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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.
Linking Place To Metabolic Syndrome Via Behavioural And Psychological Antecedents: Levers For Public Health Intervention
Funder
National Health and Medical Research Council
Funding Amount
$295,135.00
Summary
This collaboration involves the SA Health Department and community partners in analyses of local data from a 10-year biomedical cohort to (i) identify features of residential areas that are related to the metabolic syndrome and (ii) assess the mechanism by which area features influence metabolic syndrome through effects on behavioural and psychosocial mediators. The knowledge generated will inform policy intervention via urban planning and public health actions to support healthful lifestyles.
Increase Australias Capacity For Outstanding Health And Medical Research At The Highest Competitive Level Internationally
Funder
National Health and Medical Research Council
Funding Amount
$4,000,000.00
Summary
This Fellowship aims to increase Australia’s capacity for outstanding health and medical research at the highest competitive level internationally by utilising to their full potential the strategically planned population-based research resources I have already established. We have established state of the art protocols for collecting family data, and following up large cohorts of families. We are now in a superb position to rapidly translate genetic findings (ours and others) into clinical and p ....This Fellowship aims to increase Australia’s capacity for outstanding health and medical research at the highest competitive level internationally by utilising to their full potential the strategically planned population-based research resources I have already established. We have established state of the art protocols for collecting family data, and following up large cohorts of families. We are now in a superb position to rapidly translate genetic findings (ours and others) into clinical and public health programs and evaluate their impacts. This Fellowship should encourage high calibre Australian researchers to continue their work in Australia. It will give the resources in terms of people and research funds to develop to its full potential the population resource that I have built up over the last two decades. Funding will strengthen the position of Australian family and twin study resources within the international network so as to further enhance collaborations, knowledge transfer, and permit us to continue to demonstrate leadership. Continued funding of key personnel and the opportunity to recruit the best new talent through offering attractive positions, and funding to conduct our own genetic and molecular analyses rather than handing the material over to others, are essential for us to maintain and enhance the reputation in the highly competitive areas of cancer genetics. That is, we intend to demonstrate that Australia is the leader in the new discipline of MEGA Epidemiology. A major aim of this Fellowship is to use our research findings to “make a difference” to the health and well-being of Australians. This will be achieved by continuing to widen our perspective to include qualitative research techniques in trying to find out what are the issues impacting on the public – and the clinicians and bureaucrats – in decision making around the possibilities and risks being raised by new genetic findings.Read moreRead less
A Randomised Controlled Trial Of Outpatient Cervical Priming For Induction Of Labour
Funder
National Health and Medical Research Council
Funding Amount
$611,611.00
Summary
This study aims to compare two approaches that prepare pregnant women before they are induced to give birth. Eligible women who agree to be in the study will be allocated to receive (a) the usual, standard care already used in SA hospitals or, (b) a new method. In the new approach, women will have their labour primed by a midwife and will be discharged and further monitored by the midwife from hospital. This approach might give women a more satisfying experience with less medical intervention.
Improving Neurobehavioural Development In Preterm Infants: A Randomised Controlled Trial Of A Neonatal Intervention
Funder
National Health and Medical Research Council
Funding Amount
$680,920.00
Summary
Up to 50% of preterm infants will have one or more developmental difficulties. While medical complications are implicated in these problems, recent evidence points to the added effect of the infant's early environment. Hospitalised premature infants experience stress from necessary but painful hospital procedures, overstimulation and maternal deprivation. Evidence, largely from animal studies, suggests stressful early experience negatively affects brain development. We also know that premature i ....Up to 50% of preterm infants will have one or more developmental difficulties. While medical complications are implicated in these problems, recent evidence points to the added effect of the infant's early environment. Hospitalised premature infants experience stress from necessary but painful hospital procedures, overstimulation and maternal deprivation. Evidence, largely from animal studies, suggests stressful early experience negatively affects brain development. We also know that premature infants find it difficult to handle stress as they are highly disorganised neurobehaviourally. The primary aim of this study is to assess the effectiveness of a parent-based intervention in enhancing neurobehavioural development at two years of age in very premature infants. It is predicted that this stress-reduction intervention will also enhance medical stability,normal brain development, parent-child interaction and parental mental health. The intervention to be trialled involves intensive training of parents of very premature infants, and in the 12 weeks following birth the parents will be the change agents. A randomised controlled trial comparing intervention and control groups will be undertaken to assess the effectiveness of this intervention. Assessments of early brain and 2 year intellectual, emotional and behavioural development will provide important outcome measures. A major strength of this study is the inclusion of advanced Magnetic Resonance Imaging (MRI) technology as it enables differences in brain development between the intervention and control group to be assessed, the association between brain and neurobehavioural development to be explored, and the impact of stress on early brain development to be investigated. This intervention is relatively simple and inexpensive, and would be a valuable contribution to neonatal care if found to be effective in enhancing brain and neurobehavioural development.Read moreRead less
Why Do Australian Teenagers Fall Pregnant? Exploring The Antecedents Of Teenage Pregnancy.
