Displaying publications 41 - 60 of 71 in total

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  1. Quek KF, Low WY, Razack AH, Chua CB, Loh CS
    J Sex Marital Ther, 2002 Oct-Dec;28(5):423-6.
    PMID: 12378843
    The purpose of this study is to validate the English version of the Golombok-Rust Inventory of Marital State (GRIMS) in a Malaysian population. Using the test-retest method and Cronbach's alpha, we assessed reliability and internal consistency. Sensitivity to change was expressed as the effect size. Internal consistency was excellent (Cronbach's alpha value = 0.59 to 0.91) Test-retest correlation coefficient and intraclass correlation coefficient were highly significant in majority items (ICC = 0.62 and above), and there was a high degree of sensitivity and specificity. The GRIMS is suitable, reliable, valid, and sensitive to clinical change in a Malaysian population.
    Matched MeSH terms: Spouses/psychology
  2. Rahman M, Islam MJ, Haque SE, Saw YM, Haque MN, Duc NH, et al.
    Public Health Nutr, 2017 Feb;20(2):305-314.
    PMID: 27608854 DOI: 10.1017/S136898001600224X
    OBJECTIVE: To explore the association between high-risk fertility behaviours and the likelihood of chronic undernutrition, anaemia and the coexistence of anaemia and undernutrition among women of reproductive age.

    DESIGN: The 2011 Bangladesh Demographic and Health Survey, conducted from 8 July to 27 December 2011.

    SETTING: Selected urban and rural areas of Bangladesh.

    SUBJECTS: A total of 2197 ever-married women living with at least one child younger than 5 years. Exposure was determined from maternal reports of high-risk fertility behaviours. We considered three parameters, maternal age at the time of delivery, birth order and birth interval, to define the high-risk fertility behaviours. Chronic undernutrition, anaemia and the coexistence of anaemia and undernutrition among women were the outcome variables.

    RESULTS: A substantial percentage of women were exposed to have a high-risk fertility pattern (41·8 %); 33·0 % were at single high-risk and 8·8 % were at multiple high-risk. After adjusting for relevant covariates, high-risk fertility behaviours were associated with increased likelihood of chronic undernutrition (adjusted relative risk; 95 % CI: 1·22; 1·03, 1·44), anaemia (1·12; 1·00, 1·25) and the coexistence of anaemia and undernutrition (1·52; 1·17, 1·98). Furthermore, multiple high-risk fertility behaviours appeared to have more profound consequences on the outcome measured.

    CONCLUSIONS: Maternal high-risk fertility behaviours are shockingly frequent practices among women in Bangladesh. High-risk fertility behaviours are important predictors of the increased likelihood of women's chronic undernutrition, anaemia and the coexistence of anaemia and undernutrition.

