Programmatic and Organizational Barriers and Facilitators to Addressing High-Risk Issues in Supportive Housing and Housing First Programs.

Risk management is an important component of service delivery in supportive housing and Housing First programs. However, there is no evidence on the implementation of risk management approaches in these settings. This qualitative study examined what service providers working in supportive housing and Housing First programs in Canada identify as the programmatic and organizational factors that affect the prevention and management of high-risk behaviours and challenges (e.

"I want purpose in my life": A qualitative exploration of how homeless youth envision their futures.

Preparing for the future is a major developmental task during adolescence and early adulthood. However, youth experiencing homelessness face additional challenges relating to economic instability, housing insecurity, and a lack of social support. Semi-structured interviews were conducted with 38 youth, from Ottawa and Toronto, who were experiencing homelessness and participating in a randomized controlled trial of Housing First for Youth (HF4Y).

Community Mental Health Services for Frequent Emergency Department Users: A Qualitative Study of Outcomes Perceived by Program Clients and Case Managers.

Purpose Of Study: This study aimed to investigate the perceived outcomes and mechanisms of change of a community mental health service combining system navigation and intensive case management supports for frequent emergency department users presenting with mental illness or addiction.

Primary Practice Setting: The study setting was a community mental health agency receiving automated referrals directly from hospitals in a midsize Canadian city for all individuals attending an emergency department two or more times within 30 days for mental illness or addiction.

Methodology And Sample: Qualitative interviews with 15 program clients.

Managing high-risk behaviours and challenges to prevent housing loss in permanent supportive housing: a rapid review.

Permanent supportive housing is an effective intervention for stably housing most people experiencing homelessness and mental illness who have complex support needs. However, high-risk behaviours and challenges are prevalent among this population and have the potential to seriously harm health and threaten housing tenures. Yet, the research on the relationship between high-risk issues and housing stability in permanent supportive housing has not been previously synthesized.

Inertial Sensor Location for Ground Reaction Force and Gait Event Detection Using Reservoir Computing in Gait.

Inertial measurement units (IMUs) have shown promising outcomes for estimating gait event detection (GED) and ground reaction force (GRF). This study aims to determine the best sensor location for GED and GRF prediction in gait using data from IMUs for healthy and medial knee osteoarthritis (MKOA) individuals. In this study, 27 healthy and 18 MKOA individuals participated.

Food insecurity, weight-based discrimination, weight self-stigma, and mental health in post-bariatric surgery patients.

The United States Department of Agriculture defines food insecurity (FI) as reduced quality and variety of diet or overall reduced food intake. To date, limited research has investigated the relationship between FI, weight stigma, and bariatric surgery. The existing literature suggests that FI in bariatric surgery patients is significantly associated with being a person of color, depression, receiving Medicare or Medicaid, and higher eating disorder (ED) pathology.

Detecting Gait Events from Accelerations Using Reservoir Computing.

Segmenting the gait cycle into multiple phases using gait event detection (GED) is a well-researched subject with many accurate algorithms. However, the algorithms that are able to perform accurate and robust GED for real-life environments and physical diseases tend to be too complex for their implementation on simple hardware systems limited in computing power and memory, such as those used in wearable devices. This study focuses on a numerical implementation of a reservoir computing (RC) algorithm called the echo state network (ESN) that is based on simple computational steps that are easy to implement on portable hardware systems for real-time detection.

Cycles of instability: Proximal and distal influences on residential instability among people with histories of homelessness in three Canadian cities.

People with histories of homelessness often have difficulties obtaining and maintaining adequate housing. This qualitative study examined the residential transitions of people with histories of residential instability and homelessness to understand factors contributing to the instability they experience. Interviews were conducted with 64 participants about their housing transitions, in the final year of a 4-year, prospective cohort study in three Canadian cities (Ottawa, Toronto, and Vancouver).

Sexual and romantic relationships among people experiencing homelessness: A scoping review.

