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Boyd J, Holmes J, Gibbs N, Buckley C, Purshouse R, Meier P. How can agent-based modelling provide new insights into the impact of minimum unit pricing in Scotland? Drug Alcohol Rev 2024. [PMID: 38840445 DOI: 10.1111/dar.13880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 04/30/2024] [Accepted: 05/09/2024] [Indexed: 06/07/2024]
Abstract
In recent years we have gained insight into the impact of minimum unit pricing (MUP)-a legal floor price below which a given volume of alcohol cannot be sold-on population-level reductions in alcohol sales, consumption and harm. However, several questions remain unanswered including how individual-level purchasing changes impact the local economy (e.g., balance between on-licence and off-licence outlets), lead to long-term population-level trends (e.g., youth drinking) and social harms (e.g., violence). Agent-based modelling captures heterogeneity, emergence, feedback loops and adaptive and dynamic features, which provides an opportunity to understand the nuanced effects of MUP. Agent-based models (ABM) simulate heterogeneous agents (e.g., individuals, organisations) often situated in space and time that interact with other agents and/or with their environment, allowing us to identify the mechanisms underlying social phenomena. ABMs are particularly useful for theory development, and testing and simulating the impacts of policies and interventions. We illustrate how ABMs could be applied to generate novel insights and provide best estimates of social network effects, and changes in purchasing behaviour and social harms, due to the implementation of MUP. ABMs like other modelling approaches can simulate alternative implementations of MUP (e.g., policy intensity [£0.50, £0.60] or spatial scales [local, national]) but can also provide an understanding of the potential impact of MUP on different population groups (e.g., alcohol exposure of young people who are not yet drinking). Using ABMs to understand the impact of MUP would provide new insights to complement those from traditional epidemiological and other modelling methods.
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Affiliation(s)
- Jennifer Boyd
- Salvation Army Centre for Addictions Services and Research, Faculty of Social Sciences, University of Stirling, Stirling, UK
- MRC/CSO Social and Public Health Sciences Unit, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - John Holmes
- School of Medicine and Population Health, University of Sheffield, Sheffield, UK
| | - Naomi Gibbs
- School of Medicine and Population Health, University of Sheffield, Sheffield, UK
- Centre for Health Economics, University of York, York, UK
| | - Charlotte Buckley
- Department of Automatic Control and Systems Engineering, University of Sheffield, Sheffield, UK
| | - Robin Purshouse
- Department of Automatic Control and Systems Engineering, University of Sheffield, Sheffield, UK
| | - Petra Meier
- MRC/CSO Social and Public Health Sciences Unit, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
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Sileo KM, Sparks CS, Luttinen R. Spatial Analysis of the Alcohol, Intimate Partner Violence, and HIV Syndemic Among Women in South Africa. AIDS Behav 2023; 27:1339-1349. [PMID: 36197574 PMCID: PMC10038818 DOI: 10.1007/s10461-022-03870-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/16/2022] [Indexed: 11/29/2022]
Abstract
The co-occurrence of and synergistic interactions between substance abuse, violence, and HIV, known as the "SAVA syndemic," is thought to be a driver of women's elevated risk for HIV in sub-Saharan Africa. This study uses data from the 2016 South African Demographic and Health Survey (DHS) and the 2016 South African Census to examine geospatial associations between alcohol use, intimate partner violence (IPV), unprotected sex, and HIV status among a population-based sample of 8528 South African women (age 15-49). Results support the geographic clustering of alcohol use, unprotected sex, and IPV, but not HIV, and geospatial clustering of HIV alone. This study highlights the need for geographically-tailored interventions to address syndemics through integrated interventions, such as those simultaneously focused on alcohol, IPV, and sexual risk reduction, and points to the need for more targeted research to link these factors to HIV from a place-based risk perspective.
