| 1. |
- Bannon, Brittany L., et al.
(author)
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Confirmatory factor analysis of illness behavior in the Swedish Adoption/Twin Study of Aging (SATSA)
- 2017
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In: Annals of Behavioral Medicine. - : Springer. - 0883-6612 .- 1532-4796. ; 51:Suppl. 1, s. S2654-S2655
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Journal article (peer-reviewed)abstract
- Background: Illness behaviors—or affective, cognitive, and behavioral responses to symptoms of illness—predict patient outcomes, including symptom exacerbation and functional recovery, and they account for a large proportion of U.S. healthcare costs. Although priorcross-sectional work has examined illness behaviors like symptom reporting in isolation, the measurement of illness behavior using a longitudinal, multi-indicator approach has yet to be explored.Aim: We evaluated illness behavior as a latent, developmental construct in the Swedish Adoption/Twin Study of Aging (SATSA).Method: Participants were up to 1,886 individuals (from 1,223 twin pairs) ages 29 to 102 years (Mage baseline = 62.32 years; SD =13.69; 59% Female). Illness behavior indicators included somatic complaints, non-prescription medication use, pain-related disability and perceived illness complications. The psychomotor retardation subscale of the CES-D was used to index somatic complaints, and medication use was a simple composite of 9 dichotomous items on participants’ use of non-prescription medications, such as over-the-counter analgesics, in the previous month. Pain-related disability included a simple composite of three dichotomous items on the presence of neck,back, or shoulder pain that prevented participants from performing daily tasks or activities. Perceived illness disability was a composite of difference scores, calculated from subtracting a physician panel’s objective ratings of disability for each of 35 medical conditions (on a 3-pointscale; 1= Little or no disability; 3= Severe disability) from participants’ self-ratings of how much each of the same endorsed medical conditions interfered with their daily lives (on the same 3-point scale; 1= Not at all; 3= A lot). Positive composite scores reflected higher perceived disability relative to what was expected from the objective ratings, whereas a composite score of zero reflected “accuracy” or agreement in perceived illness complications. Confirmatory Factor Analysis (CFA) was used to evaluate invariance in the loadings of these four indicatorson a latent illness behavior factor across four questionnaire waves (1987-2004).Findings: Confirmatory factor analyses revealed moderate factor loadings of the four indicators (standardized loadings ranged from .49 to .52, all ps < .0001). Also, practical fit indices from the nested model comparisons suggested strong factorial invariance in the loadings across time (CFI = .96; TLI = .95, RMSEA= .03, 90% CI: [.026, .035]).Conclusion: Illness behavior as a latent, multi-indicator construct represents a promising focus for longitudinal work on behavior change and maintenance.
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| 2. |
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| 3. |
- Berman, Anne H., et al.
(author)
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Current State of the Art in Digital Interventions for Addictive Behaviors
- 2020
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In: Annals of Behavioral Medicine. - : Oxford University Press. - 0883-6612 .- 1532-4796. ; 54:S1, s. S417-S417
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Journal article (other academic/artistic)abstract
- Two years ago, a Special Issue on E-health Interventions for Addictive Behaviors was published in the International Journal of Behavioral Medicine. The issue included 16 articles, addressing topics like methodologies for developing e-health interventions, how to engage intervention users and establish a working alliance, and empirical findings from randomized controlled trials and a naturalistic study. The issue began with two articles offering a wide perspective on the field, with a systematic review of reviews on digital interventions for problematic alcohol use, as well as a too for describing e-health interventions as a step towards standardized reporting in order to facilitate communication about the interventions and comparisons between them. This symposium will follow up on the Special Issue by bringing together some of the contributors for presentations of their current work and a discussion on the current state-of-the-art in digital interventions for addictive behaviors. This symposium is sponsored by SBM’s Scientific and Professional Liaison Council (SPLC), in partnership with the International Society of Behavioral Medicine (ISBM).
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| 4. |
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| 5. |
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| 6. |
- Berman, Anne H., et al.
