DUTCH KIDNEY FOUNDATION
Final report form
Behavioural and Social Research Grant
Version 18 November 2016
The Dutch Kidney Foundation (DKF) General Funding Conditions (‘'Subsidievoorwaarden Nierstichting
Nederland'') apply to all awarded DKF subsidies as well as all proposals for DKF subsidies. Applicability of
general and other conditions of the applicant, the applicant's institute and of third parties is explicitly
excluded.
Dutch Kidney Foundation
Nierstichting
+31 (0) 35 697 8011
[email protected]
Project code:
___________________________________________________________________
Please submit electronic form (PDF) only. The PDF file should be optimized and preferably smaller
than 1 MB. The PDF file must not exceed 9 MB.
Word counts given below are indications for the maximal length of text.
Returned forms should not exceed a total length of 18 pages (using Arial 10 pt; not counting blank
pages).
Report Date:
__________________________________________________________________
1. Title
___________________________________________________________________
2. Project Leader
Name (M/F)
Institute & Department
Address:
Name Institute
Department
Room number
Street name
Postal code, Town/ city
Telephone
E-mail
3. Project
Start date
End date
Duration
1
DKF budget
2
I. GENERAL INFORMATION
1. Participants
Please provide the names of all funded and non-funded partners in the project
Name and title
Position
Institute &
Funding Hours/week
Department
Source
(FTE)
Email address
2. Summary in Dutch for the General Public / Publiekssamenvatting (max. 300 words)
Provide a description of the project in Dutch directed at the general public. Address subject and problem,
hypothesis and aims, results and discussions. Explain used terminology.
3
II. DESCRIPTION: ORIGINAL AND CHANGES
If applicable, add changes in bold script. Provide a short motivation for changes.
1. Scientific Summary (original and changes; max. 800 words)
2. Hypothesis, Aims and Objectives (original and changes; max. 350 words)
3. Personnel (original and changes; max. 250 words)
4. Work Plan Changes (max. 400 words)
If applicable, describe changes to the original work plan.
5. Time Schedule and Deliverables (original and changes; max. 350 words)
6. Inclusion of Patients (if applicable; max. 200 words)
Describe changes to the inclusion plan.
7. Budget (original and changes)
Use the FM matrix.
4
III. FINAL RESULTS
1. Project Results (max. 1500 words)
Order the results along the given objectives and aims. Describe the complete project; refer to the progress
report(s) if necessary.
2. Short Summary of the Results (max. 200 words)
Summarize the results.
3. Conclusions (max. 300 words)
Draw conclusions. Address the original problem definition and hypothesis.
4. Scientific Publications from the project (references, attach PDFs)
List the publications (in preparation, submitted, accepted and published) directly resulting from the project.
5. Publications in Public Media (references, attach PDFs)
5
IV. IMPACT
1. Innovation and Advancements (max. 500 words)
Describe the significance of the project for innovation, for advancing knowledge and for patients. Address if
applicable basic and applied knowledge, diagnosis and therapies, patient care, prevention.
2. Products (max. 300 words)
Describe products that resulted from the project.
3. Opportunities for Communication and PR (max. 400 words)
Describe the possibilities for the DKF to apply results of the project in PR and communication (e.g. public
media and presentations).
6
V. KNOWLEDGE TRANSFER, IMPLEMENTATION AND FOLLOW-UP
1. Dissemination of Project Results (max. 300 words)
Describe how the project results will be disseminated.
2. Implementation of Project Results (max. 300 words)
If applicable, describe how project results will be implemented in practice.
3. Project Follow-up (max. 200 words)
Describe possible follow-up (e.g. opportunities for application in research, collaborations and other research,
clinic, practice, spin-off).
7
VI. SIGNATURES
Name, position
Signature
Project Leader
Authorized Head of
Institute
8
Date