This qualitative study drew from Thematic Analysis, inspired by Grounded Theory, to explore how counselling students completing their internship manage their feelings of incompetence. Four master’s level counselling students from three different masters counselling programs in Ontario, Canada were interviewed using a semi-structure interview protocol to gain an in-depth understanding of how they experienced and managed FOI during their internship. Twenty-nine subthemes emerged, which were further categorized into four over arching main themes: (1) experience of FOI, which included eight subthemes; (2) effects of FOI, which included eight subthemes; (3) management of FOI, which included six subthemes; and (4) seeking supports for FOI, which included eight subthemes. The FOI that counsellors-in-training experience can directly impact their clients and the implications of this study related to counselling pedagogy and supervision are discussed.

Thesis (M.S.)--West Virginia University, 1999. / Title from document title page. Document formatted into pages; contains v, 46 p. : ill. Vita. Includes abstract. Includes bibliographical references (p. 37-45).

Consumers often pay different prices for the same product, and prices commonly vary across stores and time. Theories of fairness suggest that such price discrepancies will be deemed unfair, yet consumers’ perceptions of unfairness in such situations vary greatly (Haws and Bearden 2006). This dissertation aims to enrich our understanding of this issue by examining the role of threat in shaping consumers’ perceptions of unfairness. Specifically, integrating the extant literature on unfairness, affect and identity, it argues that an important basis for consumers’ perceptions of unfairness is the degree to which price differentials convey threatening information about important aspects of the consumers’ self-concept. In fact, it suggests that price differentials can convey threatening information about two distinct aspects of consumers’ identity – their perceived relational value and their personal identity - and identifies conditions under which such information is likely conveyed. Here, relational value refers to assessments of social worth and personal identity refers to the aspect of the self concerned with the achievement of individualized goals such as competence, mastery and conscience (Skitka 2003). The logic underlying this central argument is that self-threatening price differentials trigger more intense negative affect, which is subsequently used by consumers to inform their fairness judgments. The current work also examines whether price differentials that convey self-affirming information are likely to be deemed less unfair because of the positive feelings they inspire. Taken as a whole, this dissertation highlights the central role of threat in shaping consumers’ price fairness judgments. In doing so, it contributes to the fairness literature, both in marketing and more broadly, by offering an organizing framework for understanding the basis of consumers’ price fairness judgments. / Thesis (Ph.D, Management) -- Queen's University, 2012-09-07 08:20:05.227

Demoralization is a concept that evolved out of the study of individuals under stress. It is defined as the combination of distress and subjective incompetence in the presence of inadequate social bonds. When patients with alcohol abuse problems are diagnosed with cancer they may become demoralized and be unable to summons adequate resources to address issues associated with changing their addictive behavior. The Stage of Change Model (SOC), one of the primary approaches in addiction therapy, is used to guide individuals through the process of behavioral change. This two phase study examined the relationship between demoralization and stage of change. The fist phase was a retrospective chart review (N =112) intended to establish the psychometrics of a new instrument measuring the subjective incompetence component of demoralization. The twelve item Subjective Incompetence Scale (SIS) demonstrated strong internal consistency (.92) and strong indices of being a reliable and valid measure. As expected there was a weak relationship in a positive direction with pain and confusion, a moderate and positive relationship with avoidant coping, and a strong and positive relationship depression, anger and fatigue. There was a moderate and negative correlation with apathy which was also in the direction expected. Phase two was a correlational study using a survey research design, aimed at examining the relationship between alcohol use, depression, level of demoralization and stage of change. The study was done on a convenience sample of patients in colorectal and gastrointestinal clinics at H. Lee Moffitt Cancer Center (N=71). Depression and demoralization were found to be distinct but related constructs. Level of alcohol consumption was not correlated with SOC. The components of demoralization were regressed on Stage of Change to determine their predictive value. Social support (ISELSF), perceived stress (IES) and subjective incompetence (SIS) resulted in a significant increment in variance explained ( R2 ). The whole model produced R2 =.284, F (7, 53) = 2.847, p =.013 which explained a significant portion of the variance in stage of change. Implications for practice and directions for future research are discussed.

