2017 Research Grant Cover Page

Australian National Member Society of the International Society for Prosthetics and Orthotics Inc.

2017 RESEARCH GRANT – COVER PAGE

Project Title
Provide a title that is brief and informative. Limit: 200 characters (with spaces)
Research team
Complete with N/A if not applicable
Principal Investigator (CIA) / Co-investigator (CIB) / Co-investigator (CIC) / Co-investigator (CID) / Co-investigator (CIE)
Last name
Affiliation
Country
Summary
Summarise the aims of the research and the importance of the project. Limit: 350 words
Total requested
Enter total amount requested. Limit: AUD$20,000
Administering Institution
Complete with N/A if not applicable
Name / Location / Contact person / Contact email
Research classifications
Complete using up to 3 codes provided in the links
Research Fields, Courses and Disciplines
(RFCD)
http://www.abs.gov.au/ausstats/[email protected]/0/955FFA4EB1B23847CA25697E0018FB14?opendocument / Socio-Economic Objective
(SEO)
http://www.abs.gov.au/ausstats/[email protected]/0/CF7ADB06FA2DFD69CA2574180004CB82
1. / 1.
2. / 2.
3. / 3.
Online Electronic form
Confirm that you have completed the online electronic form after clicking to the link below
Link / Tick to confirm
http://9209.forms.mesearchr.com/form-2703606/RESEARCH-GRANT-2017Online-Form

2017 RESEARCH GRANT – APPLICATION FORM

1. Instructions

Email the PDF version of this document to and complete the electronic form by by 5:00 pm (AEST) on Fri 14/07/2017. The file name should be “2017_ISPO_RGS__[name CIA].PDF”. Receipt of your email will be acknowledged. Please, remember to use in “Plain English” in a way that is understandable to an informed reader who may have no specialist expertise in your area of research across the document when possible.

2. Contact

Adj / Prof Laurent Frossard (PhD), Chair of the ANMS ISPO Research Grant Committee of the ANMS ISPO

Email: , Phone: 04 1379 5086

3. Proposal Project Details

Project Title (Cut-and-paste from cover-page)
Provide a title that is brief and informative. Limit: 200 characters (with spaces)
Summary (Cut-and-paste from cover-page)
Summarise the aims of the research and the importance of the project. Limit: 350 words
Context and Objectives of Project
Provide a justification for the project and state the objectives. Limit: 300 words
Method and References
Describe the proposed method including details of participants (e.g., Sample size), recruitment, apparatus, procedures and statistical analysis and no more than 5 references. Limit: 300 words
Significance of the Project
Explain in which way the project will have an impact. Limit: 300 words
Innovation of the Project
Explain in which way the project will make novel contribution. Limit: 200 words
Is it a new stand-alone project?
If yes, explain how this new project will make novel contribution / Is it an extension of the existing larger project?
If yes, describes briefly the current project (e.g., aims and funding) and explain how this extension will make an new contribution
Yes or No / Yes or No
Potential for Future Developments
Explain the exit strategy for the project while indicating how you will take this work to the next step of development (e.g., grants, implementation). Limit: 300 words
Ethics Clearances
Name the organisation that will provide ethics approval for your project, the type of ethics approval required (e.g., human subject, animal research, ionising radiation) and whether the project has already received ethics approval or if it is yet to be obtained.
Note that ethics clearance must be obtained from an appropriate university or hospital committee and proof of this clearance must be made available to the Chair ANMS ISPO Research Grant Committee prior to money being paid to the grant recipient. However, at the time of application, it is acceptable to state the body to which the application will be made. Research involving human subjects needs to be in accordance with the NHMRC Statement on Human Experimentation [https://www.nhmrc.gov.au/health-ethics] and in accordance with the guidelines laid down in the NHMRC Code of Practice [https://www.nhmrc.gov.au/guidelines-publications/ea16].
Name of ethics committee
Type of ethics approval required
Status of ethics application
Anticipated Timeframes of project
Enter the information while considering feasibility of the project.
Commencement
Enter the expected commencement date for the project.
(dd/mm/yyyy) / Completion
Enter the expected completion date for the project.
(dd/mm/yyyy)
Milestone
Enter main milestones and deliverables of the project that will be used for reporting progress. Limit: 300 words
GANTT chart
Create GANTT chart of the project indicating the main phase of development as well responsibility of each investigator and milestone for each quarter during funding and beyond.