    Matched MeSH terms: Spouses/psychology*
  3. Tumian NR, Wong M, Wong CL
    J Obstet Gynaecol Res, 2015 Jun;41(6):967-70.
    PMID: 25510540 DOI: 10.1111/jog.12648
    α°-thalassemia is a well-known cause of hydrops fetalis in South-East Asia and can be detected in utero. We report a very rare case of thyrotoxic cardiomyopathy associated with hyperplacentosis secondary to α°-thalassemia-associated hydrops fetalis. A 22-year-old primigravida with microcytic anemia presented at 27 weeks' gestation with pre-eclampsia, hyperthyroidism and cardiac failure. Serum β-human chorionic gonadotrophin was markedly elevated and abdominal ultrasound revealed severe hydropic features and enlarged placenta. Serum β-human chorionic gonadotrophin, cardiac function and thyroid function tests normalized after she delivered a macerated stillbirth. Histopathology of the placenta showed hyperplacentosis. Blood DNA analysis revealed that both patient and husband have the α°-thalassemia trait. This case illustrates a very atypical presentation of α°-thalassemia-associated hydrops fetalis and the importance of early prenatal diagnosis of α-thalassemia in women of relevant ethnic origin with microcytic anemia so that appropriate genetic counseling can be provided to reduce maternal morbidity and the incidence of hydrops fetalis.
    Matched MeSH terms: Spouses
  4. Barmania S
    Lancet, 2013 Jun 15;381(9883):2070-1.
    PMID: 23776960
    Matched MeSH terms: Spouses
  5. Yusoff N, Taib NA, Ahmad A
    Asian Pac J Cancer Prev, 2011;12(10):2563-70.
    PMID: 22320956
    The aim of this study was to assess why women delay in getting treatment (i.e. surgery) for breast cancer, as well as to explore on what type of issues are involved in such delay cases. Basic interpretative of qualitative methodology was applied to construct the reality of delay phenomena, and its interaction with social worlds. Six themes were identified: new conception of breast cancer treatment, psychological defenses, health support system, symtomatology experience, model and barriers. The delay issue in breast cancer requires attention as a multidimensional problem as this will facilitate more comprehensive and effective intervention to reduce delay.
    Matched MeSH terms: Spouses
  6. Sutan R, Miskam HM
    BMC Womens Health, 2012;12:15.
    PMID: 22708998 DOI: 10.1186/1472-6874-12-15
    Women of reproductive age are vulnerable to psychosocial problems, but these have remained largely unexplored in Muslim women in developing countries. The aim of this study was to explore and describe psychosocial impact and social support following perinatal loss among Muslim women.
    Matched MeSH terms: Spouses
  7. Sonkusare S, Adinegara, Hebbar S
    Med J Malaysia, 2007 Dec;62(5):402-8.
    PMID: 18705476 MyJurnal
    The purpose of this study was to study the determinants of self rated health in the low-risk pregnant women of Melaka Tengah in Malaysia. A total of 387 subjects were analysed. The role of mental health, psychosocial stressors, support from husband, coping skills, socio-economic status and pregnancy characteristics in determining self- rated health were studied. Health items were taken from the Duke Health Profile. Bad obstetric history, poor mental health, stress from the family were found to be significantly associated with poor self - rated health whereas good support from the husband was related to good self - rated health.
    Matched MeSH terms: Spouses
  8. Walke SC, Chandrasekaran V, Mayya SS
    J Neurosci Rural Pract, 2018 5 5;9(2):180-185.
    PMID: 29725166 DOI: 10.4103/jnrp.jnrp_312_17
    Background: During a given year, almost 30% of the people around the world are affected by mentally ill health. In India, it accounts for about 20%. Caregivers face a lot of strain, ill health, and disrupted family life, with literature suggesting an increasing concern about their ability to cope up. The needs of caregivers of the mentally ill are given low priority in the current health-care setting in India.

    Aim: The aim of the study was to assess the burden of caregivers of mentally ill individuals and their coping mechanisms.

    Methods: A cross-sectional study was employed with a quantitative approach. A convenient sample of 320 caregivers was taken from two private tertiary care centers and one public secondary care center in Udupi taluk. This study was conducted using the Burden Assessment Schedule (BAS) and Brief Cope Scale (BCS). Statistical analysis was done on categorical variables, and they were expressed as frequencies and percentages. Continuous variables were measured using mean and standard deviation. Univariate and multivariate analysis using binomial logistic regression was done. SPSS version 15 was used to analyze the data.

    Results: According to BAS, severe burden accounted for 40.9% and moderate for 59.1%. The highest amount of burden was seen in the areas of physical and mental health, spouse related, and in areas of external support. The BCS showed that the most frequently used coping styles were practicing religion, active coping, and planning.

    Conclusion: This study concluded that caregivers of the mentally ill individuals do undergo a lot of burden. Hence, there is a need to develop strategies that can help them such as providing them with a support structure as well as counseling services.

