Pathways into multiple exclusion homelessness in seven UK cities

This paper interrogates pathways into multiple exclusion homelessness (MEH) in the UK and, informed by a critical realist theoretical framework, explores the potential causal processes underlying these pathways. Drawing on an innovative multistage quantitative survey, it identifies five experiential clusters within the MEH population, based on the extent and complexity of experiences of homelessness, substance misuse, institutional care, street culture activities and adverse life events. It demonstrates that the most complex forms of MEH are associated with childhood trauma. It also reveals that the temporal sequencing of MEH-relevant experiences is remarkably consistent, with substance misuse and mental health problems tending to occur early in individual pathways, and homelessness and a range of adverse life events typically occurring later. The strong inference is that these later-occurring events are largely consequences rather than originating causes of MEH, which has important implications for the conceptualisation of, and policy responses to, deep exclusion. </jats:p

Retrospective cohort study of the South Tyneside Exercise Referral scheme 2009-2014: Predictors of dropout and barriers to adherence

Background: Exercise Referral Schemes (ERS) are a prevalent method of increasing physical activity levels. However, they suffer from participant dropout and research predicting dropout or barriers to adherence is limited. This study aimed to focus upon the effect of referral characteristics on dropout, dropout predictors and whether self-reported barriers to exercise predict dropout. Methods: ERS data from 2009-2014 were retrieved for analysis. Chi squared and t-tests were used to investigate differences between referral characteristics, and logistic regression used to investigate dropout predictors. Results: Of 6894 participants, 37.8% (n=2608) dropped out within 6 weeks and 50.03% (n=3449) by the final 12th week. More males adhered (p<0.001) with dropouts being significantly younger (p<0.001). Dropout predictors were smoking (OR=1.58, 95% CI:1.29-1.93) or being a Tier 3 referral (OR=1.47, 95% CI:1.25-1.73). Increasing age (OR=0.98, 95% CI:0.98-0.99), drinking alcohol (OR=0.82, 95% CI:0.71-0.95), secondary care referrals (OR=0.68, 95% CI:0.52-0.90), having a lack of motivation (OR=0.81, 95% CI:0.69-0.95), or a lack of childcare (OR=0.69, 95% CI:0.50-0.95) decreased the likelihood of dropout. Conclusion: ERS dropout continues to be problematic. Smoking and having moderate-high comorbidities predicted dropout. Increasing age and patient-reported barriers of a lack of time or childcare decreased dropout risk. The reasons for dropout require further investigation

Some Effects of Ingested Lead-Steel Shot on Wild-Trapped Male Mallards

unpublishednot peer reviewedOpe