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Environmental Influences On Allergic Airways Disease From Birth To 8yrs: Long-term Outcomes Of A Randomised Trial (CAPS)
Funder
National Health and Medical Research Council
Funding Amount
$530,000.00
Summary
The prevalence of asthma in Australia is among the highest in the world yet no trials of primary prevention have been conducted which address the most common known causative agent (housedust mite allergens) and the most common known protective factor (dietary omega-3 fatty acids). Until the effectiveness of interventions which address these factors is certain, it will not be possible to give confident advice about how to prevent asthma. We are applying to continue follow up of the cohort of the ....The prevalence of asthma in Australia is among the highest in the world yet no trials of primary prevention have been conducted which address the most common known causative agent (housedust mite allergens) and the most common known protective factor (dietary omega-3 fatty acids). Until the effectiveness of interventions which address these factors is certain, it will not be possible to give confident advice about how to prevent asthma. We are applying to continue follow up of the cohort of the Childhood Asthma Prevention Study (CAPS) which has been underway since mid-1997. CAPS is a randomised controlled trial in which 616 infants at high risk of developing asthma because of a family history have been enrolled. The interventions include allergen reduction and dietary supplementation with omega-3 fatty acids. The interventions are designed to have maximum effect but be simple to implement by parents. Objective and subjective measurements of exposures, atopy, diet and asthmatic symptoms are being collected at 3 month intervals and at medical assessments when the children are 18 months, 3 and 5 years old. The interventions are stopped at age 5 years. The continued follow up of the cohort to age 8 will enable us to test conclusively if the interventions have had a positive effect. If so, CAPS will form the basis for a nationwide public health campaign which will have the potential to reduce the incidence of childhood asthma in Australia.Read moreRead less
Nephro-protective Effects Of L-amino Acids In Critically Ill Patients: A Multi-centre Randomised Controlled Trial
Funder
National Health and Medical Research Council
Funding Amount
$863,209.00
Summary
More than 60,000 Australians become critically ill each year with up to one third of these patients developing Acute Kidney Injury during their illness. Acute Kidney Injury leads to longer recovery times, may require lifelong dialysis and results in a significantly increased chance of dying as a result of the original critical illness. The purpose of this clinical trial is to determine if a simple and cheap amino acid infusion can reduce the onset of Acute Kidney Injury during critical illness.
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
The Impact Of Caregiving On The Health Of Informal Carers: Change Over Time And Association With Stressors And Resources
Funder
National Health and Medical Research Council
Funding Amount
$60,160.00
Summary
A large number of Australians provide care for an aged or disabled relative. This study will investigate the health of these family carers, if it changes after care-giving starts and how it varies with the duration and amount of care-giving. It will provide information about these effects in different groups such as those with time pressures due to childcare and employment as well as those with different levels of access to resources and support. It will help with policies to support carers.
Relationship Between Caregiver Time And Mental Health&well-being Of Mothers Caring For Children With Chronic Disability
Funder
National Health and Medical Research Council
Funding Amount
$355,127.00
Summary
The Australian Institute of Health and Welfare has calculated that the dollar value of unpaid caring labour is approximately double the total (monetary) welfare service expenditure in Australia. Furthermore, most authorities predict that the need for informal care will grow as the population ages and as government policies continue to emphasize de-institutionalisation and care in the community. A significant group of these informal caregivers are mothers caring for children with chronic disabili ....The Australian Institute of Health and Welfare has calculated that the dollar value of unpaid caring labour is approximately double the total (monetary) welfare service expenditure in Australia. Furthermore, most authorities predict that the need for informal care will grow as the population ages and as government policies continue to emphasize de-institutionalisation and care in the community. A significant group of these informal caregivers are mothers caring for children with chronic disabilities. These mothers have long been known to have higher rates of psychosocial problems than other mothers. However, little is known about the mechanisms by which these problems arise. This is a significant omission, as the potential benefit of home-based care for children with chronic disabilities will only be realised if caregivers remain healthy. It seems unlikely that caregivers will be able to provide effective care for children if their own health has been compromised by the demands of caring for the children's disabilities. The present study will provide new information about the relationship between the caregiving time mothers must spend caring for children with chronic disability, and maternal psychological adjustment and health-related quality of life. A better understanding of the mechanisms which give rise to maternal psychosocial problems in this population is important for two reasons. First, information in this area is an essential prerequisite for the development of effective support to reduce the problems experienced by primary caregivers and ensure they can play an effective ongoing role in the care of children with chronic disability. Second, at a theoretical level there is a great need to obtain a better understanding of the mechanisms by which environmental stressors give rise to mental health problems, particularly depression, in the general population.Read moreRead less