    Matched MeSH terms: Spouses
  9. Edhborg M, E-Nasreen H, Kabir ZN
    J Interpers Violence, 2020 11;35(21-22):4779-4795.
    PMID: 29294818 DOI: 10.1177/0886260517717489
    Intimate partner violence (IPV) during the first year postpartum is common in Bangladesh, and many infants are exposed to hostile and aggressive environment. The aim of the current study was to investigate how IPV (physical, emotional, and sexual) impacts on the mother's perception of her infant's temperament 6 to 8 months postpartum, and whether maternal depressive symptom at 6 to 8 months postpartum is a mediator in this association. A total of 656 rural Bangladeshi women and their children 6 to 8 months postpartum were included in this study. Data were collected by structured interviews. The women were asked about physical, sexual, and emotional IPV; depressive symptoms (Edinburgh Postnatal Depressive Symptoms [EPDS]); and their perception of infant temperament assessed by the Infant Characteristic Questionnaire (ICQ). Descriptive analyses were conducted for prevalence of IPV and maternal depressive symptoms. Mediation analysis was conducted with a series of linear regressions with types of IPV as independent variables, ICQ including its subscales as dependent variables and maternal depressive symptoms as potential mediator. All the analyses were adjusted for the woman's and her husband's ages and number of children of the couple. Nearly 90% of the mothers reported some kind of IPV at 6 to 8 months postpartum. All types of IPV were directly associated with the mother's perception of her infant as unadaptable. Maternal depressive symptom was a mediating factor between physical IPV and the ICQ subscales fussy-difficult and unpredictable. In addition, depressive symptoms mediated between sexual and emotional IPV, and the mother's perception of the infant as unpredictable. The results showed that IPV influenced how mothers perceived their infant's temperament. It is important that health care professionals at maternal and child health services enquire about IPV with possibilities to refer the family or the mother and infant for appropriate support.
    Matched MeSH terms: Spouses
  10. Muhammad Ridzwan Rafi’i
    Q Bulletin, 2019;1(28):26-34.
    MyJurnal
    Pregnant women with diabetes mellitus pose an increased risk of maternal and infant morbidity and mortality. In Perlis, for the year of 2016, only 3 (0.3%) out of 1,114 reproductive women with diabetes mellitus were using an intrauterine device (IUCD) as their main contraceptive measure. This project aims to improve the usage of IUCD to 10% among reproductive women with diabetes mellitus in nine health clinics of Perlis.
    A retrospective contraception card review was undertaken to determine the baseline in providing IUCD services. Two sets of validated questionnaires were distributed to patients and healthcare providers in the pre and post-remedial period.
    Customised training sessions were organised for both doctors and nurses’ group. A quick reference for IUCD was developed to guide the healthcare providers during counselling sessions. The Model of Good Care (MOGC) was integrated into the Maternal and Child Health State Plan of Action 2016 to ease the supervision of quality improvement.
    Of the 244 diabetic women who had undergone counselling, 44 (18%) agreed to use IUCD and 38 (16%) of them inserted the IUCD within two weeks. Our project was able to increase the usage of IUCD among diabetic women in nine Perlis health clinics from 3 (0.3%) to 38 (3.4%) within six months. There was a gap reduction in achievable but not achieved (ABNA) from 9.7% to 6.6%. [ABNA = Achievable benefit not achieved]
    Low usage of IUCD among diabetic women is a challenging issue and patient refusal to use IUCD, lack of husband support and comfortable with the previous contraception method were among the main contributing factors. However, providing continuous awareness and new process of effort in promoting the usage of IUCD among diabetic women do improve the uptake of the approach
    Matched MeSH terms: Spouses
  11. Pyne S, Ravindran TKS
    PMID: 33786477 DOI: 10.1089/whr.2019.0007
    Background:
    The provision of safe abortion services upholds the realization of justice in sexual and reproductive health. Many state-level studies in India have identified poor availability of abortion services in the public sector and negative attitudes toward abortion among health providers, as potential barriers to access.
    Materials and Methods:
    A cross-sectional study was done to document the availability and utilization of medical termination of pregnancy (MTP or abortion) services and to assess public sector health providers' attitudes towards safe abortion. It was carried out in a representative district of West Bengal, using a facility checklist and a validated attitude scale.
    Results:
    Only 11 of 42 public health facilities had both trained doctors and equipment to provide MTP services. Twelve facilities provided MTP services, of which only three urban-based secondary-level facilities provided second trimester MTPs. There were female providers in just 2 of the 12 MTP-providing facilities. Among the 64 health providers interviewed, 40% were trained to provide MTP. According to the attitude scale, 38% had a negative attitude toward the provision of safe abortion services. There was no statistically significant association between attitudes of health providers and provision of MTP. However, there appeared to be a subtle process of gatekeeping in operation, such as making MTP conditional on acceptance of contraception, requiring the husband's consent, and so on.
    Conclusions:
    The study shows the poor availability of abortion services in public sector facilities in a district of West Bengal, although all public health facilities from the primary health center level upwards are authorized to provide abortion services.
    Matched MeSH terms: Spouses
  12. Ismail FF, Mohamed Noor Z, Muda SM, Ab Rahman NS
    J Pharm Bioallied Sci, 2020 Nov;12(Suppl 2):S681-S690.
    PMID: 33828361 DOI: 10.4103/jpbs.JPBS_383_19
    Context: The attitude of healthcare professionals and social supports give big influence toward self-esteem of physically disabled people.

