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C4TS Newsletter Spring/Summer 2018 Issue 16
C4TS RESEARCH NEWS SPRING/SUMMER 2018 Welcome to the Centre for Trauma Sciences (C4TS) Spring/Summer 2018 newsletter. In this edition, we provide an overview of the three events that C4TS organised for trauma clinicians from London and around the UK to share learning and ideas to advance trauma care. Our trauma MScs continue to grow in popularity, and we summarise some analysis that shows the impact our former students have on their fields when they graduate. The public engagement team report on their new STEM interactive games and well attended events. Finally, we invite you to join us for a public event in September where we will discuss our research, invite lay people to get involved, and socialise over drinks and nibbles.
The Second London Major Trauma Symposium
by Dr Elaine Cole, Director of Research and Innovation, Pan-London Major Trauma System
London’s Major Trauma System symposium plays a unique role in disseminating learning and strengthening professional relationships across the capital’s four trauma networks. On 12th June, C4TS organised the second London Major Trauma System symposium at the Royal Geographical Society in South Kensington. The objective of the symposium was to bring together clinicians from across all four of London’s trauma networks, to share learning and challenges across the whole spectrum of trauma care. Over 250 delegates attended, and the symposium poster competition attracted 51 entries. The range of speakers was highly diverse, representing the multidisciplinary nature of trauma care. Topics included strategic overviews of where the system is heading as a whole; innovations and learnings in trauma related radiology; pre-hospital care; violence prevention; elderly pathways; rehabilitation; and much more. The keynote speaker was Sir Keith Porter, Professor of Clinical
C4TS lead Professor Karim Brohi addressing the second London Major Trauma System symposium in June 2018 Traumatology, who spoke of the development and impact of the Citizen Aid app, which equips ordinary civilians with the knowledge and assistance to respond effectively to emergency and disaster situations where people are injured. The prize for best research poster was won by A. Hudson and O. Morgan for ‘Elderly Trauma Mortality: a single centre review’, and the prize for best innovation poster was won
by M. Murali, L. Bolton, and S. Bhatkal for ‘Management of Elderly Trauma at a London DGH: introduction of a Silver Trauma Pathway’. All of the posters submitted can be viewed via the C4TS website. C4TS gratefully acknowledges the generous support of the symposium sponsors: Irwin Mitchell Solicitors, Unite Professionals Case Management, and London’s Air Ambulance.
C4TS Newsletter Spring/Summer 2018
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London Trauma Research Showcase by Dr Paul Vulliamy, Clinical Research Fellow
C4TS Clinical Trial Milestones Update
by Claire Rourke, Clinical Trials Manager C4TS Senior Investigator Dr Ross Davenport delivering the keynote address at the London Trauma Research Showcase
The first pan-London trauma research showcase took place in the morning of 13th June at St Bartholomew’s hospital, hosted by the Centre for Trauma Sciences. The event was attended by 120 researchers and clinicians from across the London trauma system who were treated to twenty rapid-fire research presentations, along with keynotes from C4TS’ very own Dr Ross Davenport and Major Max Marsden. The talks reflected the breadth of research being carried out in the network, covering topics ranging from rib injuries to REBOA to patient experiences to early immune signatures after injury. Feedback from the event was extremely positive and we are already looking forward to the next edition. The ‘seasoned veterans’ of trauma research were very impressed with the quality of the presentations, and particularly how the current crop of junior researchers are developing work that has gone before.
C4TS critical care research nurse Robert Christie (above right) presents some findings from the MODET study into elderly trauma
iTACTIC On 2nd July 2018, the Royal London Hospital recruited the final patient into the Implementing Treatment Algorithims for the Correction of Trauma Induced Coagulaopathy study (iTACTIC). This study is now closed to recruitment and is entering a 3-month follow-up phase that will be followed by data extraction and analysis. Preliminary results are expected later this year. TOP-ART Phase one of the Trauma Organ Protection using Artesunate study (TOP-ART) was completed on 30th June. Phase one used a treatment dose of 2.4mg/kg, which is the WHO recommended level for artesunate’s current indication. However, results from our animal models suggested a higher dose was more efficacious. We have now entered the interim analysis stage to ensure patient safety, following which (pending DMC recommendation) we will continue patient recruitment at a higher dose (4.8 mg/kg). CRYOSTAT-2 Our major clinical partner, the Royal London Hospital, was given the green light to open recruitment for the CRYOSTAT-2 study on 11th July 2018, and recruited two patients in the first week.
