As a modern phenomenon, there is currently limited understanding of the possible toxic effects and broader implications of electronic nicotine delivery systems (ENDS). Large volumes of aerosolized particles are inhaled during “vaping” and there are now an increasing number of case reports demonstrating toxic effects of ENDS, as well as human studies demonstrating impaired lung function in users. This article presents a case of respiratory bronchiolitis interstitial lung disease (RB‐ILD) precipitated by vaping in a 33‐year‐old male with 10 pack years of traditional cigarette and prior treatment for mixed germ cell tumour. The patient had started vaping 10–15 times per day while continuing to smoke 10 traditional cigarettes per day. After 3 months of exposure to e‐cigarette vapour, chest computed tomography demonstrated multiple new poorly defined pulmonary nodules with fluffy parenchyma opacification centred along the terminal bronchovascular units. Video‐assisted thoracoscopy with lung biopsy of the right upper and right middle lobes was undertaken. The microscopic findings were overall consistent with RB‐ILD. This case demonstrates toxicity with use of ENDS on open lung biopsy with resolution of radiographic findings on cessation. We believe that this is the first case where open lung biopsy has demonstrated this and our findings are consistent with RB‐ILD.
Background: Homelessness is about survival and more than an issue of bricks and mortar. It is not a static dimension and alludes to a troubled age and brokenness of society. Despite dramatic declines in numbers of people presently homeless, the issue continues to be a public health issue. The number of veterans currently homeless continues to be of national concern despite application of resources. More needs to be done to better understand the concerns of veterans, once homeless and now housed. Method: Qualitative research in the form of interviews provided insights from the veterans on their experience around achieving housing. Qualitative methods are often used in evaluations as they speak of the experience of the program being evaluated by capturing and then communicating the narratives of the participants. This study was grounded in community-based participatory research where a member of community was a part of all phases of the research process. Results: Seven interviews with formerly homeless veterans were conducted. Themes included the following: Burnt Brides and Regrets, Survival, Spirituality, Recovery and Stress, Supportive Care, Reunite Family, and Sickness and Health. Discussion: The themes provide insight into the experience of the veterans and a means to better understand the healing process. Understanding of the healing process includes the following: Acknowledging the Courage to go Deep, Time, Veterans Giving Back, and Recovery is Ongoing. Despite what was learned, further research is needed to better understand the long-term implications of people formerly homeless now housed.
With 20 million living veterans and millions more immediate family members, and approximately 9 million veterans enrolled in the nationally networked VA healthcare system, representing the interests and needs of veterans in this complex community is a substantial endeavor. Based on the importance of engaging Veterans in research, the VA Health Services Research and Development (HSR&D) Service convened a Working Group of VA researchers and Veterans to conduct a review of patient engagement models and develop recommendations for an approach to engage Veterans in health research that would incorporate their unique lived experiences and interests, and their perspectives on research priorities. The Working Group considered the specific context for Veteran engagement in research that includes other VA stakeholders from the operational and clinical leadership of the VA Health Administration (VHA). The resulting model identifies the range of potential stakeholders and three domains of relevant constructs—processes expected to facilitate Veteran engagement in research with other stakeholders, individual stakeholder and external factors, and outcomes. The expectation is that Veteran engagement will benefit research to policy and practice translation, including increasing the transparency of research and producing knowledge that is readily accepted and implemented in healthcare.
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