Reliability and validity testing of team emergency assessment measure in a distributed team context.

Medical multi-professional teams are increasingly collaborating via telemedicine. In distributed team settings, members are geographically separated and collaborate through technology. Developing improved training strategies for distributed teams and finding appropriate instruments to assess team performance is necessary. The Team Emergency Assessment Measure (TEAM), an instrument validated in traditional collocated acute-care settings, was tested for validity and reliability in this study when used for distributed teams. Three raters assessed video recordings of simulated team training scenarios (n = 18) among teams with varying levels of proficiency working with a remotely located physician via telemedicine. Inter-rater reliability, determined by intraclass correlation, was 0.74-0.92 on the TEAM instrument's three domains of leadership, teamwork, and task management. Internal consistency (Cronbach's alpha) ranged between 0.89-0.97 for the various domains. Predictive validity was established by comparing scores with proficiency levels. Finally, concurrent validity was established by high correlations, >0.92, between scores in the three TEAM domains and the teams' overall performance. Our results indicate that TEAM can be used in distributed acute-care team settings and consequently applied in future-directed learning and research on distributed healthcare teams.

Adolescents' attitudes, preferences and perceived behaviours regarding healthy eating and whole grains from a gender and health interest perspective.

Background: A healthy diet is important not only for the growth and development of the human body but also for the prevention of chronic diseases. However, most Swedish adolescents do not follow dietary recommendations, especially the intake of whole grain is very low. To create targeted conditions for healthy food choices amongst adolescents, comprehensive knowledge of factors related to adolescents' unhealthy and healthy eating is needed. Objective: To investigate adolescents' attitudes, preferences and perceived behaviours regarding healthy eating, with a specific focus on whole grains and to evaluate differences between genders and between adolescents with higher versus lower health interest. Design: A total of 1,178 Swedish adolescents responded to a questionnaire about their attitudes, preferences and perceived behabviours towards healthy eating and whole grains, and their general interest in nutrition and health. Results of girls and boys were compared, as well as adolescents with a higher versus lower health interest. Results: Displays information about healthy eating among adolescents and a comprehensive set of factors that may affect their ability to eat healthier. Overall, adolescents had a positive attitude towards food and health, but less than half felt that they managed to eat healthy. The consumption of different whole grain products was low, although the willingness to eat healthier and more whole grain was high. The most reported barrier to healthy eating, as well as increasing whole grain intake, was the unavailability of tasty healthy products, taste being even more important for adolescents with a low health interest than those with a high interest. Whole grain consumption and factors increasing the willingness of whole grain consumption were most prominent not only in adolescents with high health interest but also in girls compared with boys. Conclusion: The results show good potential to improve dietary habits amongst adolescents. Taste and availability of healthy products were rated the most important, whilst knowledge about the products' healthiness was rated the least important, especially amongst those with low health interest. By focusing on the attitudes and preferences of adolescents, the effectiveness may increase of initiatives to improve their dietary habits.

The Effect of Rye-Based Foods on Postprandial Plasma Insulin Concentration: The Rye Factor.

Consumption of whole grain has been associated with lower incidence of type-2 diabetes, cardiovascular disease and their risk factors including improved glycemic control. In comparison with other whole grain products, rye bread has been shown to induce lower insulin response in the postprandial phase, without affecting the glucose response. This phenomenon has been referred to as the "rye factor" and is being explored in this review where we summarize the findings from meal and extended meal studies including rye-based foods. Overall, results from intervention studies showed that rye-based foods vs. (wheat) control foods had positive effect on both insulin and glucose responses in the postprandial phase, rather than on insulin alone. Mechanistic studies have shown that the rye factor phenomenon might be due to slowing of the glucose uptake in the intestine. However, this has also been shown for wheat-based bread and is likely an effect of structural properties of the investigated foods rather than the rye per se. More carefully controlled studies where standardized structural properties of different cereals are linked to the postprandial response are needed to further elucidate the underlying mechanisms and determinants for the effect of specific cereals and product traits on postprandial glycemic control.

Do team and task performance improve after training situation awareness? A randomized controlled study of interprofessional intensive care teams.

