, cognitive, social, political and pedagogical factors are mentioned by the subjects as reasons why they can not dominate the reading or writing skills. The youth and adults interviewed are not happy with their school failure; the reading and writing learning is something that eases their social inclusion into a society that privileges such abilities, and that with it they could avoid the social exclusion they faced at school, in the work place, at home, in church, at health centers, on the street, at their children's school and in public assistance institutions

O lugar pedagógico da educação física na educação infantil: saberes (re)construídos na formação continuada do PAIDÉIA/UFRN

The present study aimed to investigate the overview of teachers in continuing education program who work in kindergarten, about the continuing education developed by the Paideia/UFRN through the Course of Specialization in Art Teaching and Physical Education in Childhood, having as key focus, the knowing / doing related to physical education in Childhood. From this general goal, it was elected some specific objectives as: to know the interests and expectations that motivated the teachers to participate of that referred training; the evaluation by teachers on regard of the continuing education proposed: boosters factors for possible changes in teaching activities regarding the practice of teaching physical education in kindergarten. The methodology took the principles and techniques of qualitative research strategy and the characteristics of descriptive and interpretive strategy. The locus of this research was the Course of Specialization in Art Education and Physical Education in childhood, having as the citizens of this research twenty three teachers taking that specialization course. For building and systematization of the data, we used the following tools and procedures: a questionnaire, a semi structured interview and documents analysis. The data was constructed based on the technique of content analysis, focusing the reflections and speech of the teachers about the creation of new meanings and senses for the knowing / doing in Physical Education. It was found, among other results, the need and quest for improvement of teacher education, in order to improve educational practice. It was also evident that the situations of dialogues (interactions with peers, with their professors and other professionals in the related area or not) were mentioned by most teachers in the course as a relevant moment of redefinition of knowledge. In relation to Physical Education, it was found that participation in the course of specialization provided the recognition of teaching practice of physical education as part of the curriculum and the importance of inclusion of its specificities in their educational planning. From these elaborations, we come to the conclusion that knowing the perspectives of the teachers about continuing education can contribute to the theoretical and methodological discussions in teachers education and the creation of new actions - projects and programs of continuing education constructing increasingly ways towards a successful teacher formation, able to provide new forms of acting in the educational context

Como se fora brincadeira de roda: a ciranda da ludopoiese para uma educação musical humanescente

The present work concerns an auto-ethnographic study based on life experiences and reflections of an educator at Escola Viva Preschool and Elementary-Middle School, located in the city center of Natal, Rio Grande do Norte. As a cognitive model of operation, we use the metaphor of the Circle Dance. The objective of this study is to identify, interpret and describe the ludopoetics that are achieved through a Musical Education program, which we denominate, Humanescent. The data of this investigation was derived from the music making by Preschool and Elementary-Middle School students at Escola Viva during 2007, 2008 and 2009, from which 20 learners were selected to form the corpus, along with the description and interpretation of photos of their experiences and sand tray scenes. We justify the methodological systemization of the research based on our own pedagogical practice, which supports Musical Education in the schools based on the principals of Embodiment, Autopoesis and Flow. The methodological systemization was developed through an Action Research model and on the concepts of Systemic Development, with the goal of re-reading the context investigated through the structuring of categories of Ludopoesis: Self-esteem, Self-territory, Self-connectivity, Self-realization and Selfworth. We used an observant-participant research approach with regard to the perception of emergent knowledge, the surroundings, the experience lived and the contextual and vibration of the circumstances. Besides this, we used projection to interpret the experiences lived, in the form of drawings, short poems, letters or sand tray scenes as symbolic interpretations of experience. In the unfolding of the Ludopoetic Process (Selfesteem, Self-territory, Self-connectivity, Self-realization and Selfworth) we draw conclusions about the relevance of the ludic musical experience, which foments the formation of the self based on music learning, and which is demonstrated in the Embodiment of the learners. In the auto-formative process (of learners and educators) we observe the importance of pedagogical work based on Musical Humanescent Education that gives value to the music making path to the construction of music and performance in play, creativity, and sensibility. The experience of making music in a playful way allows for organization of the self and its autonomous production in the joy of living within a ludopoetic process. These findings highlight the educator as in a permanent state of selfformation, which generates moments of flow. However, in Musical Humanescent Education, music is learned collectively, doing a circle dance, experiencing love, fostering an expansion of the creative spirit, and giving recognition to playfulness as a necessary condition for education and to the value of music made with the true nature and sensibilities of the educators