4. Research team

Research team
Complete with N/A if not applicable
Principal Investigator (CIA) / Co-investigator (CIB) / Co-investigator (CIC) / Co-investigator (CID) / Co-investigator (CIE)
Name
Affiliation
Country
Key Research Performance indicators
Enter to combined total for the whole team
Total number of abstract / Total number of articles / Total number of grants / Total amount awarded
Evidence of strength of the research team
Highlight the strength of the research team while indicating how investigators have complementary experience and skills as well as how each investigator will make significant contributions). Limit: 400 words

5. Individual track record - Principal Investigator (CIA)

Identification
Complete with N/A if not known or not applicable
First name / Last Name / Title
Email
URL
ORCID No / ANMS ISPO member if available
Current position and appointment
Department/school/other
Organisation
Postal address
State / Postcode / Country
Experience
Complete with N/A if not applicable
Highest degree / Years of graduation / Number of years of experience
Grant income
Complete with N/A if not known
Number of grants / Total amount
As the first investigator
Bibliometrics
Complete with N/A if not known
Number of articles / Number of abstracts / Total number
As senior author (First, last)
H-index / i10-Index / Number of citations
Scopus
List of key publications
Enter your 5 best publications ranked by chronological order
Biographical Sketch
Enter the key education, experience and achievements of your career. Limit: 1 page

6. Investigators track record - Co-investigator (CIB)

Identification
Complete with N/A if not known or not applicable
First name / Last Name / Title
Email
URL
ORCID No / ANMS ISPO member if available
Current position and appointment
Department/school/other
Organisation
Postal address
State / Postcode / Country
Experience
Complete with N/A if not applicable
Highest degree / Years of graduation / Number of years of experience
Grant income
Complete with N/A if not known
Number of grants / Total amount
As the first investigator
Bibliometrics
Complete with N/A if not known
Number of articles / Number of abstracts / Total number
As senior author (First, last)
H-index / i10-Index / Number of citations
Scopus
List of key publications
Enter your 5 best publications ranked by chronological order
Biographical Sketch
Enter the key education, experience and achievements of your career. Limit: 1 page

7. Investigators track record - Co-investigator (CIC)

8. Investigators track record - Co-investigator (CID)

9. Investigators track record - Co-investigator (CIE)

10. Budget

Budget Breakdown
Specify amount required per annum for each item related to salaries, equipment, consumables and any other costs Note that infrastructure/overheads will not be funded. Limit: AUD$20,000
Description, including basis for calculating total item cost / Cost
(Excluding GST)
1
2
3
4
5
6
7
8
9
10
Total / $
Budget Justification
Provide a brief justification for each item in the budget. Limit: 300 words

11. Reviewers

Preferred Reviewers
Provide name and contact details of up to three appropriate external reviewers who can be used if required.
Reviewer 1
Name
Position/Appointment
Research Institute
Address
Telephone
Email
Justification
Reviewer 2
Name
Position/Appointment
Research Institute
Address
Telephone
Email
Justification
Reviewer 3
Name
Position/Appointment
Research Institute
Address
Telephone
Email
Justification

12. Certification

Declarations
Make sure all investigators agree with each statement below
I/We certify that all details in this application are true and correct.
I/We certify that this application is not to support, or in any way duplicate, a project being funded by another agency for essentially the same research, except to augment other funding as documented.
I/We understand and agree that research involving humans or animals must be carried out in accordance with the guidelines laid down in the NHMRC Code of Practice and that I/we will obtain necessary ethics clearance from an appropriate body prior to the commencement of any research-related activity.
I/We understand that a copy of the ethics approval must be provided prior to receipt of grant funding.
I/We understand that all successful investigators will become an ANMS ISPO active member prior to receipt of grant funding
I/We understand that all successful investigators formally agree to acknowledge the contribution of ANMS ISPO Research Grant in all scientific outputs.
I/We submit with the application, evidence that the department head/manager is aware of this application and its implications, and is supportive of the project such that the general facilities of the department/institution and necessary space and instrumentation are available to support this project.
I/We agree to abide by the guidelines of the granting body, and meet its requirements for expending money and reporting of project progress and completion.
Certification
This section must be signed by all investigators.
Name / Signature / Date
(dd/mm/yyyy)
Principal investigator
(CIA)
Co-investigator
(CIB)
Co-investigator
(CIC)
Co-investigator
(CID)
Co-investigator
(CIE)

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