    Aims: To explore how impairments could affect the self-esteem of physically disabled people and how healthcare professionals and social support boost their self-esteem.

    Materials and Methods: This study was conducted qualitatively whereby face-to-face interviews were conducted among 10 participants with physical disabilities. Participants were recruited from two rehabilitation centres in Kuantan, namely Community-based rehabilitation and rehabilitation, occupational therapy, and physiotherapy of public hospital in Kuantan. Interviews were conducted using the developed interview guide that explored on the disabled peoples' self-esteem and motivation, feelings toward attitude of the healthcare professionals, and satisfaction toward the physical, services, and social support from the healthcare professionals. Thematic analysis was done to identify the themes emerged from the interview transcripts.

    Results: Five males and five females with age ranging from 31 to 58 years were interviewed. Five are still working or studying post impairments. Participants claimed being low self-esteem resulted from negative perception from the society, issue of rejection, being discriminated, and difficulty in getting support from the society. Most of the participants asserted that they gained their motivation and self-esteem due to the continuous support from various groups, such as their spouses, family members, colleagues, employers, and healthcare professionals.

    Conclusions: Despite heavy workload and stressful working environment, positive attitude showed by the healthcare professionals is highly praised. Hence, this will indirectly improve the self-esteem, motivation, and rehabilitation progress of physically disabled people.

    Matched MeSH terms: Spouses
  13. Basma Johari, Nor Azwani Mohd Shukri
    MyJurnal
    Exclusive breastfeeding (EBF) for up to six months is internationally recommended due to its benefits for both maternal and infant health. However, the rate of EBF in Malaysia is still below the desirable levels. This study examined the prevalence of EBF and assessed the knowledge, attitude, and practice (KAP), and determinants of breastfeeding among Malay mothers in Ampang, Selangor. Ninety-two Malay subjects who breastfed healthy children aged six to 36 months, were included in this study. Data were collected by dual-language, self-administered questionnaire (which included Iowa Infant Feeding Attitude Scale, IIFAS), to determine KAP of mothers towards breastfeeding. Socio-demographic, psychosocial, and environmental factors related with EBF were also assessed. Linear logistic regression model was used to identify factors that may determine breastfeeding for six months (exclusively) and beyond. A total of 28% of the subjects practised EBF up to six months, 39% less than six months, and 33% continued BF beyond six months. The mean IIFAS total score was 66.1 ± 8.11, which ranged between Neutral and Positive towards Breastfeeding Practice attitudes. Higher IIFAS score is related to intended and actual exclusive
    breastfeeding. Several variables were significantly related to breastfeeding for six months (exclusively) and beyond. This included maternal age of 30 years or more (OR:3.26, 95% CI:1.27–8.38); higher socioeconomic status (OR:8.50, 95% CI:1.76–41.06); higher educational level (OR:5.21, 95% CI:1.66–16.34); multi-parity (OR:3.15, 95% CI:1.17–8.47); nonworking status (OR:3.81, 95% CI:1.02–14.3); support from spouse (OR:2.39, 95% CI:1.01–5.65); availability of private rooms for breastfeeding at workplace (OR:4.30, 95% CI:1.77–10.63); and child birth place (OR:2.54, 95% CI:1.08–5.98). The right maternal knowledge and attitude play crucial roles in the success of breastfeeding. Hence, more health promotion is needed. Supports from spouse,
    workplace, and hospital staff after delivery, are also essential to improve EBF statistics in Malaysia.
    Matched MeSH terms: Spouses
  14. Mohamad Fuad MA, Yacob H, Mohamed N, Wong NI
    Geriatr Gerontol Int, 2020 Dec;20 Suppl 2:57-62.
    PMID: 33370853 DOI: 10.1111/ggi.13969
    AIM: This study aimed to evaluate the oral health-related quality of life (OHRQoL) among older persons in Malaysia and its associations with sociodemographic and self-perception towards general health as well as oral health.