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Affiliation(s)
- Katelyn M Sileo
- Department of Public Health, University of Texas at San Antonio, 1 UTSA Circle, San Antonio, TX, 78249-3209, USA.
| | - Corey S Sparks
- Department of Demography, University of Texas at San Antonio, San Antonio, TX, USA
| | - Rebecca Luttinen
- Department of Demography, University of Texas at San Antonio, San Antonio, TX, USA
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3
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Astbury CC, Lee KM, McGill E, Clarke J, Egan M, Halloran A, Malykh R, Rippin H, Wickramasinghe K, Penney TL. Systems Thinking and Complexity Science Methods and the Policy Process in Non-communicable Disease Prevention: A Systematic Scoping Review. Int J Health Policy Manag 2023; 12:6772. [PMID: 37579437 PMCID: PMC10125079 DOI: 10.34172/ijhpm.2023.6772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 01/14/2023] [Indexed: 08/16/2023] Open
Abstract
BACKGROUND Given the complex determinants of non-communicable diseases (NCDs), and the dynamic policy landscape, researchers and policymakers are exploring the use of systems thinking and complexity science (STCS) in developing effective policies. The aim of this review is to systematically identify and analyse existing applications of STCS-informed methods in NCD prevention policy. METHODS Systematic scoping review: We searched academic databases (Medline, Scopus, Web of Science, EMBASE) for all publications indexed by 13 October 2020, screening titles, abstracts and full texts and extracting data according to published guidelines. We summarised key data from each study, mapping applications of methods informed by STCS to policy process domains. We conducted a thematic analysis to identify advantages, limitations, barriers and facilitators to using STCS. RESULTS 4681 papers were screened and 112 papers were included in this review. The most common policy areas were tobacco control, obesity prevention and physical activity promotion. Methods applied included system dynamics modelling, agent-based modelling and concept mapping. Advantages included supporting evidence-informed decision-making; modelling complex systems and addressing multi-sectoral problems. Limitations included the abstraction of reality by STCS methods, despite aims of encompassing greater complexity. Challenges included resource-intensiveness; lack of stakeholder trust in models; and results that were too complex to be comprehensible to stakeholders. Ensuring stakeholder ownership and presenting findings in a user-friendly way facilitated STCS use. CONCLUSION This review maps the proliferating applications of STCS methods in NCD prevention policy. STCS methods have the potential to generate tailored and dynamic evidence, adding robustness to evidence-informed policymaking, but must be accessible to policy stakeholders and have strong stakeholder ownership to build consensus and change stakeholder perspectives. Evaluations of whether, and under what circumstances, STCS methods lead to more effective policies compared to conventional methods are lacking, and would enable more targeted and constructive use of these methods.
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Affiliation(s)
- Chloe Clifford Astbury
- Global Food System & Policy Research, School of Global Health, York University, Toronto, ON, Canada
| | - Kirsten M. Lee
- Global Food System & Policy Research, School of Global Health, York University, Toronto, ON, Canada
| | - Elizabeth McGill
- Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Janielle Clarke
- Global Food System & Policy Research, School of Global Health, York University, Toronto, ON, Canada
| | - Matt Egan
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Afton Halloran
- World Health Organization European Office for the Prevention and Control of Noncommunicable Diseases, Moscow, Russian Federation
- Department of Nutrition, ExercDepartment of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark.ise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Regina Malykh
- World Health Organization European Office for the Prevention and Control of Noncommunicable Diseases, Moscow, Russian Federation
| | - Holly Rippin
- World Health Organization European Office for the Prevention and Control of Noncommunicable Diseases, Moscow, Russian Federation
| | - Kremlin Wickramasinghe
- World Health Organization European Office for the Prevention and Control of Noncommunicable Diseases, Moscow, Russian Federation
| | - Tarra L. Penney
- Global Food System & Policy Research, School of Global Health, York University, Toronto, ON, Canada
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Mair C, Sumetsky N, Dougherty M, Thakar M. Do Changes to the Alcohol Retail Environment Reduce Interpersonal Violence? CURR EPIDEMIOL REP 2022; 9:282-289. [PMCID: PMC9672597 DOI: 10.1007/s40471-022-00315-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2022] [Indexed: 11/19/2022]