(author)
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Skills Training for Reducing Risky Alcohol Use in App Form Among Adult Internet Help-seekers
- 2020
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In: Annals of Behavioral Medicine. - : Oxford University Press. - 0883-6612 .- 1532-4796. ; 54:S1, s. S417-S417
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Journal article (other academic/artistic)abstract
- Background: Problematic alcohol use in Sweden occurs among 16 % of the adult population. Digital interventions of varying intensity have shown positive effects in contributing to reductions in problematic use, and the TeleCoach app has shown positive effects in non-treatment-seeking university students with excessive drinking (Gajecki et al., 2017). This pilot study evaluated the app among adult internet help-seekers, and motivated continued data collection in the current target group. Methods: Adult internet-help seekers, recruited via advertisement, were included if they scored ³6 (women) or ³8 (men) on the Alcohol Use Disorders Identification Test (AUDIT). Those with depression scores of ³31 on the Montgomery Åsberg Depression Rating Scale (MADRS-S) or problematic drug use scores of ³8 on the Drug Use Disorders Identification Test (DUDIT) were contacted for a telephone interview and included following clinical assessment; if not reached they were excluded. Participants randomized at a 1:1 ratio to the TeleCoach™ web-based app or to a web-based app with information texts from primary care-based self-help material for changing problematic alcohol use. At six-week follow-up, the primary outcome was the number of standard drinks per past week (Timeline-Followback). Results: Of 147 persons assessed for eligibility, 89 were assigned to the intervention group (n=42) or control group (n=47). Average AUDIT levels at baseline were ³18.The baseline number of standard drinks per week was 32.73 (SD 21.16) for the intervention group, and 26 (4.08) for the control group; at 6-week follow-up it was 12.73 (10.52) and 13.48 (11.13) for the intervention and control groups, respectively. No significant between-groups effects occurred, but withingroup changes over time were significant (F(1, 55)=43.98; p< 0.000), with an effect size of 1.37 for the intervention group and 0.92 for the control group. Conclusions: The results suggest that web-based apps can be of help to internet help-seekers motivated to reduce problematic alcohol use. We have proceeded with the planned larger randomized, controlled study and will present 6-week follow-up data for the entire study sample (n=∼1000) in this presentation.
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| 8. |
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| 9. |
- Der Ananian, Cheryl, et al.
(author)
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TRAJECTORIES AND SOCIO-DEMOGRAPHIC PREDICTORS OF STEPS IN A WORKSITE INTERVENTION : ASUKI-STEP
- 2015
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In: Annals of Behavioral Medicine. - New York : Springer. - 0883-6612 .- 1532-4796. ; 49, s. S170-S170
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Journal article (other academic/artistic)abstract
- Promoting physical activity (PA) through worksite wellness programs may help decrease physical inactivity in adults. Purpose: This study examined the effects of a pedometer-based intervention (ASUKI-Step) on (1) trajectories of step counts over time; (2) the proportion of individuals who accumulated at least 10,000 steps per day for a minimum of 100 days; and (3) trajectories of accelerometer-determined PA over time in a sub-set of individuals. We also examined the sociodemographic characteristics associated with each outcome. Methods: ASUKI-Step was a 6-month, pedometer-based intervention offered to employees at Arizona State University (n=712) and the Karolinska Institutet (n=1390). The intervention was grounded in the theory of social support and participants enrolled in teams of 3-4 individuals to promote social support. Trajectories of change in PA were evaluated using a single-group, pre-post quasi-experimental design. Linear growth models were used to assess trajectories of change in and predictors of pedometer-based and accelerometer-determined PA. Logistic regression analyses were used to examine the proportion of individuals who met 10,000 steps per day for at least 100 days. Results: There was a significant linear (t = -20.76, p =.001) and curvilinear change in steps over time (t = 7.65, p = 0.001). Steps declined over the six months and there was significant individual variation in the trajectory of change. Men had a greater decline in steps over time while increased age was associated with a slower decline in steps over time (p < 0.05). Overall, 52.9% (n = 1105) of the participants accumulated 10,000 steps on at least 100 days of the study. Older age, being married, working in a non-managerial position, having a normal body weight, and higher initial PA level were positively associated with meeting the step goal (p <0.05). Finally, in the subset of individuals for whom we had accelerometer-derived PA levels (n=226), there were no changes over time in minutes of physical inactivity, light activity, moderate lifestyle or moderate activity. Conclusions: Findings suggest that a low-intensity, pedometer-based intervention can work with some segments of the typical office population but a more intensive intervention may be needed for individuals who are sedentary or overweight.
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| 10. |
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| 11. |
- Farrand, Paul, et al.
