Journal of Behavioral Medicine最新文献

{"title":"Progress on theory of planned behavior research: advances in research synthesis and agenda for future research.","authors":"Martin S Hagger, Kyra Hamilton","doi":"10.1007/s10865-024-00545-8","DOIUrl":"https://doi.org/10.1007/s10865-024-00545-8","url":null,"abstract":"<p><p>The theory of planned behavior is a social cognition theory that has been widely applied to identify the psychological determinants of intentions and behavior in health contexts. Our 2015 meta-analysis of theory applications in chronic illness contributed to a burgeoning evidence base comprising syntheses supporting theory predictions in health behavior. In this review, we identify limitations of prior meta-analyses of theory applications in health behavior and highlight salient evidence gaps, summarize how recent meta-analyses of the theory have addressed some of the limitations, outline outstanding research questions, and suggest future research syntheses, including those currently in progress, to resolve them. We point to recent and ongoing meta-analyses addressing theory hypotheses and assumptions not tested in previous syntheses, such as perceived behavioral control moderating effects and indirect effects of environmental (e.g., sociostructural variables) and intrapersonal (e.g., personality traits) determinants on health behavior mediated by theory constructs. We also highlight meta-analyses examining behavioral effects of constructs representing extended processes (e.g., habit, implicit cognition) in the context of the theory. Further, we summarize recent meta-analyses addressing directional and causal inferences in theory effects, including meta-analyses of longitudinal studies and experimental and intervention research. We also highlight attempts to test the mechanisms of action of interventions based on the theory including the change meta-analysis method and mediation analyses. We conclude by summarizing the advances that recent meta-analyses of the theory have made to the evidence base of health behavior determinants and interventions and highlighting suggestions for meta-analyses that will further progress the evidence base.</p>","PeriodicalId":48329,"journal":{"name":"Journal of Behavioral Medicine","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014310","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}

{"title":"Minority stress in relation to biological outcomes among sexual and gender minority people: a systematic review and update.","authors":"Annesa Flentje, Gowri Sunder, Elliot Tebbe","doi":"10.1007/s10865-024-00539-6","DOIUrl":"https://doi.org/10.1007/s10865-024-00539-6","url":null,"abstract":"<p><p>Here we present an updated systematic review identifying studies published 2019-2024, since our prior systematic review in 2020, that examine the association between minority stress and a biological outcome among sexual and gender minority (SGM) people. Pubmed, Web of Science, and Embase were queried to identify studies that examined an association between minority stress (including prejudice events and conditions, anticipation of rejection and discrimination, concealment or disclosure of SGM identity(ies), internalized stigma, or structural stigma) and a biological health outcome among SGM people. Included studies were coded for methodological approaches, study population, minority stress measure, biological outcomes, count of overall analyses, and count of analyses where an association was detected. Fifty-nine studies met inclusion criteria and included a total of 391 analyses between an element of minority stress and a biological outcome, among which 38% of analyses detected an association (44% detected this association when study outliers were removed). All elements of minority stress demonstrated associations with outcomes: multicomponent measures, prejudice events and conditions, and structural stigma demonstrated the highest proportion of associations. Associations with minority stress were detected for general physical health, sleep, immune, cardiovascular, metabolic, hormonal, brain health, allostatic load, epigenetic and transcriptional regulation. The highest proportion of associations were detected among sleep, immune, cardiovascular, and hormonal outcomes. These studies evidence associations between minority stress and biological outcomes among gender minority people in addition to evidence among sexual minority people. Future research should consider increasing rigor in methodology and expanding our understanding of moderators and mediators of these relationships.</p>","PeriodicalId":48329,"journal":{"name":"Journal of Behavioral Medicine","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956800","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}

