Variation in compulsory psychiatric inpatient admission in England:a cross-sectional, multilevel analysis

Background: Rates of compulsory admission have increased in England in recent decades, and this trend is accelerating. Studying variation in rates between people and places can help identify modifiable causes. Objectives: To quantify and model variances in the rate of compulsory admission in England at different spatial levels and to assess the extent to which this was explained by characteristics of people and places. Design: Cross-sectional analysis using multilevel statistical modelling. Setting: England, including 98% of Census lower layer super output areas (LSOAs), 95% of primary care trusts (PCTs), 93% of general practices and all 69 NHS providers of specialist mental health services. Participants: 1,287,730 patients. Main outcome measure: The study outcome was compulsory admission, defined as time spent in an inpatient mental illness bed subject to the Mental Health Act (2007) in 2010/11. We excluded patients detained under sections applying to emergency assessment only (including those in places of safety), guardianship or supervision of community treatment. The control group comprised all other users of specialist mental health services during the same period. Data sources: The Mental Health Minimum Data Set (MHMDS). Data on explanatory variables, characterising each of the spatial levels in the data set, were obtained from a wide range of sources, and were linked using MHMDS identifiers. Results: A total of 3.5% of patients had at least one compulsory admission in 2010/11. Of (unexplained) variance in the null model, 84.5% occurred between individuals. Statistically significant variance occurred between LSOAs [6.7%, 95% confidence interval (CI) 6.2% to 7.2%] and provider trusts (6.9%, 95% CI 4.3% to 9.5%). Variances at these higher levels remained statistically significant even after adjusting for a large number of explanatory variables, which together explained only 10.2% of variance in the study outcome. The number of provider trusts whose observed rate of compulsory admission differed from the model average to a statistically significant extent fell from 45 in the null model to 20 in the fully adjusted model. We found statistically significant associations between compulsory admission and age, gender, ethnicity, local area deprivation and ethnic density. There was a small but statistically significant association between (higher) bed occupancy and compulsory admission, but this was subsequently confounded by other covariates. Adjusting for PCT investment in mental health services did not improve model fit in the fully adjusted models. Conclusions: This was the largest study of compulsory admissions in England. While 85% of the variance in this outcome occurred between individuals, statistically significant variance (around 7% each) occurred between places (LSOAs) and provider trusts. This higher-level variance in compulsory admission remained largely unchanged even after adjusting for a large number of explanatory variables. We were constrained by data available to us, and therefore our results must be interpreted with caution. We were also unable to consider many hypotheses suggested by the service users, carers and professionals who we consulted. There is an imperative to develop and evaluate interventions to reduce compulsory admission rates. This requires further research to extend our understanding of the reasons why these rates remain so high. Funding: The National Institute for Health Research Health Services and Delivery Research programme

Movement Patterns of Resident and Relocated Northern Bobwhites in East Texas

We compared home range sizes and movement patterns of resident and relocated northern bobwhites (Colinus virginianus) on an area managed specifically for the species in the Pineywoods of east Texas. During the winters of 1990–1992, 155 south Texas, 136 east Texas, and 139 resident bobwhites were radiomarked, released, and thereafter regularly located. Bird locations were plotted on a digitized map, and home range sizes and movement patterns of each group of birds were estimated. Resident bobwhites moved longer daily distances in March and had larger home ranges during the nesting season (May-Jul) than relocated birds (P \u3c= 0.05). Conversely, no differences were detected among groups in mean of daily distances moved in April or dispersal during the breeding season (Mar-Jun) (P 0.05). Annual dispersal distances (x¯ = 1.43 km) of birds that survived into November were similar among groups (P \u3e 0.05). Managers that elect to relocate northern bobwhites should consider doing so in the fall and only into habitats of ample size

Movement Patterns of Resident and Relocated Northern Bobwhites in East Texas

We compared home range sizes and movement patterns of resident and relocated northern bobwhites (Colinus virginianus) on an area managed specifically for the species in the Pineywoods of east Texas. During the winters of 1990–1992, 155 south Texas, 136 east Texas, and 139 resident bobwhites were radiomarked, released, and thereafter regularly located. Bird locations were plotted on a digitized map, and home range sizes and movement patterns of each group of birds were estimated. Resident bobwhites moved longer daily distances in March and had larger home ranges during the nesting season (May-Jul) than relocated birds (P0.05). Managers that elect to relocate northern bobwhites should consider doing so in the fall and only into habitats of ample size

Food Plot Use by Juvenile Northern Bobwhites in East Texas

We examined use of spring-summer (i.e., warm-season) food plots by northern bobwhites (Colinus virginianus) with broods using radio telemetry on a 563-ha study area in Trinity County, eastern Texas, where habitat was modified to enhance it for these birds. Bobwhites from South Texas and disjunct areas of East Texas were introduced to supplement a small, resident population. All relocated and most resident bobwhites were fitted with necklace-style transmitters. Bobwhites which produced chicks were intensively radiotracked (≥3 times/day) for ≥4 weeks or until the radio-marked parent was lost. Nine hens moved their broods to food plots within an average of 2.1 days after the eggs hatched; average distance moved was 217 m. Use of food plots by 12 broods was proportionally greater than that of native vegetation (P \u3c 0.001). Food plots had lower quail-level foliage density (P = 0.015) and more arthropods (P \u3c 0.001) than native vegetation. Our results demonstrate that warm-season food plots can potentially provide brood habitat for bobwhites in eastern Texas