Trial Of Structured Support To Enhance The Role Of Non-GP Staff In Chronic Disease Management In General Practice
Funder
National Health and Medical Research Council
Funding Amount
$780,625.00
Summary
Chronic disease presents a significant burden to individuals and the health care system , contributing to both an increasing proportion of the work of primary health care practitioners and to health expenditure. A number of interventions have been shown to result in sustained improvement of health outcomes for people with chronic diseases, including: more effective use of non-physician providers of care and nurse case management; integration of self-management support programs with guideline bas ....Chronic disease presents a significant burden to individuals and the health care system , contributing to both an increasing proportion of the work of primary health care practitioners and to health expenditure. A number of interventions have been shown to result in sustained improvement of health outcomes for people with chronic diseases, including: more effective use of non-physician providers of care and nurse case management; integration of self-management support programs with guideline based treatment plans; more intensive follow up and registries that provide reminders and feedback. While some of these approaches have been pursued within the Coordinated Care Trials and the Enhanced Primary Care (EPC) program in Australia, the role of non medical staff within general practice in chronic disease care has not been systematically investigated. In 2001 the Commonwealth introduced a number of initiatives to support better quality of care for diabetes and asthma in general practice and $104.2 million over four years was provided for general practices in areas of high workforce pressure to employ more Nurses. The roles of the Practice Manager and Receptionist have received much less attention. They include faclitating access to care, supporting the delivery of quality clinical care by the practitioners through the provision of expert management services (primarily information technology, staff, financial and facilities management) to the practice. With recent government initiatives expanding the role of general practice in Australia, effective management structures and processes within general practices are vital. Non-GP general practice staff may be the means by which more effective chronic disease management can be achieved at a time of increasing workforce pressure. This project aims to evaluate the impact of a program in which non-GP staff are trained and facilitated to be involved in the management of patients with chronic disease.Read moreRead less
An Analysis Of Blood Awareness For The Purposes Of Hepatitis C Prevention Education And Health Promotion.
Funder
National Health and Medical Research Council
Funding Amount
$196,113.00
Summary
This project will make a direct and major contribution to Hepatitis C prevention by addressing the need for blood awareness in prevention education. The need for measures to prevent the spread of HCV is based on the clinical implications of infection combined with its current prevalence and predicted spread within Australia. More than 200,000 Australians are estimated to be living with hepatitis C infection. Around 11,000 new HCV infections per year are estimated to occur across the Australia. H ....This project will make a direct and major contribution to Hepatitis C prevention by addressing the need for blood awareness in prevention education. The need for measures to prevent the spread of HCV is based on the clinical implications of infection combined with its current prevalence and predicted spread within Australia. More than 200,000 Australians are estimated to be living with hepatitis C infection. Around 11,000 new HCV infections per year are estimated to occur across the Australia. HCV is spread through blood to blood exposure. In the absence of effective medical treatment for Hepatitis C virus (HCV) education about modes of transmission presents as the most viable means of containing the spread of the virus. The promotion of blood awareness has been identified as a key strategy for such education as it may ensure greater care on the part of the general community in the prevention of blood exposures. However, the development of a heightened awareness of blood as a source of infection is fraught with social and health implications. A crucial concern for those directly involved in promoting blood awareness is the need to ensure that such a strategy does not contribute to the already existing stigmatisation of those living with HCV or, more generally, promote irrational phobias about blood. Findings of the research will assist in the development of public health education campaigns to prevent the spread of HCV. It will also contribute to education prevention for other blood borne communicable diseases including HIV and other viral hepatitides. Further, it will provide a model of inquiry for developing health promotion programs seeking blood, semen, organ and tissue donation.Read moreRead less
FAST-Australia: A Phase II Study Of Family History Screening For Chronic Disease Prevention In Primary Care.
Funder
National Health and Medical Research Council
Funding Amount
$343,429.00
Summary
Risk of developing certain cancers, heart disease and diabetes is increased by having an affected family member. People found to be at risk can be offered ways to prevent or detect these diseases early through lifestyle advice or disease screening. This project will develop and evaluate a family history questionnaire in preparation for a trial of family history screening and its impact on disease prevention.