{"title":"Children's executive functioning and health behaviors across pediatric life stages and ecological contexts.","authors":"Nichole R Kelly, Derek Kosty, Yosef Bodovski, Courtney K Blackwell, Jody M Ganiban, Jenae M Neiderhiser, Dana Dabelea, Diane Gilbert-Diamond, Judy L Aschner, Theresa M Bastain, Carrie V Breton, Nicole R Bush, Catrina A Calub, Carlos A Camargo, Marie Camerota, Lisa A Croen, Amy J Elliott, Michelle Bosquet Enlow, Assiamira Ferrara, Tina Hartert, Robert M Joseph, Margaret R Karagas, Rachel S Kelly, Kristen Lyall, Kelsey E Magee, Cindy T McEvoy, Francheska M Merced-Nieves, Thomas G O'Connor, Sara Santarossa, Susan L Schantz, Rebecca J Schmidt, Joseph B Stanford, Jennifer K Straughen, Annemarie Stroustrup, Nicole M Talge, Rosalind J Wright, Qi Zhao, Leslie D Leve","doi":"10.1007/s10865-024-00543-w","DOIUrl":"https://doi.org/10.1007/s10865-024-00543-w","url":null,"abstract":"<p><p>Executive functioning (EF) has been linked to chronic disease risk in children. Health behaviors are thought to partially explain this association. The current cross-sectional study evaluated specific domains of EF and varied health behaviors in three pediatric life stages. Pediatric participants (early childhood n = 2074, M_age = 6.4 ± 0.9 y; middle childhood n = 3230, M_age = 9.6 ± 1.2 y; adolescence n = 1416, M_age = 15.2 ± 1.7 y) were part of the Environmental influences on Child Health Outcomes (ECHO) Program. They completed neurocognitive tasks measuring cognitive flexibility, behavioral inhibition, and working memory. Parent- and/or child-report measures of dietary intake, physical activity, sleep duration and quality, income, and positive parenting were also collected. Neighborhood crime and greenspace were calculated from publicly available census-tract level indices. After adjusting for study site, child body mass index, and demographics, working memory was related in the hypothesized direction to several dietary behaviors within all pediatric life stages. Working memory and cognitive flexibility were positively related to physical activity in middle childhood and adolescence. In adolescence, behavioral inhibition was positively related to physical activity and inversely related to sugar-sweetened beverage and total caloric intake. Associations with sleep were all non-significant. All significant associations reflected small effect sizes. Income, positive parenting, greenspace, and crime did not significantly influence any of the EF-health behavior associations. Findings highlight the need to consider EF domains, specific health behaviors, and developmental stage in creating intervention strategies that target EF to improve health behaviors. The small effect sizes reinforce the need for multi-tiered interventions to maximize health.</p>","PeriodicalId":48329,"journal":{"name":"Journal of Behavioral Medicine","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956778","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}

{"title":"Differences in anxiety, depression and pain experience among adults with chronic low back pain as a function of nicotine product use.","authors":"Michael J Zvolensky, Tanya Smit, Andrew H Rogers, Jafar Bakhshaie, Joseph W Ditre, Dipali V Rinker","doi":"10.1007/s10865-024-00547-6","DOIUrl":"https://doi.org/10.1007/s10865-024-00547-6","url":null,"abstract":"<p><p>The landscape of nicotine use in the United States (US) has continued to evolve, with electronic cigarette use (hereafter e-cigarette) becoming more evident in recent years. Patterns of dual nicotine use, or using combustible nicotine in conjunction with e-cigarettes, may increase dependence on nicotine, continued exposure to toxins, and corresponding health risks. One of the most prevalent health problems related to nicotine use is the experience of chronic pain. Past work has established a bidirectional relationship between nicotine use and pain, such that pain motivates nicotine use and nicotine use contributes to pain. However, no work has explored differences in negative mood and pain experience as a product of nicotine use type among adults with chronic low back pain. The current cross-sectional study examined whether dual cigarette/e-cigarette use was associated with greater anxiety, depression, and pain experience among a sample of adult nicotine users (cigarettes and/or e-cigarettes) with self-reported mild to severe chronic low back pain (N = 1034, 66.0% female, M_age= 44.47 years, SD = 11.63). Results indicated that, compared to exclusive combustible nicotine users, dual cigarette/e-cigarette users had statistically significantly higher anxiety, depression, and pain disability scores, beyond the effects of age, sex, education, and use of opioid medications for pain. No significant group differences emerged as a function of exclusive e-cigarette use. The current findings highlight that dual cigarette/e-cigarette use may serve to mark a subpopulation of persons with chronic low back pain who present more complicated clinical features that require comprehensive care.</p>","PeriodicalId":48329,"journal":{"name":"Journal of Behavioral Medicine","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956799","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}

