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Children's Services






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    Children's Services Children's Services Document Transcript

    • THE UNIVERSITY OF NOTTINGHAM SCHOOL OF HUMAN DEVELOPMENT ACADEMIC DIVISION OF CHILD HEALTH Job Title: James Tudor Paediatric Clinical Neuro-Oncology Research Fellow Contract Status: This post will be offered on a fixed term contract for a period of three years and is open to job share. Salary: £28,930 – £50,219 per annum, depending on qualifications and experience. Location: Children’s Brain Tumour Research Centre, Queen’s Medical Centre, Nottingham Responsible to: Professor Richard Grundy, Professor of Paediatric Neuro-Oncology & Cancer Biology & Professor David Walker, Professor of Paediatric Oncology An exciting opportunity has arisen for the appointment of a three year International Clinical Research Fellow post in Paediatric Neuro-Oncology within the Children’s Brain Tumour Research Centre [CBTRC]. Funding for this post comes from the James Tudor Foundation whose main aim is the relief of sickness. In children diagnosed with brain tumours this is dependent on encouraging outstanding and talented young clinician scientists into the field of paediatric neuro-oncology. The Children’s Brain Tumour Research Centre is currently engaged in a wide range of research projects from basic laboratory research to translational research to clinical projects. The successful candidate will be offered a comprehensive portfolio of research opportunities with which you could engage depending on your particular abilities and interests. The research project will be tailored to the interests of the best candidate. The post will provide the successful candidate with academic training through a period of dedicated research leading to submission for a higher degree (either MD or PhD). The successful applicant would be expected to develop a clinical research fellowship proposal for a national research funding award from the Department of Health, Cancer Research UK, Welcome or MRC. Background Children’s brain tumours account for 25% of childhood cancer, their cumulative incidence in childhood is 1 in 2500, this means in the UK about 450 children are diagnosed each year. Primary central nervous system tumours are the leading cause of cancer-related deaths in children less than 15 years of age. Tumours of the brain and spine account for 25% of all cancers in children and young people and although treatments have improved we still only cure 50% of children so diagnosed. This accounts for the loss of 10,000 life years each year in England and Wales. Moreover, a substantial proportion of those cured are left with disability
    • which influences not only their lives but also the lives of their families and places an extra continuing burden on health, educational and social services. By contrast, survival rates for children with acute leukaemia and other solid tumours, excluding brain tumours, have risen significantly over the last 10 years (Stiller 1994). The reasons are multifactorial and include: i. The complex clinical problems created by the development of a brain tumour in the developing Central Nervous System [CNS] of childhood. ii. Until recently poorly organised infrastructure for collecting biological samples for research and entering patients into clinical trials. This is now being addressed through UK Children’s Cancer Study Group and International Society of Paediatric Oncology [SIOP]. iii. Presently our understanding of the biology of brain tumours is still developing. Advances in our understanding of the molecular pathology of a number of other cancers in children i.e. leukaemia is yet to be matched by similar insights in brain tumorigenesis. Paediatric neuro-oncology is emerging as a new and increasingly defined specialist research field requiring clinical and basic research skills linking paediatrics, neurosciences, oncology, imaging, pharmaceutical sciences, human development, stem cell technology cellular biology and molecular genetics to provide enhanced scientific and clinical understanding of these devastating tumours. The Children’s Brain Tumour Research Centre [CBTRC] at the University of Nottingham brings together such a group of clinicians and scientists. The aims and objectives of this group are directed towards applied research in this area in order to optimise survival and minimise acquired neurotoxicity from the tumour itself and the consequences of its treatment. Ultimately improved overall survival as well as quality of survival for these young children will come through a greater understanding of the biology, anatomy and physiology of these currently difficult to treat and cure tumours. The CBTRC has major research collaborations in the areas of anatomy, cell biology, biochemistry, pharmacology and physiology our laboratory facilities offer excellent scope for collaboration from a molecular to whole systems level. Clinically we have a large Neuro- oncology practice with responsibility of a population of 2.6 million and are core members of CCLG (formerly UKCCSG), SIOP and associate members of COG. The CBTRC has done much to push forward research and appreciation of Childhood brain tumours including the publication of a major textbook on Brain and Spinal Tumours of Childhood, Host International meetings of clinicians and allied health professionals looking after children with CNS tumours and to promote the appointment of the first Professor of Paediatric Neuro-Oncology in Europe – Professor Richard Grundy. We have now drawn in over £3 million of funding both peer reviewed and charitable and have a wide research portfolio literally from bench to bedside This Post Training will be provided in research methods. The University, Faculty and School run short courses which cover all aspects of research, including study design, data collection, use of statistics, computer skills, presentation and writing papers. There are weekly divisional research meetings where research methodology and work in progress are discussed and a full postgraduate education programme. Out of hours clinical work is optional and the incumbent could contribute to one of the Middle Grade rosters in paediatric medicine. Candidates should have obtained MRCP/MRCPCH, hold a National Training Number and will need to show evidence of academic aptitude. International applicants will need to show evidence of having satisfied clinical qualification compatible with higher specialist training.