Αντικείμενο της παρούσας διατριβής είναι ο προσδιορισμός του βαθμού επάρκειας κτιρίων από φέρουσα τοιχοποιία παρουσία σεισμικής έντασης. Στόχος της εργασίας είναι να διερευνηθεί πως επηρεάζεται ο βαθμός σεισμικής επάρκειας μίας κατασκευής από την ύπαρξη διαφράγματος, το πλήθος των ορόφων, το πάχος των τοίχων, το υλικό της τοιχοποιίας, το μέγεθος των ανοιγμάτων και την ασυμμετρία της κάτοψης. Στο Πρώτο Κεφάλαιο, αρχικά, παρουσιάζονται κάποια γενικά στοιχεία για τη φέρουσα τοιχοποιία. Στη συνέχεια, γίνεται αναφορά στον προσδιορισμό των μηχανικών χαρακτηριστικών της τοιχοποιίας. Ακόμα, περιγράφεται η μεθοδολογία για τον έλεγχο των ανεπαρκειών με βάση τον EC8. Τέλος, παρουσιάζεται η μέθοδος του δευτεροβάθμιου προσεισμικού ελέγχου για την εύρεση της ανεπάρκειας ενός κτιρίου. Στο Δεύτερο Κεφάλαιο γίνεται μία σύντομη αναφορά στη παθολογία κατασκευών από φέρουσα τοιχοποιία. Συγκεκριμένα, παρουσιάζονται τα αίτια που προκαλούν βλάβες στις κατασκευές, καθώς επίσης και οι βασικοί τύποι ρωγμών που απαντώνται πιο συχνά στα κτίρια από τοιχοποιία. Στο Τρίτο Κεφάλαιο παρουσιάζονται όλα τα στοιχεία που εισήχθησαν στο πρόγραμμα ETABS για τη δημιουργία κατάλληλου προσομοιώματος. Αρχικά, γίνεται πλήρης αναφορά των γεωμετρικών στοιχείων όλων των υπό εξέταση κτιρίων. Πιο συγκεκριμένα, εξετάζονται τρεις περιπτώσεις κτιρίων: ιδεατά συμμετρικά, ιδεατά ασύμμετρα και πραγματικά κτίρια. Στη συνέχεια, γίνεται αναλυτικός υπολογισμός των μηχανικών χαρακτηριστικών της τοιχοποιίας σύμφωνα με κατάλληλη βιβλιογραφία και παρουσιάζονται οι επιφάνειες επιρροής με τις οποίες προσδιορίστηκαν τα φορτία των κατασκευών. Επιπλέον, γίνεται περιγραφή του τρόπου προσομοίωσης και αναφέρονται λεπτομερώς οι παραδοχές που έγιναν κατά την ανάλυση. Στο Τέταρτο Κεφάλαιο παρουσιάζονται τα αποτελέσματα των αναλύσεων των ιδεατών συμμετρικών κτιρίων. Συγκεκριμένα, παρατίθενται οι ανεπάρκειες που προέκυψαν για την εντός επιπέδου ένταση με βάση τα μέγιστα αποδεκτά όρια του EC8 σε όρους γωνιακών παραμορφώσεων για στάθμη επιτελεστικότητας SD. Στη συνέχεια, διερευνάται η επιρροή της διαφραγματικής λειτουργίας, του πλήθους των ορόφων, του πάχους των τοίχων, του υλικού της τοιχοποιίας και του μεγέθους των ανοιγμάτων στις ανεπάρκειες τους. Στο Πέμπτο & Έκτο Κεφάλαιο παρουσιάζονται τα αποτελέσματα των αναλύσεων για τα ιδεατά ασύμμετρα και τα πραγματικά κτίρια αντίστοιχα. Ομοίως, παρατίθενται οι ανεπάρκειες που προέκυψαν για την εντός επιπέδου ένταση με βάση τα μέγιστα αποδεκτά όρια του EC8 για στάθμη επιτελεστικότητας SD. Στη συνέχεια, διερευνάται η επιρροή της διαφραγματικής λειτουργίας, του πλήθους των ορόφων, του πάχους των τοίχων και του υλικού της τοιχοποιίας στις ανεπάρκειες τους. Στο Έβδομο Κεφάλαιο παρουσιάζονται τα αποτελέσματα των ανεπαρκειών όλων των κτιρίων που προέκυψαν για την εκτός επιπέδου ένταση σύμφωνα με τα όρια των γωνιακών παραμορφώσεων που προτείνει η FEMA 356 για στάθμη επιτελεστικότητας LS. Ομοίως και σε αυτό το κεφάλαιο διερευνάται η επιρροή της διαφραγματικής λειτουργίας, του πλήθους των ορόφων, του πάχους των τοίχων και του υλικού της τοιχοποιίας στις ανεπάρκειες τους. Για τα ιδεατά συμμετρικά κτίρια εξετάζεται επιπλέον και η επιρροή του μεγέθους των ανοιγμάτων στις ανεπάρκειες τους. Στο Όγδοο Κεφάλαιο υπολογίζονται οι δείκτες ανεπάρκειας Η/R όλων των κτιρίων σύμφωνα με τη προσεγγιστική μέθοδο του ΟΑΣΠ. Επίσης, διερευνάται η αξιοπιστία του δείκτη ανεπάρκειας που προκύπτει από το δευτεροβάθμιο προσεισμικό έλεγχο μέσω της σύγκρισής του με τις ανεπάρκειες που προκύπτουν από τον EC8. Στο Ένατο Κεφάλαιο συνοψίζονται τα πιο σημαντικά συμπεράσματα που