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Ulcerative colitis (UC) is a chronic and relapsing inflammatory bowel disease (IBD) characterised by inflammation in the lining of the large bowel. Recent studies of the bacterial populations that normally reside in the large bowel (gut microbiota) have shown abnormalities (i.e., dysbiosis) in the faeces of patients with UC. Our research group has found evidence that the ability of the gut microbiota to ferment carbohydrates may be markedly defective and this cannot be corrected by simply providing more dietary fibre. Such fermentation is an important function of the microbiota as it delivers breakdown products that include short-chain fatty acids such as butyrate to the lining cells of the colon. Butyrate is the major source of nutrition for those cells and also has anti-inflammatory and anti-tumour-producing effects. This observation has potentially large implications for how we manage UC. If it is true, then manipulation of the bacteria and of the specific carbohydrate substrates they see by, for example, dietary manipulation of the types of carbohydrates they eat might have therapeutic benefit. Furthermore, such fermentation lowers acidity (pH) in the bowel and this lowering is utilised for the activation of some drugs commonly used in UC (e.g. mesalazine). Defective fermentation might lead to poor activation of those drugs and lack of effectiveness. The major problem with studying fermentation in the large bowel is that most occurs in the proximal part of the large bowel – i.e., the part furthest away from the anus - and we have only been able to study it indirectly. Using swallowed capsule technology that transmits information to a transmitter worn by the patient (as used by the ‘pill-camera’), a new wireless pH-motility device, has been developed. This device is able to capture measurements for transit (speed of passage through the gut) and pH in real time and in a non-invasive manner as it travels along the entire gut. It is the pH measurement that provides our first way of examining fermentation in the intact colon. We propose to measure the pH profiles in the gut of 10 healthy volunteers and of 20 patients with UC who do not have active disease after both a large and a minimal load of indigestible, fermentable carbohydrates. This will be achieved by controlled food intake over the 12 hours prior to the capsule being swallowed. This will give us a range of pH profiles related to high and low levels of fermentation in the gut. We will then be able to determine if the fermentation capability of patients with UC is truly deficient. The pH-motility device will also permit us to examine transit through the regions of the gut and provide mechanistic information on the role of gut transit in any abnormalities found. We anticipate variation in responses of patients (but not in healthy volunteers). In order to be able to identify patients with abnormal fermentation, we will also collect, prior to the investigations with a wireless pH-motility device, dietary intake information and faeces to determine if these indices provide the correlations with the pH profile.

Constipation is highly prevalent among users of antipsychotic medication and is linked to physical issues such as bowel obstruction and paralytic ileus as well as psychological issues such as greater distress, poor mental health and low quality of life. Aside from the prescription of laxatives, the standard approach to reducing the symptoms of constipation is with increasing fibre into the diet, increasing fluid intake, and encouraging physical activity. It can be difficult to increase the amount of fibre and fluid in the diet in patients residing in a psychiatric hospital due to limited dietary options. Only one clinical trial assessing constipation in antipsychotic medication users could be found, while most studies exclude participants where medication is the likely cause of the constipation. The objectives of this study are to evaluate the effectiveness of regular exercise on constipation in patients prescribed antipsychotic medication within a psychiatric setting and to compare this treatment against receiving written and verbal information on constipation.

Age-related macular degeneration (AMD) is a very common problem in the elderly. The treatment is given by intraocular injection, and there are two TGA approved medications (Lucentis and Eylea) which are in common use in Australia for AMD. Both have been shown to be equivalent. The investigators have shown in previous studies that a novel tool for visual testing known as multifocal objective pupil perimetry (mfPOP) is sensitive at picking up the loss of retinal function observed with AMD, and also the recovery in function following Lucentis therapy. The investigators plan to randomise 60 patients with new onset wet AMD to either Lucentis or Eylea therapy and to manage them according to standard, accepted clinical practice. They will be followed using both the standard testing and also mfPOP to see if mfPOP is an effective tool at monitoring disease progress on therapy, and also to see if mfPOP can detect any subtle differences between the two medications.