Funder
National Health and Medical Research Council
Funding Amount
$542,100.00
Summary
Teenage pregnancy is a major health, social and economic issue for Australia. The teenage birth rate in Australia is higher than many other developed countries and of additional concern is the very high pregnancy and termination rate. Teenage pregnancy places the mother and child at greater risk of lifelong adverse outcomes. Despite research over more than 3 decades, we have only a simplistic understanding of what are likely complex mechanisms leading to early pregnancy. This is thought to be th ....Teenage pregnancy is a major health, social and economic issue for Australia. The teenage birth rate in Australia is higher than many other developed countries and of additional concern is the very high pregnancy and termination rate. Teenage pregnancy places the mother and child at greater risk of lifelong adverse outcomes. Despite research over more than 3 decades, we have only a simplistic understanding of what are likely complex mechanisms leading to early pregnancy. This is thought to be the reason for the failure of nearly all teenage pregnancy prevention efforts worldwide. In addition, there has been little study of this issue in Australian teenagers, and none in Aboriginal teenagers for whom pregnancy is more common and carries worse outcomes. This 2-stage project seeks to elucidate complex biological, psychological, and social pathways to unplanned pregnancy in the teenage years. In Phase 1, perceptions, values and beliefs will be explored in a qualitative study. Aboriginal and non-Aboriginal teenagers attending antenatal, termination and family planning clinics will be interviewed. Data from these interviews will generate new hypotheses regarding pregnancy risk in this age group. In Phase 2, 600 teenagers from schools, antenatal and termination clinics will be surveyed using computerised questionnaires. They will be asked about beliefs (identified in phase 1) and a range of other individual, family, and environmental factors identified in other studies to be risk factors for early pregnancy. Statistical analysis will be used to determine how multiple risk factors interact or combine to shape sexual and childbearing behaviour. This study will lead to new understandings of teenage pregnancy in Australia, and more effective teenage pregnancy intervention programs. Because few researchers in Australia, or elsewhere, have taken such a comprehensive approach to data collection and analysis, the results will be of international significance.Read moreRead less
Improving Asthma Control: General Practice Strategies To Optimise Medication Adherence
Funder
National Health and Medical Research Council
Funding Amount
$460,820.00
Summary
Asthma is a major health problem for Australia. Many patients have frequent symptoms and need urgent health care because they do not use a preventer inhaler regularly. This may be intentional e.g. fear of side-effects, and-or unintentional e.g. forgetting. This real-life study will test two simple strategies for GPs to improve their patients' use of preventer medications, to improve asthma control. Innovative technology will allow GPs to tailor the approach to each patient during a normal visit.
Testing The Behavioural And Psychosocial Mechanisms Underlying Geographic Variation In Metabolic Syndrome
Funder
National Health and Medical Research Council
Funding Amount
$415,457.00
Summary
This study seeks to assess the mechanisms that explain the link between residential area features and the metabolic syndrome (obesity and high blood pressure, lipids and glucose), related to cardiometabolic diseases. There is more metabolic syndrome in disadvantaged areas but the reasons for this have not been empirically established. We will evaluate behavioural and psychosocialmechanisms that might independently and jointly explain the association between place and metabolic syndrome.
