Metro South Health | Report Cover Page template Web viewResearch will not commence until all ethical clearances and site specific approvals (SSAs), if required, have been obtained

Sponsored by:

Research Support Scheme2018 Application Postgraduate ScholarshipsPostgraduate Scholarships provide funding for up to three (3) years full-time / (six (6) years part-time) study towards a research higher degree. Scholarships may be offered and funded by SERTA and PARF.

Standard Postgraduate Scholarship: PARF provides a grant benchmarked against NHMRC Postgraduate Scholarships + $10,000 / for research-related expenses, consumables, conference attendance/d publication of thesis.

Medical Postgraduate Scholarship: SERTA provides salary support up to $41,000 / annum (full-time, pre-tax) + $10,000 / for research-related expenses, consumables, conference attendance and publication of thesis. PARF provides a grant benchmarked against NHMRC Postgraduate Scholarships.

Allied Health & Nursing Postgraduate Scholarship: up to $36,000 / annum (full-time, pre-tax) + $10,000 / annum for research-related expenses, consumables, conference attendance and publication of thesis. PARF provides a grant benchmarked against NHMRC Postgraduate Scholarships.

APPLICATION INSTRUCTIONS

Refer to the Research Support Scheme 2018 Funding Guidelines when preparing your application.

Press <Tab> to move between fields in the application.

All sections of the form must be completed.

The Applicant is required to sign the application on behalf of the research team.

SUBMISSION

Applications must be submitted electronically to [email protected]:

A signed copy of the application to be submitted as a PDF,

The application must also be submitted in Word format (signatures not required).

Files must not exceed 2 MB in size and should be named using the following naming convention:

Applicant Surname_2018 Funding Type

E.g., Smith_2018 Postgrad

APPLICATIONS MUST BE RECEIVED BY THE CENTRES FOR HEALTH RESEARCH NO LATER THAN 9 AM MONDAY 21ST AUGUST 2017

LATE OR INCOMPLETE APPLICATIONS MAY NOT BE ACCEPTED

ENQUIRIESEnquiries regarding the Research Support Scheme should be directed to:

Centres for Health ResearchEmail: [email protected] Phone: 07-34438057

Centres for Health Research

mailto:[email protected]

mailto:[email protected]

Sponsored by:

STUDENT / PRIMARY SUPERVISOR ELIGIBILITY CHECKLIST

To be eligible for a 2018 Postgraduate Scholarship: StudentThe Student must be able to answer Yes to questions 1-3 to be eligible Yes No

1 Are you/will you be enrolled as a Research Higher Degree (RHD) candidate at UQ, QUT or Griffith University in 2018?

2 Were you /will you be enrolled as a RHD student (as outlined above) by 30 March 2018 (unless otherwise agreed upon)?

3 Will the majority (more than 50%) of the research activity take place on a MSH campus?

The Primary Supervisor must be able to answer Yes to questions 4 (i or ii) and 5 to be eligible Yes No

4 Are you a member of staff of:

i. MSH (or hold a formal appointment to MSH)?

An MSH academic partner university school or research institute based at an MSH campus (Griffith University, QUT IHBI, UQ SOM, UQ SON, UQDI,)?

5 Will your appointment be at least 0.5 FTE for the duration of the grant?

The Student must be able to answer No to questions 7-8 to be eligible

6 Do you currently hold an Australian Postgraduate Award (APA) or Postgraduate Scholarship supported by your university/institution, or any other award currently listed in the Australian Competitive Grants Register (or international equivalent)?

7 Will you have entered the third full-time year (or part-time equivalent) of your PhD studies OR final year of your Masters studies before 1 February 2018?

1. APPOINTMENT DETAILSProvide details of the Student’s and Primary Supervisor’s MSH and/or academic partner university appointment(s) (maximum 300 characters including spaces) E.g.: Occupational Therapist at PA Hospital; MSH provides UQ with 50% of my salary; QUT Postgraduate

Candidate based at IHBI in the Translational Research Institute

NOTE: N/A (or similar) will not be accepted

Student

Primary Supervisor

2. LOCATION OF RESEARCH ACTIVITYProvide details of where the majority (more than 50%) of the research activity will take place (maximum 300 characters including spaces)

