Addiction Research & Theory最新文献_第8页

Prevalence and correlates of self-harm in a Southern California driving under the influence treatment setting 南加州醉酒驾驶自残的患病率及相关因素

IF 2.9 3区医学

Addiction Research & Theory Pub Date : 2022-10-28 DOI: 10.1080/16066359.2022.2135702

Melanie Barker, M. Zúñiga, J. Stockman, Susan Woodruff, Brittany A Wood

{"title":"Prevalence and correlates of self-harm in a Southern California driving under the influence treatment setting","authors":"Melanie Barker, M. Zúñiga, J. Stockman, Susan Woodruff, Brittany A Wood","doi":"10.1080/16066359.2022.2135702","DOIUrl":"https://doi.org/10.1080/16066359.2022.2135702","url":null,"abstract":"Abstract Background Suicide and driving under the influence of alcohol and other drugs are US public health epidemics. Research exploring the associations between driving under the influence and suicide presents a research gap. This study describes the prevalence and associations between demographic, alcohol and drug-related characteristics, depression, and self-harm (suicidal thoughts, behavior, and non-suicidal self-injury) among participants in a Southern California DUI Program. Methods Participants receiving driving under the influence treatment services (n = 1310) reported substance use, mental health and demographic data upon program intake between July 2019 and March 2020. A descriptive analysis was used to determine the prevalence of lifetime self-harm thoughts or behaviors. Bivariate analyses of associations between lifetime self-harm thoughts or behaviors and sociodemographic, alcohol, drug, and depression severity measures were explored. Manual backward elimination was used to obtain the final logistic regression model with variables statistically significant at p < 0.05 or had at least one category that was significant at p < 0.05 for non-dichotomous variables. For those reporting self-harm, a chart review extracted clinical themes to identify whether the driving under the influence event was reported as a deliberate suicide attempt. Results Ten percent (n = 135) of participants endorsed a lifetime self-harm history. Younger age, female gender, prior alcohol treatment, depressed mood, and family suicide history were significantly associated with self-harm. One individual reported the driving under the influence event as non-suicidal self-injury), and three reported it as a suicide attempt. Conclusion First- and multiple-time driving under the influence offenders represent a clinical population at increased risk for suicidal thoughts and behavior in need of specialized treatment referrals.","PeriodicalId":47851,"journal":{"name":"Addiction Research & Theory","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2022-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86867039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Five barriers to defining responsible drinking 界定合理饮酒的五大障碍

IF 2.9 3区医学

Addiction Research & Theory Pub Date : 2022-10-22 DOI: 10.1080/16066359.2022.2135703

Debi A. LaPlante, Taylor G. Lee, John M. Slabczynski, H. Shaffer, H. Gray

引用次数: 0

Meaning in life: investigating protective and risk factors for harmful alcohol consumption 生活意义:调查有害饮酒的保护和风险因素

IF 2.9 3区医学

Addiction Research & Theory Pub Date : 2022-10-21 DOI: 10.1080/16066359.2022.2134991