Affiliation(s)
- Christina Mair
- Department of Behavioral and Community Health Sciences, University of Pittsburgh School of Public Health, 6136 Public Health, 130 DeSoto Street, Pittsburgh, PA 15261 USA
- Center for Social Dynamics and Community Health, University of Pittsburgh School of Public Health, Pittsburgh, PA USA
| | - Natalie Sumetsky
- Department of Behavioral and Community Health Sciences, University of Pittsburgh School of Public Health, 6136 Public Health, 130 DeSoto Street, Pittsburgh, PA 15261 USA
- Center for Social Dynamics and Community Health, University of Pittsburgh School of Public Health, Pittsburgh, PA USA
| | - Michelle Dougherty
- Department of Behavioral and Community Health Sciences, University of Pittsburgh School of Public Health, 6136 Public Health, 130 DeSoto Street, Pittsburgh, PA 15261 USA
- Center for Social Dynamics and Community Health, University of Pittsburgh School of Public Health, Pittsburgh, PA USA
| | - Maya Thakar
- Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, PA USA
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Matson PA, Stankov I, Hassmiller Lich K, Flessa S, Lowy J, Thornton RLJ. A systems framework depicting how complex neighborhood dynamics and contextual factors could impact the effectiveness of an alcohol outlet zoning policy. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2022; 70:18-32. [PMID: 34784432 DOI: 10.1002/ajcp.12566] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 09/18/2021] [Accepted: 10/06/2021] [Indexed: 06/13/2023]
Abstract
An updated zoning policy eliminating all alcohol outlets (liquor stores) in residential districts was implemented to reduce high rates of violent crime in Baltimore City. Diverse stakeholders were engaged in group model building (GMB) activities to develop causal loop diagrams (CLDs) that elucidate the impact of the new zoning policy on crime, and more broadly, the potentially unintended social and environmental consequences of the policy. Three distinct groups, community advocates, city officials/academics, and community residents, participated in three separate GMB sessions. Three CLDs, one from each stakeholder group, were created to depict the possible outcomes of the zoning policy. Our findings offer insight into potential unintended consequences of removing liquor stores from residential areas that may undermine the policy. Community members described the need for additional supports related to mental health and substance use, opportunities for investment in the community, access to other goods and services, and community-police relations to ensure the policy achieved its intended goal of reducing violent crime. Our findings highlight the importance of timely engagement of local stakeholders to understand how complex neighborhood dynamics and contextual factors could impact the effectiveness of a zoning policy change.
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Affiliation(s)
- Pamela A Matson
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Ivana Stankov
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA
- UniSA Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Kristen Hassmiller Lich
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina Chapel Hill, Chapel Hill, North Carolina, USA
| | - Sarah Flessa
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jacob Lowy
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Rachel L J Thornton
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Goldstick JE, Jay J. Agent-Based Modeling: an Underutilized Tool in Community Violence Research. CURR EPIDEMIOL REP 2022; 9:135-141. [PMID: 35821794 PMCID: PMC9263807 DOI: 10.1007/s40471-022-00292-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/30/2022] [Indexed: 11/27/2022]
Abstract
Purpose of Review Recent Findings Summary
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Affiliation(s)
- Jason E. Goldstick
- Injury Prevention Center, University of Michigan, 2800 Plymouth Road, Suite B10-G080, Ann Arbor, MI 48109-2800 USA
- Department of Emergency Medicine, University of Michigan, 1500 E Medical Center Drive, Ann Arbor, MI 48109 USA
- Health Behavior & Health Education, School of Public Health, University of Michigan, Ann Arbor, MI 48105 USA
| | - Jonathan Jay
- Boston University School of Public Health, 715 Albany St, Boston, MA 02118 USA
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Lemke MK, Wolf DA, Drake SA. A Call for Complex Systems and Syndemic Theory in Firearm Violence Research. Am J Prev Med 2022; 62:459-465. [PMID: 34879969 DOI: 10.1016/j.amepre.2021.08.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 07/27/2021] [Accepted: 08/18/2021] [Indexed: 11/01/2022]
Affiliation(s)
- Michael K Lemke
- Department of Social Sciences, College of Humanities and Social Sciences, University of Houston-Downtown, Houston, Texas.
