Displaying publications 81 - 100 of 157 in total

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  1. Gillani SW, Ansari IA, Zaghloul HA, Abdul MIM, Sulaiman SAS, Baig MR, et al.
    J Diabetes Res, 2018;2018:4079087.
    PMID: 29854822 DOI: 10.1155/2018/4079087
    BACKGROUND: This study is aimed at investigating the various disease-specific and health-related psychosocial concepts of HRQOL among insulin-dependent diabetes mellitus (IDDM) and understanding the gender differences in HRQOL among IDDM patients.

    METHODS: A cross-sectional observational study was conducted to assess the effect of health-related and psychosocial correlates on HRQOL of IDDM patients in Penang, Malaysia. The participants were recruited from five governmental diabetic clinics. Patients with insulin use only, IDDM diagnosed at least 1 year earlier, were identified from clinical registers. The sample was then age stratified for 20-64 years, and severe complications (e.g., end-stage renal failure, hemodialysis, and liver cirrhosis) were excluded; a total of 1003 participants were enrolled in the study. Multivariate regression analysis was used to predict the response.

    RESULTS: A total of 853 (100%) participants were enrolled and completed the study. Women exhibited significantly higher/better mental health (p < 0.013) and health perception scores (p < 0.001) despite high prevalence of impaired role (49.2%), social (24.2%), and physical (40.5%) functionings as compared to men. Women with longer diabetes exposure and uncontrolled glycemic levels (HbA1c) have poorer HRQOL. Availability of social support showed no significant association with either HRQOL or diabetes distress levels. Diabetes distress levels remained not associated with social support. Women also showed significantly higher association with health perception (15% versus 13% men, p < 0.001) and mental health (13% versus 11% men, p < 0.001) in diabetes-specific psychosocial factors. Thus, among women alone, diabetes-related specific and psychosocial factors explained 15% and 13% of variations in HRQOL extents, respectively.

    CONCLUSION: Women exhibit extensive and significant patterns with health-related factors and diabetes-specific psychosocial factors (self-efficacy, social support, and DLC) to improve HRQOL. Also, women have significantly high reported distress levels and low social functioning compared to men.

    Matched MeSH terms: Quality of Life/psychology*
  2. Mardhiyah A, Panduragan SL, Mediani HS
    J Nurs Meas, 2023 Nov 29;31(4):480-488.
    PMID: 37945052 DOI: 10.1891/JNM-2021-0049
    Background: Hope is regarded positively as a factor in achieving a higher quality of life, particularly in chronic disease patients. Objectives: This study aims to adapt, validate, and establish the reliability of the Children's Hope Scale (CHS) questionnaire in Indonesian adolescents with thalassemia. Methods: The current study used iterative mixed methods. The data collection procedure was divided into three stages: instrument translation and cultural adaptation, validation, and reliability. The Content Validity Index (CVI) was used to assess the translated instrument's content validity, importance, contextual relevance, and acceptability of wording. Confirmatory factor analysis (CFA) was used to determine the factor structure of the CHS. Pearson correlation analyses were used to determine the associations between the two hope subscales. Cronbach's alpha coefficient and test-retest data were used to determine its reliability. Results: The CVI values ranged from 0.80 to 1.00. The CFA has shown that the two-factor model has adequate fitness factors. The Cronbach's alpha for the Indonesian CHS was 0.705, and the test reliability rate (CI 95%) was 0.81 (.73-.91). Conclusion: The CHS is a valid and reliable instrument for assessing hope in Indonesia. Additional research should be conducted to adapt and evaluate the CHS in other samples and social context in order to verify the factor consistency.
    Matched MeSH terms: Quality of Life/psychology
  3. Mohamed NF, Ghazali SR, Yaacob NA, Rahim AAA, Maskon O
    Sultan Qaboos Univ Med J, 2018 Nov;18(4):e494-e500.
    PMID: 30988969 DOI: 10.18295/squmj.2018.18.04.011
    Objectives: Heart failure (HF) is a common clinical syndrome with an enormous impact on prognosis and lifestyle. Accordingly, rehabilitation measures need to be patient-specific and consider various sociocultural factors so as to improve the patient's quality of life (QOL). This study aimed to develop and validate a HF-specific QOL (HFQOL) questionnaire within a multicultural setting.