Amber Copeland, Andrew Jones, Samuel F. Acuff, J. Murphy, M. Field

{"title":"Meaning in life: investigating protective and risk factors for harmful alcohol consumption","authors":"Amber Copeland, Andrew Jones, Samuel F. Acuff, J. Murphy, M. Field","doi":"10.1080/16066359.2022.2134991","DOIUrl":"https://doi.org/10.1080/16066359.2022.2134991","url":null,"abstract":"Abstract Background Individuals with greater meaning in life tend to consume less alcohol. However, research elucidating pathways through which meaning in life influences consumption is lacking. Behavioral economic theories posit that distortions in valuation processes, whilst negative reinforcement models posit that avoidance or regulation of negative internal states, are central in decisions to consume alcohol. Method Pre-registered, cross-sectional design. Five hundred forty-six regular alcohol consumers (≥18 years old) completed an online questionnaire which asked about alcohol use, meaning in life, alcohol-free reinforcement, alcohol value, depressive symptoms, and drinking to cope motives. Results Presence of meaning had a significant negative association with AUDIT scores (β = −.26, p < .001), but neither search for meaning nor alcohol-free reinforcement were significant predictors (ps > .53). Subsequent path analyses revealed a significant indirect effect of presence of meaning on AUDIT scores through lower alcohol value (95% CI = −.17 to −.08) and drinking to cope (95% CI = −.07 to −.00), and a serial mediation effect through both lower depressive symptoms and drinking to cope (95% CI = −.09 to −.04). Although search for meaning was not a direct predictor of AUDIT scores, there was a significant indirect effect through greater drinking to cope (95% CI = .01 to .06) and a serial mediation effect through both greater depressive symptoms and drinking to cope (95% CI = .01 to .04). Conclusions Meaning in life subscales predict alcohol consumption indirectly via individual differences in alcohol value, depressive symptoms, and drinking to cope.","PeriodicalId":47851,"journal":{"name":"Addiction Research & Theory","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2022-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89876294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Alcohol cravings and engagement with alcohol content on social media 对酒精的渴望和对社交媒体上酒精内容的参与

IF 2.9 3区医学

Addiction Research & Theory Pub Date : 2022-10-18 DOI: 10.1080/16066359.2022.2134990

Jonathan K. Noel, Fabiana Serna

{"title":"Alcohol cravings and engagement with alcohol content on social media","authors":"Jonathan K. Noel, Fabiana Serna","doi":"10.1080/16066359.2022.2134990","DOIUrl":"https://doi.org/10.1080/16066359.2022.2134990","url":null,"abstract":"Abstract Background Use of social media may activate similar regions of the brain as psychoactive substances, and research suggests a close relationship between social media and alcohol use. But research on alcohol use cravings in relation to social media is scant. The current study sought to determine if alcohol cravings were associated with engagement (i.e. Liking, Sharing, Commenting) with social media alcohol content. Method In all, n = 723 participants (18–65 years old) completed the Desires for Alcohol Questionnaire (DAQ) before and after viewing 6 social media alcohol posts. The likelihood of Liking, Sharing, and Commenting on each depiction was assessed after each exposure. Path analysis assessed direct and indirect effects after adjusting for age, sex, race, ethnicity, social media involvement, and AUDIT score, and clustering of responses within persons. Results Pre-exposure DAQ scores were positively associated with the likelihood of ad Liking (p < .001), Sharing (p < .001), and commenting (p < .001). Likelihood of ad Liking (p = .035) and commenting (p = .028) were positively associated with post-exposure DAQ scores, with the indirect effects also statistically significant (p’s < .05). Conclusions Persons with high alcohol cravings may be more likely to engage with alcohol content on social media, and the act of engagement may subsequently increase alcohol cravings, which suggests a possible positive feedback loop. The role of social media should be accounted for in the prevention and treatment of alcohol use disorders.","PeriodicalId":47851,"journal":{"name":"Addiction Research & Theory","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2022-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81597743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Increased levels of hope are associated with slower rates of relapse following detoxification among people living with opioid dependence 在阿片类药物依赖者中，希望水平的提高与戒毒后复发率的降低有关

IF 2.9 3区医学

Addiction Research & Theory Pub Date : 2022-10-13 DOI: 10.1080/16066359.2022.2132238