| | - Dwayne A Wolf
- Medical Examiner's Office, Harris County Institute of Forensic Sciences, Houston, Texas
| | - Stacy A Drake
- College of Nursing, Texas A&M University, Houston, Texas
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McGill E, Petticrew M, Marks D, McGrath M, Rinaldi C, Egan M. Applying a complex systems perspective to alcohol consumption and the prevention of alcohol-related harms in the 21st century: a scoping review. Addiction 2021; 116:2260-2288. [PMID: 33220118 DOI: 10.1111/add.15341] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 10/09/2020] [Accepted: 11/17/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND AND AIMS A complex systems perspective has been advocated to explore multi-faceted factors influencing public health issues, including alcohol consumption and associated harms. This scoping review aimed to identify studies that applied a complex systems perspective to alcohol consumption and the prevention of alcohol-related harms in order to summarize their characteristics and identify evidence gaps. METHODS Studies published between January 2000 and September 2020 in English were located by searching for terms synonymous with 'complex systems' and 'alcohol' in the Scopus, MEDLINE, Web of Science and Embase databases, and through handsearching and reference screening of included studies. Data were extracted on each study's aim, country, population, alcohol topic, system levels, funding, theory, methods, data sources, time-frames, system modifications and type of findings produced. RESULTS Eighty-seven individual studies and three systematic reviews were identified, the majority of which were conducted in the United States or Australia in the general population, university students or adolescents. Studies explored types and patterns of consumption behaviour and the local environments in which alcohol is consumed. Most studies focused on individual and local interactions and influences, with fewer examples exploring the relationships between these and regional, national and international subsystems. The body of literature is methodologically diverse and includes theory-led approaches, dynamic simulation models and social network analyses. The systematic reviews focused on primary network studies. CONCLUSIONS The use of a complex systems perspective has provided a variety of ways of conceptualizing and analyzing alcohol use and harm prevention efforts, but its focus ultimately has remained on predominantly individual- and/or local-level systems. A complex systems perspective represents an opportunity to address this gap by also considering the vertical dimensions that constrain, shape and influence alcohol consumption and related harms, but the literature to date has not fully captured this potential.
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Affiliation(s)
- Elizabeth McGill
- Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Mark Petticrew
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Dalya Marks
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Michael McGrath
- Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Chiara Rinaldi
- Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Matt Egan
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
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Opara I, R Leonard N, Thorpe D, Kershaw T. Understanding Neighborhoods' Impact on Youth Substance Use and Mental Health Outcomes in Paterson, New Jersey: Protocol for a Community-Based Participatory Research Study. JMIR Res Protoc 2021; 10:e29427. [PMID: 34047712 PMCID: PMC8196357 DOI: 10.2196/29427] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 04/24/2021] [Accepted: 04/26/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Substance use among youth is a major public health concern. Of note, substance use among youth is increasing in prevalence, and the incidence of substance use at earlier ages is rising. Given the long-term consequences of early substance use, it is important to identify factors that increase youth vulnerability to drug use, as they may be important targets for future interventions. OBJECTIVE This study aims to use innovative methods, such as venue-based sampling, to recruit youth who are disconnected from school and use community-based participatory research to gain a better understanding of the prevalence of substance use and important correlates among youth aged between 13 and 21 years in Paterson, New Jersey, a low-income, urban community. The study will use a convergent, mixed methods design involving multiple data collection components and the analysis of a ministrative data source, designed with the strengths of complex intervention frameworks in mind. The overall aims of the study are to identify the prevalence of substance use among youth who are engaged in school and not engaged in school; to understand important antecedents and correlates of substance use; and to use this information to inform social, environmental, and culturally appropriate interventions to address substance use and its correlates among youths in a lower-resourced urban community. METHODS This study will use both qualitative and quantitative methods to address important questions. Specifically, semistructured interviews using focus group and interview methodologies will be used to assess youths' lived experiences and will account for specific details that quantitative methods may not be able to attain. In addition, quantitative methods will be used to examine direct and multilevel associations between neighborhood factors and youth substance use and mental health outcomes. RESULTS A previous analysis from a substance use initiative in Paterson, New Jersey found that youth who use substances such as marijuana and alcohol are more likely to have higher rates of depression and anxiety. On the basis of the research questions, this study will examine the association between neighborhood characteristics, substance use, and mental health symptoms among youth in Paterson by using quantitative and qualitative methods and will use these findings to inform the adaptation of a community- and evidence-based substance use prevention intervention for these youths. CONCLUSIONS The findings of this study will provide an important contribution to understanding the role of socioecological factors in predicting substance use and mental health outcomes among youth in a lower-resourced, urban community. Furthermore, these findings will serve as evidence for the development of a culturally informed, community-based prevention program to address substance use disparities for youth, including those who are truant in Paterson, New Jersey. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/29427.
