Este trabalho tem o propósito de examinar as implicações da estrutura federativa brasileira no processo de regionalização das ações e serviços de saúde do Sistema Único de Saúde (SUS). A ideia nuclear é que, por sua natureza federativa, a regionalização da saúde no Brasil deve realizar-se no contexto das relações intergovernamentais fundadas na configuração institucional do federalismo cooperativo do país e em sua expressão na área da saúde. O método empregado inclui a utilização de material bibliográfico e a incorporação de componentes de investigação empírica. A análise desenvolvida baseia-se numa abordagem diacrônica do federalismo, tomando-o como princípio organizador do Estado que se manifesta em suas diversas dimensões. Desse modo, o fenômeno do federalismo é estudado em função de sua evolução no tempo e, de forma concatenada, partindo de seus aspectos gerais em direção aos específicos que se exprimem no Estado brasileiro e particularmente no âmbito da saúde. O federalismo sanitário brasileiro é abordado a partir de seu ingresso no ordenamento constitucional, identificando dois períodos bem delimitados de formação: a descentralização e a regionalização. Agregam-se elementos empíricos de pesquisa em que a regionalização da saúde é caracterizada a partir de concepções expressas por atores políticos que representam as perspectivas das três esferas de governo. Os condicionantes do processo de regionalização do SUS são então explorados à luz do referencial teórico do federalismo em três dimensões de análise: base normativa, estrutura de financiamento e dinâmica política. Assim, identificam-se pontos facilitadores e entraves para a regionalização e apontam-se possibilidades para a efetivação dessa diretriz organizativa no SUS. Conclui-se que a regionalização da saúde no Brasil está apoiada em arcabouço normativo bem definido, proveniente da assimilação dos princípios do federalismo cooperativo no direito sanitário brasileiro, e que encontra obstáculos derivados do modelo federativo de financiamento e relacionados ao funcionamento das relações intergovernamentais instituídas no SUS. / This study aims to examine the implications of Brazilian federal structure in the regionalization process of healthcare services of the national health system (Sistema Único de Saúde SUS). The core idea is that, by its federal nature, the regional health planning in Brazil must take place in context of intergovernmental relations founded on the institutional configuration of cooperative federalism in the country and on its expression in health. The method includes the use of bibliographic material and incorporation of empirical research components. The analysis is based on a diachronic approach, taking federalism as an organizing principle of State which is manifested in its various dimensions. Therefore, the phenomenon of federalism is studied in terms of its evolution in time and, so concatenated, starting with its general aspects towards specific ones which are expressed in the Brazilian State and particularly in health. The Brazilian health federalism is approached from its entry into the constitutional order, with two clearly defined development periods: decentralization and regionalization. Empirical elements are added from a study in which health regionalization is characterized from ideas expressed by political actors representing the perspectives of three levels of government. The conditioning factors of SUS regional health planning are then explored in light of the federalism theoretical framework taking three dimensions of analysis: normative basis, funding structure and political dynamics. Thus, facilitators and barriers to regional health planning are identified and opportunities for actualizing this organizational guideline in SUS are indicated. It is concluded that health regionalization in Brazil is supported by well-defined regulatory framework, proceeding from assimilation of cooperative federalism principles in Brazilian health law, and that it has obstacles derived from the federal model of financing and related to the operation of intergovernmental relations established in SUS

Dans les applications de puissance, les systèmes de stockage d'énergie électrique tels que les supercondensateurs sont fortement sollicités. Compte tenu des limitations existantes lors de l'utilisation d'un seul composant, un système de stockage d'énergie électrique (module) est constitué d'une association d'éléments (cellules) permettant de s'adapter aux besoins de l'application visée. Afin d'assurer la sécurité de l'équipement et de son utilisateur, un système de gestion d'énergie, qui a pour rôle de surveiller et de contrôler continuellement les cellules, est associé au module de stockage. Le but des travaux de thèse est l'amélioration de la durée de vie des systèmes de stockage d'énergie. Cet objectif est réalisé grâce au contrôle des circuits d'équilibrage, éléments du système de gestion d'énergie, et déjà présents sur ces modules de stockage. Différentes méthodes de contrôle sont donc présentées, analysées et comparées afin d'évaluer l'état de santé des supercondensateurs surveillés. Une nouvelle approche d'équilibrage se basant sur le niveau de dégradation estimée est exposée. Elle permet d'équilibrer les vitesses de vieillissement des cellules et ainsi de prolonger la durée de vie de l'ensemble du système. Certains principes des résultats obtenus sont transposables aux batteries / Energy storage system such as supercapacitors are widely used in high power applications. However, due to single cell voltage limitation, an energy storage system (module) is often employed. It contains a chain structure of identical elements and ensures voltage adaptation to the corresponding application requirements. Energy management systems are associated to energy storage systems in order to assure user and equipment security. Their main role is to monitor and control energy storage systems elements continuously. The work presented aims to enhance the lifetime of energy storage systems. It relies on establishing balancing circuits on the terminals of the storage system elements. These control circuits are energy management system devices. Thus, various control approaches are discussed, analyzed and compared. They aim to estimate the supercapacitor's state of health. In addition, a new approach of balancing circuits is proposed. It is based on estimating the level of degradation of the elements. Thus, It allows aging speed equalization between module elements and storage system lifetime maximization. Some main results of the work could be generalized to batteries

The objectives of the study were to determine infant and young child feeding (IYCF) knowledge of Household Health Promoters (HHPs) and examine its relationship with demographic characteristics. Quantitative, non-experimental descriptive design was used. Seventy-one randomly selected HHPs participated in the study. A structured questionnaire was used to collect the data. The results showed that the mean IYCF knowledge score was 77.8% (N=71). The knowledge of the respondents was not uniform across the components of IYCF which ranged between 19.72% for duration of breastfeeding to 100% for colostrums feeding. None of the socio-demographic characteristic was significantly associated to the mean knowledge score. The study identified that refresher training should be provided to the HHPs on IYCF with emphasis on the aspects of IYCF with scores below the mean / Health Studies

The objectives of the study were to determine infant and young child feeding (IYCF) knowledge of Household Health Promoters (HHPs) and examine its relationship with demographic characteristics. Quantitative, non-experimental descriptive design was used. Seventy-one randomly selected HHPs participated in the study. A structured questionnaire was used to collect the data. The results showed that the mean IYCF knowledge score was 77.8% (N=71). The knowledge of the respondents was not uniform across the components of IYCF which ranged between 19.72% for duration of breastfeeding to 100% for colostrums feeding. None of the socio-demographic characteristic was significantly associated to the mean knowledge score. The study identified that refresher training should be provided to the HHPs on IYCF with emphasis on the aspects of IYCF with scores below the mean / Health Studies