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Extreme weather can cause ill health in older persons due to a direct thermal effect on the body's thermoregulation and difficulties in maintaining a healthy lifestyle and accessing the health services they need. To understand experiences in relation to their exposures to extreme weather and how they responded to such weather conditions, including cold snaps, heat and air pollution in northern Thai communities, a descriptive qualitative study was conducted to uncover details and the essence of perspectives and experiences of older persons and family members. Three focus group discussions with 15 older persons and 15 family members occurred in three communities in Chiang Rai, a northern province of Thailand. Thematic analysis was performed. Experiences of older persons and families in relation to extreme weather conditions were described in five themes: local actions against weather changes, the double challenges, awareness and reactions to weather changes, protective and comfortable living environments, and mitigation of the impacts of weather conditions. Seasonal adaptability was key for older persons to stay safe and healthy during extreme weather changes. Heat, cold snaps, and air pollution made health and daily living routine maintenance among older persons challenging, especially among those with declining health. Older persons and families employed predictive and adaptive strategies to avoid and minimise extreme weather impacts and maximise their comfort and optimal living.

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BACKGROUND: The concept and philosophy of healing environments in health care is not new and there has been recent research into the experience of nurses and families experience of healing environments producing positive outcomes in relieving stress and improving quality of life. However, there is little in-depth information about student nurse's experience of healing environments in support of patients. AIM: To report on the stories of student nurses who participated in formal and informal activities in a healing haven environment called a Fairy Garden (FG) within a hospital in northern Thailand. Their beliefs about the care of sick children in an environment designed to provide educational and recreational activity during hospital care are explored. METHODS: Narrative inquiry, a qualitative methodology was selected to capture the main threads of the participants' experience. Clandinin's narrative inquiry framework involving the three commonality dimensions of sociality, temporality and place were used in analysing the data. Sixty-two student nurses from a Thai College of Nursing and from an Australian university were interviewed. RESULTS: In this study the place of a FG has been investigated as a non-clinical environment providing sick children with exposure to nature, play activities and spaces to explore. Findings include three main threads: freedom to be a child not a sick child, engaging in care and professionalism, a moment in time of living fantasy. CONCLUSIONS: Student nurses in this study had a broader understanding of health care other than the biomedical model. It transformed their learning and opened their eyes to a more holistic approach to humanising care of sick children.

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AIMS AND OBJECTIVES: To report on the stories of registered nurses and nurse administrators in a Thai hospital that recently constructed a healing haven environment called a 'Fairy Garden' to support the formal and informal activities of sick children. BACKGROUND: While there has been some research into healing environments in health for adults, there has been no qualitative research into healing environments such as natural gardens for children. DESIGN: Narrative inquiry was selected to capture the holistic notion of the participant's experience. Clandinin's narrative inquiry framework involving three dimensions sociality, space and temporality was used to analyse the data. METHODS: Eight nurses (including two head nurses, three ward nurses and three nurse administrators) were interviewed in three separate focus groups between November 2011-June 2012. RESULTS: Findings included storylines/threads of happiness, relaxation and calmness, imagination, spirituality and cooperation in reporting observed responses of sick children to the 'Fairy Garden'. Importantly, play was seen as a distractor from the children's pain and illness, with the children's ward no longer viewed as simply a clinical hospital site. Rather the opportunities that were afforded to children to interact with the 'Fairy Garden' environment expanded their hospital experience to include play, social interaction and educational activities. CONCLUSION: The Nurses' stories capture numerous storylines and threads in which the 'Fairy Garden' becomes an environment beyond the constraints of the hospital ward. Storylines indicate increased acceptance and adherence to treatment as the 'Fairy Garden' opens up alternatives for children, especially those children long term in the hospital. Children exhibit behaviours that suggest the 'Fairy Garden' supports psycho-social and physical benefits that improve their hospital stay and provide potential for improved clinical outcomes. RELEVANCE TO CLINICAL PRACTICE: Designed hospital environments need to consider the addition of natural and activity spaces to support sick children and their families. Reports from nurses caring for children indicate benefits of the natural environment outside the clinical area.

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For the past 4 years, undergraduate students from the Faculty of Health, University of Newcastle, Newcastle, Australia, have undertaken a two week cultural study tour in Thailand, being exposed to a broad range of cultural interactions, health settings in rural and remote areas, and health-treatment approaches, including traditional and complementary therapies. Student evaluations and reflections were collected after the 2010 and 2011 study tours. This paper reports on findings following thematic analysis of the data, which identified central themes, including connectivity to others, "awakenings", "embodiment", and looking to the future. Findings included a recognition by students of a growth in awareness and change in perspective, which they felt would impact on their future approach in caring for patients from culturally- and linguistically-diverse backgrounds. We conclude that the study tour provided an effective way of sensitizing students to cultural differences and promoting cross-cultural awareness.

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BACKGROUND: The double burden of communicable and noncommunicable diseases (NCD) is an increasing trend in low- and-middle income developing countries. Rural and minority populations are underserved and likely to be affected severely by these burdens. Knowledge among young people could provide immunity to such diseases within a community in the long term. In this study we aimed to assess the knowledge of several highly prevalent NCDs (diabetes, hypertension, and chronic obstructive pulmonary disease [COPD]) and several highly incident communicable diseases (malaria and diarrheal diseases) among Karen high school students in a rural district in far northwest of Thailand. The aim of the study is to explore information for devising life-course health education that will be strategically based in schools. METHOD: A cross-sectional survey approved by the ethics committee of Boromarajonani College of Nursing Nakhon Lampang (BCNLP), Lampang, Thailand was conducted in Thasongyang, Tak province, from September 2011 to January 2012. Questionnaires for assessing knowledge regarding diabetes, hypertension, COPD, malaria, and diarrheal diseases were delivered to all 457 Karen high school students attending Thasongyang high school. A total of 371 students returned the questionnaires. Experts' validation and split-half reliability assessment was applied to the instrument. RESULTS: Students' main sources of health information were their teachers (62%), health care workers (60%), television (59%), and parents (54%). Familial risk factors of diabetes and hypertension were not known to more than two thirds of the students. Except obesity and physical inactivity, lifestyle-related risk factors were also not known to the students. Though living in a malaria-endemic area, many of the Karen students had poor knowledge about preventive behaviors. Half of the students could not give a correct answer about the malaria and hygienic practice, which might normally be traditionally relayed messages. CONCLUSION: Health education and knowledge about common NCD and communicable diseases are yet to be prompted among the Karen students. A broader and more comprehensive school-based health education strategy for prevention of double burden diseases would benefit the rural minority population at the Thai-Myanmar border.

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The purpose of this study was to describe the falls that occurred over a 5-year period in a group of older adults living in a continuing care retirement community (CCRC) and to test two models, one mediating whether or not the individual fell and the second the number of falls the individual experienced. Of the 312 participants, 177 (57%) residents experienced at least one fall. There were a total of 594 falls with the mean number of falls per person being 1.9 (SD = 3.0), and the range of falls from 1 to 19. Age, gender, and neurologic disease significantly influenced whether or not a fall occurred. Mental health, regular use of alcohol, and neurologic problems all significantly influenced the number of falls that occurred.

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