Homelessness is widely recognized as a pervasive issue. Despite increasing research on factors affecting the health and well-being of people who are homeless, one that remains relatively understudied is the role of romantic and sexual relationships. Given that this population has the same needs for intimacy and closeness as anyone else, it is important to understand how these relationships occur, what barriers exist in developing and maintaining them, and what is their impact.

Experiences of LGBTQ Adults Who Have Accessed Emergency Shelters in a Large Urban City in Canada.

This study examines the experiences of adults who identify as LGBTQ (lesbian, gay, bisexual, transgender, queer) and who have accessed emergency shelters in an urban Canadian city. Twenty LGBTQ adults who were currently or formerly homeless participated in one qualitative interview. The interview protocol included questions on the participants' experiences accessing emergency shelters, with a focus on interactions with other emergency shelter residents.

[Preoxygenation by high-flow nasal cannula in a patient with difficult ventilation and intubation criteria].

The different protocols and algorithms for difficult intubation highlight the need for early detection of patients at risk of ventilation and difficult intubation. These protocols allow an adaptation of the management and all conclude that an emergency trans-tracheal approach is necessary in case of impossible intubation. In this context, the prevention of hypoxemia must be a major concern of any anaesthetic management.

The use of eHealth interventions among persons experiencing homelessness: A systematic review.

Objective: eHealth interventions are being developed to meet the needs of diverse populations. Despite these advancements, little is known about how these interventions are used to improve the health of persons experiencing homelessness. The aim of this systematic review was to examine the feasibility, effectiveness, and experience of eHealth interventions for the homeless population.

Finding home: Community integration experiences of formerly homeless women with problematic substance use in Housing First.

Aims: This study explored community integration among women participating in a Housing First program. Physical, social, and psychological dimensions of community integration were examined.

Methods: This study used neighborhood walk-along and photo-elicitation interviews to explore 16 formerly homeless women's experiences of community integration.

"It's not just injecting drugs": Supervised consumption sites and the social determinants of health.

Background: People who inject drugs are highly vulnerable to social determinants of health (SDOH) inequities, such as homelessness, food insecurity, lack of social support, and poor access to healthcare. Supervised consumption sites (SCSs) have been developed to reduce harms associated with injection drug use but their social impacts remain largely unknown. This study explored service users' experiences with SCSs and how their service use affected their SDOH.

Service use and recovery among currently and formerly homeless adults with mental illness.

Background: A range of health and social services exist to address the many life adversities experienced by people with mental illness. However, the effects of services on their recovery in the context of ongoing homelessness and poverty have been minimally examined.

Aims: This qualitative study sought to better understand the role of health and social services in the recovery processes of people with mental illness and histories of homelessness.

Vascular retinal biomarkers improves the detection of the likely cerebral amyloid status from hyperspectral retinal images.

Introduction: This study investigates the relationship between retinal image features and β-amyloid (Aβ) burden in the brain with the aim of developing a noninvasive method to predict the deposition of Aβ in the brain of patients with Alzheimer's disease.

Methods: Retinal images from 20 cognitively impaired and 26 cognitively unimpaired cases were acquired (3 images per subject) using a hyperspectral retinal camera. The cerebral amyloid status was determined from binary reads by a panel of 3 expert raters on F-florbetaben positron-emission tomography (PET) studies.

Surviving versus living life: Capabilities and service use among adults with mental health problems and histories of homelessness.

The capabilities approach is a framework that can be applied to marginalised populations, including people with mental health problems and histories of homelessness, to measure well-being. Although a range of health and social services exist to address the many challenges associated with mental health problems and homelessness, the extent to which these services impact capabilities is unknown. This qualitative study explored the perspectives of people with mental health problems and histories of homelessness to understand how they perceived their service use as affecting their capabilities.

Non-invasive in vivo hyperspectral imaging of the retina for potential biomarker use in Alzheimer's disease.

