Adoption and maintenance of a Mediterranean diet in patients with coronary heart disease from a Northern European population: a pilot randomised trial of different methods of delivering Mediterranean diet advice.

BACKGROUND: A Mediterranean diet has been shown to protect against coronary heart disease (CHD). Adherence to a Mediterranean diet can be assessed using a Mediterranean diet score. The primary aim of this pilot study was to examine whether CHD patients in a Northern European population would adopt and maintain a Mediterranean diet, with a secondary aim of comparing the effectiveness of different methodologies aimed at improving compliance. METHODS: Sixty-one patients with a diagnosis of CHD were randomised to one of three groups: either to receive conventional dietetic advice for CHD or advice to implement a Mediterranean-style diet using either behavioural counselling or nutritional counselling. Patients received a follow-up assessment at 6 months (adoption) and a subset of patients was followed up at 12 months (maintenance). The primary outcome measure was the between-group difference in the mean change in Mediterranean diet score (MDS). RESULTS: The change in MDS was not significantly different between groups. However, all three groups reported a significant within-group increase in MDS (P < 0.01) at 6 and 12 months follow-up. CONCLUSIONS: All three groups made dietary changes towards a Mediterranean diet, but behavioural counselling did not have significant additional benefit over nutritional counselling in initiating and maintaining dietary change, and neither method offering specific Mediterranean diet advice had any significant benefit in terms of improvement in MDS over conventional dietetic practice.

Grammatical characteristics of children's conversational utterances that contain disfluency clusters.

Selected characteristics of disfluent conversational utterances with and without disfluency clusters were examined in 14 children who stutter (CWS) and 14 children who do not stutter (CWNS). For CWS, utterances with disfluency clusters contained significantly more syllables and clausal constituents than disfluent utterances without clusters, which, in turn, contained significantly more syllables, clauses, and clausal constituents than fluent utterances. For both groups of children, disfluency clusters coincided significantly more often with utterance or clause onset than they did with grammatical constituents located elsewhere within an utterance. CWNS produced a significantly greater percentage of disfluency clusters that contained grammatical revision than did CWS. No significant between-group differences were observed in terms of the number of syllables, clauses, or clausal constituents within cluster-inclusive utterances. Findings are taken to suggest that disfluency clusters are typically produced within the most complex linguistic contexts and that they reflect the effects of producing multiple syntactic constituents within an utterance.

Selected temporal, grammatical, and phonological characteristics of conversational utterances produced by children who stutter.

The purpose of this study was to assess clause, syllable, and response latency characteristics of conversational utterances produced by children who stutter. Subjects were 14 boys who stutter (M age = 52.07 months; SD = 9.02 months) and 14 boys who do not stutter (M age = 51.93 months; SD = 8.55 months). Selected aspects of speech fluency, clause and syllable structure, and response latency were analyzed in utterances collected from each subject as he spoke with his mother during a 30-minute conversation. Results indicated that stuttered utterances of children who stutter contained significantly more clausal constituents than their length-matched fluent utterances. There was, however, no significant difference in syllable structure of the length-matched utterances, and neither stuttering frequency nor duration was significantly associated with syllable structure measures. Further, there was no significant difference in response latency of non-length-matched stuttered and fluent utterances. Findings are taken to suggest that changes in the number of clausal constituents that must be constructed, stored, or coordinated within an utterance may influence the likelihood of speech errors and, hence speech disfluencies within that utterance.

Parents as partners in the treatment of childhood stuttering.

Speech-language pathologists involved in treating childhood stuttering have increasingly emphasized the need for parental involvement in intervention. In this article, we review prevailing theoretical models of stuttering and illustrate various ways in which these models can be used to guide practitioners in determining how best to include parents in intervention. We argue that successful parental involvement depends upon the ability of parents and clinicians to reach consensus on issues such as the parents' role in the onset and development of stuttering, the rationale for including parents in fluency intervention, and the importance early intervention. The article concludes with a discussion of specific ways that parents can assist in intervention through modeling, managing conversational pace and complexity, and, in some cases, directly instructing their children.