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A National Population-based Study Of Rheumatic Heart Disease In Pregnancy
Funder
National Health and Medical Research Council
Funding Amount
$877,826.00
Summary
Whilst overall a rare disease, Indigenous peoples have disproportionately high rates of rheumatic heart disease (RHD). This study explores the prevalence and distribution of RHD in pregnancy in Australia and New Zealand. It details current management, diagnostic and referral process and risk factors. Key attributes of culturally safe models of care for RHD in pregnancy are explored, particularly as they relate to Indigenous women. Findings will inform policy, guidelines and education resources.
Detection And Management Of Depression In General Practice Patients With Chronic Manifestations Of Ischaemic Heart Disea
Funder
National Health and Medical Research Council
Funding Amount
$499,797.00
Summary
This research will investigate the impact of ischemic heart disease on the prevalence and severity of patients with depression. This will be done via a 12 month general practice based program of 1) systematic screening for depression 2) informing general practitioners of best-practice guidelines for management of depression in these patients, and 3) providing the treating general practitioner with patient-specific, psychiatric advice.
The END RHD CRE: Developing An Endgame For Rheumatic Heart Disease In Australia
Funder
National Health and Medical Research Council
Funding Amount
$2,601,147.00
Summary
Rheumatic heart disease (RHD) is caused by an abnormal immune reaction to some bacterial infections. Although RHD is rare in developed countries, Indigenous Australians still live with the burden of RHD. The END RHD CRE will explore risk factors for RHD, prevention with antibiotics, management of RHD and the potential for vaccine development. Individuals and communities experiencing RHD are integral partners to this work. The CRE will establish a strategy for ending RHD in Australia.
Innovative Health Programs To Reduce Inequality In Heart Disease
Funder
National Health and Medical Research Council
Funding Amount
$876,005.00
Summary
As part of his Senior NHMRC Fellowship, Prof Simon Stewart, a world-renowned health services researcher, will lead an internationally linked team of researchers from a broad range of health disciplines to undertake a program of research designed to improve the lives of those most vulnerable to heart disease and poor health outcomes. His program of research will focus on Indigenous Australians, patients with complex forms of heart disease and urban African communities in economic transition.
Which Heart Failure Intervention Is Most Cost Effective In Reducing Hospital Care (WHICH? II) Trial: A Multicentre, Randomised Trial Of Standard Versus Intensified Management Of Metropolitan And Regional-dwelling Patients With Heart Failure
Funder
National Health and Medical Research Council
Funding Amount
$1,891,210.00
Summary
Chronic heart failure (CHF) management programs are now the gold-standard to cost-effectively care for thousands of Australians hospitalised with CHF each year. We’ve shown that home-based management is most cost-effective in reducing hospital stay in CHF. The Which Intervention is most Cost-effective in reducing Hospital care (WHICH? II) Trial, a multicentre, randomised study, will determine if more intensive care (via home visits and remote care contacts) further improves poor outcomes in CHF.
Which Heart Failure Intervention Is Most Cost-effective And Consumer Friendly In Reducing Hospital Care: The Which
Funder
National Health and Medical Research Council
Funding Amount
$921,640.00
Summary
Chronic heart failure (CHF) is a costly, debilitating and deadly condition that has reached near epidemic proportions in Australia. In the absence of a permanent cure for CHF, the number of people affected by CHF has risen beyond 350,000 and is expected to increase by 20-30% in the next 20 years. We recently reviewed the benefits of applying nurse-led, CHF management programs (CHF-MPs) to typically old and fragile patients, in whom recurrent hospital admissions and a premature death are common. ....Chronic heart failure (CHF) is a costly, debilitating and deadly condition that has reached near epidemic proportions in Australia. In the absence of a permanent cure for CHF, the number of people affected by CHF has risen beyond 350,000 and is expected to increase by 20-30% in the next 20 years. We recently reviewed the benefits of applying nurse-led, CHF management programs (CHF-MPs) to typically old and fragile patients, in whom recurrent hospital admissions and a premature death are common. We confirmed the results of pioneering Australian research that CHF-MPs dramatically improve health outcomes in CHF. CHF-MPs now form part of the recommended gold-standard management of CHF. However, we also have evidence that only a small proportion of patients are exposed to a CHF-MP in Australia. Residual issues such as consumer preference and the cost of applying these programs are hindering their wide-spread application. The WHICH? Study addresses this _road block� to implementing a potentially valuable health care service by tackling a number of critical issues: which