BACKGROUND: When working in complex environments with critically ill patients, team performance is influenced by situation awareness in teams. Moreover, improved situation awareness in the teams will probably improve team and task performance. The aim of this study is to evaluate an educational programme on situation awareness for interprofessional teams at the intensive care units using team and task performance as outcomes. METHOD: Twenty interprofessional teams from the northern part of Sweden participated in this randomized controlled intervention study conducted in situ in two intensive care units. The study was based on three cases (cases 0, 1 and 2) with patients in a critical situation. The intervention group (n = 11) participated in a two-hour educational programme in situation awareness, including theory, practice, and reflection, while the control group (n = 9) performed the training without education in situation awareness. The outcomes were team performance (TEAM instrument), task performance (ABCDE checklist) and situation awareness (Situation Awareness Global Assessment Technique (SAGAT)). Generalized estimating equation were used to analyse the changes from case 0 to case 2, and from case 1 to case 2. RESULTS: Education in situation awareness in the intervention group improved TEAM leadership (p = 0.003), TEAM task management (p = 0.018) and TEAM total (p = 0.030) when comparing cases 1 and 2; these significant improvements were not found in the control group. No significant differences were observed in the SAGAT or the ABCDE checklist. CONCLUSIONS: This intervention study shows that a 2-h education in situation awareness improved parts of team performance in an acute care situation. Team leadership and task management improved in the intervention group, which may indicate that the one or several of the components in situation awareness (perception, comprehension and projection) were improved. However, in the present study this potential increase in situation awareness was not detected with SAGAT. Further research is needed to evaluate how educational programs can be used to increase situation awareness in interprofessional ICU teams and to establish which components that are essential in these programs. TRIAL REGISTRATION: This randomized controlled trial was not registered as it does not report the results of health outcomes after a health care intervention on human participants.

Factors Influencing Team and Task Performance in Intensive Care Teams in a Simulated Scenario.

INTRODUCTION: Healthcare teams and their performance in a complex environment such as that of intensive care units (ICUs) are influenced by several factors. This study investigates the relationship between team background characteristics and team as well as task performance. METHODS: This study included 105 professionals (26 teams), working at the ICUs of 2 hospitals in Northern Sweden. The team-based simulation training sessions were video recorded, and thereafter, team performance and task performance were analyzed based on ratings of the TEAM instrument and the ABCDE checklist. RESULTS: The final analyses showed that a higher age was significantly associated with better total team performance (ß = 0.35, P = 0.04), teamwork (ß = 0.04, P = 0.04), and task management (ß = 0.04, P = 0.05) and with a higher overall rating for global team performance (ß = 0.09, P = 0.02). The same pattern was found for the association between age and task performance (ß = 0.02, P = 0.04). In addition, prior team training without video-facilitated reflection was significantly associated with better task performance (ß = 0.35, P = 0.04). On the other hand, prior team training in communication was significantly associated with worse (ß = -1.30, P = 0.02) leadership performance. CONCLUSIONS: This study reveals that a higher age is important for better team performance when caring for a severely ill patient in a simulation setting in the ICU. In addition, prior team training had a positive impact on task performance. Therefore, on a team level, this study indicates that age and, to some extent, prior team training without video-facilitated reflection have an impact on team performance in the care of critically ill patients.

Side-stream products of malting: a neglected source of phytochemicals.

Whole grain consumption reduces the risk of several chronic diseases. A major contributor to the effect is the synergistic and additive effect of phytochemicals. Malting is an important technological method to process whole grains; the main product, malted grain, is used mainly for brewing, but the process also yields high amounts of side-stream products, such as rootlet. In this study, we comprehensively determined the phytochemical profile of barley, oats, rye, and wheat in different stages of malting and the subsequent extraction phases to assess the potential of malted products and side-streams as a dietary source of bioactive compounds. Utilizing semi-quantitative LC-MS metabolomics, we annotated 285 phytochemicals from the samples, belonging to more than 13 chemical classes. Malting significantly altered the levels of the compounds, many of which were highly increased in the rootlet. Whole grain cereals and the malting products were found to be a diverse and rich source of phytochemicals, highlighting the value of these whole foods as a staple. The characterization of phytochemicals from the 24 different sample types revealed previously unknown existence of some of the compound classes in certain species. The rootlet deserves more attention in human nutrition, rather than its current use mainly as feed, to benefit from its high content of bioactive components.

Fecal short chain fatty acids in children living on farms and a link between valeric acid and protection from eczema.