    Methods: This study took place at the National Heart Institute and Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia, between March 2013 and March 2014. A self-administered 75-item HFQOL questionnaire was designed and administrated to 164 multi-ethnic Malaysian HF patients. Exploratory factor analysis was performed to assess the instrument's construct validity. Cronbach's alpha coefficients were used to determine internal consistency.

    Results: A total of 33 out of 75 items were retained in the final tool. The HFQOL questionnaire had three common factors-psychological, physical-social and spiritual wellbeing-resulting in a cumulative percentage of total variance of 44.3%. The factor loading ranges were 0.450-0.718 for psychological wellbeing (12 items), 0.394-0.740 for physical-social wellbeing (14 items) and 0.449-0.727 for spiritual wellbeing (seven items). The overall Cronbach's alpha coefficient of the questionnaire was 0.82, with coefficients of 0.86, 0.88 and 0.79 for the psychological, physical-social and spiritual wellbeing subdomains, respectively.

    Conclusion: The HFQOL questionnaire was found to be a valid and reliable measure of QOL among Malaysian HF patients from various ethnic groups. Such tools may facilitate cardiac care management planning among multi-ethnic patients with HF.

    Matched MeSH terms: Quality of Life/psychology*
  4. Ng CG, Mohamed S, See MH, Harun F, Dahlui M, Sulaiman AH, et al.
    PMID: 26715073 DOI: 10.1186/s12955-015-0401-7
    Depression and anxiety are common psychiatric morbidity among breast cancer patient. There is a lack of study examining the correlation between depression, anxiety and quality of life (QoL) with perceived social support (PSS) among breast cancer patients. This study aims to study the level of depression, anxiety, QoL and PSS among Malaysian breast cancer women over a period of 12 months and their associations at baseline, 6 and 12 months.
    Matched MeSH terms: Quality of Life/psychology*
  5. Kok JK, Yap YN
    J Aging Stud, 2014 Dec;31:54-61.
    PMID: 25456622 DOI: 10.1016/j.jaging.2014.08.007
    Longer lives and extended retirement have created a 'young old age' stage of life. How people spend their "young old age" has become increasingly important. This research aims to investigate the different ageing experiences of Japanese and Malaysian women and the activities they engaged in their "young old age". In-depth interviews were conducted to collect data and an adapted grounded theory approach was used for data analysis. Findings reveal many common characteristics for both groups of research participants. The emerging themes show that Japanese and Malaysian Chinese have different life missions evident in their daily activities, one passing on culture and the other passing on family values and life experience. They also differ in their choice of living arrangement (independent versus dependent/interdependent), attitudes to life (fighting versus accepting) and activities in which to engage (aesthetic pursuits versus family oriented activities).
    Matched MeSH terms: Quality of Life/psychology
  6. Mohd Din FH, Hoe VC, Chan CK, Muslan MA
    Qual Life Res, 2015 May;24(5):1275-80.
    PMID: 25373928 DOI: 10.1007/s11136-014-0850-1
    PURPOSE: The Pain Catastrophizing Scale (PCS) is designed to assess negative thoughts in response to pain. It is composed of three domains: helplessness, rumination, and magnification. We report on the translation, adaptation, and validation of scores on a Malay-speaking version of the PCS, the PCS-MY.

    METHOD: Guidelines for the process of cross-cultural adaptations of assessment measures were implemented. A sample of 303 young military recruits participated in the study. Factor structure, reliability, and validity of scores on the PCS-MY were examined. Convergent validity was investigated with the Positive and Negative Affect Scale, Short-form 12 version 2, and Ryff's Psychological Well-being Scale.

    RESULTS: Most participants were men, ranging in age from 19 to 26. The reliability of the PCS-MY scores was adequate (α = 0.90; mean inter-item correlation = 0.43). Confirmatory factor analysis showed that a modified version of the PCS-MY provided best fit estimates to the sample data. The PCS-MY total score was negatively correlated with mental well-being and positively correlated with negative affect (all ps < 0.001).

    CONCLUSION: The PCS-MY was demonstrated to have adequate reliability and validity estimates in the study sample.