(author)
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Effectiveness of Cognitive Behavioural Self-Help for the Treatment of Depression and Anxiety in People with Long-Term Physical Health Conditions : a Systematic Review and Meta-Analysis of Randomised Controlled Trials
- 2015
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In: Annals of Behavioral Medicine. - : Oxford University Press. - 0883-6612 .- 1532-4796. ; 49:4, s. 579-593
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Journal article (peer-reviewed)abstract
- BACKGROUND: Depression and anxiety are prevalent comorbidities in people with long-term physical health conditions; however, there is limited access to evidence-based treatments for comorbid mental health difficulties.PURPOSE: This study is a meta-analysis examining the effectiveness of cognitive behavioural self-help for physical symptoms, depression and anxiety in people with long-term conditions.METHODS: This study involves a systematic search of electronic databases supplemented by expert contact, reference and citation checking and grey literature.RESULTS: The meta-analysis yielded a small effect size for 11 studies reporting primary outcomes of depression (g = -0.20) and 8 studies anxiety (g = -0.21) with a large effect size (g = -1.14) for 1 study examining physical health symptoms. There were no significant moderators of the main effect.CONCLUSIONS: Limited evidence supports cognitive behavioural self-help for depression, anxiety and physical symptoms in people with long-term conditions. Small effect sizes for depression and anxiety may result from failure to recruit participants with clinical levels of these difficulties at baseline.
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| 12. |
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| 13. |
- Gustafsson, Per E, et al.
(author)
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Social and material adversity from adolescence to adulthood and allostatic load in middle-aged women and men : results from the Northern Swedish Cohort
- 2012
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In: Annals of Behavioral Medicine. - New York : Oxford University Press (OUP). - 0883-6612 .- 1532-4796. ; 43:1, s. 117-28
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Journal article (peer-reviewed)abstract
- BackgroundLittle is known about the theoretically assumed association between adversity exposure over the life course and allostatic load in adulthood.PurposeThis study aims to examine whether social and material adversity over the life course is related to allostatic load in mid-adulthood.MethodsA 27-year prospective Swedish cohort (N = 822; 77% response rate) reported exposure to social and material adversities at age 16, 21, 30 and 43 years. At age 43, allostatic load was operationalized based on 12 biological parameters.ResultsSocial adversity accumulated over the life course was related to allostatic load in both women and men, independently of cumulative socioeconomic disadvantage. Moreover, social adversity in adolescence (in women) and young adulthood (in men) was related to allostatic load, independently of cumulative socioeconomic disadvantage and also of later adversity exposure during adulthood.ConclusionExposure to adversities involving relational threats impacts on allostatic load in adulthood and operates according to life course models of cumulative risk and a sensitive period around the transition into adulthood.
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| 14. |
- Kilic, Aysenur, et al.
(author)
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Using Virtual Technology for Fear of Medical Procedures : A Systematic Review of the Effectiveness of Virtual Reality-Based Interventions
- 2021
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In: Annals of Behavioral Medicine. - : Oxford University Press. - 0883-6612 .- 1532-4796. ; 55:11, s. 1062-1079
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Research review (peer-reviewed)abstract
- BackgroundInnovations in virtual reality (VR) technologies have improved the adaptability of its use in therapeutic settings, and VR has shown to be a promising treatment for fear of medical procedures, with research increasing in this area in recent years.PurposeThis review aims to collate evidence for the impact of VR on fear of medical procedures.MethodsCENTRAL (Cochrane), MEDLINE, EMBASE, and PsychINFO databases were searched up to October 2020. A mix of experimental and case-control studies were included for review, which evaluated the effectiveness of VR for fear, anxiety, and pain of medical procedures for people with needle phobia, dental phobia, claustrophobia of medical scans, and burn wound care anxiety. Risk of bias (RoB) was assessed by Cochrane and ROBINS-I tools.ResultsTwenty-eight studies were selected. Some studies included mixed participant groups of young people adults. The interventions varied, with VR used for distraction, hypnosis, or exposure. These were shown to be effective for reducing fear of medical procedures. However, effectiveness for blood-injection-injury phobias and burn wound care patients was unclear.ConclusionsEvidence on the effectiveness of VR suggests that it does decrease fear of medical procedures in some situations. However, the RoB assessment illustrated a poor quality of studies across those included in this review, limiting the ability to draw firm general conclusions from the study findings. There is a need for further research exploring the use of VR technologies in the management of anxiety in physical health care settings.