form of CHF-MP (home or specialist clinic-based follow-up), will produce the best health outcomes, save the most money and meet the needs of consumers at the same time? To answer this question, we will undertake a randomised, head-to-head study of a home versus clinic-based CHF-MP, in 1000 recently hospitalised CHF patients recruited from SA, VIC, NSW and QLD. Patterns and of health care and consumer preferences and quality of life will then be compared for these two different forms of CHF-MP from a combined health economic, health policy and consumer perspective to determine the best form of CHF-MP to be applied. A _consensus� vision for applying an Australia-wide service will then be developed. The potential impact of the results of the study will then be modelled on the status of Australian CHF-MPs in the year 2010 and a blue-print for action devised.Read moreRead less
Evaluating The Genetic Contribution To Rheumatic Heart Disease Pathogenesis In Australian Aboriginal And Torres Strait Islander Communities
Funder
National Health and Medical Research Council
Funding Amount
$1,782,074.00
Summary
Rheumatic heart disease is highly prevalent in Aboriginal people in Australia and leads to early cardiac disease. Despite decades of research, the underlying genetic mechanisms for why it occurs are not well understood. We are conducting a genetic study to better understand why some people are susceptible to RHD and others are not. The study will involve substantial Aboriginal leadership and consultation and will be a model for the conduct of genetic studies in Aboriginal populations.
PrtFII, A Streptococcus Pyogenes Fibronectin Binding Protein, And Invasive Diseases.
Funder
National Health and Medical Research Council
Funding Amount
$296,540.00
Summary
Our recent work revealed that, in the Aboriginal population, young age is a risk factor for severe invasive diseases caused by group A streptococcus. For group A streptococcus infection to occur, bacterial attachment is the first step. The bacterium attaches to host cells through interactions involving host fibronectin and the pathogen's fibronectin-binding proteins. We have found that streptococcal strains from severe disease cases are more likely to have the gene for PrtFII, a fibronectin bind ....Our recent work revealed that, in the Aboriginal population, young age is a risk factor for severe invasive diseases caused by group A streptococcus. For group A streptococcus infection to occur, bacterial attachment is the first step. The bacterium attaches to host cells through interactions involving host fibronectin and the pathogen's fibronectin-binding proteins. We have found that streptococcal strains from severe disease cases are more likely to have the gene for PrtFII, a fibronectin binding protein, than those from uncomplicated skin sores. In this application we propose to extend this observation and compare biochemical properties of PrtFII from strains belonging to the above two sets of collections. We hypothesise that PrtFII from invasive strains bind to fibronectin more tightly than the proteins from strains that cause uncomplicated infection. We also will test whether sera from invasive disease cases have lower titre of antibodies to the conserved region of PrtFII than sera from uncomplicated cases. A streptococcal vaccine by necessity has to be a multi-component vaccine to cover a wide spectrum of diseases and epidemiological differences. The study proposed here may provide a basis to argue whether or not to include PrtFII in such a multi-component vaccine.Read moreRead less
CENTRE OF RESEARCH EXCELLENCE TO REDUCE INEQUALITY IN HEART DISEASE
Funder
National Health and Medical Research Council
Funding Amount
$2,607,253.00
Summary
There is increasing recognition of a societal responsibility to provide effective and sustainable health care to the entire population and not just to selected parts. Indigenous and regional Australians are most affected by Australia's biggest killer - heart disease. In response, the CRE to Reduce Inequality in Heart Disease, is a national collaboration of researchers from a range of health disciplines. Together they aim to address this problem by developing sustainable and cost-effective health ....There is increasing recognition of a societal responsibility to provide effective and sustainable health care to the entire population and not just to selected parts. Indigenous and regional Australians are most affected by Australia's biggest killer - heart disease. In response, the CRE to Reduce Inequality in Heart Disease, is a national collaboration of researchers from a range of health disciplines. Together they aim to address this problem by developing sustainable and cost-effective health care services.Read moreRead less
Rhinovirus impairs physiological and immunological lung development and causes exacerbation of allergic airways disease. Rhinovirus (RV) infections account for around 90 per cent of asthma exacerbations, yet the mechanisms behind this are unknown. This project will use mouse models to study the effects of early life RV infection and allergic sensitisation on respiratory and immunological development, with the expectation that early life RV infection disrupts anitgen presenting cell function.