    Matched MeSH terms: Quality of Life/psychology*
  7. Khor HM, Tan J, Saedon NI, Kamaruzzaman SB, Chin AV, Poi PJ, et al.
    Arch Gerontol Geriatr, 2014 Nov-Dec;59(3):536-41.
    PMID: 25091603 DOI: 10.1016/j.archger.2014.07.011
    The presence of pressure ulcers imposes a huge burden on the older person's quality of life and significantly increases their risk of dying. The objective of this study was to determine patient characteristics associated with the presence of pressure ulcers and to evaluate the risk factors associated with mortality among older patients with pressure ulcers. A prospective observational study was performed between Oct 2012 and May 2013. Patients with preexisting pressure ulcers on admission and those with hospital acquired pressure ulcers were recruited into the study. Information on patient demographics, functional status, nutritional level, stages of pressure ulcer and their complications were obtained. Cox proportional hazard analysis was used to assess the risk of death in all patients. 76/684 (11.1%) patients had pre-existing pressure ulcers on admission and 30/684 (4.4%) developed pressure ulcers in hospital. There were 68 (66%) deaths by the end of the median follow-up period of 12 (IQR 2.5-14) weeks. Our Cox regression model revealed that nursing home residence (Hazard Ratio, HR=2.33, 95% confidence interval, CI=1.30, 4.17; p=0.005), infected deep pressure ulcers (HR=2.21, 95% CI=1.26, 3.87; p=0.006) and neutrophilia (HR=1.76; 95% CI 1.05, 2.94; p=0.031) were independent predictors of mortality in our elderly patients with pressure ulcers. The prevalence of pressure ulcers in our setting is comparable to previously reported figures in Europe and North America. Mortality in patients with pressure ulcer was high, and was predicted by institutionalization, concurrent infection and high neutrophil counts.
    Matched MeSH terms: Quality of Life/psychology*
  8. Tan AH, Mahadeva S, Thalha AM, Gibson PR, Kiew CK, Yeat CM, et al.
    Parkinsonism Relat Disord, 2014 May;20(5):535-40.
    PMID: 24637123 DOI: 10.1016/j.parkreldis.2014.02.019
    BACKGROUND: Recent studies reported a high prevalence of small intestinal bacterial overgrowth (SIBO) in Parkinson's disease (PD), and a possible association with gastrointestinal symptoms and worse motor function. We aimed to study the prevalence and the potential impact of SIBO on gastrointestinal symptoms, motor function, and quality of life in a large cohort of PD patients.
    METHODS: 103 Consecutive PD patients were assessed using the lactulose-hydrogen breath test; questionnaires of gastrointestinal symptoms and quality of life (PDQ-39); the Unified PD Rating Scale (UPDRS) including "on"-medication Part III (motor severity) score; and objective and quantitative measures of bradykinesia (Purdue Pegboard and timed test of gait). Patients and evaluating investigators were blind to SIBO status.
    RESULTS: 25.3% of PD patients were SIBO-positive. SIBO-positive patients had a shorter mean duration of PD (5.2 ± 4.1 vs. 8.1 ± 5.5 years, P = 0.007). After adjusting for disease duration, SIBO was significantly associated with lower constipation and tenesmus severity scores, but worse scores across a range of "on"-medication motor assessments (accounting for 4.2-9.0% of the variance in motor scores). There was no association between SIBO and motor fluctuations or PDQ-39 Summary Index scores.
    CONCLUSIONS: This is the largest study to date on SIBO in PD. SIBO was detected in one quarter of patients, including patients recently diagnosed with the disease. SIBO was not associated with worse gastrointestinal symptoms, but independently predicted worse motor function. Properly designed treatment trials are needed to confirm a causal link between SIBO and worse motor function in PD.
    KEYWORDS: Gastrointestinal dysfunction; Parkinson's disease/Parkinsonism; Small intestinal bacterial overgrowth
    Matched MeSH terms: Quality of Life/psychology
  9. Yusof ZY, Jaafar N
    PMID: 24325653 DOI: 10.1186/1477-7525-11-205
    The study objective was to compare children's oral health related quality of life (OHRQoL) in schools with 6 years of implementation of a health promoting school model in Malaysia, i.e. the Doktor Muda Programme (DMP) and in schools without the DMP.
    Matched MeSH terms: Quality of Life/psychology*
  10. Ibrahim N, Din NC, Ahmad M, Ghazali SE, Said Z, Shahar S, et al.
    Asia Pac Psychiatry, 2013 Apr;5 Suppl 1:59-66.
    PMID: 23857839 DOI: 10.1111/appy.12068
    INTRODUCTION: This study aimed to examine the role of social support and depression in predicting the quality of life among the elderly living in a rural Federal Land Development Authority (FELDA) community in Malaysia.
    METHODS: A total of 162 elderly settlers of FELDA Sungai Tengi, aged 60 years and above, were selected by universal sampling method in this cross-sectional study. Three standardized instruments - the 12-item Short Form (SF-12), 15-item Geriatric Depression Scale (GDS-15) and Medical Outcome Study Social Support (MOS-Social Support) - were used to assess for quality of life, depression and social support.