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Affiliation(s)
- Ijeoma Opara
- School of Public Health, Yale University, New Haven, CT, United States
| | - Noelle R Leonard
- Silver School of Social Work, New York University, New York, NY, United States
| | - Daneele Thorpe
- Department of Psychology, Stony Brook University, Stony Brook, NY, United States
| | - Trace Kershaw
- School of Public Health, Yale University, New Haven, CT, United States
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Ghanem L, Lee JP, Sumetsky N, Pagano A, Gruenewald P, Mair C. Place management in off-premise alcohol outlets: Results of a multi-methods study in a six-city California area. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2020; 80:102735. [PMID: 32416539 DOI: 10.1016/j.drugpo.2020.102735] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 03/17/2020] [Accepted: 03/18/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Associations between neighborhood crime and alcohol outlets are often theorized as resulting from poor place management. Barriers and supports to place management have been examined for on-premise (bars, restaurants) but not for off-premise alcohol outlets. Few studies have assessed place management issues across a range of off-premise outlet and neighborhood types, and none have included the perspectives of off-premise outlet managers themselves. Combining qualitative and quantitative methods within an ethnographic approach, we investigated barriers and supports to place management across off-premise outlets in a large urban area. METHODS We unobtrusively assessed outlet operating characteristics including crime prevention strategies at all 403 off-premise outlets in six contiguous California cities; interviewed managers in 40 outlets; and conducted extensive naturalistic observations in 15 of these 40 outlets. We analyzed data for frequencies and thematic content. RESULTS Small and independently operated off-premise outlets were the most common type of outlet in our study, but demonstrated fewer resources and more challenges to place management compared to large and chain establishments. Security guards were more observed in large and chain outlets. Small and independent outlets were more likely to post signs prohibiting loitering and to enable surveillance of interior spaces. Problems most commonly cited by managers were theft and loitering. Challenges to place management included physical and verbal threats from customers and intoxicated persons, and insufficient law enforcement. Managers evidenced some ability to assert authority over interior, private space, but less so over exterior, public space. CONCLUSIONS Although tasked with maintaining public health and safety, small and independent store managers reported challenges that are seldom acknowledged in policy or research literature. Managers may provide valuable insights on preventing and reducing neighborhood-level problems associated with off-premise alcohol outlets. Local communities should consider enhancing place management resources for managers of small and independent outlets.
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Affiliation(s)
- Lina Ghanem
- Prevention Research Center, Pacific Institute for Research and Evaluation, 2150 Shattuck Avenue #601, Berkeley CA 94704, United States.
| | - Juliet P Lee
- Prevention Research Center, Pacific Institute for Research and Evaluation, 2150 Shattuck Avenue #601, Berkeley CA 94704, United States.
| | - Natalie Sumetsky
- School of Public Health, University of Pittsburgh, 6136 Public Health, 130 DeSoto Street, Pittsburgh, PA 15261, United States.
| | - Anna Pagano
- Prevention Research Center, Pacific Institute for Research and Evaluation, 2150 Shattuck Avenue #601, Berkeley CA 94704, United States.
| | - Paul Gruenewald
- Prevention Research Center, Pacific Institute for Research and Evaluation, 2150 Shattuck Avenue #601, Berkeley CA 94704, United States.
| | - Christina Mair
- School of Public Health, University of Pittsburgh, 6136 Public Health, 130 DeSoto Street, Pittsburgh, PA 15261, United States.
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