O(s) saber(es) e o(s) fazer(es) do professor formador :reflexões sobre a prática docente

This study, developed in conjunction to the Pedagogical Practice research line and the Curriculum of Post-graduation in Education Program of UFRN is about investigations on formation of professors and teaching knowledge. Its objective is to analyze fundamental concepts for lecturing and the relationship that establishes between those concepts and the practice of forming professors. We adopted as referential the principles of social-historical approach, in the context of concepts making and development (Vygotsky, Luria and Rubinstein), and of collaborative theoric-methodological approach (Jacullo-Noto, Kemmis and Ibiapina). Collaboration with professors was mediated by diary writing, collaborative observation and conceptual network creation, essential to perceiving the given meanings to concepts that sustain the practice of 06 (six) forming professors from the UFPI Pedagogy Course. Teresina Campus. This way, reflections with collaborator professors allowed to build conceptual networks, in which prominence was given to the meanings of concepts that gave sustaining to their lecturing practices in the referred course, showing a fragmentation and disarticulation between theory and forming practice. They also indicate a need to give new concepts to the meanings of teaching concepts, learning and lecturing of these professors, in a meaning of a greater understanding about those concepts for their effective practice. On the context of collaborative reflection about conceptual networks, it was evident the conflict generated between the meanings attributed by professors and the practice developed in class, pointing to the need of rethinking the articulation between theory and practice not only on the formative process developed, but also on the continual formation of forming professors and on the construction of discussing spaces and materialization of the curricular principles of the Pedagogy Course

Avaliação de um programa de educação ambiental não formal: a Caravana Ecológica na visão dos participantes

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Hospital de Pediatria da UFRN: resgatando memórias na construção da história

This study deals with a historical, descriptive and exploratory approach aiming to recall the origin and trajectory of the Pediatrics Hospital at Universidade Federal do Rio Grande do Norte. This research also deals with the insertion of the nursing department in the same Hospital. This was realized through existing records and discourse collected through interview of professionals-doctors, nurses, midwifes, nursing attendants and psychologists. Thus, a network was established and consisted of qualified informants, composed through reference analysis. Data treatment and analysis was performed based on the collection of oral data. The data was considered according to the font s context, all of which depending on process of comprehension and interpretation. The research was based on the main theme, through oral history used in order to build a historical background. These main themes were then subdivided and other discourses were made present such as: the historical scene, the dream came true and the insertion of nursing, present in the history construction; all of which enabled the research. Thus, in this process, it was possible to identify the most important characters of the origin of children s health services organization and assistance at Rio Grande do Norte. It was possible to perceive that this institution aimed to initiate health services that dealt with an education for future generations. This was observed through the creation of the Faculty of Medicine of Natal and as a consequence, the installation of a Pediatrics Hospital that dealt with medical education. The research made evident that the nursing contributed for a structuring of quality health assistance towards children, even though the resources and working conditions were scarce, extensive work shifts and low professional qualification. It was observed that the there was change in the category s profile, once nurses were introduced in the service. Once this happened, changes in mentality, and innovative processes as well as professional conducts were established. The distinctive relation between acting and doing of doctors and nurses were also dealt with. Thus, the first item is done towards the idealization, projection and prescription. The second issue deals with concretization in realization of something that was not projected and realized, causing suffering and unsatisfaction. At the end, it was possible to confirm that oral history is a very rich element and it is possible through subjects that build history, through their perceptation of the facts and the context in that their are inside

