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This paper deals with the global existence for a class of Keller–Segel model with signal-dependent motility and general logistic term under homogeneous Neumann boundary conditions in a higher-dimensional smoothly bounded domain, which can be written as
To examine how household food insecurity is related to adolescent weight status and disordered eating.
Cross-sectional, population-based study. Adolescents self-reported unhealthy weight control behaviours, binge eating and meal frequency; weight status was measured. Household food insecurity was assessed by asking parents to respond to the validated six-item US Household Food Security Survey Module.
Adolescents surveyed within Minneapolis/St. Paul public middle and high schools completed surveys at school, and their parents/guardians were surveyed by mail during the 2009–2010 academic year.
Ethnically/racially diverse, primarily low-income adolescents (mean age: 14·4 years, range: 10–22 years) and their parents/guardians (n 2285 dyads).
More than one-third (38·9 %) of the adolescents experienced past-year household food insecurity, 43·2 % reported disordered eating and 39·6 % were overweight. Generalised regression models showed that food insecure (FI) compared with food secure (FS) adolescents had higher prevalence of overweight (FI: 42·3 % v. FS: 37·9 %, P = 0·039), lower breakfast consumption (FI: 4·1 times/week v. FS: 4·4 times/week, P = 0·005) and greater use of unhealthy weight control behaviours (FI: 49·0 % v. FS: 39·5 %, P < 0·001) in unadjusted models. Models adjusted for parental education, ethnicity/race, sex and age found that food insecurity was associated with higher prevalence of unhealthy weight control behaviours (FI: 44·5 % v. FS: 37·8 %, P = 0·007), but not with weight status or other eating behaviours.
These results suggest that food insecurity may be an independent risk factor for unhealthy weight control behaviours, indicating a need to approach these intersecting issues in a comprehensive manner.
Urban sub-Saharan Africa is in a nutrition transition shifting towards consumption of energy dense nutrient poor diets and decreasing physical activity. Determinants of nutrition transition in sub-Saharan Africa are presently not well understood. The objective of this review was to synthesize available data on determinants of dietary and physical activity behaviours among women of reproductive age in urban sub-Saharan Africa according to the socio-ecological framework. We searched MEDLINE, EMBASE, Scopus, Web of Science and bibliographies of included articles for qualitative, observational and randomized controlled studies published in English from January 2000 to September 2018. Studies conducted within general population of women aged 18 to 49 years were included. Searches were according to a predefined protocol published on PROSPERO (ID=CRD42018108532). Two reviewers independently screened identified studies. From a total of 9853 unique references, 23 studies were retained, and were mainly from South and West Africa. No rigorous designed quantitative study was identified. Hence, data synthesis was narrative. Notable determinants of dietary behaviour included; convenience, finances, social network, food skills and knowledge gaps, food deserts and culture. Cultural beliefs include strong relationship between high social status and weight gain, energy dense confectionary, salt or fat rich foods. Physical activity is influenced by fast-changing transport environment and cultural beliefs which instigate unfavourable gender stereo types. Studies with rigorous qualitative and quantitative designs are required to validate and develop the proposed frameworks further especially within East Africa. Nevertheless, available insights suggest a need for comprehensive skill-based interventions focusing on socio-cultural misconceptions and financial limitations.
To identify factors influencing dietary behaviours in urban food environments in Africa and identify areas for future research.
We systematically reviewed published/grey literature (protocol CRD4201706893). Findings were compiled into a map using a socio-ecological model on four environmental levels: individual, social, physical and macro.
Urban food environments in Africa.
Studies involving adolescents and adults (11–70 years, male/female).
Thirty-nine studies were included (six adolescent, fifteen adolescent/adult combined and eighteen adult). Quantitative methods were most common (twenty-eight quantitative, nine qualitative and two mixed methods). Studies were from fifteen African countries. Seventy-seven factors influencing dietary behaviours were identified, with two-thirds at the individual level (45/77). Factors in the social (11/77), physical (12/77) and macro (9/77) environments were investigated less. Individual-level factors that specifically emerged for adolescents included self-esteem, body satisfaction, dieting, spoken language, school attendance, gender, body composition, pubertal development, BMI and fat mass. Studies involving adolescents investigated social environment-level factors more, for example, sharing food with friends. The physical food environment was more commonly explored in adults, for example, convenience/availability of food. Macro-level factors associated with dietary behaviours were food/drink advertising, religion and food prices. Factors associated with dietary behaviour were broadly similar for men and women.