Children growing up on farms have low rates of allergy, but the mechanism for this protective effect has not been fully elucidated. Short chain fatty acids (SCFAs) produced by the gut microbiota may play a role in protection from allergy. We measured fecal SCFA levels in samples collected from 28 farming and 37 control children over the first 3 years of life using gas chromatography. Data on diet and other host factors were recorded and allergy was diagnosed at 8 years of age. Among all children, median propionic and butyric acid concentration increased over the first 3 years, and longer SCFAs typically appeared by 1 year of age. Farm children had higher levels of iso-butyric, iso-valeric and valeric acid at 3 years of age than rural controls. In addition, children with elder siblings had higher levels of valeric acid at 3 years of age, and dietary factors also affected SCFA pattern. High levels of valeric acid at 3 years of age were associated with low rate of eczema at 8 years of age. The fecal SCFA pattern in farm children suggests a more rapid maturation of the gut microbiota. Valeric acid or associated microbes may have protective potential against eczema.

Reliability of instruments that measure situation awareness, team performance and task performance in a simulation setting with medical students.

OBJECTIVES: The assessment of situation awareness (SA), team performance and task performance in a simulation training session requires reliable and feasible measurement techniques. The objectives of this study were to test the Airways-Breathing-Circulation-Disability-Exposure (ABCDE) checklist and the Team Emergency Assessment Measure (TEAM) for inter-rater reliability, as well as the application of Situation Awareness Global Assessment Technique (SAGAT) for feasibility and internal consistency. DESIGN: Methodological approach. SETTING: Data collection during team training using full-scale simulation at a university clinical training centre. The video-recorded scenarios were rated independently by four raters. PARTICIPANTS: 55 medical students aged 22-40 years in their fourth year of medical studies, during the clerkship in anaesthesiology and critical care medicine, formed 23 different teams. All students answered the SAGAT questionnaires, and of these students, 24 answered the follow-up postsimulation questionnaire (PSQ). TEAM and ABCDE were scored by four professionals. MEASURES: The ABCDE and TEAM were tested for inter-rater reliability. The feasibility of SAGAT was tested using PSQ. SAGAT was tested for internal consistency both at an individual level (SAGAT) and a team level (Team Situation Awareness Global Assessment Technique (TSAGAT)). RESULTS: The intraclass correlation was 0.54/0.83 (single/average measurements) for TEAM and 0.55/0.83 for ABCDE. According to the PSQ, the items in SAGAT were rated as relevant to the scenario by 96% of the participants. Cronbach's alpha for SAGAT/TSAGAT for the two scenarios was 0.80/0.83 vs 0.62/0.76, and normed χ² was 1.72 vs 1.62. CONCLUSION: Task performance, team performance and SA could be purposefully measured, and the reliability of the measurements was good.

Food and Nutrient Intake during Pregnancy in Relation to Maternal Characteristics: Results from the NICE Birth Cohort in Northern Sweden.

Linkages between diet and other lifestyle factors may confound observational studies. We used cluster analysis to analyze how the intake of food and nutrients during pregnancy co-varies with lifestyle, clinical and demographic factors in 567 women who participated in the NICE (nutritional impact on immunological maturation during childhood in relation to the environment) birth-cohort in northern Sweden. A food frequency questionnaire, Meal-Q, was administered in pregnancy Week 34, and the reported food and nutrient intakes were related to maternal characteristics such as age, education, rural/town residence, parity, pre-pregnancy smoking, first-trimester BMI, allergy and hyperemesis. Two lifestyle-diet clusters were identified: (1) High level of education and higher age were related to one another, and associated with a diet rich in fruits, vegetables, whole grains and fish, and (2) smoking before pregnancy and higher BMI in early pregnancy were related to one another and associated with a diet that contained white bread, French fries, pizza, meat, soft drinks, candy and snacks. More than half of the women had lower-than-recommended daily intake levels of vitamin D, folate, selenium, and iodine. Complex lifestyle-diet interactions should be considered in observational studies that link diet and pregnancy outcome.

Exposure to a Farm Environment During Pregnancy Increases the Proportion of Arachidonic Acid in the Cord Sera of Offspring.

Growing up in a farm environment is protective against allergy development. Various explanations have been put forward to explain this association. Fatty acids are regulators of immune function and the composition of fatty acids in the circulation system may affect immune development. Here, we investigate whether the fatty acid composition of cord serum differs for infants born to Farm (n = 26) or non-Farm mothers (n =29) in the FARMFLORA birth-cohort. For comparison, the levels of fatty acids in the maternal diet, serum and breast milk around 1 month post-partum were recorded. The fatty acids in the cord sera from infants born to Farm mothers had higher proportions of arachidonic acid (20:4 n-6) and adrenic acid (22:4 n-6) than those from infants born to non-Farm mothers. No differences were found for either arachidonic acid or adrenic acid in the diet, samples of the serum, or breast milk from Farm and non-Farm mothers obtained around 1 month post-partum. The arachidonic and adrenic acid levels in the cord blood were unrelated to allergy outcome for the infants. The results suggest that a farm environment may be associated with the fatty acid composition to which the fetus is exposed during pregnancy.