{"title":"A remote examination of acute stress responses: examining the influence of psychological resilience.","authors":"Briana N DeAngelis, Dorothy K Hatsukami, Sharon S Allen, Mustafa al'Absi","doi":"10.1007/s10865-024-00537-8","DOIUrl":"https://doi.org/10.1007/s10865-024-00537-8","url":null,"abstract":"<p><strong>Background: </strong>A few studies have examined psychological resilience as a predictor of physiological responses to acute stress; however, no studies have directly examined psychological resilience as a moderator of subjective responses to acute stress.</p><p><strong>Methods: </strong>Adults were recruited to participate in an acute stress response study that was conducted remotely. Demographics, psychological resilience, nicotine use and desire to quit, and information related to cannabis use were measured during a medical screening session. Positive, stressed, and anxious moods were measured during baseline rest prior to acute stress, after performing acute stress tasks, and after 30- and 55-minutes of post-stress recovery during an acute stress session.</p><p><strong>Results: </strong>Acute stress was successfully induced during the remote audio-video stress session. There were significant increases in stressed and anxious moods and significant decreases in positive mood immediately after the acute stress tasks, followed by a return to baseline levels of these moods. Moreover, psychological resilience was inversely related to stressed and anxious moods reported at baseline and immediately after acute stress. In addition, psychological resilience was positively related to positive mood.</p><p><strong>Conclusion: </strong>The results are consistent with previous research linking psychological resilience to general reports of positive and negative affect. Further, the results demonstrate, for the first time, that psychological resilience may be a significant predictor of negative mood immediately after acute stress.</p>","PeriodicalId":48329,"journal":{"name":"Journal of Behavioral Medicine","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142911001","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}

{"title":"Psychosocial predictors of short-term glucose among people with diabetes: A narrative review.","authors":"Fiona S Horner, Vicki S Helgeson","doi":"10.1007/s10865-024-00536-9","DOIUrl":"https://doi.org/10.1007/s10865-024-00536-9","url":null,"abstract":"<p><p>Type 1 and type 2 diabetes are metabolic disorders that require one to manage one's blood glucose levels on a daily basis through a series of behaviorally complex tasks. Research shows that psychosocial factors, including mood, stress, and social relationships, have a significant influence on one's ability to maintain these disease management routines and achieve healthy blood glucose levels. However, researchers have typically approached these questions from a between-person perspective. Here, we argue for greater consideration of short-term, within-person links of psychosocial factors-including mood, stress, and social interactions-to glucose outcomes. Drawing from existing social and health psychology theories, we put forth an organizing theoretical framework describing how psychosocial experiences may operate on glucose outcomes over subsequent hours. We then review the small but burgeoning literature of intensive longitudinal studies that have examined the short-term effects of negative affect, positive affect, stress, and social interactions on glucose outcomes. Findings showed somewhat stronger links for negative affect and stress compared to positive affect and social interactions, but studies varied greatly in their methodologies, making direct comparisons challenging. A number of findings, particularly in the social interaction literature, depended on dispositional or contextual factors, further complicating interpretation. There was little investigation of the mechanistic pathways that may connect psychosocial factors to glucose outcomes, and few studies conducted lagged analyses to probe the directionality of these links. We conclude by proposing best practices for future research that will address the key weaknesses in the extant literature.</p>","PeriodicalId":48329,"journal":{"name":"Journal of Behavioral Medicine","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142865760","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}