Food Plot Use by Juvenile Northern Bobwhites in East Texas

We examined use of spring-summer (i.e., warm-season) food plots by northern bobwhites (Colinus virginianus) with broods using radio telemetry on a 563-ha study area in Trinity County, eastern Texas, where habitat was modified to enhance it for these birds. Bobwhites from South Texas and disjunct areas of East Texas were introduced to supplement a small, resident population. All relocated and most resident bobwhites were fitted with necklace-style transmitters. Bobwhites which produced chicks were intensively radiotracked (≥3 times/day) for ≥4 weeks or until the radio-marked parent was lost. Nine hens moved their broods to food plots within an average of 2.1 days after the eggs hatched; average distance moved was 217 m. Use of food plots by 12 broods was proportionally greater than that of native vegetation (P \u3c 0.001). Food plots had lower quail-level foliage density (P = 0.015) and more arthropods (P \u3c 0.001) than native vegetation. Our results demonstrate that warm-season food plots can potentially provide brood habitat for bobwhites in eastern Texas

Survival and Causes of Mortality of Relocated and Resident Northern Bobwhites in East Texas

We estimated survival of 3 groups of northern bobwhites (Colinus virginianus) on a 563-ha intensively managed study area in eastern Texas. During the 3-year study, 155 bobwhites from South Texas and 136 bobwhites from East Texas were captured, radio-marked, and relocated to the study area; 139 bobwhites that were resident on the study area were also captured, radio-marked, and released at the point of capture. There were no differences (P \u3e 0.05) in survival among the 3 groups of bobwhites. However, survival of bobwhites from South Texas were consistently lower than those of the other 2 groups during each year; both bobwhites from East Texas and resident bobwhites survived better than bobwhites relocated from South Texas. Avian predation claimed 57.6% of 243 known-fate birds, mammalian predation and apparent capture stress each caused 9.1 % mortality, while 1.2% of the birds died of snake predation and 14.0% were lost to unidentifiable causes

Reproduction of Relocated and Resident Northern Bobwhites in East Texas

We examined reproduction by relocated and resident northern bobwhites (Colinus virginianus) on an intensively managed 563-ha study area in Trinity County, eastern Texas. During the late winters of 1990-1992, 155 South Texas (84 hens, 71 cocks) and 136 East Texas (64 hens, 72 cocks) bobwhites were captured, radio-tagged, and relocated to the study area; 139 resident birds (73 hens, 66 cocks) were also captured, radio-tagged, and released at the point of capture. For the 3 years combined, the 33 South Texas, 33 East Texas, and 39 resident hens alive at the beginning of the breeding season produced 6, 13, and 22 documented nests (P = 0.004) and 0, 3, and 4 fledged broods. Pooled, the number of nests by East Texas and resident hens was higher than that of South Texas hens (P = 0.003); numbers of nests of East Texas and resident hens were similar (P = 0.150). Our results do not support relocation of South Texas bobwhites into the East Texas Pineywoods

Survival and Causes of Mortality of Relocated and Resident Northern Bobwhites in East Texas

We estimated survival of 3 groups of northern bobwhites (Colinus virginianus) on a 563-ha intensively managed study area in eastern Texas. During the 3-year study, 155 bobwhites from South Texas and 136 bobwhites from East Texas were captured, radio-marked, and relocated to the study area; 139 bobwhites that were resident on the study area were also captured, radio-marked, and released at the point of capture. There were no differences (P \u3e 0.05) in survival among the 3 groups of bobwhites. However, survival of bobwhites from South Texas were consistently lower than those of the other 2 groups during each year; both bobwhites from East Texas and resident bobwhites survived better than bobwhites relocated from South Texas. Avian predation claimed 57.6% of 243 known-fate birds, mammalian predation and apparent capture stress each caused 9.1 % mortality, while 1.2% of the birds died of snake predation and 14.0% were lost to unidentifiable causes

Reproduction of Relocated and Resident Northern Bobwhites in East Texas

We examined reproduction by relocated and resident northern bobwhites (Colinus virginianus) on an intensively managed 563-ha study area in Trinity County, eastern Texas. During the late winters of 1990-1992, 155 South Texas (84 hens, 71 cocks) and 136 East Texas (64 hens, 72 cocks) bobwhites were captured, radio-tagged, and relocated to the study area; 139 resident birds (73 hens, 66 cocks) were also captured, radio-tagged, and released at the point of capture. For the 3 years combined, the 33 South Texas, 33 East Texas, and 39 resident hens alive at the beginning of the breeding season produced 6, 13, and 22 documented nests (P = 0.004) and 0, 3, and 4 fledged broods. Pooled, the number of nests by East Texas and resident hens was higher than that of South Texas hens (P = 0.003); numbers of nests of East Texas and resident hens were similar (P = 0.150). Our results do not support relocation of South Texas bobwhites into the East Texas Pineywoods

Complexity Synchronization in Emergent Intelligence

In this work, we use a simple multi-agent-based model (MABM), implementing selfish algorithm (SA) agents, to create an adaptive environment and show, using modified diffusion entropy analysis (MDEA), that the mutual-adaptive interaction between the parts of such a network manifests complexity synchronization (CS). CS has been experimentally shown to exist among organ-networks (ONs) of the brain (neurophysiology), lungs (respiration), and heart (cardiovascular reactivity) and to be explained theoretically as a synchronization of the multifractal scaling parameters characterizing each time series. Herein, we find the same kind of CS in the emergent intelligence (i.e., without macroscopic control and based on self-interest) between two groups of agents playing an anti-coordination game, thereby suggesting the potential for the same CS in real-world social phenomena and in human-machine interactions.Comment: 28 pages, 12 Figure