H. Reddon, J. Ivers

{"title":"Increased levels of hope are associated with slower rates of relapse following detoxification among people living with opioid dependence","authors":"H. Reddon, J. Ivers","doi":"10.1080/16066359.2022.2132238","DOIUrl":"https://doi.org/10.1080/16066359.2022.2132238","url":null,"abstract":"Abstract Background The present study was conducted to estimate the association between measures of hope for the future and time to substance use relapse among people living with opioid dependence following their discharge from opioid detoxification programs. Method The data for this investigation were collected from a prospective cohort study of patients who completed detoxification in Ireland (N = 142). After baseline, participants completed follow-up visits at three, six and nine months. Cox regression models were used to analyze the association between measures of hope and time to relapse. Results Of the 142 participants included in this study, 43 (30.3%) were female and the mean duration of substance use was 14.3 years (standard deviation: 5.8). In the multivariable analysis, a five-unit increase in mean Trait Hope Scale scores was associated with a mean decrease of 23% in the Hazard Ratio (HR) of relapse following detoxification (HR = 0.77, 95% Confidence Interval [CI]: 0.63–0.94; p = 0.011). In the sub-analysis, the hope-agency subdomain was significantly associated with lower rates of relapse (HR = 0.59, 95% CI: 0.41–0.83; p = 0.009), while the hope-pathway subdomain was not significantly associated with relapse rates (HR = 0.74, 95% CI: 0.50–1.11; p = 0.146). Conclusions In the present study, increased mean levels of hope were associated with slower rates of relapse among people living with opioid dependence following discharge from detoxification programs. These findings suggest that empowering people in recovery and providing additional support following services such as detoxification may be valuable strategies to reduce relapse rates among people living with opioid dependence.","PeriodicalId":47851,"journal":{"name":"Addiction Research & Theory","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2022-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88534567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Comorbid eating disorders among women receiving treatment for substance use disorders: a systematic review and meta-analysis 接受药物使用障碍治疗的女性共病性饮食障碍:系统回顾和荟萃分析

IF 2.9 3区医学

Addiction Research & Theory Pub Date : 2022-10-04 DOI: 10.1080/16066359.2022.2127692

Laura D. Robinson, Emma E. Walter, F. Deane, B. Larance

{"title":"Comorbid eating disorders among women receiving treatment for substance use disorders: a systematic review and meta-analysis","authors":"Laura D. Robinson, Emma E. Walter, F. Deane, B. Larance","doi":"10.1080/16066359.2022.2127692","DOIUrl":"https://doi.org/10.1080/16066359.2022.2127692","url":null,"abstract":"Abstract Objective Comorbid eating disorders (EDs) and substance use disorders (SUDs) are common. Most research has explored substance use among individuals with an ED. Few studies describe the prevalence of EDs in samples of women with SUD who are attending treatment. This study is a systematic review and meta-analysis of the point and lifetime prevalence of comorbid ED among treatment-seeking female patients with SUD. Method Using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guideline, six databases were systematically searched to identify studies. Prevalence rates of EDs and/or ED behaviors and methodological factors were extracted from each eligible study. Risk of bias was assessed using the AXIS tool. Random-effects meta-analysis was used to pool prevalence estimates. The protocol is registered in PROSPERO. Results Full text reviews were conducted on 131 studies and 24 (N = 4767) met inclusion criteria. Point prevalence of disordered eating behaviors (DEBs) was 38.71% and lifetime prevalence 20.95%. The point prevalence of a diagnosed ED was 15.69% and lifetime prevalence was 15.67%. For any ED or disordered eating, the point prevalence was 29.99% and lifetime prevalence was 19.40%. Age was a significant negative moderator for point prevalence of AN which was 5.41%. Conclusions This review indicates that there is a high rate of women attending treatment for SUDs with comorbid EDs and/or DEBs. Implications for treatment approaches and suggestions for future research are provided.","PeriodicalId":47851,"journal":{"name":"Addiction Research & Theory","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2022-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90502227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Limbic platform capitalism: understanding the contemporary marketing of health-demoting products on social media 边缘平台资本主义:理解社交媒体上贬低健康产品的当代营销

IF 2.9 3区医学

Addiction Research & Theory Pub Date : 2022-09-26 DOI: 10.1080/16066359.2022.2124976

