This study assessed the prevalence of asthma in Canadian children living on and off farms and the risk of asthma and respiratory symptoms of children exposed to certain farming activities. A cross-sectional survey was sent to parents of school children ages 6 to 13 living in an agricultural community in rural Saskatchewan. History of asthma and respiratory symptoms (cough, phlegm, or wheeze), location of home, and exposure to farming activities including haying, harvesting, moving, or playing with hay bales, feeding livestock, cleaning or playing in barns, cleaning pens, and emptying or filling grain bins were assessed. The response rate was 90.6% (n = 553). The prevalence of asthma and respiratory symptoms were 18.8% and 39.8%, respectively, and did not differ by home location (farm/nonfarm). In the adjusted multivariable models conducted with each farming activity separately, children who were exposed to emptying and filling of grain bins had a higher odds of asthma (odds [OR] = 2.18, 95% confidence interval [CI]: 1.03-4.62]. Reports of playing on or near hay bales (OR = 1.89, 95% CI:1.19-3.01), (OR = 2.08, 95% CI:1.07-4.06), and cleaning pens (OR = 2.70, 95% CI:1.05-6.97) were associated with increased respiratory symptoms. Certain farming activities associated with dust and animals appear to be risk factors for asthma and respiratory symptoms in this study population and should be avoided.

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Background:  Rural and remote nursing has unique practice requirements that create a need for distinct education and practice preparation.  Preparing registered nurses (RNs) to work in rural and remote communities is essential for the support and advancement of rural and remote health, as there is a shortage of rural and remote health care providers. Purpose:  An integrative literature review was conducted to identify the current continuing education needs of rural and remote RNs internationally. Sample: Eight studies were included in the integrative review of the literature.  Countries reported in the literature included Canada (n = 2), Australia (n = 2), Sweden (n = 1) and the United States (n = 3). Method:  An integrative literature review on rural and remote nursing practice continuing education was conducted using Torraco’s (2005) guidelines, in addition to Whittemore and Knafl’s (2005) methodological strategies.  A search strategy was created, tested, and approved by the research team.Themes were extracted, collated, analyzed, and knowledge synthesized. Findings:  Rural and remote RNs identified areas requiring enhanced ongoing training.  The identified training areas were summarized into the following four themes: 1) Comprehensive specialized nursing practice for direct patient care, 2) Unanticipated events, 3) Non-direct patient care, and 4) Advanced specialty courses. Conclusion:  The autonomy, competency, and expertise that is expected of RNs working in rural and remote locations requires educational supports. Rural and remote nursing continuing education is required in the areas of: comprehensive specialized nursing practice for direct patient care, unanticipated events, non-direct patient care, and advanced specialty courses.     Keywords: continuing education, integrative review, registered nurse(s), remote, rural Acknowledgements: The authors thank Saskatchewan Polytechnic for partial funding of this review through the Seed Applied Research Program.  The authors also thank their research team member Chau Ha and research assistant Devendrakumar Kanani for their contributions to this integrative review.

Purpose Diabetes self‐management for adolescents with type 1 diabetes (T1D) is a complex and multifaceted process that requires careful consideration of a supportive or shared approach to care. The purpose of this review was to synthesize the qualitative and quantitative evidence regarding the nature of adolescent−parent interactions and relationships in the context of T1D management. Of particular interest was the role of interdependence in this relationship. Methods An integrative review of the literature was conducted between January 2021 and April 2021 using Whittemore and Knafl's (2005) methodological strategies. Results Eleven studies published between 2003 and 2018 met the review criteria. Thematic analysis identified the following three themes related to parent−adolescent relationships in care including the Effectiveness of Parental Involvement and T1D Management, Shared Responsibility and T1D Task Management, and Gaining Independence in T1D Management. This review highlights the importance of both parent and adolescent shared involvement in T1D management. In particular, parental involvement appears necessary for improved glycemic control, better adherence to the T1D management regime, and for practicing self‐management in adolescents with T1D. Practice Implications Better understanding of the parent−child interaction in diabetes care will provide important information to aid family nurses to identify, support, and help maintain the sharing of T1D management responsibilities between parents and their adolescents.

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