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Psychosocial Disability And Return To Work In Younger Stroke Survivors
Funder
National Health and Medical Research Council
Funding Amount
$511,216.00
Summary
Each year about 12,000 Australians of working age survive a stroke. These younger survivors have responsibility for generating an income or providing care for families and state that their main objective is to return to work for financial reasons and to help rebuild confidence and independence. This observational 3 year study will determine thefactors are associated with returning to work, improving the wellbeing of thousands of stroke survivors and their families using multivariate regression.
Certain Death In Uncertain Time: A Qualitative Study Of The Experience Of Advanced Ovarian Cancer.
Funder
National Health and Medical Research Council
Funding Amount
$221,755.00
Summary
Modern medicine aims to find effective treatments for life-threatening diseases. Cures are seldom found, however. More typically, rapidly fatal diseases gradually become less rapidly fatal. Consequently, there is a category of patients who are certain they will die from their disease or a related factor, but who are equally uncertain as to whether they have weeks or years left to live. It is difficult to discuss this predicament because we do not even have a name for it, let alone a useful termi ....Modern medicine aims to find effective treatments for life-threatening diseases. Cures are seldom found, however. More typically, rapidly fatal diseases gradually become less rapidly fatal. Consequently, there is a category of patients who are certain they will die from their disease or a related factor, but who are equally uncertain as to whether they have weeks or years left to live. It is difficult to discuss this predicament because we do not even have a name for it, let alone a useful terminology to describe it. The absence of discussion exacerbates patients' social isolation. Also, the quality of their remaining life, and the quality of the care they get, depends heavily on the quality of understanding and communication within the social systems that support them. A growing proportion of patients in developed countries fall into this category, including the 1200 Australian women who are diagnosed each year with advanced ovarian cancer. This study aims to increase our understanding of the experience of certain death in uncertain time by recruiting a group of 20 women with advanced ovarian cancer, and interviewing them every few months over three years. The study will explore all aspects of the experience of having advanced ovarian cancer, and generate a terminology for it - one that grows out of the women's own language. The study will inform the organisation and delivery of clinical care and services to women with ovarian cancer. It will also inform patient education programs, and help to tune medical education to the particular needs and perceptions of patients who are experiencing the certainty of death in uncertain time. Finally, the researchers will also explore the implications of the findings for medical ethics and health law, and for communication, information and decision-making in cancer medicine.Read moreRead less
Improving Psychosocial Outcomes For Cancer Carers: A Randomised Control Trial
Funder
National Health and Medical Research Council
Funding Amount
$533,738.00
Summary
This multi-centre randomised trial will test a novel telephone-based intervention for carers of patients with advanced gastrointestinal cancer. The intervention involves five structured calls from a nurse to the carer over 10 weeks, aiming to improve psychosocial outcomes for both carers and patients. If the results are positive, this telephone intervention could be implemented broadly in both metropolitan and rural areas, and could be adapted for other groups of carers.
Controlled Clinical Trial Of Desensitization To Chronic Pain
Funder
National Health and Medical Research Council
Funding Amount
$349,149.00
Summary
An estimated 17.1% of males and 20.0% of females in NSW report having chronic pain. Chronic pain sufferers are major users of health services, with frequent medical consultations and high pharmacological consumption. A recent NSW population-based study found that 78% of pain sufferers had consulted at least one healthcare practitioner in the previous 6 months about their pain, and 71% of those sampled were taking regular oral analgesic medications. Disability due to chronic pain is often associa ....An estimated 17.1% of males and 20.0% of females in NSW report having chronic pain. Chronic pain sufferers are major users of health services, with frequent medical consultations and high pharmacological consumption. A recent NSW population-based study found that 78% of pain sufferers had consulted at least one healthcare practitioner in the previous 6 months about their pain, and 71% of those sampled were taking regular oral analgesic medications. Disability due to chronic pain is often associated with higher levels of distress and use of healthcare services. Unfortunately, at present there are no lasting curative treatments for most chronic pain conditions and most people with these conditions are told they have to learn to live with their ongoing pain. One of the most effective ways of teaching chronic pain sufferers to live with their pain are known as cognitive behavioural therapy (CBT) interventions. But even though many find these methods helpful, a significant proportion of cases remain distressed by their pain. This places them at higher risk of relapse and further treatment seeking. If this group of pain sufferers could be taught more effective ways of minimising their pain-related distress, their overall functional and long-term quality of life goals could be maximised. The study has the potential to achieve a major improvement in outcomes for distressed patients with disabling chronic pain, traditionally a very intractable group. The study would also have important implications for the prevention of disability associated with persisting pain. If successful, it could alter the ways in which many health professionals advise patients to cope with their chronic pain, especially in relation to the use of the common modalities of relaxation and distraction techniques, as well as the use of pain reducing interventions. The study represents the first major clinical test of an alternative to these traditional modalities.Read moreRead less
Case-control Studies Of Completed And Attempted Suicide In Young People In NSW
Funder
National Health and Medical Research Council
Funding Amount
$819,000.00
Summary