    • The Academic Division of Child Health The Academic Division of Child Health has a national reputation for teaching, research and innovation in the field of paediatrics and child health. The Academic Division is administered as part of the School of Human Development, which also includes fetal medicine, obstetrics, gynaecology, reproductive medicine and midwifery. Current research interests are focussed on the perinatal period (including perinatal physiology, neonatal biology, nutrition and neurology, and the relationship of perinatal events to developmental disabilities), paediatric pharmacology, cancer in growth and development including paediatric neuro-oncology, head injury and community child health. Within the School of Human Development there are related research interests in MRI in pregnancy, perinatal and reproductive science, oncology and in Clinical Trials. Current research grants are held in excess of £2.5m with research in the Academic Division of Child Health being funded by research councils (MRC, BBSRC), AMRC, Department of Health and Regional R&D funds and European Union (EUFP6). There is a new neuro-oncology research group being established under Professor Grundy’s leadership investigating genetics and functional imaging. The main department is situated next to the children's wards in the Queen's Medical Centre, comprising offices, state-of-the-art molecular biology laboratories, teaching rooms, and computer room. There are also offices and laboratories adjacent to the Department of Neonatal Medicine at Nottingham City Hospital and a further Department at Derbyshire Children's Hospital. There are extensive computer facilities linked to the University network and the Internet. A new Children’s Hospital on the Queens Medical Centre site is planned. The Academic Division of Child Health is responsible for organising undergraduate teaching in child health and examinations, and contributes to a variety of postgraduate training courses. The Division continues to produce popular textbooks for undergraduates, postgraduates in neuro-oncology, community paediatrics and children's nurses. The undergraduate course in child health has high ratings within the Medical School. Current staff Professor Michael Symonds Professor of Developmental Physiology and Head of Division Professor Terence Stephenson Professor and Dean of the Faculty of Medicine Professor Imti Choonara Professor of Child Health in Derby Professor Neil Marlow Professor of Neonatal Medicine Professor David Walker Professor of Paediatric Oncology Professor Richard Grundy Professor of Paediatric Neuro-oncology Dr Alan Smyth Associate Professor/Reader in Paediatric Respiratory Medicine (based at City Hospital) Dr Helen Budge Senior Lecturer in Neonatal Medicine Mr Michael Vloeberghs Senior Lecturer in Paediatric Neurosurgery Dr William Whitehouse Senior Lecturer in Paediatric Neurology Dr Alan Watson Special Senior Lecturer in Child Health Dr Beth Coyle Lecturer, Children’s Brain Tumour Research Centre Mrs Sharon Conroy Lecturer in Paediatric Clinical Pharmacy Professor Leon Polnay Emeritus Professor Professor Nick Rutter Emeritus Professor Professor Sir David Hull Emeritus Professor Professor Derek Johnston Special Professor in Child Health and Endocrinology Two lecturers in child health Fourteen PhD students One lecturer in community child health Three research nurses Eight clinical research fellows Three research psychologists Two post doctoral research fellows Two research assistants