    METHODS: A cross-sectional survey among community dwelling older persons utilizing stratified cluster sampling was conducted in 2018. Well-trained interviewers conducted a face-to-face interview with older persons aged ≥60 years to collect information on participants' sociodemographic characteristics, self-perception on general as well as oral health using the Geriatric Oral Health Assessment Index (GOHAI). Multivariate analysis of the data collected was performed using SPSS version 23.

    RESULTS: Overall, the GOHAI mean ± SD score for older persons in Malaysia was 51.83 ± 7.98, which was an average of fair mean (P 

    Matched MeSH terms: Spouses
  15. Mansor M, Oo SS, Abdullah KL
    MyJurnal
    Family planning is an important practice for women as it can help to improve financial and social status. Unwanted pregnancy has negative effects for husband and financial. However, couples married at a late age may not practice family planning because they want to have kids. The aims of this study were to determine the prevalence, factors associated with
    husband’s socio demography and decision making in family planning practices among women in reproductive age who attended a polyclinic in Serdang, Malaysia. A cross sectional study was conducted on 245 women with a systematic random sampling. Descriptive analysis, Fisher exact and Chi-square tests were conducted to identify the influence of husband’s socio demographic factors and decision making in family planning practices. The prevalence of family planning practices among married women was moderate (53.9%). Family planning practices among women showed significant relationship with the husband’s socio demography which were husband’s race (p = 0.018), religion (p = 0.008) and making decision in family planning (p = 0.002). The husband’s socio demography showed a significant relationship with the prevalence of the wife practicing family planning. This clearly indicates that the husband is the individual that influence the wife to use contraceptive method. Decision making in family planning by both the husband and wife is important in choosing to use contraceptive method. Health promotion in the concept of health education for male contraceptive method such as pamphlet and booklet is important to promote husband involvement in family planning.
    Study site: Klinik Kesihatan Seri Kembangan, Serdang, Selangor, Malaysia
    Matched MeSH terms: Spouses
  16. Mohd Zukri, I., Noor Hassim, I.
    MyJurnal
    Introduction: The effect of stress among correctional officers at the workplace can contribute to various health problems and this also affect their work performance and motivation.
    Methodology: Study was done at a prison located at the rural district in Kedah. The study was conducted by using randomized stratified sampling method. A total of 418 self administrated questionnaires were distributed. These questionnaires included socio demographic factor, family and marriage factor, Personal Stress Inventory (using Stress Symptom Scale with 52 items), work related stressors (Job Stress Survey) and Brief COPE (Coping Orientation for Problems Experienced with 28 items).
    Result: Response rate was 90.9%. Stress prevalence for correctional officers was 45.8%. Socio demographic factors which have significant relation with stress status were marital status, promotion factor, age, monthly salary, duration of service and number of children (p< 0.05). Family and marriage factor which have significant relation with stress status among married officer were pressure from relatives, clean up house, sexual frustration, conflict with spouse, conflict with children, conflict due to household work and no babysitter (p< 0.05).
    Discussion: The study showed that work related stressors that have influence with stress were excessive workload, working after work hours, not enough staff, disgraced words from fellow workers, competition in carrier development and excessive work stress (p< 0.05). Multiple linear regression model was done in this study and revealed factors that explained 52% of variation in stress score distributions were behavioural disengagement, no babysitter, denial, conflict with children, replace other worker’s duty, not enough time with family, competition in carrier development, venting of emotion, positive reframing and emotional support. Coping strategies that have significant effect in reducing stress symptoms are positive reframing and emotional support.
    Conclusion: Stress management programs should be implemented and emphasizing on specific stressors and coping mechanism are important to reduce the risk of occupational stress among correctional officers.
    Matched MeSH terms: Spouses
  17. Oras Zaki Saadoon, Rahmah Mohd Amin, Saad Ahmed Ali Jadoo
    MyJurnal