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| 15. |
- Raymaekers, Koen, et al.
(author)
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A Person-Centered Perspective on the Role of Peer Support and Extreme Peer Orientation in Youth with Type 1 Diabetes: A Longitudinal Study.
- 2020
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In: Annals of behavioral medicine : a publication of the Society of Behavioral Medicine. - : Oxford University Press (OUP). - 1532-4796.
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Journal article (peer-reviewed)abstract
- Despite clear evidence that peers are crucial for youth development, research on the role of peers for youth with Type 1 diabetes (T1D) is scarce.The present study identified trajectory classes of perceived peer functioning in youth with T1D, based on peer support and extreme peer orientation (EPO). Further, classes were compared with respect to their trajectories of depressive symptoms, diabetes-specific distress, treatment adherence, and HbA1c values.Five hundred and fifty-nine youth (14-25 years) with T1D completed questionnaires at baseline, 1, 2, and 3 years later. Latent class growth analysis identified classes of perceived peer functioning. Multigroup latent growth curve modelling assessed whether these classes were characterized by different trajectories of general and diabetes-specific functioning.A socially normative class (48%) was characterized by trajectories of high support and low EPO over time. A socially reserved class (29%) was characterized by low support and EPO, and a socially oriented class (17%) by high support and EPO. Finally, a socially vulnerable class (6%) was characterized by low support and high EPO. The normative class functioned significantly better over time than the other classes. The vulnerable class functioned significantly worse compared to the reserved class, despite experiencing equally low levels of support.The results underscore the need to take youths' orientation toward the peer context into account alongside support when tapping into the role of peers, because individuals with low levels of support and EPO functioned substantially better than individuals with similar low levels of support but high levels of EPO.
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| 16. |
- Raza, Auriba, et al.
(author)
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Home and Workplace Neighborhood Socioeconomic Status and Behavior-related Health : A Within-individual Analysis
- 2021
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In: Annals of Behavioral Medicine. - : Oxford University Press (OUP). - 0883-6612 .- 1532-4796. ; 55:8, s. 779-790
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Journal article (peer-reviewed)abstract
- Background: The influence of individual and home neighborhood socioeconomic status (SES) on health-related behaviors have been widely studied, but the majority of these studies have neglected the possible impact of the workplace neighborhood SES.Objective: To examine within-individual associations between home and work place neighborhood SES and health-related behaviors in employed individuals.Methods: We used participants from the Swedish Longitudinal Occupational Survey of Health who responded to a minimum of two surveys between 2012 and 2018. Data included 12,932 individuals with a total of 35,332 observations. We used fixed-effects analysis with conditional logistic regression to examine within-individual associations of home, workplace, as well as time-weighted home and workplace neighborhood SES index, with self-reported obesity, physical activity, smoking, excessive alcohol consumption, sedentary lifestyle, and disturbed sleep.Results: After adjustment for covariates, participants were more likely to engage in risky alcohol consumption when they worked in a workplace that was located in the highest SES area compared to time when they worked in a workplace that was located in the lowest SES area (adjusted odds ratios 1.98; 95% confidence interval: 1.12 to 3.49). There was an indication of an increased risk of obesity when individuals worked in the highest compared to the time when they worked in the lowest neighborhood SES area (1.71; 1.02–2.87). No associations were observed for the other outcomes.Conclusion: These within-individual comparisons suggest that workplace neighborhood SES might have a role in health-related behaviors, particularly alcohol consumption.
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| 18. |
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| 19. |
- Stenberg, Una, et al.
