BACKGROUND: In the United States in 2019, there was an outbreak of electronic cigarette, or vaping, product use-associated lung injury (EVALI). The manifestations of EVALI in adolescents are not well characterized. We describe the diagnosis, evaluation, and management of EVALI in adolescents hospitalized at a tertiary care, university-affiliated children's hospital. METHODS:A multidisciplinary committee developed an EVALI algorithm on the basis of guidelines from the Centers for Disease Control and Prevention. A retrospective chart review was conducted on patients diagnosed with EVALI. Descriptive analyses included sociodemographic characteristics, clinical presentation, laboratory and imaging results, pulmonary function testing, oxygen requirements, and clinic follow-up.RESULTS: Thirteen hospitalized adolescents were diagnosed with confirmed or probable EVALI. The majority were female (54%) with a mean age of 15.9 years. Sixty-nine percent of patients presented with respiratory symptoms, whereas gastrointestinal symptoms were prominent in 85% of patients. Vaping D-9-tetrahydrocannabinol was reported in 92% of patients, and vaping nicotine was reported in 62% of patients. All had bilateral ground-glass opacities on the chest computed tomography (CT) scan. Treatment with glucocorticoids led to clinical improvement in 11 of 12 patients. Treatment with glucocorticoids led to improvement in both forced expiratory volume in 1 second and forced vital capacity (P , .05). Four patients required home oxygen on the basis of 6-minute walk test results.CONCLUSIONS: Diagnosis of EVALI should be suspected on the basis of vaping history and clinical presentation. Glucocorticoid treatment led to an improvement in symptoms and lung function. The 6-minute walk test may help determine oxygen needs at discharge. WHAT'S KNOWN ON THIS SUBJECT:The prevalence of electronic cigarette use has more than doubled among eighth-to 12thgraders over the past 2 years. An outbreak of electronic cigarette, or vaping, product use-associated lung injury (EVALI) linked to vaping D-9-tetrahydrocannabinol occurred this fall, and adolescents were among those affected.WHAT THIS STUDY ADDS: Many teenagers affected by EVALI were female, were Hispanic, and had multiple psychosocial stressors. Lung function deficits due to EVALI appear reversible with steroids. Six-minute walk test results may help identify adolescents who would benefit from home oxygen.

Although it is widely recognized that the most marginalized people tend to face extra barriers when accessing mainstream services intended to serve everyone, few studies have dealt with the specific barriers and challenges that immigrant and refugee youth from small, marginalized communities encounter when seeking access to services aimed at facilitating their settlement and integration into Canadian society. Our exploratory study of the participation of young African newcomers in youth programs in Metro Vancouver goes some way towards filling this gap. In this paper, we report our key findings and their policy implications. The central finding of this study is that there are many gaps between the needs of young African newcomers and the services available in the wider community. While gaps inhibit successful integration by maintaining a separation of youth from mainstream society, bridges create a continuum of services that offer a stable pathway for youth and promote their integration into mainstream society. Unfortunately, in their attempts to access formal support networks, young African newcomers encounter more gaps than bridges. While newcomers from all countries have particular needs and challenges, the experiences of the young Africans described in this study provide an important reference point for scholars and practitioners who are concerned about the predicaments of newcomer youth, particularly refugees and those from marginalised communities. Bien qu’il soit largement reconnu que les personnes les plus marginalisées ont tendance à faire face à des obstacles supplémentaires quand ils cherchent à accéder aux services conventionnels destinés à tous, peu d’études ont porté sur les obstacles spécifiques et les défis auxquels les jeunes immigrants et refugiés, de petites communautés marginalisées rencontrent lorsqu’ils cherchent à accéder aux services pouvant faciliter leur établissement et intégration dans la société canadienne. Notre étude exploratoire de la participation des jeunes nouveaux arrivants africains dans les programmes de jeunesse de Metro Vancouver, va dans le sens de combler cette lacune. Dans cet article, nous présentons nos conclusions principales ainsi que leurs implications politiques. La conclusion principale de cette étude est qu’il y a beaucoup d’écarts entre les besoins des jeunes nouveaux arrivants africains et les services disponibles dans la communauté plus large. Pendant que les écarts empêchent l’intégration réussie en maintenant la jeunesse séparée de la société principale, les ponts créent une continuité des services qui offre une voie stable aux jeunes et promeut leur intégration dans la société principale. Malheureusement, dans leurs tentatives d’accès à des réseaux formels de soutien, les jeunes nouveaux arrivants africains rencontrent plus d’é-carts que de ponts. Alors que les nouveaux arrivants de tous les pays ont des besoins et défis particuliers, l’expérience des jeunes africains décrite dans cette étude fournit un point de référence important pour les chercheurs et praticiens qui sont préoccupés par les conditions précaires des jeunes nouveaux arrivants, particulièrement les réfugiés et ceux des communautés marginalisées.

Our purpose in this article is to examine refugees' access to housing in metropolitan Vancouver. How are refugees faring in Vancouver's housing market relative to non‐humanitarian immigrants? Is there evidence that their housing circumstances change over time? Following from this, can we detect systematic differences in housing experiences between refugees selected and supported by the Canadian government versus those who come to Canada seeking asylum? Finally, what are the most important barriers for refugees in Vancouver's housing market and how are they addressed? Our study involved three main forms of data collection: focus groups with representatives of organizations that support newcomers, focus groups with newcomers, and a systematic survey exploring the housing experience of immigrants and refugees. While this article focuses on the survey results, we also draw upon the contextual knowledge obtained through the focus groups. We find that refugees are more likely than economic immigrants to lack the resources needed to access adequate and affordable housing. Many inhabit inadequately maintained, overcrowded, and unaffordable housing units and experience increased risk of homelessness. Therefore, we conclude that there is a need for greater coordination between housing and settlement policy to enable all newcomers to meet their housing needs.