A. Lyons, I. Goodwin, Nicholas Carah, Jessica Young, Angela Moewaka Barnes, T. McCreanor

{"title":"Limbic platform capitalism: understanding the contemporary marketing of health-demoting products on social media","authors":"A. Lyons, I. Goodwin, Nicholas Carah, Jessica Young, Angela Moewaka Barnes, T. McCreanor","doi":"10.1080/16066359.2022.2124976","DOIUrl":"https://doi.org/10.1080/16066359.2022.2124976","url":null,"abstract":"Abstract The purposive design, production and marketing of legal but health-demoting products that stimulate habitual consumption and pleasure for maximum profit has been called ‘limbic capitalism’. In this article, drawing on alcohol and tobacco as key examples, we extend this framework into the digital realm. We argue that ‘limbic platform capitalism’ is a serious threat to the health and wellbeing of individuals, communities and populations. Accessed routinely through everyday digital devices, social media platforms aggressively intensify limbic capitalism because they also work through embodied limbic processes. These platforms are designed to generate, analyse and apply vast amounts of personalised data in an effort to tune flows of online content to capture users’ time and attention, and influence their affects, moods, emotions and desires in order to increase profits. Social media are central to young people’s socialising, identities, leisure practices and engagement in civic life. Young people actively appropriate social media for their own ends but are simultaneously recruited as consumers who are specifically targeted by producers of limbic products and services. Social media platforms have seen large increases in users and traffic through the COVID-19 pandemic and limbic capitalism has worked to intensify marketing that is context, time and place specific, driving online purchases and deliveries of limbic products. This has public health implications that require immediate attention as existing regulatory frameworks are woefully inadequate in this era of data-driven, algorithmic marketing.","PeriodicalId":47851,"journal":{"name":"Addiction Research & Theory","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2022-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81064111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 3

“The peer workers, they get it” – how lived experience expertise strengthens therapeutic alliances and alcohol and other drug treatment-seeking in the hospital setting “同伴工作者，他们明白了”——生活经验如何加强治疗联盟以及在医院环境中寻求酒精和其他药物治疗

IF 2.9 3区医学

Addiction Research & Theory Pub Date : 2022-09-21 DOI: 10.1080/16066359.2022.2124245

Leanne Francia, Amelia Berg, T. Lam, Kirsty Morgan, S. Nielsen

{"title":"“The peer workers, they get it” – how lived experience expertise strengthens therapeutic alliances and alcohol and other drug treatment-seeking in the hospital setting","authors":"Leanne Francia, Amelia Berg, T. Lam, Kirsty Morgan, S. Nielsen","doi":"10.1080/16066359.2022.2124245","DOIUrl":"https://doi.org/10.1080/16066359.2022.2124245","url":null,"abstract":"Abstract Introduction and aims Despite a long history of the adoption of a peer workforce in alcohol and other drug treatment service provision, there is limited peer reviewed literature on the benefits of peer worker role integration in the hospital setting. Our qualitative study explored the perceptions of people with lived experience of problematic alcohol and other drugs use and their experiences of peer worker roles in the hospital setting. Design and methods Twenty semi-structured interviews with people who experienced problematic alcohol and other drug use. Transcripts were thematically analyzed and guided by a broad interest in a therapeutic alliance. Results We identified four themes related to how lived experience expertise within a peer worker role strengthened therapeutic alliances: (i) by building trust and credibility; (i) by building hope; (iii) the ability to approach informally; and (iv) in continuing to be accessible long term. Discussion and conclusion The results partly echo earlier literature, however highlight two innovative aspects that relate to lived experience expertise that maintain therapeutic alliances in the hospital setting being, firstly, the ability to approach informally, and secondly, an opportunity for longer-term engagement. In Australia at present there is a window of opportunity to better integrate peer workers into clinical care models, and as such our results have implications for how policy makers might better approach peer worker integration and configuration to improve treatment-seeking intentions both within and beyond the hospital setting.","PeriodicalId":47851,"journal":{"name":"Addiction Research & Theory","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2022-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79075241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Toward the nature of automatic associations: item-level computational semantic similarity and IAT-based alcohol-valence associations 自动联想的本质:项目级计算语义相似度和基于ai的醇价联想

IF 2.9 3区医学

Addiction Research & Theory Pub Date : 2022-09-19 DOI: 10.1080/16066359.2022.2123474