προέκυψαν από το σύνολο των διερευνήσεων που πραγματοποιήθηκαν στα πλαίσια στης παρούσας εργασίας. Ακολουθεί η βιβλιογραφία και στο τέλος παρατίθενται τα παραρτήματα. / The purpose of this study is to determine the level of competence of masonry buildings subjected to seismic actions. The aim of this project is to investigate how the degree of seismic resistance of a structure is affected by existing diaphragms, the number of floors, the thickness of the walls, the material of the walls, the size of the openings and the symmetry in plan. Some general data for masonry is initially presented in chapter one. Subsequently, reference is made to the determination of the mechanical characteristics of the masonry. Furthermore, the assessment method based on EC8 is described. Finally, the second level pre-earthquake assessment method for masonry buildings is presented. In the second chapter, there is a brief description of the structural characteristics of masonry in relation to expected damaged. In particular, the causes of construction defects are presented as well as the basic types of cracks that can be found more frequently in masonry buildings. The third chapter lists all the data entered into the ETABS computer program to create appropriate simulations. Initially, the geometric data of all investigated buildings is given. More specifically, the following three cases of buildings are examined: idealised symmetric, idealised asymmetric and real buildings. Then, detailed calculations of the mechanical characteristics of masonry based on appropriate literature are performed and include using influence surfaces to determined the loads of the buildings. Moreover, a description of the simulation method and details of the assumptions made in the analysis are given. The fourth chapter presents the results of analyses of the idealised symmetrical buildings. Specifically, the inadequacies are listed that resulted from the specified maximum acceptable limits of EC8 in terms of displacements for the Significant Damage performance level. Then, the influence of diaphragm action, the number of floors, the thickness of the walls, the material of the walls and the size of openings and their deficiencies are investigated. In the fifth and sixth chapters, the results of analyses for idealised asymmetric and actual buildings are presented respectively. Similarly, the inadequacies are listed that resulted from the specified maximum acceptable limits of EC8 for the Significant Damage performance level. Then, the influence of diaphragm action, the number of floors, the thickness of the walls and the masonry type and the size of openings and their deficiencies are examined. The seventh chapter presents the results for all buildings based on the limits of deformations proposed by FEMA 356 for the Life Safety performance level. Similarly, the influence of diaphragm action, the number of floors, the thickness of the walls, building material and their weaknesses are examined. For idealised symmetrical buildings, the influence the size of the openings and their deficiencies are examined further. In chapter eight the deficiency indicator H/R is calculated for all buildings according to the approximate method of EPPO. The reliability failure index resulting from second level pre-earthquake assessment by comparison with the inadequacies arising from the EC8 is also investigated. The ninth chapter summarises the most important conclusions of all investigations carried out by the present project. After the references at the end, annexes are presented.