The dominance of studies exploring individual-level factors suggests a need for research to explore how social, physical and macro-level environments drive dietary behaviours of adolescents and adults in urban Africa. More studies are needed for adolescents and men, and studies widening the geographical scope to encompass all African countries.
To evaluate the relationship between fruits and vegetables (F&V) availability at home and young people’s F&V consumption behaviour, and how the theory of planned behaviour (TPB) constructs could potentially mediate the relationship.
Cross-sectional face-to-face survey questionnaire to assess the TPB constructs and home food availability assessed using open inventories method. F&V availability was categorised into low and high levels based on median split.
Two hundred and ten households (each consisting one parent–child pair) recruited via stratified cluster sampling with child participants ranging from 9 to 16 years of age.
Mediation analyses were conducted using structural equation modelling. The relationship between home F&V availability and F&V consumption behaviour did not have a significant direct association, but there were significant indirect effects through the routes of perceived behavioural control (PBC) and intention as well as attitude and intention. Specifically, higher level of F&V availability at home was related to more positive PBC and attitude towards F&V, and subsequently greater intention to consume F&V and higher consumption of F&V.
Parents should make F&V more readily available at home as increased exposure to F&V could be related to enhanced liking, sense of control and intention to consume F&V and facilitate children’s healthy diet.
Chapter 1 sets out the concerns, aim, approach and focus of the book, and lists some of its major findings. Its guiding concern is with the lack of uncontroversial answers to questions about the existence and nature of Neanderthal language. Its maim aim is to disperse the murk veiling this phenomenon. For pursuing this aim, the book adopts The Windows Approach to language evolution. In terms of this approach, for claims about Neanderthal language to be credible, they must be conclusions of sound inferences about it. The book, accordingly, unpacks a range of important inferences about Neanderthal language and appraises their soundness. These inferences are drawn from four allegdly symbolic and three non-symbolic behaviours. The book restricts its focus further to inferences about language as a cognitive capacity as distinct from speech as a form of behaviour that presupposes language. To guage the heuristic potential of Neanderthal behaviours as windows on Neanderthal language, the book apparaises in addition the soundeness of important inferences drawn about Neanderthal language from two biological attributes of Neanderthals: the FOXP2 gene and the Broca’s area of the brain.
Compared with standard wines, low-alcohol wines may have several social and health benefits. Innovative production processes have led to high-quality light wines. It is, however, unclear how consumers perceive and consume these alcohol-reduced wines. The current study aimed to investigate how people evaluate low-alcohol wine (Sauvignon Blanc) and if the reduction in alcohol and the information that a wine is low in alcohol influences consumption.
Randomised controlled trial (RCT).
Participants were invited to a wine tasting and randomised into one of the three conditions: they either tasted a ‘new white wine’ (12·5 % alcohol content), a ‘new low-alcohol white wine’ (8·0 % alcohol content) or they tasted the low-alcohol wine but were not aware that the wine was reduced in alcohol (low-alcohol, blinded).
Ninety participants (42 % male, mean age = 41 (sd 14) years).
Mean comparisons showed similar ratings for the low-alcohol conditions and the standard alcohol condition (mean > 5·6/7). The mean consumed amount across all conditions did not differ (162 (sd 71) ml, (F2,86 = 0·43, P > 0·05)), hence people who tasted the low-alcohol wine consumed approximately 30 % less alcohol. However, participants were willing to pay more for the normal wine compared with the low-alcohol wine, (F2,87 = 3·14, P < 0·05).
Participants did not alter their drinking behaviour in response to the reduced alcohol content, and the low-alcohol wine was perceived positively. There might be an emerging market potential for wine of reduced alcohol content, but consumers may not be willing to pay the same price as for the standard wine.