    • Teaching Training will be provided in teaching methods and the development of teaching skills. The University's Training and Staff Development Unit and the School of Continuing Education run short courses for new lecturers leading towards a Post-graduate Certificate in Medical Education. The Faculty of Medicine and Health Sciences runs courses for NHS and academic staff in teaching skills and appraisal. There is a senior lecturer in medical education and two part-time facilitators (one pre-clinical, one clinical) who encourage and stimulate staff of the Faculty to improve their skills, appraise their performance and look at alternative methods of teaching and examination of medical students. The Lecturer will share in the organisation, teaching and examination of undergraduate medical students under the supervision of the course co-ordinator. Teaching in Child Health is confined to the middle clinical year - there are four groups of students per year who each spend ten weeks in paediatrics. Clinical firms are also based in Nottingham City Hospital, Derby and Mansfield. There is a two-day introductory course at the start of the ten weeks for each group. At the end of the attachment, students are examined on two case presentations, a clinical and an MCQ paper. In addition, the lecturer will contribute to postgraduate teaching, formally at the weekly neonatal journal club and neonatal Grand Rounds and the Paediatric Postgraduate programme and informally particularly to senior house officers who are sitting the MRCPCH exam. Children’s Services The department is large and includes both NHS and academic staff working closely together. Acute and specialist paediatric services are provided for the children of Nottingham and the Mid-Trent region and the unit prides itself in multidisciplinary team working. The department is situated in the East and Centre Blocks of the QMC. The first floor has the Neonatal Intensive Care Unit (18 cots) adjacent to the delivery suite. The paediatric Out- Patients is also located here. The second and third floors contain the obstetric and gynaecology wards. The fourth floor has paediatric orthopaedics, paediatric ENT and the paediatric rehabilitation unit. The top floor is allocated to paediatric services and includes clinical areas and the Academic Division of Child Health. There is the paediatric intensive care unit acute admission short stay unit, paediatric medical wards, oncology unit, neurosciences ward and the paediatric surgical ward. In 2000/2001, the paediatric unit had nearly 12,900 in-patient admissions, 374 admissions to the neonatal ICU, over 500 admissions to the paediatric ICU whilst 42,000 children attended the Paediatric A+E. There were over 30,000 attendances to the paediatric out-patients. It is planned to amalgamate with the paediatric service at Nottingham City Hospital to bring the service together as one on the QMC site. This will bring further specialist expertise in terms of paediatric nephrology and respiratory medicine, together with the regional cleft lip and palate service under one roof. The department has 12 specialist registrars who are all on the Mid-Trent training scheme. These posts rotate through Nottingham City Hospital, Nottingham Community Unit, Derby, Mansfield, Chesterfield and Lincoln. The rotations are well structured and have proved to be very popular. There are 28 SHOs in paediatrics within the QMC. There are separate rotas for the medical and surgical wards, the neonatal unit and the paediatric A+E. There are well established, formal, protected teaching sessions for all grades. Further particulars Because of the nature of the work for which you are applying, this post is exempted from the provisions of Section 4 (2) of the Rehabilitation of Offenders Act 1974 by virtue of the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975.
    • Applicants are therefore, not entitled to withhold information about convictions, which for other purposes are “spent” under the provisions of the Act, and in the event of employment any failure to disclose such convictions could result in dismissal or disciplinary action by the University. Any information given will be strictly confidential and will be considered only in relation to an application for positions to which the Order applies. The post cannot be taken up until a satisfactory disclosure certificate has been received.