Objectives: Pelvic vein incompetence (PVI) has been suggested as a cause for chronic pelvic pain. The overall objective of this thesis is to determine how PVI affects women, identify suitable methods of diagnosis and provide evidence regarding its association with chronic pelvic pain. This thesis will also evaluate the evidence behind its treatment. Methods: Four observation studies were completed during this thesis. A characterisation study encompassing 120 participants was performed to determine symptoms commonly experienced by women with PVI. Two observation studies analysed the ability of trans-vaginal ultrasound to detect PVI and compared its accuracy with reflux venography; considered the reference standard. A further 70 participants were recruited in a case-control study to determine the prevalence of PVI in women with and without chronic pelvic pain. A randomised control trial treating women with PVI and pelvic pain was also designed. Results: Women with PVI had an increased frequency of CPP when compared with healthy controls or women with varicose veins. This pain was associated with the menstrual cycle and intercourse. It was also found to frequently radiate into the upper thighs. Trans-vaginal ultrasound was shown to have a sensitivity and positive predictive value of 100% and 95% respectively when compared with reflux venography. The frequency of PVI in women with chronic pelvic pain was found to be 47% compared with 25% in women with no history of CPP (p < 0.001). Conclusion: The results of this thesis suggest PVI to be a possible cause of CPP in women and likely to be under-diagnosed. It can be identified by trans-vaginal ultrasound although the degree of accuracy is still yet to be determined. PVI merits further research and attention from clinicians and researchers. The proposed randomised control trial is needed both to further understanding of the role of PVI in CPP and to assess the efficacy of an under-researched treatment approach currently used in practice.

Background: The world population aging is evident and as a consequence, there is an increase of chronic diseases prevalence such as diabetes mellitus (DM) and cardiovascular diseases. The latter represent the main cause of death in elderly, especially coronary artery disease (CAD) and stroke. The chronotropic incompetence (CI) is characterized by an attenuated heart rate response to exercise. It represents a predictor of mortality and adverse cardiovascular events, and is defined as the failure to achieve less than 80% of heart rate reserve. However, its physiopathological mechanisms have not been clearly defined. One of the hypothesis postulates that it represents an abnormality in cardiovascular autonomic control. The DM and its chronic complications, such as autonomic neuropathy, are independent risk factors for stroke. As a possible manifestation of autonomic dysfunction, CI may be useful for cardiovascular risk stratification in diabetic patients. Objective: Estimate the value of chronotropic incompetence for predicting stroke in elderly diabetic patients that were submitted to exercise stress echocardiography, events included acute myocardial infarction (AMI), stroke and death. Methods: This was a restrospective observational H that assessed 298 elderly diabetic patients (from a population of 8269). Exercise stress echocardiography was performed by all participants of the study from January, 2000 to December, 2010. After exclusion criteria, patients