Tail-biting occurs pre-weaning, but literature on tail damage during lactation and on the development of damage over time is sparse, especially for non-docked piglets. We assessed the prevalence of tail damage in non-docked piglets in a commercial Danish piggery during the lactation and weaning period, and investigated the within-animal association of tail lesions pre- and post-weaning. Non-docked piglets (n = 741) from 51 loose-housed sows were individually marked and tracked from birth to 9 weeks (w9) of age. Tail damage was scored during lactation at w1 and w4, and once a week post-weaning (average weaning age 30 days) at w6 to w9. The within-animal association of tail damage before and after weaning was investigated at pig level using generalized mixed models. Tail damage was prevalent already pre-weaning. During the lactation period, the prevalence of tail lesions was 5% at w1 and 42% at w4, with the most prevalent score being ‘superficial damages’ (66.7%, score 1; pre-weaning scheme: 0 = no damage, 3 = tail wound). Post-weaning, 45% of pigs had a tail lesion at least once over the four assessments, with 16.7% of pigs having a tail lesion at least at two assessments. The majority of lesions were ‘minor scratches’ (34.2%, score 1; post-weaning scheme: 0 = no damage, 4 = wound – necrotic tail end) and a ‘scabbed wound’ (19.9%, score 3). The number of pigs with lesions as well as wound severity increased over time. More pigs had a tail wound at w8 (15%, P < 0.001 and < 0.01) and w9 (19%, P < 0.001 and < 0.001) compared to w6 (2.7%) and w7 (5.6%). Pigs with tail lesions pre-weaning (w1: OR 3.0, 95% CI 0.9 to 10.2; w4: OR 3.4, 95% CI 2.0 to 5.8) had a significantly higher risk of having a wound post-weaning, and pigs with lesions at w4 additionally were at a higher risk (OR 3.0, 95% CI 1.8 to 5.1) of having a lesion over several assessments. Females compared to castrated males had a significantly lower risk of having tail lesions at w1 (OR 0.3, 95% CI 0.1 to 0.8). Similarly, females were at a significantly lower risk (OR 0.5, 95% CI 0.4 to 0.9) of having a wound post-weaning, and tended to have a lower risk of having lesions over several assessments (OR 0.7, 95% CI 0.5 to 1.2). Our study confirmed that tail damage is prevalent already during the lactation period, and that pre-weaning tail damage is predictive of tail wounds post-weaning.
To examine if increased intake of locally available nutrient-dense foods among pregnant women improved the quality of their dietary intake and if use of the Theory of Planned Behaviour could explain changes in their dietary behaviour.
We used data from a randomised controlled trial where the intervention group received nutrition education and dietary counselling. We promoted the use of recipes that utilised powders to enhance dietary diversity. We examined how the intervention achieved changes in dietary intakes and used mixed effects logistic regression models with random effects at village level to explore changes over time of the outcomes, adjusted for selected explanatory variables.
The study was conducted in twenty villages in rural Malawi.
Data from 257 pregnant women who were enrolled during late first trimester and followed until birth.
The intervention achieved improvements in the Dietary Diversity Score (DDS) and the Six Food Group Pyramid (SFG) score, especially in intakes of micronutrient-rich foods. A third of the women in the intervention group attained optimal DDS, whereas about 50 % attained optimal SFG. The theorised behaviour mediators (i.e. nutrition attitudes, nutrition behaviour control and subjective norm) that had improved were also significantly associated with high DDS.
Improved dietary intakes were achieved through promoting the use of locally available nutrient-dense foods. Attainment of high DDS was a consequence of the women’s belief in the effectiveness of the proposed nutrition recommendations. We identified critical personal and environmental constraints related to dietary intakes during pregnancy in a low-resource setting.
By simply modifying management decisions towards an environmentally friendly approach, organisations can minimise their negative operational impacts on the environment. A key question is whether a manager’s pro-environmental decision-making behaviour can be determined by their personal characteristics. Our study hypothesised that three core attributes (personal values, attitudes, and subjective norms) of a person can predict their future pro-environmental behavioural intention — the closest proxy of actual pro-environmental behaviour. Using the theoretical lenses of Value-Attitude-Behaviour theory (VAB) and Value-Belief-Norm theory (VBN), we examined the roles of three core attributes of future business leaders (MBA students) on their intention to behave pro-environmentally. The results of structural equation modelling indicate that future managers’ environmental values, attitudes, and subjective norms are positively associated with their intentions related to pro-environmental behaviour. Mediation test of the structural model further indicates that environmental attitudes mediate the link between personal values and intention; however, subjective norms does not. Our results imply that effective recruitment and selection mechanisms may incorporate these attributes to assist organisations in the identification of environmentally responsible business leaders. By hiring environmentally responsible managers, organisations will be able to better fulfil their commitment towards sustainability outcomes.