    • Person Specification: Essential Desirable Qualifications/ MRCP/MRCPCH OR FRCS Education Neurosurgery National Training Number Evidence of academic aptitude. International applicants will need to show evidence of having a clinical qualification compatible with higher specialist training. Skills/Training Research methods Intercalated degree Experience Laboratory Experience Statutory/Legal Satisfactory enhanced disclosure is obtained from the Criminal Records Bureau. GMC registration Personal Enthusiastic, motivated, ambitious, Attributes team worker. Informal enquiries may be addressed to Professor R Grundy, tel: 0115 823 0620, Email: Richard.Grundy@Nottingham.ac.uk or Professor David Walker, tel: 0115 823 0629/0611, Email David.Walker@Nottingham.ac.uk Please quote ref. MED/115. Closing date: 9 March 2007.
    • APPENDIX Laboratory/Translational Research Projects We envisage the James Tudor Fellow would work alongside scientific post-doctoral fellows providing clinical input and creating the bridge between bench and bedside. It is apparent that high resolution genetic studies generate vast amounts of data, interpreting that data from a clinical perspective is essential. The James Tudor Fellow undertaking biological studies would work directly with Professor Richard Grundy. Project Overview i. To undertake gene expression studies using Affymetrix™ systems technology– comparing and contrasting the molecular fingerprints and genomic imbalances of primary and relapsed paediatric brain tumours. ii. To validate these changes and to analyse important genetic alterations/prognostic markers and their correlation with histopathological and clinical parameters. iii. To link genetic changes with clinical details, histopathology and patient outcome, thereby developing a biological basis for diagnosis, prognosis and novel treatment development. iv. To investigate the biological significance of the observed genetic alterations by examining the spatial and temporal expression of candidate genes during normal development. We hypothesise that these comprehensive methodologies will facilitate the identification of clinicopathological relationships, define prognostic/diagnostic markers, elucidate pathways involved in the pathogenesis of childhood brain tumours identify novel targets for therapy and shed light on tumour origin. We have ongoing molecular studies of 4 major childhood brain tumours including collaborative studies with the Paediatric Brain Tumour Consortium in the USA (*). It is likely that there will be an opportunity to spend time in the research laboratories of Dr Richard Gilbertson and Suzy Baker at St Jude Research Hospital, Memphis USA. Who will do the work and how will it be supervised and managed? The work would be carried out within the School of Human Development. The person appointed will be jointly supervised by Professors Richard Grundy and David Walker. Day to day supervision would be driven by the nature of the project undertaken, for example biological studies will be undertaken in the laboratory of Professor Grundy and Beth Coyle. Personnel with whom James Tudor Fellow would work: Dr Beth Coyle, Children’s Brain Tumour Research Fellow and Taylor Trust Lecturer University of Nottingham. Tenure Track Dr Vikki Rand, Senior Post Doc (Jan 06-09) Global approaches to characterising the molecular basis of paediatric ependymoma Dr Adamowicz- Brice, Junior Post Doc (Jan 06-09) Co-operative Research Strategy for Paediatric High Grade Glioma Comprehensive Mapping of Gene Expression and Genomic Gains and Losses in Paediatric High Grade and diffuse pontine Glioma: A Joint UKCCSG and Paediatric Brain Tumour Consortium Study (USA) Dr Rogers, Junior Post Doc (Jan 06-09): Genome-wide molecular characterisation of supratentorial PNET (stPNET) Suzanne Miller PhD Student: Genome-wide molecular characterisation of supratentorial PNET (stPNET) Jennifer Barrow PhD Student: Co-operative Research Strategy for Paediatric High Grade Glioma Comprehensive Mapping of Gene Expression and Genomic Gains and Losses in