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RESEARCH SUPPORT SCHEME 2018 POSTGRADUATE SCHOLARSHIP APPLICATION

1. PROJECT TITLE(Maximum 200 characters including spaces)

2. INVESTIGATIVE TEAMS = Student; PS = Primary Supervisor; CS = Co-Supervisor (maximum of 3)

Title Name Health profession

Organisation

S Click to choose First name Surname Click to choose Click to choose

PS Click to choose First name Surname Click to choose Click to choose

CS1 Click to choose First name Surname Click to choose Click to choose



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3. ASSESSMENT OF POST-GRADUATE SCHOLARSHIP APPLICATIONS WILL BE AGAINST THE CRITERIA LISTED BELOW: Assessment Criteria 1: Scientific Quality Assessment Criteria 2: Clinical Significance Assessment Criteria 3: Originality and Innovation Assessment Criteria 4: Track Record - Relative to Opportunity Assessment Criteria 5: Collaborative Strength

3.1ASSESSMENT CRITERIA 1: SCIENTIFIC QUALITY (20%)3.1.1 RESEARCH PROPOSAL Provide your research proposal on the following pages. Include Applicant’s name, Title of project; Hypothesis; Expected outcomes, Background, Research protocol and references.

Assessment of the scientific quality of the research will be based on: Definition of project (based on clear articulation of the Hypothesis, Background, Expected outcomes)

Study Design (Based on Methods, Research Protocol)

Feasibility (including assessment of Methods and Budget);

Whether the proposal would be competitive nationally.

Insert your Research Proposal in the box below (You can type directly into the box; cut and paste or insert an embedded PDF. See Instructions – inserting text)

Instructions

1. Research Proposal Format

Maximum 4 pages including references

Arial font with a minimum size of 10 point (including tables, table legends and figure legends)

Line spacing of 1.5 lines

Top and bottom page margins of 2 cm

Left and right page margins of 2 cm

DO NOT alter headers or footers.

2. Inserting Text

Type directly into the text box above, maintaining format as described above; or

Cut and paste (e.g. from a previous document) into the text box – note you may lose formatting if you choose this option; or

Embed a PDF document of your complete proposal, maintaining formatting as described below.

- Prepare your Research Proposal as per the format instructions above - Save your Research Proposal as a PDF document- Place Cursor in the box above- Select “Insert” tab on MSWord Toolbar- Select “Object” and choose “Create from File” from drop down- Browse for your PDF document- Select Insert- Select “Display as Icon”- Click OK- An icon of your Research Proposal content should be displayed in the box above.

You may remove the text box border for all options.

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3.2 ASSESSMENT CRITERIA 2: CLINICAL SIGNIFICANCE (20%)

3.2.1 BURDEN OF DISEASEDescribe how this project will address and reduce the burden of disease addressed in your proposal (maximum 750 characters including spaces)

3.2.2 TRANSLATIONAL ASPECT OF THE RESEARCH PROPOSAL

What is the translational aspect of your project? (Please indicate in boxes to the left)

T0 – Identification of opportunities and approaches to a health problem (basic research)

T1 – Findings from basic research tested for clinical effect and/or applicability (Phase I and II clinical trials; observational studies)

T2 – Health application to evidence based practice guidelines (Phase III clinical trials; observational studies; evidence synthesis and guidelines development)

T3 – Practice guidelines to health practices (dissemination research; implementation research; diffusion research; Phase IV clinical trials)

T4 – Practice to population health (outcomes research; population monitoring of morbidity, mortality, benefits and risk studies)

Not applicable

Definitions taken from UC San Diego Clinical and Translational Research Institute

3.2.3 RESEARCH SIGNIFICANCE Why is this research clinically significant? (Maximum of 750 characters including spaces)

3.3 ASSESSMENT CRITERIA 3: CLINICAL ORIGINALITY AND INNOVATION (20%)Describe how your proposal is clinically original and / or innovative ? (maximum of 750 characters including spaces)

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3.4 ASSESSMENT CRITERIA 4: TRACK RECORD (40%)

3.4.1 STUDENT (APPLICANT)

CONTACT DETAILS

Applicant name Click to choose First Name Surname

Position

Organisational department Department name

Phone number(s) Primary: Secondary:

Email address

Postal address Address line 1

Address line 2

Address line 3

Suburb and Postcode

ACADEMIC QUALIFICATIONS

Qualification Awarding institution Date

DD/MM/YEAR

DD/MM/YEAR

DD/MM/YEAR

DD/MM/YEAR

RESEARCH EXPERIENCEDescribe your research experience, including projects worked on as an undergraduate student, employee or trainee (maximum 3,000 characters including spaces)

BENEFIT OF SCHOLARSHIP TO STUDENTDescribe how receiving a Research Support Scheme Postgraduate Scholarship will assist in developing your research and/or clinical career (maximum 3,000 characters including spaces)

PUBLICATIONSList your publications produced in the last 5 years which have the most relevance to the study proposed in this application with ALL authors provided Press <Enter> after each publication to maintain the numbering system

1.

