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Susceptibility To Venous Leg Ulceration: Investigation Of The First Genetic Risk Factor
Funder
National Health and Medical Research Council
Funding Amount
$291,000.00
Summary
This application aims to confirm our preliminary identification of the first candidate gene as a risk factor for developing venous leg ulceration. Since patients with venous leg ulcers experience pain and psychological consequences including anger and depression, all of which impact negatively on quality of life, active prevention of ulceration will have significant lifestyle and financial benefits. Venous leg ulcers occur in patients who have venous disease, in particular in patients with previ ....This application aims to confirm our preliminary identification of the first candidate gene as a risk factor for developing venous leg ulceration. Since patients with venous leg ulcers experience pain and psychological consequences including anger and depression, all of which impact negatively on quality of life, active prevention of ulceration will have significant lifestyle and financial benefits. Venous leg ulcers occur in patients who have venous disease, in particular in patients with previous deep vein thrombosis. However, not all patients with a deep vein thrombosis or other forms of venous disease will go on to develop a venous ulcer. Our preliminary results show that patients with a venous ulcer have a greater frequency of this gene than healthy controls without venous ulcers, and suggest that patients with the candidate gene have a greater risk of developing venous ulceration. In this study we aim to determine whether the gene itself contributes to ulcer susceptibility or whether it is just a marker of that susceptibility. We can do this by assessing related genes and the levels of the protein produced by this gene. In this study we also aim to assess whether patients with a proven deep vein thrombosis are more likely to develop venous ulceration if they have the candidate gene. These studies have the potential to lead to the development of a diagnostic screening test for use in patients with venous disease, to assess the likelihood of developing leg ulceration. This will enable more active treatment to prevent leg ulceration. If this gene contributes to ulcer susceptibility new specific treatments may be developed for ulcer management and prevention.Read moreRead less
An International Randomised Trial Of Low-dose Aspirin To Prevent Recurrent Venous Thromboembolism (INSPIRE)
Funder
National Health and Medical Research Council
Funding Amount
$1,989,986.00
Summary
Patients who develop venous blood clots or pulmonary embolism, without an underyling cause, are at very high risk of recurrence once anticoagulant treatment (warfarin) is discontinued. The international INSPIRE trial is assessing whether low-dose aspirin treatment (a simple and cheap alternative to warfarin) is effective and safe in preventing further blood clots. If proven effective, aspirin could potentially prevent thousands of patients worldwide from experiencing such events.
Low-dose Aspirin To Prevent Recurrent Venous Thromboembolism (ASPIRE) Study: A Multicentre Randomised Trial
Funder
National Health and Medical Research Council
Funding Amount
$1,108,600.00
Summary
In approximately one-third of patients who develop deep vein thrombosis or pulmonary embolism, this event is 'unprovoked' . These patients are at very high risk of recurrence once treatment with warfarin is discontinued. Warfarin treatment is very effective to prevent recurrence but is inconvenient because it has to be very closely monitored with blood tests and also causes serious bleeding complications in a significant number of patients. There are currently no other treatments available to pr ....In approximately one-third of patients who develop deep vein thrombosis or pulmonary embolism, this event is 'unprovoked' . These patients are at very high risk of recurrence once treatment with warfarin is discontinued. Warfarin treatment is very effective to prevent recurrence but is inconvenient because it has to be very closely monitored with blood tests and also causes serious bleeding complications in a significant number of patients. There are currently no other treatments available to prevent recurrent thrombosis. Low-dose aspirin treatment offers a simple, inexpensive, and widely practicable alternative to warfarin but has not yet been proven to be effective for preventing recurrent thrombosis. This study will investigate the effectiveness and safety of aspirin to prevent recurrence in patients with unprovoked deep vein thrombosis or pulmonary embolism who have completed standard anticoagulation with heparin and warfarin. If proven to be effective, aspirin could potentially prevent thousands of patients from experiencing recurrent venous thromboembolism or fatal pulmonary embolism worldwide and also save millions of dollars in health care costs each year.Read moreRead less
Identifying The Relationship Between Biochemical Markers And Healing In Chronic Leg Ulcers Treated With Compression
Funder
National Health and Medical Research Council
Funding Amount
$374,159.00
Summary
Chronic leg ulcers are a significant cause of pain, immobility and decreased quality of life for 1 - 3% of the over 60 years age group. The condition is difficult to heal and commonly becomes a long term problem, costing the Australian health care system over $500 million - year. Additional costs to the community include loss of productivity and social support systems necessary for people with limited mobility. As the number of people aged over 65 years is expected to double in the next few deca ....Chronic leg ulcers are a significant cause of pain, immobility and decreased quality of life for 1 - 3% of the over 60 years age group. The condition is difficult to heal and commonly becomes a long term problem, costing the Australian health care system over $500 million - year. Additional costs to the community include loss of productivity and social support systems necessary for people with limited mobility. As the number of people aged over 65 years is expected to double in the next few decades, this problem will become increasingly significant. Most chronic leg ulcers are caused by venous disease, and compression bandage therapy is the accepted standard treatment. However, there is little information available on the cellular responses associated with compression treatment and how they promote wound healing. The project proposed here will examine the cellular responses to compression and investigate the relationships between these cellular responses and wound healing. Knowledge gained from the study will provide valuable information for improved techniques to promote wound healing, improved ulcer healing rates, informed decisions on wound care treatment, improved qualtiy of life and reduced health care costs.Read moreRead less
Preventing Recurrence Of Leg Ulcers In Older Adults With Peripheral Vascular Disease: Identifying Predictors And Evaluating Strategies.
