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Stroke is a leading cause of serious long-term disability in the United States. The neurological insult following a stroke may leave the survivor with a chronic illness encompassing a lifetime of recovery. Recovery for the stroke survivor entails more than the return of function. A synopsis of the literature indicates that there are three domains of stroke recovery: physical, psychological, and social. There are six categories that comprise the three domains: cognition, function, health perception, self-concept, relationships, and role change. Stroke is a multifaceted and complex disease. Individual aspects of stroke recovery do not occur in isolation and cannot be separated from one another. In the future, studies involving the integration of the domains of stroke recovery are needed to understand the interactive processes that support recovery.

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La prévision des incendies de forêt reste un défi puisque vitesse et direction de propagation dépendent des interactions multi-échelles entre la végétation, la topographie du terrain et les conditions météorologiques. Un modèle à l’échelle régionale peut donc difficilement prendre en compte le détail des processus physiques mis en jeu. Toute modélisation est entachée de nombreuses incertitudes (modélisation incomplète, méconnaissance du terrain, de la végétation et des interactions flamme/atmosphère, etc.) qu’il est nécessaire de quantifier et de corriger. Ces travaux de thèse proposent ainsi une modélisation régionale des incendies qui a des meilleures capacités de simulation et prévision, basée sur une évaluation des modèles et l’assimilation de données. L’évaluation de modèles a consisté à développer des simulations multi-physiques à l’échelle de la flamme, incluant la résolution des équations de Navier-Stokes réactives, l’évaluation du transfert radiatif vers la végétation, la construction d’un modèle de pyrolyse de la végétation ainsi que la modélisation de l’interface flamme/végétation afin de mieux comprendre la dynamique des incendies. La seconde approche proposée a consisté à mettre en place un prototype d’assimilation de données pour le suivi de la propagation du front de feu. L’idée est de rectifier la trajectoire simulée du front au fur et à mesure que de nouvelles observations sont mises à disposition, la différence entre les positions observées et simulées du front étant traduite en une correction des paramètres de vitesse de propagation ou directement de la position du front via l’algorithme du filtre de Kalman d’ensemble. Ces approches, tenant compte des incertitudes à la fois sur la modélisation des incendies et sur les observations disponibles, permettent ainsi d’améliorer la prévision de la dynamique des feux ainsi que des émissions atmosphériques, ce qui constitue un enjeu de taille pour la protection civile et environnementale. / Because wildfires feature complex multi-physics occurring at multiple scales, our ability to accurately simulate their behavior at large regional scales remains limited. The mathematical models proposed to simulate wildfire spread are currently limited because of their inability to cover the entire range of relevant scales, because also of knowledge gaps and/or inaccuracies in the description of the physics as well as inaccuracies in the description of the controlling input parameters (i.e., the vegetation, topographical and meteorological properties). For this purpose, the uncertainty in regional-scale wildfire spread modeling must be quantified and reduced. In this context, the goals of this thesis are two-fold. First, multi-physics detailed simulations of fire propagation, solving for the flame structure using Navier-Stokes equations for multi-species reacting flow and including radiation heat transfer, biomass pyrolysis as well as a flame/vegetation interface, were performed at the flame scale. These simulations were compared to measurements to provide a comprehensive understanding of the mechanisms underlying fire propagation. Second, the use of a data-driven simulator that sequentially integrates remote sensing measurements and relies on an empirical spread model was explored for regional-scale fire front tracking. The idea underlying this data assimilation strategy was to translate the differences in the observed and simulated fire front locations into a correction of the input parameters of the empirical model or directly of the fire front location via the ensemble Kalman filter algorithm. Since these two approaches account for uncertainties in fire spread modeling and measurements, they improve our ability to forecast wildfire dynamics and plume emissions. These challenges have been identified as a valuable research objective with direct applications in fire emergency response for civil defense and environmental protection.

Complications due to stroke account for a significant proportion of admissions to medical wards in Thailand. Unlike western countries where community rehabilitation programs have been established to provide services following the acute stage of stroke recovery, there is no stroke rehabilitation team in the community and family care givers are the primary source of ongoing care and support. This research was a comparative study with concurrent controls, using a two-group pre-test and post test design. The aims of this study were to develop and implement a nurse led supportive educative learning program for care givers of stroke survivors, and to evaluate outcomes for patients and their carers. The study demonstrated that providing education and support to the family caregiver of stroke survivors does benefit both the survivors and caregiver by empower carers to make decisions about the care they provide which has a follow on effect of reducing care stress and burden. It is recommended that programs to provide carers with skills and knowledge to assume an active and therapeutic role in the management of family members who suffer a stroke be established and appropriately supported. Furthermore, implementing this research in other regions of Thailand is recommended. / Doctor of Philosophy (PhD)

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