(author)
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To Live Close To A Person With Cancer : Experiences Of Family Caregivers
- 2012
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In: Annals of Behavioral Medicine. - New York City : Springer. - 0883-6612 .- 1532-4796. ; 43:Suppl. 1, s. S11-S11
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Journal article (peer-reviewed)abstract
- A cancer diagnosis affects not only the patient, but also Family Caregivers (FCs) and close friends. The purpose of this study was to obtain an in-depth understanding of the experiences of FCs living close to a person with cancer. A convenience sample of 15 FCs, five men and 10 women age 35 to 77, was recruited through the Norwegian Cancer Society’special interest groups. Nine were spouses, five were sons/daughters and one was a sister. FCs participated in individual interviews using a thematic interview guide. Audio-taped interviews were transcribed and analyzed using qualitative hermeneutic analysis. Two major themes emerged from the interviews: The first theme that became apparent was that living close to a cancer patient over the course of his or her illness affected many aspects of FCs’ lives in significant ways. Most challenging were changes and disruptions in daily life, more responsibilities on the part of the FC, changes in roles, social life, in relationships and personal strength in different ways than before. The second major theme was that living close to a cancer patient is to live and work in a world of constant tension, conflicting interests and dilemmas. FCs experienced a constant need to balance different demands, needs, the known with the unknown, and to manage uncertainty and the experience of being helpless and skilled at the same time. This study contributed to deeper insights into FCs experiences than previously reported in the literature. It also became apparent that FCs could greatly benefit from support that help them fulfill their desired roles as primary source of social and emotional support for patients, while being able to maintain their own health and well-being at the same time.
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| 20. |
- Stinesen-Kollberg, Karin, et al.
(author)
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Chronic Stress in Vocational and Intimate Partner Domains as Predictors of Depressive Symptoms After Breast Cancer Diagnosis.
- 2019
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In: Annals of behavioral medicine : a publication of the Society of Behavioral Medicine. - : Oxford University Press (OUP). - 1532-4796. ; 53:4, s. 333-344
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Journal article (peer-reviewed)abstract
- After cancer diagnosis, depressive symptoms are elevated on average and decline over time, but substantial variability is apparent. Few studies have examined to what extent chronic stress in distinct life domains affects depressive symptoms.Chronic stress in vocational and intimate partner life domains, and their interaction, were tested as predictors of depressive symptoms after breast cancer diagnosis.Women (N = 460) completed validated interviews regarding chronic stress in specific life domains shortly after diagnosis and a measure of depressive symptoms every 6 weeks for 6 months.In latent growth curve modeling analyses, greater chronic stress in work (b = 2.90; p < .001) and intimate partner domains (b = 1.38, p = .02) was associated with higher depressive symptoms at study entry (intercept), and greater work stress predicted faster recovery from depressive symptoms over time (b = -0.10; p = .01). The two domains of chronic stress also interacted significantly on depressive symptoms at study entry (b = -1.54; p < .02) and over time (b = 0.14; p < .001). Greater work stress was associated with higher depressive symptoms at study entry regardless of intimate partner stress, but greater intimate partner stress was associated with higher depressive symptoms when work stress was low. The decline over 6 months in initially elevated depressive symptoms predicted by high work stress was significantly steeper when intimate partner stress was low.Targeting interventions to recently diagnosed breast cancer patients living with chronically stressful vocational and intimate partner life circumstances could be worthwhile.
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| 21. |
- Vanderhaegen, Janne, et al.
(author)
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Identity Formation and General and Cancer-specific Functioning in Adolescent and Emerging Adult Survivors of Childhood Cancer: A Longitudinal Study into Directionality of Effects.
- 2023
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In: Annals of behavioral medicine : a publication of the Society of Behavioral Medicine. - 0883-6612 .- 1532-4796. ; 57:9, s. 722-732
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Journal article (peer-reviewed)abstract
- Adolescent and emerging adult survivors of childhood cancer generally adjust well psychologically similar to their peers. Nevertheless, some survivors are at greater risk for developing psychological and physical difficulties. To shed light on the psychosocial functioning of adolescent and emerging adult survivors of childhood cancer, personal identity formation and its interplay with general and cancer-specific functioning need to be investigated.To examine the longitudinal associations linking identity formation to general and cancer-specific functioning in adolescent and emerging adult childhood cancer survivors using three-wave data over a 2-year period.Dutch-speaking survivors (at baseline: n = 125; 53% female; age range: 14-25 years) treated at the pediatric oncology department of the University Hospitals Leuven (Belgium), completed self-report questionnaires at three annual timepoints. Directionality of effects and correlated changes were examined using cross-lagged structural equation modeling.Regarding general functioning, bidirectional effects occurred. Life satisfaction positively predicted identity synthesis and both life satisfaction and good physical functioning negatively predicted identity confusion over time. Identity synthesis, in turn, positively predicted life satisfaction and identity confusion negatively predicted good physical functioning over time. Regarding cancer-specific functioning, mainly unidirectional effects occurred. Post-traumatic stress symptoms negatively predicted identity synthesis and positively predicted identity confusion over time, whereas the reverse pattern of associations was found for benefit finding. Several correlated changes were found linking identity formation and psychosocial functioning as well.The present study uncovered clinically meaningful pathways linking identity formation to psychosocial functioning over time in adolescents and emerging adults who survived childhood cancer.