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CONFERENCE PRESENTATIONSList research conference presentations you have delivered (maximum of 10)

Presentation type

Presentation title Conference name Location Date(s)

Click to select

Click to select

Click to select

Click to select

Click to select

Click to select

Click to select

Click to select

AWARDS, PRIZES OR GRANTSList your six most significant awards, prizes or grants obtained

Awarding body Title Type Year

---

---

---

---

---

---

OTHER SCHOLARSHIP APPLICATIONSList details of all other scholarship applications submitted in the current year

Funding body Project title Amount $

RESEARCH PERFORMANCE RELEVANT TO OPPORTUNITY

Are there any disruptions to your career (greater than 28 calendar days) that may have impacted on your research performance that you would like to have taken into consideration?

For example: Pregnancy; Major Illness or or injury; Carer responsibilities.

Please outline in the section below in 300 characters or less.

1.

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2.

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3.4.2 PRIMARY SUPERVISOR (PS1)

PS1 CONTACT DETAILS

PS1 name Click to choose First Name Surname

Position

MSH site Click to choose


Phone number

Email address

PS1 ACADEMIC QUALIFICATIONS & APPOINTMENTS

Academic QualificationsEg: MBBS:

Academic AppointmentsEg: Senior Lecturer, XXDept, UQ :

PS1 RESEARCH TIME

Expected 2018 time allocation to: This study (hr/wk): Other studies (hr/wk):

Do you expect to have an extended period of absence during 2018?

Yes No

If Yes, provide expected dates DD/MM/YEAR - DD/MM/YEAR

Reason:(300 characters including spaces)

PS1 PUBLICATIONSList your publications produced in the last 5 years which have the most relevance to the study proposed in this application with ALL authors provided) Press <Enter> after each publication to maintain the numbering system

1.

PSI GRANTSProvide details of research funding received in the last 5 years and indicate whether the funding relates to the proposed research of this application. If more than 15 – please eliminate least applicable to this research proposal.

Funding body and type Start dateEnd date

Amount Relevant to this application?

[DD/MM/YYYY] $ Yes

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[DD/MM/YYYY]

No

[DD/MM/YYYY]

[DD/MM/YYYY]

$ Yes

No

[DD/MM/YYYY]

[DD/MM/YYYY]

$ Yes

No

[DD/MM/YYYY]

[DD/MM/YYYY]

$ Yes

No

[DD/MM/YYYY]

[DD/MM/YYYY]

$ Yes

No

3.4.3 CO-SUPERVISOR 1 (CS1)

CS1 CONTACT DETAILS

CS1 name Click to choose First Name Surname

Position



Phone number

Email address

CS1 ACADEMIC QUALIFICATIONS & APPOINTMENTS


Academic AppointmentsEg: Senior Lecturer, XXDept, UQ :

CS1 RESEARCH TIME


Does CS1 expect to have an extended period of absence during 2018?

Yes No


Reason(300 characters including spaces)

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CS1 PUBLICATIONS List publications produced in the last 5 years which have the most relevance to the study proposed in

this application with ALL authors provided

Press <Enter> after each publication to maintain the numbering system

1.

CS1 GRANTSProvide details of research funding received in the last 5 years and indicate whether the funding relates to the proposed research of this application. If more than 15 – please eliminate least applicable to this research proposal.



[DD/MM/YYYY]

[DD/MM/YYYY]

$ Yes

No

[DD/MM/YYYY]

[DD/MM/YYYY]

$ Yes

No

[DD/MM/YYYY]

[DD/MM/YYYY]

$ Yes

No

[DD/MM/YYYY]

[DD/MM/YYYY]

$ Yes

No

[DD/MM/YYYY]

[DD/MM/YYYY]

$ Yes

No

3.4.4 CO-SUPERVISOR 2 (CS2)

CS2 CONTACT DETAILS

CS2 name Click to choose First Name Surname

Position



Phone number

Email address

CS2 ACADEMIC QUALIFICATIONS & APPOINTMENTS


Academic Appointments

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Eg: Senior Lecturer, XXDept, UQ :

CS2 RESEARCH TIME


Does CS2 expect to have an extended period of absence during 2018?