    RESULTS: Quality of life of the elderly people in this community was high, especially in terms of physical components as compared to mental components. The mean scores for emotional role in the SF-12 was relatively the highest (90.74 ± 21.59) with social functioning being the lowest (30.35 ± 22.29). The results also showed that the mean value was higher for physical component summary (74.40) as compared to mental component summary (51.51). Approximately 23.5% suffered mild depression and only 2.5% had severe depression.
    DISCUSSION: This study showed that the elderly FELDA settlers have a high quality of life, mainly on the physical components of life and low rate of severe depression, a positive indicator of their psychological well-being. Social support in the form of emotional/informational support, and depression were significant factors related to their good quality of life.
    KEYWORDS: depression; elderly; quality of life; rural community; social support
    Study site; FELDA Sungai Tengi, Selangor, Malaysia
    Device, Questionnaire & Scale: Short Form Health Survey (SF-12); Geriatric Depression Scale (GDS-15; Medical Outcome Study Social Support (MOS-Social Support)
    Matched MeSH terms: Quality of Life/psychology*
  11. Norlelawati AT, Kartini A, Norsidah K, Ramli M, Wan Azizi WS, Tariq AR
    Asia Pac Psychiatry, 2015 Mar;7(1):45-53.
    PMID: 23857669 DOI: 10.1111/appy.12089
    INTRODUCTION: The present study investigated the relationship between psychological symptoms and psychosocial function and the role of relevant sociodemographic data and antipsychotic use in the prediction of psychosocial function among multiracial schizophrenia outpatients in Malaysia.
    METHODS: A total of 223 participants were recruited in this cross-sectional study conducted from December 2010 to April 2011. Psychological symptoms were assessed using the Positive and Negative Syndrome Scale whilst the psychosocial function was assessed using the Personal and Social Performance scale. Sociodemographic and treatment variables were gathered through interview or review of the medical records.
    RESULTS: All dimensions of psychosocial functions were inversely correlated with Positive and Negative Syndrome Scale sub-domains. Only the disorganization sub-domain significantly predicts all dimensions of psychosocial function. For social data, body mass index and employment status were significant predictors of all dimensions of psychosocial functions. Typical antipsychotics significantly predict social function negatively as compared to sulpiride (β = -0.152, P = 0.028).
    DISCUSSION: We found that the relationship between psychological symptoms and psychosocial functions were relatively consistent with the findings from the Caucasian population. Additionally, disorganization was the only significant predictor of all dimensions of psychosocial functions. This further emphasized the importance of cognition in psychosocial function. The roles of sulpiride, body mass index and employment status as predictors of psychosocial function were also discussed.
    KEYWORDS: antipsychotics; psychosocial function; schizophrenia; symptoms
    Study site: Psychiatric clinic, Hospital Tengku Ampuan Afzan, Kuantan, Pahang, Malaysia
    Matched MeSH terms: Quality of Life/psychology
  12. Ibrahim R, Abolfathi Momtaz Y, Hamid TA
    Psychogeriatrics, 2013 Jun;13(2):71-9.
    PMID: 23909963 DOI: 10.1111/psyg.12000
    Social isolation is one of the most important emerging issues among ageing populations, as it reduces well-being, health and quality of life. The purpose of this study was to identify prevalence and risk factors of social isolation in older Malaysians.
    Matched MeSH terms: Quality of Life/psychology*
  13. Abolfathi Momtaz Y, Hamid TA, Ibrahim R, Yahaya N, Abdullah SS
    Psychogeriatrics, 2012 Mar;12(1):43-53.
    PMID: 22416828 DOI: 10.1111/j.1479-8301.2011.00381.x
    Research has found that physical health decline in later life is associated with poor psychological well-being. This study aimed to examine the possible moderating effect of Islamic religiosity on the relationship between chronic medical conditions and psychological well-being.
    Matched MeSH terms: Quality of Life/psychology
  14. Atif M, Sulaiman SA, Shafie AA, Ali I, Hassali MA, Saleem F
    Int J Clin Pharm, 2012 Aug;34(4):506-9.
    PMID: 22706597 DOI: 10.1007/s11096-012-9657-8
    Worldwide, the treatment of tuberculosis is based on evidence-based guidelines developed by the World Health Organization (WHO) for national tuberculosis programs. However, the importance of health related quality of life, the adequate management of side effects associated with antituberculosis drugs and the elaboration of tuberculosis treatment outcome categories are a few issues that need to be addressed in forthcoming WHO guidelines for the treatment of tuberculosis.
    Matched MeSH terms: Quality of Life/psychology
  15. Yusof FA, Goh A, Azmi S