    • Paediatric High Grade and diffuse pontine Glioma: A Joint UKCCSG and Paediatric Brain Tumour Consortium Study (USA) Lee Ridley Research Assistant: Tissue Micro array construction, immunohistochemistry studies A Research Technician FISH, DNA and RNA studies Diagnostic Research: Biology and Imaging Hypotheses: 1) Molecular genetic abnormalities in childhood brain tumours correlate with tumour biochemical profiles measured by 1H magnetic resonance spectroscopy. 2) FI can improve the classification of brain tumours and with biological studies identify new targets for drug development. 3) FI can guide therapy and provide an early measure of response. 4) FI can detect treatment related brain abnormalities and predict cognitive, neurological and quality of life outcomes. Paediatric Neuro oncology is supported by a dedicated imaging centre that consists of two 1.5 Tesla and one recently installed 3 Tesla MRI scanner along with a 16 slice CT scanner on which CT perfusion scanning is undertaken in conjunction with stereo tactic surgical planning. The neuro-radiology input is led by Professor Dorothee Auer, as lead academic and specific expertise in the field of neurocognition and advanced MRI applications, and Dr Tim Jaspan, with specific interest in paediatric neuro-oncology. Dr Paul Morgan, Senior Lecturer provides MR physics input in the academic department of radiology. Over the past 2-3 years, this has included quantitative single voxel proton MR spectroscopy (MRS) using LCModel analysis, 2D chemical shift imaging and diffusion tensor imaging. The University of Nottingham is one of 21 partners in a European Union funded Framework 6 project entitled ‘eTumour – Web Accessible MR Decision Support system for Brain Tumour Diagnosis and Prognosis, Incorporating In Vivo and Ex Vivo Genomic and Metabolomic Data’. Professor Grundy is the Local Principal Investgator. This 7.5 million Euro project investigates the role of MRS and high resolution genetic analysis as a non-invasive tool for diagnosis, prognosis and improved classification of childhood brain tumours. We are testing the hypothesis that metabolite and gene expression data provides biomarkers of disease, enable the better classification of brain tumours and identify novel prognostic markers by the identification of key metabolic pathways. Since many of the patients will be enrolled in UKCCSG treatment studies, prognostic information for specific patient groups will be available. The in vivo MRS will also provide valuable baseline data for future treatment studies and allow differences between tumour profiles at diagnosis and relapse to be determined. Nottingham is also in the vanguard of developing UK wide functional imaging (FI) for the diagnosis, management and understanding of childhood brain tumours. We are one of the most active members of the UK Children’s Cancer Study group Functional Imaging group and one of only 3 centres to provide data from MRS data to the UKCCSG database. New technology will be developed and translated into clinical practice by the integration of FI within clinical trials and biological studies run by the UK Children’s Cancer Study Group. We are actively contributing to two open UKCCSG Functional imaging studies CNS2004 10 and CNS 2004 11. We are looking for clinical input to help develop the role of functional imaging in improving the diagnostic and prognostication of childhood brain tumours, an ideal role for a James Tudor Clinical fellow. Personnel with whom James Tudor Fellow would work Professors Richard Grundy, David Walker, Dorothee Auer (Professor of Neuro-Radiology) Dr Tim Jaspan consultant in Neuro-Radiology. Dr Rogers, Junior post Doc (Jan 06-09) Framework 6 European Union Funding - e TUMOUR
    • Martin Wilson, Co supervised, PhD Student, University of Birmingham, October 04-07 eTUMOUR FP6 Funding Pathways Project II This project has been running for the last two years and has reached a point of maturity. If appropriate to the interests of the James Tudor Fellow, this project could be taken on from September. This is not a full time commitment, but we envisage that the Fellow would undertake this research as well as be involved one of the other projects i.e. biological studies. Hypotheses i. Tracking pathways of referral of patients diagnosed with brain or spinal tumour will identify common presentation of symptoms and assist with development of guidelines for streamlining process of diagnosis and referral in order to reduce delay and risks of complications. ii. Detailed analysis of anatomical location of tumour related cerebellar injury will predict or specific characteristics of neuropsychological dysfunction after rehabilitation. iii. Selection, validation and application of Child Health Outcome measures will promote enhanced techniques for clinical trials in CNS tumours, brain injury and enhance patient and family understanding of the rehabilitation process. The time between the first symptom onset and diagnosis of childhood brain tumours is considerably longer than other childhood cancers. This is likely to adversely affect health outcomes. We have begun a programme of research that will result in the publication of guidelines obtained after consensus discussion with stakeholders that will aim to raise awareness of signs and symptoms that could result from a CNS tumour and may help clinicians justify and obtain appropriate and timely diagnosis.