Funder
National Health and Medical Research Council
Funding Amount
$311,860.00
Summary
Peripheral vascular disease – disease of the arteries and veins in the limbs – leads to chronic leg ulcers for 1–4% of adults aged over 60. The ulcers are slow and difficult to heal and after healing, up to 70% recur, many within a few weeks. The aim of this research is to identify predictors and evaluate strategies to prevent recurrence of chronic leg ulcers; and improve our understanding of relationships between biology, localised disease and health in adults suffering from chronic leg ulcers.
Non-invasive Electrical Nerve Stimulation To Improve Healing Of Chronic Venous Leg Ulcers
Funder
National Health and Medical Research Council
Funding Amount
$206,210.00
Summary
Chronic venous leg ulcers are common in the elderly. They often last for many months or years, causing much suffering and expense (currently around $600,000,000 per year in Australia). As more and more Australians live into advanced age, more and more people will be troubled by leg ulcers, particularly as the likelihood of having a leg ulcer increases markedly in the very old. We have developed a painless, cheap treatment that improves wound healing. The treatment consists of electrical stimulat ....Chronic venous leg ulcers are common in the elderly. They often last for many months or years, causing much suffering and expense (currently around $600,000,000 per year in Australia). As more and more Australians live into advanced age, more and more people will be troubled by leg ulcers, particularly as the likelihood of having a leg ulcer increases markedly in the very old. We have developed a painless, cheap treatment that improves wound healing. The treatment consists of electrical stimulation of nerves that supply the wound. Low frequency current is passed through the skin from small battery powered stimulators. We have tested this technique in laboratory animals and in just a few older people with diabetes and have shown it is remarkably effective. We now plan to test this technique properly in a large study in older adults. If successful, the electrical stimulation could result in healing of wounds in relatively few weeks that otherwise would not heal for many months. Much suffering and expense would be avoided. As people age, nerve function deteriotes. Another part of the project will explore whether electrical nerve stimulation can improve damaged nerves themselves. This will provide interesting scientific insight about nerve repair and could lead to treatments for peripheral neuropathy that occurs in diabetes and other medical conditions. Australia needs to act on this now because the number of people aged over 65 will increase from around 2.3 million at present to over 6 million in the next half century. The increase in those over 85 will be even more marked with numbers increasing four fold to over one million people. Many of these people will experience severe impairment of their quality of life from leg ulcers that could be avoided, or at least minimized if a successful treatment is developed and made available to them. Similarly, much unnecessary expense could be avoided.Read moreRead less
Facilitating Venous Leg Ulcer Guideline Implementation: Closing The Gap
Funder
National Health and Medical Research Council
Funding Amount
$177,197.00
Summary
Venous leg ulcers are a continuing challenge to patients, health care professionals and healthcare systems. Healing is protracted and ulcer recurrence common. Early identification and treatment is paramount to optimise health. Best practice treatment is compression, however more than 50% of ulcers remain unhealed after two years due to variability in clinical practice. I will conduct a scoping systematic review to identify reasons for gaps between evidence-based care and clinical practice.
Structural And Functional Studies On The Interaction Between Alpha2-Antiplasmin And Plasmin
Funder
National Health and Medical Research Council
Funding Amount
$280,400.00
Summary
Fibrinolysis is the process by which the body dissolves clots. In this proposal we aim to investigate how the fibrinolysis inhibitor alpha2-antiplasmin interacts with the clot dissolving protease enzyme plasmin. These data will be useful for developing new approaches to accelerate plasmin-mediated clot breakdown.