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National Trauma Research and Innovation Collaborative (NaTRIC) by Richard Carden, Clinical Research Fellow
NaTRIC is a new National Trauma Research & Innovation Collaborative set up by C4TS. NaTRIC has been established to support doctors, nurses, paramedics, and allied health professionals to deliver national research projects. Research collaborations in surgery and anaesthesia have already been very successful, and have led to the completion of multiple projects and publications. NaTRIC is the first pandiscipline group to focus specifically on trauma. NaTRIC held its inaugural meeting on 13th June at the Robin Brook Centre, St Bartholomew’s Hospital. Tickets for the event sold out quickly, demonstrating how valuable people viewed the idea of a national collaborative! The rationale for NaTRIC is twofold; first, there is a real opportunity to take advantage of the infrastructure of the major trauma networks in England. This would allow individuals from trauma units and major trauma centres across the country to participate in research, and hopefully improve the patient experience and outcomes. The second reason was in acknowledgement of the potential barriers for many health professionals to participate in research – many don’t know where to start, how to access supervision, or navigate the necessary paperwork. The Centre for Trauma Sciences (C4TS) is throwing open its doors on Tuesday 11th September to talk to interested members of the public and former patients about our world-leading research and discoveries, and the many different ways lay people can help. Public and patient perspectives and contributions have always played a major part in influencing our research program, and this event aims to increase our numbers of research volunteers.You don’t need to be a scientist or a doctor to have a huge impact on shaping new and better treatments for people who have suffered serious injury! The C4TS team will talk about our research and achievements to date, and lay people already involved in research will share what they have gained from their experiences. There will also be stands by Barts Charity and AfterTrauma, and displays of information and interactive games from our public engagement activities. Drinks and nibbles will follow!
Trauma trainees from a wide range of disciplines share ideas for research collaborations at the inaugural NaTRIC gathering The meeting generated a number of great ideas for research projects, so the next steps are aimed at fleshing these out and working towards starting the first NaTRIC project. The group hope that by engaging with the regional trauma networks (both in London and nationally) they will be able to conduct some large and clinically meaningful projects that will help shape the way trauma care is delivered in the UK. Watch this space! For more information, visit our website Na.tric@outlook.com
or contact:
Date for the diary: C4TS public talk & drinks! DATE AND TIME Tue 11 September 2018 15:30 – 18:30 BST LOCATION The Old Library Garrod Building (next to the Royal London Hospital) Turner St London E1 2AD RSVP Eventbrite link: https://www.eventbrite.co.uk/e/get-involved-with-injuryresearch-tickets-24424448182
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EDUCATION HIGHLIGHTS Our distance learning Masters degree in trauma sciences sets up graduates to make an impact on global care. MSc Trauma Sciences impact
Figure 1: Participation of Trauma MSc graduates in education %
by Dr Barry Schyma, Education Research Fellow Our distance learning Master’s degree (MSc) in Trauma Sciences at QMUL attracts anaesthetists, surgeons, emergency, pre-hospital and critical care physicians, nurses and paramedics from around the globe. We recently undertook some analysis to find out if (as we hoped) students graduating from this program make a global impact in trauma care, education and research. My MSc colleagues and I undertook a worldwide electronic survey of Trauma Sciences MSc alumni who had graduated between 2013 and 2016. We collected information about our former students’ current clinical involvement in trauma management, and their presentation and publication of MSc work. Further academic progression and roles in trauma education were also explored. Additional supporting demographics, including clinical background, nationality, age and programme outcome were extracted from the QMUL student database.