Atuação dos profissionais de saúde no atendimento à criança vítima de violência

This study had the purpose of identifying the health professional performance during the care of children victimized by violence. Its objectives were the evaluation of how health professionals diagnose violence on the hospitalized child during the care process; the identification, according to the experience of each health professional, of the types of violence on the hospitalized child, the child's aggressors and the most frequent1y injured area in the body and the analysis of conducts adopted by health professionals upon the recognition of a violence case on a hospitalized child. The study was of the descriptive-exploratory type, using a quantitative approach, performed on Hospital da Criança Santo Antônio (HCSA) in Boa Vista - RR. The population consisted of 235 health professionals, with data collected from June to August 2006. The results show a clear predominance of the female gender, (76,17%); aged 31 to 35 (26,81%); married (45,96%). As for professional formation, 63,9% were nursing auxiliaries and technicians,16,2% physicians, 14,8% nurses, 3,9% social assistants and 2,1% psychologists; 45,96% had completed middle-level education, 51,06% of which coming from private education establishments and 48,94% from public education institutions.; 97,66 % have specialization or improvement courses on their area; 32,77% among 05 to 09 years of work time; 32,06(10 worked on pediatric infirmaries; 75,74% state they have experience with children victimized by violence; 96,22% consider themselves capable of identifying the types of violence suffered by children; 29,00% consider physical violence the most common kind; 91,57% sought to identify the aggressors; 27,72% consider the mother to be the child's main aggressor, 26,36% the father, and 22,28% the stepfather; 26,55% consider the limbs and pelvic waist to be the body region most affected by violence; 26,91% take the attitude of reporting to the nurse and 20,13% to the social service; 70,79% state that the conducts were performed as a team; 26,25% of the professionals consider that the social assistants helped the most on deciding which conduct to adopt; 76,40% state there was no one opposed to the performing of these conducts; but 23,60% that stated there was no one opposed to the performing of these conducts, 77,08% reveal that the family members were against the conducts taken by the team. We conclude that, the hea1th professionals who were part of the study, apparently are not adequate prepared to diagnose and report the violence on child. The results were more drastic when we related the physicians and the nurses' answers, considering that they give directed assistance to these victims social assistants and psychologists are the ones best prepared to conduct cases of child mistreatment. However, we are conscious of our responsibility with professional education not only in upper grade institution but also on the middle-level. We believe also, that a continued education program can help to improve the professional knowledge and improve the quality of care

Educação corporativa para Micro e Pequenas empresas: aplicação do MADEC em empresas do setor supermercadista

This study searches to supply an existing gap in the empirical research about the performance of controllers of Micron and Small Companies (MSCs) in the context of corporative education (EC) through the Method of Support of Decision in Corporative Education (MSDCE). In the context of MCSs, this is a pioneering work, for other works related to this thematic searched in literature are limited to conjecture the possibility of its implantation via cooperation between companies; moreover, they do not apply any type of diagnosis method or viability. The object of study is an association of supermarkets of the city of Natal/RN, composed by 16 stores, of what 14 had been searched. The main objective of this work was to apply the first stage of the MSDCE and to verify the possibility of implanting the Corporative Education in the searched MSCs. As a result, it was obtained the profile of the companies and the validation of the above-mentioned Method. The phase of diagnosis conceived through the implantation of the first stage occurred through visits to the stores, interviews, application of questionnaires and place observation. The first stage - strategical analysis for professional education - was divided in two phases: analysis of the current corporative situation and available identification of the involved difficulties and resources. The implantation of the first stage of the MSDCE in the Association of Supermarkets Parceiros da Economia demanded a mapping of abilities and demonstrated how the education management works, the main difficulties and limitations of the MCSs of the supermerket branch of Natal/RN. Beyond the technological aspects, it was verified that cultural and educational aspects need to be worked to reach efficiency in the process of implantation of a corporative education program