were divided into two groups: G1 (patients who failed to achieve 80% of the age-predicted chronotropic index during exercise echocardiography) and G2 (patients who were able to achieve 80% of the age-predicted chronotropic index during exercise echocardiography). Results: There were 109 (36,6%) patients with chronotropic incompetence. Concerning clinical features, there were differences between the groups with reference to male gender (p=0,01), previous dyspneia (p=0,02) and typical angina. Concerning exercise stress echocardiography variables, there were divergences between groups for WMSI at rest, WMSI after exercise, LV mass index and LA diameter. In relation to cardiovascular events, the G1 group presented stroke in a higher frequency (9,2 % vs. 3,2%; p= 0,27) with relative risk 2,89 and G1 95% 1,05 - 7,95. The CI group presented higher frequency of death in patients that had AMI (p =0, 015) and stroke (p =0, 004). Conclusion: Our data suggest that CI predicts a worse prognosis for the occurrence of stroke in elderly diabetics as well as mortality for patients who developed with stroke and AMI. / Fundamento: devido ao envelhecimento populacional acelerado, principalmente em países em desenvolvimento como o Brasil, há aumento da prevalência de doenças crônicas como diabetes mellitus (DM) e patologias cardiovasculares. As principais causas de morte tanto em idosos como em diabéticos são a doença arterial coronariana (DAC) e a doença cerebrovascular (DCV). A incompetência cronotrópica (IC), caracterizada como uma incapacidade de atingir ao menos 80% da frequência cardíaca (FC) de reserva é um fator preditor de mortalidade e de eventos cardiovasculares. Embora seu mecanismo subjacente não seja bem definido, algumas hipóteses vêm sendo propostas, dentre elas, a disfunção autonômica. As complicações crônicas do DM, como neuropatia autonômica, são fatores de risco independentes para DCV. A IC pode ser útil para estratificação do risco cardiovascular nesta população. A ecocardiografia sob estresse pelo esforço físico (EF) é uma metodologia segura e eficaz na avaliação de pacientes com IC. Objetivos: avaliar o valor prognóstico da IC em idosos diabéticos submetidos à EF, considerando como desfechos: IAM, DCV e óbito geral; secundariamente, comparar características clínicas e ecocardiográficas entre idosos diabéticos com e sem IC. Método: estudo de coorte retrospectiva de 298 pacientes idosos e diabéticos submetidos à EF de janeiro de 2001 a dezembro de 2010. Os pacientes foram divididos em dois grupos: G1 109 pacientes com IC e G2 189 pacientes sem IC.Resultados: na amostra estudada a frequência de IC foi de 36,6% e o seguimento foi de 53,7 ± 32,5 meses com mínimo de 5 e máximo de 122 meses. O grupo G1 apresentou maior frequência de: sexo masculino (62,4% vs. 46,6%;p= 0,01), queixa de dispneia prévia à EF (7,5% vs. 2,1%; p= 0,02), angina prévia à EF (17% vs. 8%; p= 0,02), maior diâmetro do átrio esquerdo (4,1 ± 0,48 vs. 3,9 ± 0,45; p= 0,02), maior índice de massa do ventrículo esquerdo (101,82 ± 28,56 vs. 95,16 ± 26,43; p= 0,05), maior índice de escore de motilidade do ventrículo esquerdo (IEMVE) no repouso (1,07 ± 0,18 vs. 1,03 ± 0,12; p= 0,04) e de maior IEMVE no esforço (1,1 ± 0,2 vs. 1,05 ± 0,16; p= 0,004). Foi observada maior frequência de DCV no grupo G1 (9,2 % vs. 3,2%; p= 0,27) com risco relativo 2,89 e IC 95% 1,05 - 7,95. Conclusão: a IC foi associada de forma independente à ocorrência de DCV em idosos diabéticos .