Figure 2: Trauma MSc graduates presented & published work %
Findings
Half of alumni approached responded to the survey. All survey responders were providing regular clinical care to trauma patients, 79.6% on at least a weekly basis. 12.2% were in PhD programs, and 4.1% in formal academic positions. 73.5% of students were now engaged in teaching (Figure 1). Students also published MSc work in peer reviewed journals and presented at national and international conferences (Figure 2). Evangelos Anagnostou is a first year MSc Trauma Sciences student (Military and Humanitarian) who is already influencing trauma care in his native Greece. He has just published a paper in the esteemed Injury journal outlining the case for the establishment of a major trauma system in his country. He says: “The MSc program is not just an opportunity to acquire invaluable, up-to-date knowledge in this field, but also an inspiration to make a difference.” His next step is to work with other experts to write a plan for the government to approve. You can read Evangelos’ article here.
Evangelos Anagnostou
Implications
We think these data suggest that our distance learning programme provides a robust trauma education curriculum and serves as a platform to improve trauma management globally. Our completion rate (67.6% of students graduated) is enviable compared with other distance learning courses, and is independent of clinical seniority and age. Our graduates make an international multidisciplinary impact in the global trauma community with diverse roles in clinical management, research and trauma education. More information about our three MScs in trauma sciences and the MSc in emergency medicine is available on our website. From an abstract presented at the 2018 ANZCA ASM. Manuscript in preparation. Co-authors: E.Cole, S.M Wren, K.Brohi, S.I Brundage
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PUBLIC ENGAGEMENT The C4TS public engagement team have been teaching children and families about our research the fun way - games! QMUL Festival of Communities by Sannah Sultan, Public Engagement Team
In May 2018, the Centre for Trauma Sciences attended the QMUL Festival of Communities to talk to local residents in Tower Hamlets about trauma, the immune system, bleeding and some of the research we carry out. The festival took place over two days and was located at both the university and a local park. As part of the event we tried out some of our new games, teaching children about immune cells and organ function in trauma. Most of our visitors were young families and children under 10, so our main activity allowed even our youngest visitors to get involved in designing their own immune cells. Whilst the children made colourful and shiny adaptations to our immune cell templates, we discussed how immune cells make antibodies and help to capture and destroy germs. Other visitors got involved with our adapted Guess Who game and took part in Our Clot-Plunk Clot-Plunk game game shows shows our Multi-Organ Failure Giant Jenga! These activities were designed to discuss the Our discoveries in coagulopathy and discoveries in coagulopathy and is different organs in the body and what happens when these organs are affected always popular always popular in trauma. In Giant Jenga, children pull blocks out of a ‘body tower’, and can see how the body is weakened when organs are damaged. As always, Clot-Plunk was a great way to explain blood clotting and bleeding to our visitors and was greatly enjoyed by children and parents alike. Guess Who allowed the children to describe different organs and immune cells in order to guess each other’s cards. This game facilitated discussions about the function of different organs and cells.
C4TS researchers with our new displays and games about trauma and the immune system Kids’ share ‘the coolest thing they learnt about trauma’! “I learnt that white blood cells protect your body from infections” “Scabs = platelets!”
Over the two days we interacted with over 200 children, ran out of immune cell templates and played countless games of Guess Who. We even had some repeat visitors on the second day, keen to play some of our games again. We did all this again at our Big Bang Tower Hamlets public engagement event in July, where we also showcased our new interactive trauma body map! If you would like to know more about how you can access our displays, games, and leaflets please contact: s.gillespie@qmul.ac.uk. More info on our website and follow us on Twitter at #Immune2Trauma.
Barts Charity’s Transform Trauma appeal, which seeks to raise money for trauma research and treatments, will be kick-starting national awareness of the appeal again in September, with feature articles planned for the Sunday Mirror and other media outlets on trauma patient experiences and C4TS research. You can start your own fundraising activity or simpy donate by visiting the appeal page: https://www.justgiving.com/campaigns/charity/blc/transformtrauma