T. Gladwin

{"title":"Toward the nature of automatic associations: item-level computational semantic similarity and IAT-based alcohol-valence associations","authors":"T. Gladwin","doi":"10.1080/16066359.2022.2123474","DOIUrl":"https://doi.org/10.1080/16066359.2022.2123474","url":null,"abstract":"Abstract Automatic associations involving alcohol have been proposed to play a role in drinking behavior. Such associations are often assessed using implicit measures such as the Implicit Association Test (IAT). Neural network language models provide computational measures of semantic relationships between words. These model-based measures could be related to behavioral alcohol-related associations as observed using the IAT. If so, this could provide a step toward better understanding of the nature of automatic associations and their relationship to behavior. The current study therefore aimed to test whether there is a systematic covariation over items between model-based and behavior-based associations. Analyses were performed for two single-target IATs from a previously published study. One task involved alcohol versus nonalcohol drinks and positive associates, and the other alcohol versus nonalcohol drinks and negative associates. The GenSim library and a pretrained word2vec model were used to calculate a relative computational association between specific items from the positive and negative categories, respectively, and the alcohol versus nonalcohol word sets. In both tasks, a significant covariance between items’ computational and behavioral measures of association was found over participants. The results thus add to the information on the relationship between neural network language models and psychological associations. They may provide methodological strategies for task design and data analysis. Models of semantic associations connect computational linguistics and social-cognitive psychology and may provide a theoretical link between measures of alcohol-related associations using verbal stimuli and alcohol-related cognition and behaviors.","PeriodicalId":47851,"journal":{"name":"Addiction Research & Theory","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2022-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72514942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Ontological diversity in gaming disorder measurement: a nationally representative registered report 游戏障碍测量中的本体多样性:一份具有全国代表性的注册报告

IF 2.9 3区医学

Addiction Research & Theory Pub Date : 2022-09-05 DOI: 10.1080/16066359.2022.2115033

Veli-Matti Karhulahti, Jukka Vahlo, Marcel Martončik, M. Munukka, R. Koskimaa, M. V. von Bonsdorff

{"title":"Ontological diversity in gaming disorder measurement: a nationally representative registered report","authors":"Veli-Matti Karhulahti, Jukka Vahlo, Marcel Martončik, M. Munukka, R. Koskimaa, M. V. von Bonsdorff","doi":"10.1080/16066359.2022.2115033","DOIUrl":"https://doi.org/10.1080/16066359.2022.2115033","url":null,"abstract":"Abstract Gaming-related health problems have been researched since the 1980s with numerous different ontologies as reference systems, from self-assessed ‘game addiction’ to ‘pathological gambling’ (in the Diagnostic and Statistical Manual of Mental Disorders [DSM]-IV), ‘internet gaming disorder’ (in the third section of the DSM-5) and most recently ‘gaming disorder’ (in the International Classification of Diseases [ICD]-11). Our goal was to investigate how screening instruments that derive from different ontologies differ in identifying associated problem groups. By using four central screening instruments, each representing a different ontological basis, we hypothesized differences and similarities in prevalence, overlap, and health. A nationally representative (N = 8217) sample of Finnish participants was collected. The screening instruments produced significantly different prevalence rates (from 0.4% to 6.9%) and the binomial probabilities of group overlap ranged from poor (0.419) to good (0.919). Expectedly, the problem groups had lower mental health than the general population, yet exploratory analyses implied equivalent or significantly higher physical health. We also found strong exploratory evidence for mischievous responding to complicate the measurement of gaming problems. Considering that several major differences were confirmed between the four gaming problem constructs, we recommend researchers to clearly define their construct of interest, i.e. whether they are studying the ICD-11 based official mental disorder, the DSM-5 proposed ‘internet gaming disorder’, or other gaming problems—especially in future meta-analyses.","PeriodicalId":47851,"journal":{"name":"Addiction Research & Theory","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2022-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74199893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 9