Background: The world population aging is evident and as a consequence, there is an increase of chronic diseases prevalence such as diabetes mellitus (DM) and cardiovascular diseases. The latter represent the main cause of death in elderly, especially coronary artery disease (CAD) and stroke. The chronotropic incompetence (CI) is characterized by an attenuated heart rate response to exercise. It represents a predictor of mortality and adverse cardiovascular events, and is defined as the failure to achieve less than 80% of heart rate reserve. However, its physiopathological mechanisms have not been clearly defined. One of the hypothesis postulates that it represents an abnormality in cardiovascular autonomic control. The DM and its chronic complications, such as autonomic neuropathy, are independent risk factors for stroke. As a possible manifestation of autonomic dysfunction, CI may be useful for cardiovascular risk stratification in diabetic patients. Objective: Estimate the value of chronotropic incompetence for predicting stroke in elderly diabetic patients that were submitted to exercise stress echocardiography, events included acute myocardial infarction (AMI), stroke and death. Methods: This was a restrospective observational H that assessed 298 elderly diabetic patients (from a population of 8269). Exercise stress echocardiography was performed by all participants of the study from January, 2000 to December, 2010. After exclusion criteria, patients were divided into two groups: G1 (patients who failed to achieve 80% of the age-predicted chronotropic index during exercise echocardiography) and G2 (patients who were able to achieve 80% of the age-predicted chronotropic index during exercise echocardiography). Results: There were 109 (36,6%) patients with chronotropic incompetence. Concerning clinical features, there were differences between the groups with reference to male gender (p=0,01), previous dyspneia (p=0,02) and typical angina. Concerning exercise stress echocardiography variables, there were divergences between groups for WMSI at rest, WMSI after exercise, LV mass index and LA diameter. In relation to cardiovascular events, the G1 group presented stroke in a higher frequency (9,2 % vs. 3,2%; p= 0,27) with relative risk 2,89 and G1 95% 1,05 - 7,95. The CI group presented higher frequency of death in patients that had AMI (p =0, 015) and stroke (p =0, 004). Conclusion: Our data suggest that CI predicts a worse prognosis for the occurrence of stroke in elderly diabetics as well as mortality for patients who developed with stroke and AMI. / Fundamento: devido ao envelhecimento populacional acelerado, principalmente em países em desenvolvimento como o Brasil, há aumento da prevalência de doenças crônicas como diabetes mellitus (DM) e patologias cardiovasculares. As principais causas de morte tanto em idosos como em diabéticos são a doença arterial coronariana (DAC) e a doença cerebrovascular (DCV). A incompetência cronotrópica (IC), caracterizada como uma incapacidade de atingir ao menos 80% da frequência cardíaca (FC) de reserva é um fator preditor de mortalidade e de eventos cardiovasculares. Embora seu mecanismo subjacente não seja bem definido, algumas hipóteses vêm sendo propostas, dentre elas, a disfunção autonômica. As complicações crônicas do DM, como neuropatia autonômica, são fatores de risco independentes para DCV. A IC pode ser útil para estratificação do risco cardiovascular nesta população. A ecocardiografia sob estresse pelo esforço físico (EF) é uma metodologia segura e eficaz na avaliação de pacientes com IC. Objetivos: avaliar o valor prognóstico da IC em idosos diabéticos submetidos à EF, considerando como desfechos: IAM, DCV e óbito geral; secundariamente, comparar características clínicas e ecocardiográficas entre idosos diabéticos com e sem IC. Método: estudo de coorte retrospectiva de 298 pacientes idosos e diabéticos submetidos à EF de janeiro de 2001 a dezembro de 2010. Os pacientes foram divididos em dois grupos: G1 109 pacientes com IC e G2 189 pacientes sem IC.Resultados: na amostra estudada a frequência de IC foi de 36,6% e o seguimento foi de 53,7 ± 32,5 meses com mínimo de 5 e máximo de 122 meses. O grupo G1 apresentou maior frequência de: sexo masculino (62,4% vs. 46,6%;p= 0,01), queixa de dispneia prévia à EF (7,5% vs. 2,1%; p= 0,02), angina prévia à EF (17% vs. 8%; p= 0,02), maior diâmetro do átrio esquerdo (4,1 ± 0,48 vs. 3,9 ± 0,45; p= 0,02), maior índice de massa do ventrículo esquerdo (101,82 ± 28,56 vs. 95,16 ± 26,43; p= 0,05), maior índice de escore de motilidade do ventrículo esquerdo (IEMVE) no repouso (1,07 ± 0,18 vs. 1,03 ± 0,12; p= 0,04) e de maior IEMVE no esforço (1,1 ± 0,2 vs. 1,05 ± 0,16; p= 0,004). Foi observada maior frequência de DCV no grupo G1 (9,2 % vs. 3,2%; p= 0,27) com risco relativo 2,89 e IC 95% 1,05 - 7,95. Conclusão: a IC foi associada de forma independente à ocorrência de DCV em idosos diabéticos .