Breeding values for feed intake and feed efficiency in beef cattle are generally derived indoors on high-concentrate (HC) diets. Within temperate regions of north-western Europe, however, the majority of a growing beef animal’s lifetime dietary intake comes from grazed grass and grass silage. Using 97 growing beef cattle, the objective of the current study was to assess the repeatability of both feed intake and feed efficiency across 3 successive dietary test periods comprising grass silage plus concentrates (S+C), grazed grass (GRZ) and a HC diet. Individual DM intake (DMI), DMI/kg BW and feed efficiency-related parameters, residual feed intake (RFI) and gain to feed ratio (G : F) were assessed. There was a significant correlation for DMI between the S+C and GRZ periods (r = 0.32; P < 0.01) as well as between the S+C and HC periods (r = 0.41; P < 0.001), whereas there was no association for DMI between the GRZ and HC periods. There was a significant correlation for DMI/kg BW between the S+C and GRZ periods (r = 0.33; P < 0.01) and between the S+C and HC periods (r = 0.40; P < 0.001), but there was no association for the trait between the GRZ and HC periods. There was a significant correlation for RFI between the S+C and GRZ periods (r = 0.25; P < 0.05) as well as between S+C and HC periods (r = 0.25; P < 0.05), whereas there was no association for RFI between the GRZ and HC periods. Gain to feed ratio was not correlated between any of the test periods. A secondary aspect of the study demonstrated that traits recorded in the GRZ period relating to grazing bite rate, the number of daily grazing bouts and ruminating bouts were associated with DMI (r = 0.28 to 0.42; P < 0.05 - 0.001), DMI/kg BW (r = 0.36 to 0.45; P < 0.01 - 0.001) and RFI (r = 0.31 to 0.42; P < 0.05 - 0.001). Additionally, the number of ruminating boli produced per day and per ruminating bout were associated with G : F (r = 0.28 and 0.26, respectively; P < 0.05). Results from this study demonstrate that evaluating animals for both feed intake and feed efficiency indoors on HC diets may not reflect their phenotypic performance when consuming conserved forage-based diets indoors or when grazing pasture.
The Child Eating Behaviour Questionnaire (CEBQ), a widely used instrument that has been validated mostly in high-income countries, has limitations in its factorial validity when used among different cultures. This study examines whether the CEBQ instrument is culturally appropriate and valid to be used in a low- and middle-income country (LMIC) in a setting where child undernutrition remains prevalent.
The study employed a qualitative process to validate the content of items relative to the culture and setting, which was followed by a survey to test the psychometric properties of the instrument. Tests of factorial validity, convergent validity and reliability were performed.
Three different socio-economic settings of Yogyakarta, Indonesia.
The participants of this study were mothers of children aged 25–60 months. In-depth interviews were conducted with twenty-four mothers and the questionnaire validation process involved 238 mothers in the survey.
A Confirmatory Factor Analysis model with eight subscales provided the best fit (root-mean-square error of approximation = 0·048 (90 % CI 0·040, 0·057); Comparative Fit Index = 0·95 and Tucker Lewis Index = 0·95) after three new items and eight items from the original CEBQ were removed. Convergent validity with child’s weight was found for two subscales, slowness in eating and satiety responsiveness. Reliability measured using Cronbach’s alpha provided values between 0·62 and 0·78.
The original eight-factor structure of the CEBQ showed adequate content validity and provided factorial, discriminant and convergent validity with mothers of preschool children living in a LMIC where child nutrition remains a significant public health issue.
To synthesise the current best evidence on both pharmacological and non-pharmacological behaviour management interventions for adult patients in the acute hospital setting with traumatic brain injury (TBI) or post-traumatic amnesia (PTA).
A comprehensive search of 10 electronic databases was completed.
Systematic reviews (SRs) published in English before September 2018 were included. Initial search resulted in 4604 citations, 2916 for title and abstract screening with duplicates removed, and 2909 articles failed to meet the inclusion criteria leaving seven reviews for inclusion. Five reporting pharmacological management approaches, two reporting non-pharmacological management approaches, and one reporting both pharmacological and non-pharmacological management approaches.