Yes No


Reason(300 characters including spaces)

CS2 PUBLICATIONS List publications produced in the last 5 years which have the most relevance to the study proposed in

this application with ALL authors provided

Press <Enter> after each publication to maintain the numbering system

1.

CS2 GRANTSProvide details of research funding received in the last 5 years and indicate whether the funding relates to the proposed research of this application. If more than 15 – please eliminate least applicable to this research proposal.



[DD/MM/YYYY]

[DD/MM/YYYY]

$ Yes

No

[DD/MM/YYYY]

[DD/MM/YYYY]

$ Yes

No

[DD/MM/YYYY]

[DD/MM/YYYY]

$ Yes

No

[DD/MM/YYYY]

[DD/MM/YYYY]

$ Yes

No

[DD/MM/YYYY]

[DD/MM/YYYY]

$ Yes

No

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4.0 REVIEWER NOMINATIONS

Applicants must nominate three reviewers for this applicationFor nominations to be eligible the Applicant must be able to answer Yes to all questions

Yes No

1 Are all three nominated reviewers external to MSH and the university school(s)/research institute(s) of all named investigators?

2 Is at least one nominated reviewer from interstate or overseas?

3 Are all three nominated reviewers an acknowledged expert in the field of the proposed research (i.e. publication track record, PhD or equivalent research experience)?

4 Are all three nominated reviewers completely independent of the investigative team (including AIs) and without conflict of interest? (See section 7.1 of the 2018 Funding Guidelines)

5 Have all three nominated reviewers agreed to be available from September to October to assess your application?

Note: A breach of the above may disadvantage your application

4.1 REVIEWER 1

Name Click to choose First Name Surname

Health profession Click to choose

Organisation/Institution Organisation/Institution name

Department Department name

Phone number: Email:

Availability confirmed? Yes No

Comments (300 characters)

Who contacted this reviewer?

4.2 REVIEWER 2









4.3 REVIEWER 3







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4.4 EXCLUDED REVIEWERS

If relevant, list details of up to two reviewers you would like excluded from assessing your application and provide justification for their exclusion

EXCLUDED REVIEWER 1





Justification Provide details

EXCLUDED REVIEWER 2





Justification Provide details

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5.0 AGREEMENTS AND CERTIFICATION OF SUPPORTCERTIFICATION BY THE PRINCIPAL INVESTIGATORPlease carefully read each criterion and ensure the application complies. Ticking each indicates your certification of each criterion. Incomplete applications may be deemed ineligible.

I, certify that:

Written agreement (such as an email) has been obtained from all investigators named in this Research Support application and that all details provided are correct.

I understand that should this application be successful, all named Co-Investigators on this application will be required to sign the Acceptance of Offer.

On behalf of the investigative team, we accept and agree to comply with the ethical standards as set out by the National Health and Medical Research Council, and any additional standards required by the appropriate Human Research/Animal Ethics Committee (including, but not limited to the National Statement on Ethical Conduct in Human Research and Australian Code for the Responsible Conduct of Research).

Research will not commence until all ethical clearances and site specific approvals (SSAs), if required, have been obtained.

I acknowledge and accept that grant payments from SERTA can only be made to a Metro South Health (MSH) employee, and must be deposited into a MSH research cost centre.

The research team meets the relevant eligibility criteria for the Research Support Scheme and all mandatory questions have been answered.

Progress reports (Ethics and Projects) must be provided annually and / or a final report must be provided at the end of the support period

On behalf of the investigative team, we accept and agree to comply with Metro South Health. Policies and Procedures and requests from the Centres for Health Research – Metro South Health in the management of these grants.

Name of Applicant Signature

DD/MM/YEAR

Date:

Name of Supervisor Signature

DD/MM/YEAR

Date:

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6 CERTIFICATION BY HEAD(S) OF DIVISION/DEPARTMENT

I certify that:

The proposed research is appropriate to the general facilities in my Division/Department and that I am prepared to have the project carried out in my Division/Department.

Experiments involving humans/animals (will) conform to the general principles set out in the National Health and Medical Research Committee’s National Statement on Ethical Conduct in Human Research/Australian Code of Practice for the Care and Use of Animals for Scientific Purposes

Name of Head of Department (print): Signature

DD/MM/YEAR

Date:

Name of MSH site/university school:

Note: If the Head of Department is also the Principal Investigator then he / she cannot provide certification. Certification must then be given by the Head of Department’s supervisor.

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Documents

Metro South Health | Report Cover Page template Web viewResearch will not commence until all ethical clearances and site specific approvals (SSAs), if required, have been obtained