{"title":"Maintaining habitual physical activity by overcoming disruptive competing actions: mechanisms and interventions.","authors":"Navin Kaushal, Donya Nemati, Darko Jekauc, Aleksandra Luszczynska, Martin S Hagger","doi":"10.1007/s10865-024-00541-y","DOIUrl":"https://doi.org/10.1007/s10865-024-00541-y","url":null,"abstract":"<p><p>Habits are mental representations of associations between actions and contextual contingencies. Habit formation can be efficacious in promoting health behavior maintenance, including for highly complex behaviors such as physical activity. Changes in circumstances (e.g., job transitions, moving home) or the advent of disruptive events (e.g., work-related or personal responsibilities) can lead to habit discontinuity by eliminating the contextual contingencies associated with the behavior. Recently, habit theorists have distinguished between preparation or instigation and execution habits, with preparation or instigation habits proposed as central to the development and maintenance of complex habitual behaviors. Discontinuity for complex habitual behaviors may entail disruption of preparation, instigation, or execution habits making such behaviors highly vulnerable to disruption and discontinuity. We propose that the advent of events such as increased work demands or personal responsibilities (e.g., job demands or personal circumstances such as caregiving) and competing highly rewarding activities (e.g., technology-mediated screen activities such as using smartphone apps and games) have high potential to disrupt preparation and instigation habits for complex behaviors. We outline the mechanisms involved and propose several strategies that may be employed to minimize disruption and discontinuity of complex habitual behaviors using physical activity as an illustration. We identify reaffirming original goals, self-monitoring, and planning strategies as potentially efficacious means to minimize the potential for events and competing activities to disrupt physical activity preparation and instigation habits. We call for future research to investigate the efficacy of these strategies in managing disruptive events and promote maintenance of habitual physical activity habit maintenance.</p>","PeriodicalId":48329,"journal":{"name":"Journal of Behavioral Medicine","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142865759","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}

{"title":"The relationship between depressive symptoms and coping style on asthma outcomes in older adults.","authors":"Naomi Greenfield, Matthew Wysocki, Kimberly Arcoleo, Juliana Rodriguez, Sunit Jariwala, Paula Busse, Alex Federman, Juan Wisnivesky, Jonathan M Feldman","doi":"10.1007/s10865-024-00538-7","DOIUrl":"https://doi.org/10.1007/s10865-024-00538-7","url":null,"abstract":"<p><strong>Objective: </strong>To examine the impact of coping styles in older adults with asthma on the prospective relationship between depressive symptoms and asthma outcomes, and how their perceptions of social support influenced their coping styles.</p><p><strong>Methods: </strong>Adults 60 and over with asthma were recruited and interviewed about their experiences of asthma, depression, and other psychosocial factors over three time points (Baseline, 6-month, and 12-month visits). Structural equation models examined the mediating roles of coping styles in the relationship between depressive symptoms (assessed by BDI-II) and asthma outcomes (i.e., asthma control, asthma quality of life, asthma-related distress, asthma-related hospitalizations, and oral corticosteroid use) and the mediating role of perceived social support in the relationship between depressive symptoms and coping style.</p><p><strong>Results: </strong>455 participants were included in this study. Overall, 33.9% of the study population self-identified as Black and 32.8% as Hispanic. Depressive symptoms at baseline predicted less spiritual coping at 6 months (β =  - 0.15, p = 0.03), more negative coping at 6 months (β = 0.44, p < .0001), and worse asthma outcomes at 12 months (β = 0.31, p < .0001). None of the coping styles significantly mediated the relationship between depressive symptoms and asthma outcomes. Perceived social support mediated the relationship between depressive symptoms and positive coping, such that more depressive symptoms predicted less perceived social support, which in turn resulted in less positive coping engagement (β =  - 0.06, p = 0.03).</p><p><strong>Conclusions: </strong>This study demonstrates that in older adults with asthma depressive symptoms impact perceived social support, coping strategy selection (including spiritual coping), and subsequent asthma outcomes.</p>","PeriodicalId":48329,"journal":{"name":"Journal of Behavioral Medicine","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822614","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}