Methodological quality was assessed independently by two reviewers using the Critical Appraisal Skills Programme Tool for SRs. Data were extracted from the studies based on the recommendations of the Joanna Briggs Institute (JBI) Methodology for JBI Umbrella Reviews.
The SRs were of low-to-moderate quality overall. High-quality SRs were characterised by low numbers of studies and significant biases. The evidence relating to pharmacological interventions demonstrates low level and variable quality. The evidence relating to non-pharmacological interventions was limited and of low quality.
The current evidence for the management of challenging behaviours in patients with acute TBI/PTA is generally equivocal, potentially reflecting the heterogeneity of patients with TBI and their clinical behaviours. More studies with rigorous methodologies are required to investigate the most suitable pharmacological and non-pharmacological behavioural interventions for the acute phase of TBI or PTA.
In the past few weeks, coronavirus disease 2019 (COVID-19) has dramatically expanded across the world. To limit the spread of COVID-19 and its negative consequences, many countries have applied strict social distancing rules. In this dramatic situation, people with eating disorders are at risk of their disorder becoming more severe or relapsing. The risk comes from multiple sources including fears of infection, the effects of social isolation as well as the limited availability of adequate psychological and psychiatric treatments. A potential practical solution to address some of these problems is to deliver enhanced cognitive behaviour therapy (CBT-E), an evidence-based treatment for all eating disorders, remotely. In this guidance we address three main topics. First, we suggest that CBT-E is suitable for remote delivery and we consider the challenges and advantages of delivering it in this way. Second, we discuss new problems that patients with eating disorders may face in this period. We also highlight potential opportunities for adapting some aspects of CBT-E to address them. Finally, we provide guidelines about how to adapt the various stages, strategies and procedures of CBT-E for teletherapy use in the particular circumstances of COVID-19.
Excessive worry is a common phenomenon. Our research group has previously developed an online intervention for excessive worry based on operant principles of extinction (IbET; internet-based extinction therapy) and tested it against a waiting-list. The aim of this study was to evaluate IbET against an active control comparator (CTRL).
A 10-week parallel participant blind randomised controlled trial with health-economical evaluation and mediation analyses. Participants (N = 311) were randomised (ratio 4.5:4.5:1) to IbET, to CTRL (an internet-based stress-management training program) or to waiting-list. The nation-wide trial included self-referred adults with excessive worry. The primary outcome was change in worry assessed with the Penn State Worry Questionnaire from baseline to 10 weeks.
IbET had greater reductions in worry compared to CTRL [−3.6 point difference, (95% CI −2.4 to −4.9)] and also a significantly larger degree of treatment responders [63% v. 51%; risk ratio = 1.24 (95% CI 1.01–1.53)]. Both IbET and CTRL made large reductions in worry compared to waiting-list and effects were sustained up to 1 year. Treatment credibility, therapist attention, compliance and working alliance were equal between IbET and CTRL. Data attrition was 4% at the primary endpoint. The effects of IbET were mediated by the hypothesized causal mechanism (reduced thought suppression) but not by competing mediators. Health-economical evaluation indicated that IbET had a 99% chance of being cost-effective compared to CTRL given societal willingness to pay of 1000€.
IbET is more effective than active comparator to treat excessive worry. Replication and extensions to real-world setting are warranted.
The effective management of chronic asthma requires long-term adherence to both pharmacotherapy and optimal self-management practices. The use of mobile applications (apps) offer a promising and cost-effective platform to support the self-management of asthma. However, students as consumers may not always be sufficiently knowledgeable to select the best app to link with the management of their condition. If school psychologists become familiar with apps, they may be better positioned to provide guidance to students about app selection and how to identify apps that include appropriate behaviour change techniques (BCT). Accordingly, the overall aim of this study was to present a method by which school psychologists could identify quality apps for the purpose of supporting students who need to self-manage chronic asthma. A directed content analysis was used to evaluate asthma apps, based on behaviour change content and app quality. A systematic selection process yielded a total of 36 apps (26 from iTunes, 12 from Google Play) that were evaluated using two published rating measures. Overall, apps contained limited BCTs and a low level of quality health information. Conversely, apps with higher quality health information utilised a larger range of BCTs than lower quality apps. It was concluded that while apps designed to support the management of asthma appear to be a potentially valuable addition to traditional interventions, the technology is still in its infancy, and school psychologists should be aware of the limited behaviour change content, age appropriateness of apps, and whether the health information provided is evidence-based.