Impact of activated sludge ozonation on filamentous bacteria viability and possible added benefits.

Ozone was applied to return activated sludge in full-scale to study how ozone impacts filamentous bacteria viability (Live/Dead®). Additionally, the ozonated sludges were subjected to anaerobic digestion trials and analysis of micropollutants (MPs). Ozone treatment (3-4.8 g O3/kg total suspended solids) improved the settling properties of the sludge by lowering the diluted sludge volume with 7-35%. Ozone inactivated filamentous bacteria outside the floc structures and the fraction of inactivated filaments increased with an increasing ozone dose. It was observed that ozone treatment may act selectively towards different types of filaments. With respect to the two dominating morphotypes present, Type 0041 filamentous bacteria were found to be more resistant to ozone attack than Microthrix parvicella. Thus, higher ozone doses may be required to mitigate sludge bulking caused by Type 0041 filaments. No effects could be discerned by ozone addition on neither the methane production of the sludge nor on the concentrations of MPs analysed for this study. The lack of effect on both methane production and micropollutant removal was deemed to be caused by insufficient ozone doses.

Nutritional impact on Immunological maturation during Childhood in relation to the Environment (NICE): a prospective birth cohort in northern Sweden.

INTRODUCTION: Prenatal and neonatal environmental factors, such as nutrition, microbes and toxicants, may affect health throughout life. Many diseases, such as allergy and impaired child development, may be programmed already in utero or during early infancy. Birth cohorts are important tools to study associations between early life exposure and disease risk. Here, we describe the study protocol of the prospective birth cohort, 'Nutritional impact on Immunological maturation during Childhood in relation to the Environment' (NICE). The primary aim of the NICE cohort is to clarify the effect of key environmental exposures-diet, microbes and environmental toxicants-during pregnancy and early childhood, on the maturation of the infant's immune system, including initiation of sensitisation and allergy as well as some secondary outcomes: infant growth, obesity, neurological development and oral health. METHODS AND ANALYSIS: The NICE cohort will recruit about 650 families during mid-pregnancy. The principal inclusion criterion will be planned birth at the Sunderby Hospital in the north of Sweden, during 2015-2018. Questionnaires data and biological samples will be collected at 10 time-points, from pregnancy until the children reach 4 years of age. Samples will be collected primarily from mothers and children, and from fathers. Biological samples include blood, urine, placenta, breast milk, meconium, faeces, saliva and hair. Information regarding allergic heredity, diet, socioeconomic status, lifestyle including smoking, siblings, pet ownership, etc will be collected using questionnaires. Sensitisation to common allergens will be assessed by skin prick testing and allergic disease will be diagnosed by a paediatrician at 1 and 4 years of age. At 4 years of age, the children will also be examined regarding growth, neurobehavioural and neurophysiological status and oral health. ETHICS AND DISSEMINATION: The NICE cohort has been approved by the Regional Ethical Review Board in Umeå, Sweden (2013/18-31M). Results will be disseminated through peer-reviewed journals and communicated on scientific conferences.

Efficiency of blue-green stormwater retrofits for flood mitigation - Conclusions drawn from a case study in Malmö, Sweden.

Coupled one-dimensional (1D) sewer and two-dimensional (2D) overland flow hydrodynamic models were constructed to evaluate the flood mitigation efficiency of a renowned blue-green stormwater retrofit, i.e. Augustenborg, in Malmö, Sweden. Simulation results showed that the blue-green stormwater systems were effective in controlling local surface flooding in inner-city catchments, having reduced the total flooded surfaces by about 70%. However, basement flooding could still be a potential problem depending on the magnitude of the inflows through combined sewer from upstream areas. Moreover, interactions between blue-green retrofits and the surrounding pipe-system were studied. It was observed that the blue-green retrofits reduced the peak flows by approximately 80% and levelled out the runoff. This is a substantial advantage for downstream pipe-bound catchments, as they do not receive a cloudburst-equivalent runoff from the retrofitted catchment, but a reduced flow corresponding to a much milder rainfall. Blue-green retrofits are more effective if primarily implemented in the upstream areas of a pipe-bound catchment since the resulting reduced runoff and levelled out discharge would benefit the entire network lying downstream. Implementing blue-green retrofits from upstream towards downstream can be considered as a sustainable approach.