    Cervical cancer is the seventh most common cancer among women in Iraq. This study aimed to assess the factors influencing Pap smear practice among married primary school teachers in Diyala City, Iraq. A total of 222 teachers (aged 20 years to 63 years) residing in Diyala City were enrolled in a cross sectional study from 1st August till 30th September 2012. The sampling method was a self-administered survey using a multistage sampling technique. The prevalence of Pap smear practice was very low (12.6%). Relatives and friends were the main source of information about the Pap smear test for more than one third (41.9%) of the respondents. However, the medical doctor’s advice was the most important reason for undergoing a Pap smear test in more than two third (60.7%) of respondents. Only 32.4% of the teachers have good knowledge about cervical cancer and Pap smear test, but 76.1% of them showed a positive attitude toward learning about cervical cancer and Pap smear. Based on multiple logistic regression analysis results only the husband’s encouragement (p= 0.003, prevalence odds ratio [POR] = 0.256, 95%CI 0.10-0.63) was significantly associated with Pap smear practice. A more effective educational program is needed to educate Iraqi women about cervical cancer and screening tests, including Pap smear.
    Matched MeSH terms: Spouses
  18. Noraihan Mohd. Nordin, Sharda, Priya, Zainab Shamsuddin
    MyJurnal
    Objectives: The objectives of this study were to ascertain the prevalence of Indonesians obstetrics immigrant and to assess the fetal maternal outcome. Methodology: A prospective cohort study design was used to analyse 54 consecutive Indonesians obstetrics immigrant compared to 56 Malay women. Chi square and student t test were used where appropriate, p < 0.05 was considered to be of statistical significance. Results: There was a reducing trend in the incidence admission of Indonesians from 10.5 in 1999 to 6.5 % in 2002. The maternal mortality ratio showed an increasing trend from 1999 (40.0/100000) to 2001 (162.9/100000) but decreased to 5.8/100000 in 2002. The majority was between 20-40 years old, multiparous and booked, which was similar to the Malay population. Most Malays were in occupational class 1 to 3 and the husband has secondary and tertiary education compared to the Indonesians who were in class 4 and 5 and the husband has primary and no formal education. Significantly more immigrants were housewives compared to Malays who were working women. There was no significant difference in the antenatal complications. There were no significant difference in terms of delivery and most delivered vaginally. The perinatal outcome in terms of gestation, birth weight, Apgar score and admission to neonatal ICU were similar in both populations and there was no perinatal mortality. In conclusion, the incidence admission of Indonesian immigrant was on the decreasing trend. The outcome of these patients managed in MHKL was similar to the Malay population. Further studies with enrollment of a larger number of patients should be carried out to ascertain the significance of these findings.
    Matched MeSH terms: Spouses
  19. Hejar, A.R, Noraihan, M. N., Liyana Mastura, M.J., Nurzoara Aisha Noorazyze, R.A.N.
    MyJurnal
    Passive smoking among pregnant mothers has been associated with numerous maternal and fetal effects. The aim of this study was to determine the effects of passive smoking on the fetal outcome among women who delivered at the Maternity Hospital Kuala Lumpur. This cross sectional study was carried out at the Maternity Hospital Kuala Lumpur in July 2004. Universal sampling of the women who delivered at the hospital was used and data was collected by interview using pre-tested questionnaire and patients’ medical records. Analysis was done by SPSS version 11.5. More than 75% were Malays, between 21 to 35 years, married, received secondary education, housewives and family income between RM 1000 – RM 1999. Seventy-seven per cent of the women were exposed to environmental tobacco smoke and majority were exposed at home and for less than 1 hour a week. There were significant relationships between duration of exposure with exposure at workplace, exposure at home and exposure in the car. Most of the babies delivered were males, term, normal weight and normal. Health education of the adverse effects of smoking to the pregnant women, spouses and family members need to be intensified by the hospital and the Ministry of Health.
    Matched MeSH terms: Spouses
  20. Nazatul, S.B., Ruby, H.
    JUMMEC, 2009;12(2):70-73.
    MyJurnal
    The exclusive breastfeeding rate in Malaysia is very low. However in recent years the awareness of breastfeeding among mothers has increased. A preliminary qualitative research was carried out on these motivated mothers. The objective of this study was to understand the challenges encountered by breastfeeding mothers and to explore the support and motivation received by them. Information from the motivated mothers was obtained from focus group discussion. Some obstacles faced by the mothers were lack of knowledge on breastfeeding and lack of support from health professionals, parents and siblings. Facilities to express breast milk while at work were not readily available. The main motivation to breastfeed came from the mother herself and support from the husband. A holistic approach must be used to help mothers to continue breastfeeding. This includes breastfeeding promotion and education, setting up more Baby Friendly Hospitals, availability of breastfeeding support groups and provision of enough breastfeeding facilities at work and public places.
    Matched MeSH terms: Spouses
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