Search

Purpose Strategies for preventing and ending homelessness are frequently measured by their effectiveness on indices of tenancy sustainment. To shift this narrative, we conducted research to identify what is needed to “thrive” following homelessness from the perspectives of persons with lived experience in Ontario, Canada. Methods Conducted in the context of a community-based participatory research study aimed at informing the development of intervention strategies, we interviewed 46 persons living with mental illness and/or substance use disorder [n = 25 (54.3%) unhoused; n = 21 (45.7%) housed following homelessness] using qualitative interviews. A subsample of 14 participants agreed to engage in photovoice interviews. We analysed these data abductively using thematic analysis informed by health equity and social justice. Results Participants described experiences of “living in a state of lack” following homelessness. This essence was expressed through four themes: 1) housing as part one of the journey to home; 2) finding and keeping “my people”; 3) meaningful activity as critical for thriving following homelessness; and 4) struggling to access mental health supports in the context of challenging circumstances. Conclusions Individuals struggle to thrive following homelessness in the context of insufficient resources. There is a need to build on existing interventions to address outcomes beyond tenancy sustainment.

Purpose Self-management is recommended for addressing chronic conditions, and self-management programmes improve health behaviours and outcomes. However, social and economic factors have been neglected in self-management research, despite their relevance for marginalized groups. Thus, we aimed to explore barriers and facilitators that influence self-management among socioeconomically marginalized people who use drugs (PWUD). Methods Using community-based participatory methods, we developed a qualitative interview guide and conducted peer-led recruitment. Participants were admitted into the study after self-identifying as using non-prescribed drugs, having a chronic health issue, and experiencing socioeconomic marginalization. Data were analysed using reflexive thematic analysis, taking a relational autonomy lens. Results Participants highlighted substantial barriers to managing their health issues, mostly stemming from their social and economic environments, such as unstable housing, low income, lack of supportive social networks, and negative healthcare experiences. Participants also described how their ability to self-manage their chronic conditions benefited from specific aspects of social interactions, including close relationships, community connectedness, and engaging in peer support. Conclusions Our findings suggest that structural interventions are needed to support self-management among marginalized PWUD, especially stable housing. Self-management supports for PWUD would benefit from including a range of low-barrier community-based options, peer work opportunities, and advocacy for needs.

Positron emission tomography (PET) and single-photon emission-computed tomography (SPECT) are important nuclear-medical imaging tools in diagnosing cancers and creating effective treatment plans. Commercially imaging systems are operated externally and can create 3D images of the whole body or of specific organs by rotating the gamma-ray detectors, and then employing software to reconstruct the 3D images from the multiple 2D projections at different angles of view. However, their uses in intraoperative environments or for imaging specific small organs, e.g., the prostate, ovary, and cervix, are limited because of their bulky designs and the long working-distance, hence causing low efficiency and poor spatial-resolution. In such situations, compact imaging devices, e.g., the trans-rectal gamma camera developed at Brookhaven National Laboratory (BNL) and Hybridyne Imaging Technologies, are preferable for detecting intra-prostatic tumors. The camera uses pixilated cadmium zinc telluride (CdZnTe) detectors with a matched parallel-hole collimator. However, their lack of 3D imaging capability limits their use in clinics, because the acquired images cannot be interpreted easily due to missing depth information. Given the constraint on space in such operations, the traditional 3D-image acquisition methods are impractical. For this reason, we designed an interwoven collimator dedicated for 3D imaging using an endocavity probe. This novel collimator allows us to take two or multiple views of a specific organ or tissue without rotating the camera. At the first stage of design for the collimator, we carried out Monte-Carlo simulations to study the response of the collimator and the attached detectors to gamma rays, and then developed a maximum-likelihood-based algorithm for reconstructing 3D images. In this paper, we detail our modeling of the collimator on a cluster Linux computer, and discuss the imaging capability of this novel collimator.