{"title":"Impact of weight and health-behavior information on evaluations of girls' health.","authors":"Habiba Naanai, Lenny R Vartanian","doi":"10.1007/s10865-024-00535-w","DOIUrl":"https://doi.org/10.1007/s10865-024-00535-w","url":null,"abstract":"<p><p>The dominant public health narrative equates excess weight with poor health, and previous research has demonstrated that people judge adults with higher body weights as being in poor health, even when they engage in healthy lifestyles. The present study investigated whether the same pattern of beliefs holds for perceptions of children's health. Participants (n = 445) viewed the health profile of a female child that varied in terms of weight status (normal weight, obese), health behaviors (good, poor), and age (younger, older), and then rated the child's overall health and indicated their agreement with suggested behavior recommendations. For older children, targets with obesity were perceived as less healthy and were recommended to engage in more healthy and weight control behaviors than were the targets with normal weight. Health behaviors did influence perceptions of health and behavioral recommendations, but much less so for the target with obesity than for the target with normal weight. For younger children, participants placed a greater emphasis on health behaviors than on weight in their perceptions of the target's health and healthy behavior recommendations, but the target's weight did play a greater role in weight-control behavior recommendations. Overall, perceptions of older children reflect the mainstream weight-centric health beliefs that are perpetuated in public health messaging, whereas perceptions of younger children seem to be more aligned with the scientific evidence supporting the importance of health behaviors to overall health. Public health messaging, particularly messaging targeting parents, should be reframed to focus on the importance of engagement with health behaviors without reference to weight.</p>","PeriodicalId":48329,"journal":{"name":"Journal of Behavioral Medicine","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781488","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}

{"title":"Adapting a pain coping skills training intervention for people with chronic pain receiving maintenance hemodialysis for end stage Kidney disease.","authors":"Jennifer L Steel, Carrie E Brintz, Alicia A Heapy, Francis Keefe, Martin D Cheatle, Manisha Jhamb, Daniel W McNeil, Amanda J Shallcross, Paul L Kimmel, Laura M Dember, David M White, Joey Williams, Daniel Cukor","doi":"10.1007/s10865-024-00534-x","DOIUrl":"10.1007/s10865-024-00534-x","url":null,"abstract":"<p><p>Pain Coping Skills Training (PCST) is a first-line cognitive-behavioral, non-pharmacological treatment for chronic pain and comorbid symptoms. PCST has been shown to be effective in racially and ethnically diverse cohorts across several chronic medical conditions. However, PCST has not been evaluated in those with end stage kidney disease (ESKD) receiving in-center maintenance hemodialysis. Due to the high rates of morbidity associated with ESKD, and time-intensive treatment, an adaptation of PCST was warranted to address the unique challenges experienced by people living with ESKD. Using current guidelines developed by Card and colleagues for intervention adaptation, PCST was adapted so that it could be implemented among people living with ESKD in a national multisite trial. The objective of this paper was to describe the adaption process outlined by Card and colleagues including how the team selected an effective intervention to adapt, developed a program model, identified mismatches in the original intervention and study population, and then adapted the intervention for those with ESKD treated with in-center maintenance hemodialysis. Finally, we briefly describe future directions for clinical practice and research with the adapted PCST intervention for those with ESKD.Trial registration: ClinicalTrials.gov #NCT04571619.</p>","PeriodicalId":48329,"journal":{"name":"Journal of Behavioral Medicine","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773818","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}