The obesity pandemic is an increasing burden for society. Information on key drivers of the nutrition cycle of (a) social causation, (b) biological causation and (c) health selection is vital for effective policies targeted at the reduction of obesity prevalence. However, empirical causal knowledge on (a) the social predictors of diet quality, (b) its impact on corpulence and (c) the socioeconomic consequences of obesity is sparse. We overcome the limitations of previous research and acquire comprehensive causal insight into this cycle.
Therefore, we analyse two German socio-epidemiological panel surveys exploiting their longitudinal panel structure utilising hybrid panel regression models.
General population of Germany.
German Health Interview and Examination Survey for Children and Adolescents (KiGGS, n 17 640; age 0–24 years) and the German National Nutrition Monitoring (NEMONIT, n 2610; age 15–82 years).
The results indicate that (a) interestingly only sex, education and age explain healthy diets; (b) increases in a newly developed Optimised Healthy Eating Index (O-HEI-NVSII) and in nuts intake reduce BMI, while growing overall energy intake, lemonade, beer and meat (products) intake drive corpulence; (c) in turn, developing obesity decreases socioeconomic status.
These results suggest that policies targeted at the reduction of obesity prevalence may be well advised to focus on boys and men, people with low education, the promotion of a healthy diet and nuts intake, and the limitation of lemonade, beer and meat (products) intake. Therefore, future research may focus on the replication of our findings utilising longer panels and experimental approaches.
Antibiotic prescription is a major driver of antibiotic resistance. The majority of antibiotic prescribing occurs in community care settings, often for respiratory infections. A substantial proportion of prescriptions are issued not according to guidelines, particularly for acute respiratory infections which can be self-limiting. Prescribers in these settings need support to prescribe antibiotics more prudently. Patients and the public also need support to manage infections which are self-limiting. This chapter presents a summary of how antimicrobial stewardship (AMS) activities are being used in community settings. Firstly, types of community-level interventions are discussed, including those aimed at clinicians, patients and the public. Next, we assess interventions based on their effectiveness at reducing antibiotic prescriptions or use and their cost-effectiveness. Finally, we discuss directions for future research and consider how the research to date could influence policy.
To develop a scale to assess health motivation influencing food choices and to explore its performance in the associations with food intakes and nutritional biomarkers.
Psychometric study using cross-sectional self-report questionnaires and nutritional biomarkers.
Multi-centre investigation conducted in ten European cities.
2954 adolescents who were included in the HELENA study and completed the Food Choices and Preferences (FCP) questionnaire.
Nineteen out of 124 items of the FCP questionnaire were in the same dimension. Sixteen presented adequate parameters for the Scale of evaluatiOn of Food choIcEs (SOFIE). The scores were positively associated with the intakes of cereals, dairy products, meats and eggs, and fish, as well as with blood concentrations of vitamin C, β-carotene, n-3 fatty acids, cobalamin, holo-transcobalamin and folate; scores were negatively associated with the intake of alcohol.
SOFIE can improve the assessment of motivation influencing food choices based on items with the best performance and is proposed as a new measure to health-related studies.
The scope and scale of wildlife crimes around the world have risen in intensity and complexity, yet current enforcement strategies have often not delivered desired effects on illegal activities, even within protected areas. Tackling the array of illegal activities by emphasizing law enforcement above other options is challenging and potentially unsustainable. We explored the potential for social norms, community regulations and socioeconomic factors to promote compliance with wildlife laws by interviewing 334 respondents in 28 villages that share boundaries with protected areas in Nigeria. Using an anonymous direct questioning approach, we recorded a high prevalence of non-compliance behaviours in all studied communities. Injunctive norms (i.e., perceptions of acceptable behaviour within a social group) significantly predicted compliance, as respondents with no complicit friends or family members were more likely to comply with wildlife regulations. Perceived likelihood of community-level sanctions played a more salient role than the fear of arrest by rangers in influencing compliance. In addition, non-compliance increased with number of dependents, but reduced with average monthly household income. Our study demonstrates that clear knowledge of the social norms that drive local behaviour as well as the authorities that enforce them is integral to understanding the forces that drive community involvement and participation in conservation. Incorporating local communities in planning enforcement interventions may help protect threatened species and landscapes.