A Randomised Trial Of A Decision Aid For Women At Increased Risk For Ovarian Cancer
Funder
National Health and Medical Research Council
Funding Amount
$115,110.00
Summary
Epithelial ovarian cancer is the leading cause of death from gynaecological malignancy in Australia. The majority of women with ovarian cancer are diagnosed with advanced disease, and the chance of cure is low. The strongest risk factor for ovarian cancer identified to date is a family history of ovarian cancer, and up to 5% of all ovarian cancers are thought to be due to dominantly inherited mutations in a small number of ovarian-cancer-related genes. National guidelines on surveillance and pro ....Epithelial ovarian cancer is the leading cause of death from gynaecological malignancy in Australia. The majority of women with ovarian cancer are diagnosed with advanced disease, and the chance of cure is low. The strongest risk factor for ovarian cancer identified to date is a family history of ovarian cancer, and up to 5% of all ovarian cancers are thought to be due to dominantly inherited mutations in a small number of ovarian-cancer-related genes. National guidelines on surveillance and prophylactic strategies have recently been ratified. These are largely based on expert opinion. Because of the uncertain efficacy of ovarian cancer screening and the high mortality associated with ovarian cancer, prophylactic oophorectomy is considered an option for women at high risk. Decisions about optimal care are difficult for both women and their doctors. Efforts to improve services for women who are trying to make informed decisions about screening and prophylactic strategies under conditions of uncertainty must be informed by sound knowledge of the efficacy of educational interventions. Decision aids have been developed as adjuncts to practitioners' counselling to prepare patients for decision-making. The proposed randomised controlled trial will compare the efficacy of a general educational pamphlet and that of a tailored decision aid. A total of 120 women at risk for ovarian cancer who are attending one of five familial cancer clinics will be included in the trial to determine the efficacy of different educational interventions in preparing women for decision-making about screening and prophylactic options.Read moreRead less
Aboriginal Birth Cohort Study: From Childhood To Adulthood.
Funder
National Health and Medical Research Council
Funding Amount
$505,212.00
Summary
Aboriginal peoples have poor health at both ends of their life span. There are more low birth weight babies at the beginning and more kidney, heart disease and diabetes at the end of the life spectrum. The Aboriginal Birth Cohort study aims to examine the effect of early life events (such as low birth weight) on the risk of developing chronic disease in later life with a view to early intervention. The babies of the study were last seen at 11 years and are now being seen again near their 18th bi ....Aboriginal peoples have poor health at both ends of their life span. There are more low birth weight babies at the beginning and more kidney, heart disease and diabetes at the end of the life spectrum. The Aboriginal Birth Cohort study aims to examine the effect of early life events (such as low birth weight) on the risk of developing chronic disease in later life with a view to early intervention. The babies of the study were last seen at 11 years and are now being seen again near their 18th birthday. Data available are weight, length and gestational age of these babies at birth, the health and lifestyle of their mothers during pregnancy and the children's growth and health. By 11 years of age, the low birth babies still remained shorter and thinner than their peers who were normal size at birth, but importantly, markers of chronic disease were not higher in these children. The current round of investigation, in addition to the tests done before, now includes non-invasive markers of heart disease, such as heart rate variability, measures of arterial stiffness and the thickness of carotid intima media (lining) and a dental examination looking at both teeth and gums. For the first time, the study will look beyond the physical to examine the psychological wellbeing of these young adults using a specially designed questionnaire (Strong souls). Little is known about this age group because they are relatively healthy and do not present to clinics for treatment. The continuing life course study of this cohort, forming the oldest and largest birth cohort of any indigenous population in the world, will help us understand the relationships between early life and the sequential events that lead to chronic adult disease. This will help determine the most effective time for intervention programmes, and will influence public health planning and policy directed towards the improvement of the health of Aboriginal peoples.Read moreRead less