    Value Health, 2012 Jan-Feb;15(1 Suppl):S85-90.
    PMID: 22265073 DOI: 10.1016/j.jval.2011.11.024
    OBJECTIVES: To estimate a EQ-5D value set for Malaysia by using time trade-off (TTO) and visual analogue scale (VAS) valuation methods.
    METHODS: TTO and VAS valuations were obtained from face-to-face surveys of a convenience sample of patients, caregivers, and health professionals conducted at nine government hospitals in 2004 and 2005. Forty-five EQ-5D questionnaire health states were valued, divided into five sets of 15 health states. Analysis was conducted by using linear additive regression models applying N3 and D1 specifications. Model selection was based on criteria of coefficient properties, statistical significance, and goodness of fit.
    RESULTS: One hundred fifty-two respondents were interviewed, yielding 2174 TTO and 2265 VAS valuations. Respondents found TTO valuations to be more difficult than VAS valuations, and there were more inconsistencies in TTO valuations. All the independent variables in the models were statistically significant and consistent with expected signs and magnitude, except for the D1 specification modeled on TTO valuations. The N3 model provided the best fit for the VAS valuation data, with a mean absolute error of 0.032.
    CONCLUSION: This study provides a Malaysian EQ-5D questionnaire value set that can be used for cost-utility studies despite survey limitations.
    Study site: convenience sampling from three categories of respondents (patients undergoing dialysis, patients’ carers, and dialysis center staff) from public hospitals
    Matched MeSH terms: Quality of Life/psychology*
  16. Priscilla D, Hamidin A, Azhar MZ, Noorjan KO, Salmiah MS, Bahariah K
    East Asian Arch Psychiatry, 2011 Sep;21(3):108-14.
    PMID: 21921304
    Objectives: To determine the relationship between major depressive disorder, anxiety disorders and the quality of life of haematological cancer patients.
    Methods: This cross-sectional study was conducted at Ampang Hospital Kuala Lumpur, Malaysia, a tertiary referral centre hospital for haematological cancer. The Mini-International Neuropsychiatric Interview was used for the diagnosis of major depressive disorder and anxiety disorders. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire was utilised to measure patients’ quality of life.
    Results: A total of 105 haematological cancer patients were included in the study with response rate of 100%. Major depressive disorder correlated with almost all domains of the quality of life, except the pain scores. Logistic regression showed that insomnia and financial difficulties were related to major depressive disorder. Different anxiety disorders also correlated with quality of life in specific domains. The leading anxiety disorders that correlated mostly with quality of life scales were generalised anxiety disorder, followed by obsessive-compulsive disorder, social anxiety disorder, as well as post-traumatic stress disorder and panic disorder with agoraphobia (p < 0.05).
    Conclusions: Psychological treatment along with medication and intervention should be implemented to
    improve the overall quality of life and psychiatric disorder symptoms among the haematological cancer
    patients.
    Key words: Anxiety; Depression; Hematologic neoplasms; Quality of life
    Matched MeSH terms: Quality of Life/psychology*
  17. Lua PL, Neni WS
    Epilepsy Behav, 2011 Jul;21(3):248-54.
    PMID: 21576038 DOI: 10.1016/j.yebeh.2011.03.039
    The influence of awareness, knowledge, and attitudes (AKA) on the health-related quality of life (HRQoL) of patients with epilepsy has not been widely established. The aims of this preliminary study were to (1) assess general AKA and HRQoL levels, (2) correlate AKA and HRQoL levels, and (3) compare the HRQoL of patients with epilepsy with different AKA levels. A cross-sectional sample of outpatients with epilepsy were recruited from the Neurology Clinic, Hospital Sultanah Nur Zahirah, Kuala Terengganu, Malaysia. Data analysis was carried out using the Statistical Package for Social Sciences Version 15 employing descriptive and nonparametric statistics. On written consent, included patients completed the Malay AKA Epilepsy and the Malay Quality of Life in Epilepsy-30 (MQOLIE-30) instruments. Across all patients, both AKA levels (median: 80.0, range: 0-170) and overall HRQoL (median 51.5; range 15-97) were moderate. Awareness was significantly correlated only with Seizure Worry (r(s)=+0.29, p<0.05), whereas Knowledge was not significantly linked to any domain. However, Attitudes was significantly correlated with all domains (r(s)=+0.35 to +0.47, p<0.01) except Medication Effects and Seizure Worry. Patients with good AKA levels (Total Score ≥ median) experienced significantly better Overall Quality of Life and Cognitive Functioning (p<0.05). Findings showed that AKA may play an important role in influencing patients' HRQoL, suggesting that epilepsy treatment efforts should also focus on enhancing AKA through epilepsy awareness to improve health outcomes.