Evaluation of direct membrane filtration and direct forward osmosis as concepts for compact and energy-positive municipal wastewater treatment.

Municipal wastewater treatment commonly involves mechanical, biological and chemical treatment steps to protect humans and the environment from adverse effects. Membrane technology has gained increasing attention as an alternative to conventional wastewater treatment due to increased urbanization. Among the available membrane technologies, microfiltration (MF) and forward osmosis (FO) have been selected for this study due to their specific characteristics, such as compactness and efficient removal of particles. In this study, two treatment concepts were evaluated with regard to their specific electricity, energy and area demands. Both concepts would fulfil the Swedish discharge demands for small- and medium-sized wastewater treatment plants at full scale: (1) direct MF and (2) direct FO with seawater as the draw solution. The framework of this study is based on a combination of data obtained from bench- and pilot-scale experiments applying direct MF and FO, respectively. Additionally, available complementary data from a Swedish full-scale wastewater treatment plant and the literature were used to evaluate the concepts in depth. The results of this study indicate that both concepts are net positive with respect to electricity and energy, as more biogas can be produced compared to that using conventional wastewater treatment. Furthermore, the specific area demand is significantly reduced. This study demonstrates that municipal wastewater could be treated in a more energy- and area-efficient manner with techniques that are already commercially available and with future membrane technology.

Potential of combining mechanical and physicochemical municipal wastewater pre-treatment with direct membrane filtration.

At a full-scale wastewater treatment plant, raw municipal wastewater from the sand trap outlet was mechanically and physicochemically pre-treated before microfiltration (MF) in a large pilot-scale study. MF was performed using a low transmembrane pressure (0.03 bar) without backflushing for up to 159 h (∼6.6 d). Pre-filtration ensured stable MF operation compared with the direct application of raw wastewater on the membrane. The combination of physicochemical pre-treatment, such as coagulation, flocculation, and microsieving, with MF meets the European and Swedish discharge limits for small- and medium-sized wastewater treatment plants (WWTPs). The specific electricity footprint was 0.3-0.4 kWh·m-3, which is an improvement compared to the median footprint of 0.75 kWh·m-3 found in 105 traditional Swedish WWTPs with sizes of 1500-10,000 person equivalents. Furthermore, the biological treatment step can be omitted, and the risk of releasing greenhouse gases was eliminated. The investigated wastewater treatment process required less space than conventional wastewater treatment processes, and more carbon was made available for biogas production.

Influences of mechanical pretreatment on the non-biological treatment of municipal wastewater by forward osmosis.

Municipal wastewater treatment involves mechanical, biological and chemical treatment steps for protecting the environment from adverse effects. The biological treatment step consumes the most energy and can create greenhouse gases. This study investigates municipal wastewater treatment without the biological treatment step, including the effects of different pretreatment configurations, for example, direct membrane filtration before forward osmosis. Forward osmosis was tested using raw wastewater and wastewater subjected to different types of mechanical pretreatment, for example, microsieving and microfiltration permeation, as a potential technology for municipal wastewater treatment. Forward osmosis was performed using Aquaporin Inside™ and Hydration Technologies Inc. (HTI) membranes with NaCl as the draw solution. Both types of forward osmosis membranes were tested in parallel for the different types of pretreated feed and evaluated in terms of water flux and solute rejection, that is, biochemical oxygen demand (BOD7) and total and soluble phosphorus contents. The Aquaporin and HTI membranes achieved a stable water flux with rejection rates of more than 96% for BOD7 and total and soluble phosphorus, regardless of the type of mechanical pretreated wastewater considered. This result indicates that forward osmosis membranes can tolerate exposure to municipal waste water and that the permeate can fulfil the Swedish discharge limits.

The effects of physicochemical wastewater treatment operations on forward osmosis.

