No difference was found in the relationship between nasalance and nasality when nasality was rated using EAI as opposed to DME procedures. Nasometer test sensitivity and specificity were similar for EAI- and DME-rated nasality. A linear model accounted for the greatest proportion of explained variance in EAI and DME ratings. Consequently, clinicians should be able to obtain valid and reliable estimates of nasality using EAI or DME.

Purpose : This study investigated both the ability of children to rate nasality and the relationship of those ratings to expert ratings and social acceptance judgments. Method : A total of 10 speech samples were judged for nasality by 44 children ranging in age from 8 to 11 and by an expert judge. Listeners rated nasality on a 3-point response scale. The peer listeners also made five social acceptance ratings about each speaker. Results : Kappas for interrater reliability were moderate to substantial. There was no difference between peer ratings and expert ratings. As ratings of nasality increased, social acceptance ratings became more negative. Conclusion : Professionals who evaluate and treat children with cleft palate should consider the negative social consequences of even mild hypernasality.

For clinical purposes, care should be exercised when comparing nasalance scores between the old Nasometer and the Nasometer II.

The compensatory substitutional placements for phonemes produced by MoS speakers may detract from the intelligibility of speech. This is similar to the McGurk-MacDonald effect, whereby an illusory auditory signal is perceived when visual information from lip movements does not match the auditory information from speech. It also suggests that observers use contextual clues, more than the acoustic signal alone, to arrive at the accurate recognition of the message of the speakers with MoS. Therefore, speakers with MoS should be counseled in the top-down approach of auditory closure. When the speech signal is degraded, predictable messages are more easily understood than unpredictable ones. It is also important to confirm the speaking partner's understanding of the topic before proceeding.

Central line-associated bloodstream infection (CLABSI) rates above the national average precipitated a quality improvement project aimed at reducing this trend. We implemented daily chlorhexidine bathing and used 4 strategies to promote a change in practice and culture in our medical/surgical units. These strategies include the following: (1) staff education, (2) leadership support, (3) resource availability, and (4) increased awareness and accountability. Since implementing these strategies, there has been a significant reduction in CLABSI rates in the medical/surgical units.