    Study site: Neurology Clinic, Hospital Sultanah Nur Zahirah
    Matched MeSH terms: Quality of Life/psychology*
  18. Thumboo J, Seah A, Tan CT, Singhal BS, Ong B
    Ann Acad Med Singap, 2011 Feb;40(2):67-73.
    PMID: 21468459
    INTRODUCTION: The Multiple Sclerosis International Quality of Life questionnaire (MusiQoL) is a self-administered, multi-dimensional, patient-based health-related quality of life (HRQoL) instrument. With increasing prevalence of multiple sclerosis (MS) in Asian countries, a valid tool to assess HRQoL in those patients is needed. The aim of this study was to evaluate patient acceptability, content validity and psychometric properties of an Asian version of the English MusiQoL in Singapore, Malaysia and India.

    MATERIALS AND METHODS: English speaking patients older than 18 years of age with a defi nite diagnosis of MS were included. The self-administered survey material included the adapted HRQoL questionnaire, a validated generic HRQoL questionnaire: the short-form 36 (SF-36), as well as a checklist of 14 symptoms. We assessed the internal and external validity of the adapted MusiQoL.

    RESULTS: A total of 81 patients with MS were included in the study. The questionnaire was generally well accepted. In the samples from Malaysia and Singapore, all scales exhibited good internal consistency (Cronbach's alpha >0.70). Correlation to SF-36 was generally good, demonstrating high construct validity (P <0.001) in some aspects of the MusiQoL.

    CONCLUSION: The Asian adaptation of the English version of the MusiQoL in evaluating HRQoL seems to be a valid, reliable tool with adequate patient acceptability and internal consistency.

    Matched MeSH terms: Quality of Life/psychology*
  19. Misajon R, Manderson L, Pallant JF, Omar Z, Bennett E, Rahim RB
    PMID: 17156494
    Although non-communicable and chronic disease now accounts for 47% of the global burden of disease, little is known of the everyday experiences and social aspects of disability and disablement in middle and low income countries. This article aims to address this gap by exploring the subjective experience of mobility impairment in Malaysia. Specifically, it examines health-related quality of life and the impact and distress related to impaired mobility, and investigates any gender differences in relation to the experience of disability.
    Matched MeSH terms: Quality of Life/psychology*
  20. Ismail A, Campbell MJ, Ibrahim HM, Jones GL
    PMID: 16813662
    Health Related Quality of Life (HRQoL) studies on children with chronic illness such as thalassaemia are limited. We conducted the first study to investigate if children with thalassaemia have a lower quality of life in the four dimensions as measured using the PedsQL 4.0 generic Scale Score: physical, emotional, social and role (school) functioning compared to the healthy controls allowing for age, gender, ethnicity and household income.
    Matched MeSH terms: Quality of Life/psychology*
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