In late 2015, Kerrie Luck counted 1,592 cigarette butts a day at the front and back entrance of the Saint John Regional Hospital. She wanted a baseline to measure the impact of a comprehensive smoke-free policy that had just been implemented. The number of cigarette butts dropped to 60 once it was in effect – a 96 per cent reduction.
The New Brunswick native was recognized as one of three Rising Stars for April by the New Brunswick Health Research Foundation (NBHRF) for a qualitative research piece she published on the Global Qualitative Nursing Research Journal in January.
The article looked at the impact of this smoke-free policy on healthcare providers. It was part of her PhD degree, which she recently completed.
“I was curious to find out how is this policy impacting healthcare providers within the institution, within the hospital,” she said.
Luck helped lead the implementation of that policy, which covers all of Horizon Health Network’s hospitals in New Brunswick. It was first implemented at The Saint John Regional Hospital.
It’s now against the law to smoke anywhere on New Brunswick health authority property, including the parking lot.
Luck interviewed various healthcare workers to look at their perceptions, experiences and behaviours after the implementation of that policy.
She found that the policy led to greater support for tobacco reduction, enhanced patient care and interaction in relation to tobacco, and improved staff morale. But barriers still existed.
“A lot of healthcare providers still require a lot of support and training for tobacco reduction,” she said. “They also require more training in regards to enforcing the policy because a lot of them aren’t overly comfortable about what to do when they see someone breaking the policy.”
After the policy was implemented, she said patients also became more receptive to tobacco withdrawal management treatments like nicotine patches.
“Ideally, we want them to quit smoking but we’re not forcing them to quit smoking. Some people just never have the opportunity to get patches to manage withdrawal symptoms,” she said.
“Something that we all have to understand is smoking is an addiction in nicotine and you have to be respectful of that. These policies are not to belittle or minimalize smokers, but we also have to balance out what’s best for the entire community.”
Luck’s interest in this field was sparked by her work as an occupational therapist since 1994. When she returned to Dalhousie University to complete her Master’s Degree in Science in Occupational Therapy, she studied “the occupational transition of smoking cessation in women.”
Today, she continues to do consulting and advocacy work for a smoke-free environment. She most recently asked her town council in Quispamsis to consider a by-law for smoke-free places.
“Smoking is still the number one preventable cause of death in Canada. If we can try to lower that by different means, a policy is one of them, we can slowly, hopefully denormalize tobacco,” she said.
Sarah Filiatreault Seeks Better Care for Hip Fracture Patients
A Master’s of Nursing student at UNB Fredericton, Sarah Filiatreault said her work as an emergency nurse in Canada and the U.K. led her to pursue her current studies.
“I’ve been a nurse for 15 years and I worked in a large trauma center in Western Canada for over a decade,” she said. “So you get to really see how the healthcare system worked and where we’re failing, in a way.”
Filiatreault was recognized as a Rising Star for her umbrella review of clinical practice guidelines for the management of hip fracture patients. It was published in the Journal of Advanced Nursing in February, with the guidance of her supervisor Dr. Marilyn Hodgins, who co-authored the study.
As a nurse, Filiatreault became “frustrated” when she couldn’t provide patients with the quality of care she wanted due to multiple system issues.
“I went back to graduate studies to see if I can exact some real change through research,” she said.
The review is part of her Master’s thesis work. Filiatreault came up with a set of seven Quality Statements to monitor and evaluate the quality of care hip-fracture patients receive in the emergency department.
“If they don’t get good quality of care at the very beginning, they’d have adverse outcomes,” she said. “There’s a high percentage of people that never end up going home after [a hip fracture], or they end up really confused, or they lose their ability to live independently.”
A Quality Statement establishes the aspects of care that caregivers should complete. Currently, Filiatreault said there’s only one Quality Statement for hip fracture in Canada – that’s for hip fracture patients to receive surgery within 48 hours.
Filiatreault plans to test the feasibility of her Quality Statements through electronically recorded clinical data from one hospital in New Brunswick.
“Then clinical decision makers can see where they need to improve the quality of care they’re providing and also where they’re doing well,” she said. “My big hope is it’s something that can be usable across the country, not just within New Brunswick.”
Originally from Edmonton, Alta., Filiatreault moved to New Brunswick to pursue her master’s degree at UNB at the same time her partner was offered a job in the province.
“It’s a good province to be in when you want to do research in aging because it does have the highest proportion of older people across the country,” she said.
Family illnesses inspired Dr. Shreya Sarkar’s cancer and cardiovascular research
Dr. Shreya Sarkar, a post-doctoral fellow at Dalhousie Medicine in Saint John, was recognized as a Rising Star for work she did at the Chittaranjan National Cancer Institute in India.
The Calcutta native co-authored a study that looked at the role of the Human Papillomavirus (HPV) as a risk factor in head and neck cancer among patients in eastern India.
The study was published in the Medical Microbiology and Immunology Journal in 2017.
“It’s known that HPV is widely presented for cervical cancer. But for other cancers, HPV is equally important,” she said. “It’s slowly coming up as an important risk factor for head and neck cancer.”
One of the study’s key conclusions is that HPV infection starts in the dysplasia phase, a stage preceding the development of cancer. That first infection is “really important” for head and neck cancer, Sarkar said.
While HPV vaccines are already being used to help prevent cervical cancer, Sarkar said the study’s findings indicate a wider use of the vaccine could be beneficial.
“Think of giving HPV vaccine to children, before puberty and before they have any kind of sexual contact. It would be one of the preventive measures for cancer,” she said.
“We could have that vaccine which not only takes care of cervical cancer, but we could give it for head and neck cancer, penile cancer, so we could stop them in the initial stage.”
It was illnesses in her family that led Sarkar to pursue cancer research, and now switch to studying metabolism in cardiovascular diseases. She plans to link knowledge from the two fields together.
“I had an aunt who died of cancer, so I thought I would be working in a field that would benefit [cancer] patients. And then my dad got sick,” she said. “My dad is a heart patient, that was something that motivated me to go into cardiovascular research.”
This year, Sarkar already has two papers published in the field of head and neck cancer.
She’s also involved with Impart, a Dalhousie Medicine medical team that studies the effects of metabolic and inflammatory diseases on the body and the wider community. The team won $500,000 at the Medical Dragons’ Den in Saint John in April.
Sarkar decided to do her post-doctoral work in Canada after she “fell in love” with the country when she came as a tourist in 2016.
“The people here are awesome, there’s no doubt about it,” she said. “It’s a cold country where the people are so warm.”