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| 23. |
- Varsi, Cecilie, et al.
(author)
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Barriers Related To The Implementation Of An Informatics Intervention Into Regular Clinical Practice : A Leadership Perspective
- 2012
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In: Annals of Behavioral Medicine. - : Oxford University Press (OUP). - 0883-6612 .- 1532-4796. ; 43:S1, s. S197-S197
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Journal article (peer-reviewed)abstract
- The importance of studying real world implementation of efficacious interventions and the roles of key players for implementation success, such as leadership, is highly recognized. This study explored clinical managers’ experiences and perceptions about the implementation of an informatics intervention called Choice into regular clinical practice. Choice is designed to support patient-provider communication and had shown to be efficacious in a previous RCT.6 nurses and 3 physicians in leadership positions at the 5 units in which Choice was implemented were interviewed post-implementation according to a structured interview guide. The following barriers emerged from the transcribed interviews: In spite of extensive preparation and training prior to implementation, more was needed; there was still resistance to change practice and a lack of motivation among some care providers. Also, time pressure and high turn-over rates required continuous re-training that hampered intervention use. Managers perceived sustained support from and collaboration with the interventionists as vital for the integration of Choice into routine practice.This study confirms that attitudes, established practices and clinical cultures are deeply rooted and hard to change. More research is needed to identify strategies for overcoming these barriers, and how leadership may be better supported to utilize the key role they play for implementation success.
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| 25. |
- Al-Khan, A., et al.
(author)
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IFPA Meeting 2010 Workshops Report II: Placental pathology; Trophoblast invasion; Fetal sex; Parasites and the placenta; Decidua and embryonic or fetal loss; Trophoblast differentiation and syncytialisation
- 2011
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In: Placenta. - : Elsevier BV. - 1532-3102 .- 0143-4004. ; 32:Suppl. 2, s. 90-99
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Journal article (other academic/artistic)abstract
- Workshops are an important part of the IFPA annual meeting. At IFPA Meeting 2010 diverse topics were discussed in twelve themed workshops, six of which are summarized in this report. 1. The placental pathology workshop focused on clinical correlates of placenta accreta/percreta. 2. Mechanisms of regulation of trophoblast invasion and spiral artery remodeling were discussed in the trophoblast invasion workshop. 3. The fetal sex and intrauterine stress workshop explored recent work on placental sex differences and discussed them in the context of whether boys live dangerously in the womb.4. The workshop on parasites addressed inflammatory responses as a sign of interaction between placental tissue and parasites. 5. The decidua and embryonic/fetal loss workshop focused on key regulatory mediators in the decidua, embryo and fetus and how alterations in expression may contribute to different diseases and adverse conditions of pregnancy. 6. The trophoblast differentiation and syncytialisation workshop addressed the regulation of villous cytotrophoblast differentiation and how variations may lead to placental dysfunction and pregnancy complications. (C) 2011 Published by IFPA and Elsevier Ltd.
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| 26. |
- Greco, Ornella, et al.
(author)
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Syzygies of the Veronese Modules
- 2016
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In: Communications in Algebra. - : Taylor & Francis. - 0092-7872 .- 1532-4125. ; 44:9, s. 3890-3906
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Journal article (peer-reviewed)abstract
- We study the minimal free resolution of the Veronese modules, S-n,S- d,S- k = circle plus S-i >= 0(k+id), where S = K[x(1), ... , x(n)], by giving a formula for the Betti numbers in terms of the reduced homology of some skeleton of a simplicial complex. We prove that S-n,S- d,S- k is Cohen-Macaulay if and only if k < d, and that its minimal resolution is pure and has some linearity features when k > d (n - 1) - n. We prove combinatorially that the resolution of S-2,S- d,S- k is pure. We show that HS(S-n,S- d,S- k; z) = 1/(n-1)d(n-1)/dz(n-1) [z(k+n-1)/1-z(d)]. As an application, we calculate the complete Betti diagrams of the Veronese rings K[x, y, z]((d)), for d = 4, 5, and K[x, y, z, u]((3)).
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