Studies of rodent models of Alzheimer's disease (AD) and of human tissues suggest that the retinal changes that occur in AD, including the accumulation of amyloid beta (Aβ), may serve as surrogate markers of brain Aβ levels. As Aβ has a wavelength-dependent effect on light scatter, we investigate the potential for in vivo retinal hyperspectral imaging to serve as a biomarker of brain Aβ. Significant differences in the retinal reflectance spectra are found between individuals with high Aβ burden on brain PET imaging and mild cognitive impairment (n = 15), and age-matched PET-negative controls (n = 20).

Pathways Into Homelessness Among LGBTQ2S Adults.

This article examines entries into homelessness among adults who identify as LGBTQ2S (lesbian, gay, bisexual, transgender, queer, two-spirit). Twenty LGBTQ2S adults who were currently or formerly homeless participated in one qualitative interview. The interview protocol included questions on the participants' history of homelessness, causes of homelessness, and relationship of their gender and/or sexual identity to their homelessness.

Perceptions of Service Use Among Currently and Formerly Homeless Adults with Mental Health Problems.

This qualitative study used in-depth interviews to examine the service experiences of 52 currently and formerly homeless people with mental health problems. Thematic analysis identified five themes associated with positive and negative service experiences: (1) accessibility of services, (2) humanity in approach to care, (3) perceptions and relationships with other service users, (4) physical space and environment, and (5) outcomes of service use. Overall, minimal differences were found between currently and formerly homeless people with mental health problems, suggesting that both groups have the same wants and needs related to service use, including to be treated fairly and without judgment, receive needed support and assistance, and feel good following their service experience.

Predictors of Mental Health Recovery in Homeless Adults with Mental Illness.

For people with mental illness, experiences of homelessness can complicate mental health recovery processes. This study used longitudinal data from a randomized controlled trial of housing first (HF) to examine predictors of recovery among homeless people with mental illness. Findings showed that health and community predictors were most strongly associated with mental health recovery.

Perceptions of Housing and Shelter among People with Histories of Unstable Housing in three Cities in Canada: A Qualitative Study.

Housing is a key social determinant of health that contributes to the well-documented relationship between socioeconomic status and health. This study explored how individuals with histories of unstable and precarious housing perceive their housing or shelter situations, and the impact of these settings on their health and well-being. Participants were recruited from the Health and Housing in Transition study (HHiT), a longitudinal, multi-city study that tracked the health and housing status of people with unstable housing histories over a 5-year period.

The effects of housing stability on service use among homeless adults with mental illness in a randomized controlled trial of housing first.

Background: Housing First is an effective intervention to stably house and alter service use patterns in a large proportion of homeless people with mental illness. However, it is unknown whether there are differences in the patterns of service use over time among those who do or do not become stably housed and what effect, if any, Housing First has on these differing service use patterns. This study explored changes in the service use of people with mental illness who received Housing First compared to standard care, and how patterns of use differed among people who did and did not become stably housed.

Community Psychology and Community Mental Health: A Call for Reengagement.

Community psychology is rooted in community mental health research and practice and has made important contributions to this field. Yet, in the decades since its inception, community psychology has reduced its focus on promoting mental health, well-being, and liberation of individuals with serious mental illnesses. This special issue endeavors to highlight current efforts in community mental health from our field and related disciplines and point to future directions for reengagement in this area.

Poverty and Serious Mental Illness: Toward Action on a Seemingly Intractable Problem.

This paper examines the issue of poverty among people with serious mental illness (SMI), positioning it as a key issue to be confronted by community mental health systems and practitioners. The paper reviews three perspectives on poverty, considering how each sheds light on poverty among people with SMI, and their implications for action: (a) monetary resources, (b) basic needs, and (c) capabilities. The paper argues that community mental health programs and systems are currently unable to address poverty as they are overly focused on individual-level interventions that, on their own, cannot raise people out of poverty.