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2020 NIHR ACF PES Cambridge Acute Care



2020 NIHR Academic Clinical Fellowship in Priority Research Themes

HEE Local Office: East of England
Medical School: University of Cambridge
Research Theme: Acute Care
Specialty Options: Emergency Medicine or Intensive Care Medicine or Trauma and Orthopaedic Surgery

Plain English Summary

Cambridge is the Major Trauma Centre for the East of England and the hub of the East of England Trauma Network. The training opportunities available during this post can support candidates from Emergency Medicine, Intensive Care Medicine, or Trauma and Orthopaedics. The successful candidate will undertake a bespoke training programme, with 25% protected academic time scheduled flexibly to support their individual training needs and allow development of a high-quality research fellowship application focused on acute trauma - an area of significant unmet clinical need. The unifying feature of all types of trauma is that despite precipitation by an acute event, trauma is not a single insult that then simply resolves, but a complex interaction between host and injury, resulting in activation of dynamic processes that remain active for years, leading to very diverse clinical outcomes. The proposed projects are focused on developing targeted interventions for individuals experiencing acute trauma with the aim of improving clinical outcomes. The Cambridge Acute Care specialties in this application have an outstanding track record of nurturing academic trainees. Our research training is based on a portfolio of current grants >£35 million, underpinned by collaborations within and beyond Cambridge.

Non-neurological trauma:
Intensive Care Medicine (ICM) and Trauma and Orthopaedics have substantial experience of detailed clinical, biological and physiological phenotyping of critically ill/injured patients to identify host/injury factors that modulate the response to injury. The available projects would aim to integrate multiple types of data (clinical, biological etc.) to identify mechanistically discrete sub-types of trauma with the longer-term aim of developing targeted interventions.

Traumatic brain injury (TBI):
Our TBI research spans all severities (mild to severe), disease types (acute/ chronic), and contexts (Emergency Department (ED), Intensive Care Unit, ward, outpatients). Data from ~5000 patients and a ~20,000 patient registry includes clinical parameters, biological data, CT and MRI imaging, and extensive outcome data, representing an excellent substrate for research.

Violence reduction:
The ED has a successful collaboration with RAND Europe and the Institute of Public Health to investigate the utility of ambulance data in violence prevention. Characterising the mechanism, location, and precipitating factors associated with violent trauma presenting to the ED allows liaison with the police and other regulatory authorities to develop interventions (e.g. changing alcohol licensing permissions) and study their impact on the incidence and nature of violent trauma, with the aim of facilitating violence reduction.

Translational solutions for bone and cartilage repair:
This translational research programme includes stratification tools based around imaging and tissue analysis and new treatments including both molecular endogenous cell targeting and cell therapies, seeking to repair and regenerate injured tissues at an early stage. This area includes a range of projects from laboratory-based through to clinical outcome and delivery, particularly in the field of major trauma and injury. The research is supported world-class facilities and science together with a supportive environment: Arthritis Research UK Tissue Engineering Centre, UK Regenerative Medicine Platform Hub; Engineered cell environment. We also participate in the innovative European Commission Adipoa2 EU2020 collaboration.