Vários materiais têm sido introduzidos nas pregas vocais na tentativa de solucionar a incompetência glótica, porém poucos são os estudos que avaliam o processo cicatricial decorrente da enxertia destes materiais. O objetivo desta pesquisa foi quantificar o processo inflamatório celular na prega vocal de coelhos submetidos a enxerto unilateral de gordura ou fáscia muscular. Estudamos 24 coelhos, divididos em 2 grupos, nos quais gordura ou fáscia foi enxertada. O grupo controle foi formado pela prega vocal contralateral, a qual foi submetida ao mesmo procedimento, excetuando-se a colocação do enxerto. Metade dos coelhos de cada grupo foi sacrificada após 90 dias, enquanto a outra metade foi sacrificada após 180 dias da cirurgia. A densidade celular inflamatória peri-enxerto foi avaliada em todas as pregas vocais. Houve um aumento do infiltrado inflamatório no grupo submetido à enxertia de gordura, quando comparado ao submetido à enxertia de fáscia. Bem como ao grupo controle, após 90 dias. Quanto aos coelhos sacrificados após 180 dias, não houve diferença entre os grupos entre si e em relação ao grupo controle. Esse estudo sugere que o enxerto de fáscia parece ser mais aceitável que o enxerto de gordura para a prega vocal, uma vez que origina menor reação inflamatória tecidual / Several material have been introduced into the vocal folds in attempt to solve glottic incompetence, however just a few studies are related with the consequent inflammatory process. The aim of this article was to quantify the cellular inflammatory process in rabbit vocal fold, which have undergone unilateral fat or muscular fascia introduction. Twenty-four rabbits were allocated into two groups, in which muscular fascia or fat were implanted. The control group, formed by the contra-lateral vocal fold, underwent the same surgical procedure, except for the grafting. Half the rabbits from each group were sacrificed after 90 days from the surgery, while the other half was sacrificed after 180 days. The inflammatory cellular density around the graft was measured in all vocal folds. There was a higher cellular inflammatory reaction in the group submitted to fat grafting when compared to the group submitted to muscular fascia grafting, and to the control group, after 90 days. As for the rabbits sacrificed after 180 days, there was no significant difference between the implanted groups with each other, and with the control group. This study suggests that muscular fascia graft seems to be more acceptable than fat grafts for the vocal fold, as it produces a lower local inflammatory reaction

Statement of the problem. Hypernasality resulting from velopharyngeal insufficiency or incompetency is a resonance disorder that has negative consequences for speech production and intelligibility of afflicted individuals. Purpose. The purpose of this prospective study is to ascertain if a palatal lift prosthesis with a generic silicon velar lamina, termed the Toronto Palatal Lift Prosthesis (TPLP), can assist velopharyngeal valve function to reduce hypernasality in patients. Methods. A prospective study of six patients treated with the TPLP was compared by the outcome measures of nasalance scores, perceptual evaluations, and patient satisfaction to those obtained using a contemporary acrylic palatal lift prosthesis. Results. The six patients had varying degrees of reduction in hypernasality and acceptance of the TPLP. Conclusion. On the basis of this preliminary study on the TPLP it is possible to fabricate a palatal lift prosthesis with a generic silicon velar lamina that reduces hypernasality in select patients.