Raw municipal wastewater from a full-scale wastewater treatment plant was physicochemically pretreated in a large pilot-scale system comprising coagulation, flocculation, microsieve and microfiltration operated in various configurations. The produced microsieve filtrates and microfiltration permeates were then concentrated using forward osmosis (FO). Aquaporin InsideTM FO membranes were used for both the microsieve filtrate and microfiltration permeates, and Hydration Technologies Inc.-thin-film composite membranes for the microfiltration permeate using only NaCl as the draw solution. The FO performance was evaluated in terms of the water flux, water flux decline and solute rejections of biochemical oxygen demand, and total and soluble phosphorus. The obtained results were compared with the results of FO after only mechanical pretreatment. The FO permeates satisfied the Swedish discharge demands for small and medium-sized wastewater treatment plants. The study demonstrates that physicochemical pretreatment can improve the FO water flux by up to 20%. In contrast, the solute rejection decreases significantly compared to the FO-treated wastewater with mechanical pretreatment.

Serum fatty acids in infants, reflecting family fish consumption, were inversely associated with allergy development but not related to farm residence.

AIM: In this study, differences in serum fatty acid patterns between farm and nonfarm infants were investigated and related to subsequent allergy development. We also related allergy-related serum fatty acids to maternal diet and breast milk fatty acids. METHODS: The FARMFLORA birth cohort included 28 farm and 37 nonfarm infants. Serum was obtained from 21 farm infants and 29 controls at four months post-partum and analysed for phospholipid fatty acids. Allergy was diagnosed by paediatricians at three years of age. RESULTS: Serum fatty acid patterns were similar in farm and control infants, although farm infants had lower 18:1 omega-7 proportions. Serum proportions of eicosapentaenoic acid (EPA) were unrelated to farming status, but lower in children who subsequently developed allergy, with an odds ratio of 0.47 and 95% confidence interval of 0.27-0.83 (p = 0.01) for every 0.1% EPA increase. The infants' serum EPA proportions correlated with breast milk EPA proportions, which, in turn, correlated with maternal oily fish intake during lactation. CONCLUSION: The allergy-protective effect of farming was not linked to infant serum fatty acid composition. However, healthy infants had higher proportions of EPA in their sera, probably reflecting a family diet rich in fish, compared to subsequently allergic children.

The inhibitory effects of reject water on nitrifying populations grown at different biofilm thickness.

Suppression of nitrite oxidizing bacteria (NOB) is of vital importance to achieve successful, energy efficient, mainstream anammox processes for wastewater treatment. In this study, biofilm carriers from a fully nitrifying MBBR system, fed with mainstream wastewater, were temporarily exposed to reject water from sludge dewatering, to evaluate this as a possible strategy to inhibit NOB and achieve nitrite production under realistic conditions. Two different carrier types were compared, in which biofilm thickness was maintained at approximately 400 and 50 µm, respectively, and reject treatment was tested at different exposure time and loading rates. Reject exposure almost always resulted in an increased nitrite production in the thinner biofilm, and overall, nitrifiers growing in the thin biofilm were more sensitive than those grown in the thicker biofilm. The effect from reject exposure remained in the systems for four days after returning to mainstream operation, with nitrite production gradually increasing for three days. Increased concentrations of free ammonia correlated with reject exposure and may be the cause of inhibition, although other factors cannot be excluded.

Diet in 1-year-old farm and control children and allergy development: results from the FARMFLORA birth cohort.

BACKGROUND: A farming environment confers strong protection against allergy development. We have previously shown that farming mothers consume more full-fat dairy than control mothers, who instead consume more low-fat dairy, margarine, and oils; margarine and oil intake was associated with increased risk of allergy development in their children. OBJECTIVES: The aims of this study were to investigate the differences in diet between children in farming and control families at 1 year of age, to investigate the relation between the diets of the mothers and their children, and to relate the children's diet to allergy development. DESIGN: The diet of 1-year-old children from dairy farming families (n=28) and from control families in the same rural area (n=37) was assessed by 24-h dietary recalls, followed by 24-h food diaries. Allergy was diagnosed by pediatricians at 3 years of age using strict predefined criteria. RESULTS: Farm children had a higher intake of farm milk, whole cream, cholesterol, saturated fat, and fat in total and tended to eat more butter, while controls consumed more carbohydrates and poultry and tended to eat more margarine. Farm children also had higher intakes of homemade porridge/gruel, oily fish, and iodine. The intake of butter and whole milk in children and mothers correlated significantly in farm families but not in controls. A weak negative association was found between seafood intake and allergy development, while allergy was positively associated with the intake of pork as well as zinc in the control group; these intakes also correlated with each other. CONCLUSIONS: Consistent with mothers in farming families, the children consumed more full-fat dairy and saturated fat than did controls, but this could not be linked to the low risk of allergy in the farming group. Seafood intake might protect against allergy development, in accordance with earlier findings.