Youth suicide rates have been increasing dramatically over the last three to four decades. The causes and determinants of these suicide rate changes remain unclear, as do the causes and determinants of the suicides themselves. Despite a range of risk factors being identified by researchers, predicting an individual suicide is difficult due to the range of factors involved and the complex interactions between them. This study will investigate associations between individual and environmental fact ....Youth suicide rates have been increasing dramatically over the last three to four decades. The causes and determinants of these suicide rate changes remain unclear, as do the causes and determinants of the suicides themselves. Despite a range of risk factors being identified by researchers, predicting an individual suicide is difficult due to the range of factors involved and the complex interactions between them. This study will investigate associations between individual and environmental factors for both completed suicides and suicide attempts in young people aged 18-34 years living in NSW. The study will be undertaken in Sydney, Newcastle and in identified rural areas. The study is embedded in existing treatment, counselling and support services and will aid their improvement and augmentation. Cases of suicide and attempted suicide will be compared with community controls, and also completed suicides with attempted suicides, to identify potentially modifiable risk factors associated with suicidal behaviour. This will provide more comprehensive information relating to how various risk factors interact and influence suicidal behaviour, including in rural areas with significant Aboriginal and Torres Strait Islander communities. Information from this study will improve prevention initiatives and assist with community strategic development and provide evidence to enhance current health service and coronial interventions.Read moreRead less
Talking The Walk: A Longitudinal Study Of Refugee Mens Health And Resettlement
Funder
National Health and Medical Research Council
Funding Amount
$440,450.00
Summary
Refugee men are commonly portrayed in negative contexts: domestic violence, unemployment, alcohol abuse. This study will follow up 242 adult refugee men to investigate their physical and mental health, and the social and cultural issues they face as they negotiate their settlement in a new country. The study will identify ways in which refugee men can best be assisted to ensure they are healthier, settle successfully, and develop their full potential as active members of the Australian community
A Randomised Control Trial Of Non-specific Clinical Management Versus CBT In Chronic Anorexia Nervosa
Funder
National Health and Medical Research Council
Funding Amount
$555,843.00
Summary
Anorexia nervosa (AN) is a serious mental illness that usually starts in adolescence and often runs a chronic course. With an estimated prevalence rate between 0.5% and 3.7% of women, and up to 50% remaining chronically ill, the illness poses a disproportionate burden on health and social services. AN has inpatient costs alone that exceed that for schizophrenia. Chronic AN has the highest mortality rate of any mental illness. Chronic AN patients are known for their ambivalence about engaging in ....Anorexia nervosa (AN) is a serious mental illness that usually starts in adolescence and often runs a chronic course. With an estimated prevalence rate between 0.5% and 3.7% of women, and up to 50% remaining chronically ill, the illness poses a disproportionate burden on health and social services. AN has inpatient costs alone that exceed that for schizophrenia. Chronic AN has the highest mortality rate of any mental illness. Chronic AN patients are known for their ambivalence about engaging in treatment and poor motivation to change their eating disorder behaviours. They often fail to respond to traditional treatments and develop a history of negative treatment experiences and repeated treatment failures. A new approach is needed to reduce both the personal suffering and the burden of the illness on social and medical services. To date, there has been little scientific investigation into the development of specific treatment for those patients with chronic AN. This study will trial a recently manualised therapy - non-specific supportive clinical management - which initial evidence suggests may hold promise for chronic AN because it offers a more indirect, motivationally-matched approach. This treatment will be compared to the establishment therapy Cognitive Behavioural Therapy. Patients will be randomly allocated to one of the two treatment conditions and will receive 40 sessions over 12 months. They will be thoroughly assessed prior to during and after they have completed treatment and followed up for 6 months. This is the worlds first trial of a psychological treatment for chronic AN; it is hoped the study will establish an effective treatment for this debilitating and expensive illness. Further, as the project aims to explore the core, but often over-looked, feature of AN - poor motivation for recovery - it will also be in a position to shed light on the deep psychological processes that maintain this illness.Read moreRead less
Development Of A Health-related Quality Of Life Instrument For Children With Cerebral Palsy
Funder
National Health and Medical Research Council
Funding Amount
$114,000.00
Summary
This project aims to develop and test a measure of quality of life for children with cerebral palsy (CP). This is a new project of international significance that has been recommended as the highest research priority of the United Cerebral Palsy Association with the strong support of CP researchers and clinicians internationally. CP remains the most common cause of physical disability in childhood, with an incidence of 2-2.0-2.5 per 1,000 live births. Described as a 'non-progressive motor impair ....This project aims to develop and test a measure of quality of life for children with cerebral palsy (CP). This is a new project of international significance that has been recommended as the highest research priority of the United Cerebral Palsy Association with the strong support of CP researchers and clinicians internationally. CP remains the most common cause of physical disability in childhood, with an incidence of 2-2.0-2.5 per 1,000 live births. Described as a 'non-progressive motor impairment of central origin recognised in infancy or childhood', CP presents as a static lesion on the brain characterised by progressive muscoskeletal deformity. Its impact on children and families is profound, resulting in extensive and life-long burden of care for families, and significant limitations to children's development and wellbeing. The management of the neuromuscular sequelae and health problems is a considerable cost to the health system because children require frequent visits for medical management, surgical procedures and rehabilitation. Trials of CP management effectiveness are hampered by the absence of patient outcome measures. Whilst new treatment options aim to provide substantial improvements in impairment and functioning they have disadvantages. For example, spasticity management includes Botulinum toxin A and intrathecal baclofen, both may improve function but are costly and invasive; treatments for ambulation (multi-level orthopaedic surgery) offer improved gait and mobility but require extensive rehabilitation; treatments for severe eating difficulties and poor growth (gastrostomy) may improve survival but result in aggravation of gastro-oesophageal reflux; and surgery for intractable epilepsy may improve seizure disorder but result in functional deficits. Quality of life is now a mandatory component of clinical trial research; valid and reliable tools sensitive to detecting change are urgently required.Read moreRead less