Age related hearing loss (ARHL) is a very common disorder in older adults. Previous studies have demonstrated that up to 2/3 of those over the age of 70 years may be affected. There is no known cure for the disease nor preventive actions for the disease progression. While ARHL has recently been associated with cognitive decline, the synergistic effect of age related hearing loss and cognitive decline has never been observed with a treatment intervention. ASPREE-HEARING will investigate whether ARHL is affected by aspirin vs placebo. It will also examine in healthy older adults the association between age related heariang loss and cognitive decline in adults over a 3 year follow up period and whether daily low dose aspirin is protective against hearing threshold change and cognitive decline. The study will also appraise the potential vascular mechanism of hearing loss by using retinal vascular imaging.

This study is looking to assess if a commercially available seawead extract (fucoidan) has an effect on blood sugar and insulin levels, as well as other markers of cardio (heart) and metabolic health, when taken over three months. To allow us to assess its impact, one half (approx 40) of the enrolled participants will take a placebo capsule which does not contain fucoidan or any other active ingredient.

Psoriasis currently has no cure. Whilst new therapies manage severe psoriasis well mild-moderate conditions have evidence of poor management. Chinese medicine regularly treats psoriasis successfully in a clinical scenario. This study will test a previously researched herbal formula and evaluate its efficacy when integrated with standard conventional therapy (calcipotriol). The study will randomize participants to either a herbal medicine plus calcipotriol group or a placebo plus calcipotriol group and compare changes in symptom severity, quality of life and blood markers for changes after 12 weeks of the intervention. It will also assess the safety of integrating the two therapies and acceptability of the treatment as well as assess any significant difference between health resource utilization of the two groups.

This study is evaluating whether radiolabelled Cetuximab exhibits tumour uptake sufficiently to enable targeted radioimmunotherapy in patients with advanced head and neck cancer. Who is it for? You may be eligible to join this study if you are aged 18 years or above and have been diagnosed with advanced head and neck squamous cell carcinoma, without option for further surgery or radiotherapy. Study details: All participants in this study will undergo a precursor imaging study with gallium-68-cetuximab. If appropriate they will be offered salvage radioimmunotherapy with newly developed Rhenium-188-Cetuximab or Lutetium-177-Cetuximab using the tumour-targeting ability of Cetuximab to deliver internal radiation to the tumour. Follow up assessments will comprise standard-of-care imaging and blood testing. Given a favourable response, repeat radioimmunotherapy may be contemplated for subsequent relapse with either of the aforementioned beta emitting radionuclides.

Many people with MS develop ankle contractures (a stiffening of the ankle joint) that can impact on normal movement at a very early stage. There is moderate-to-high quality evidence that stretch, the first line of intervention for prevention and treatment of joint contracture in physiotherapy, does not have clinically useful immediate, short-term or long-term effects on joint range of motion. This study will investigate whether exercise that stretches the calf muscle while they contract (eccentric exercise) can be used to treat ankle contractures in people with MS. 40 people with MS who have developed ankle contractures will be randomly allocated either to receive or not receive a 12-week program of eccentric exercise of calf muscle. Ankle joint range of motion, calf muscle properties and parameters of gait and mobility will be measured before and after the 12-week period.

Severe chronic pain affects up to 8% of adolescents, with many suffering from significant emotional distress and physical disability. This often limits school attendance and impacts on the family as a whole. This pilot randomised controlled trial aims to evaluate an intervention designed to help these families. The project tests an innovative service delivery model with interdisciplinary pain management being provided in face-to face workshops followed with Telehealth sessions delivered to the family home. The treatment team is led by a Physiotherapist and also includes an Occupational Therapist and Clinical Psychologist.

Online social-networking has tremendous reach and high engagement - innovative research is needed to harness this for public health gain. We aim to develop and evaluate a 50-day team-based social-network-based physical activity intervention. Delivered via a Facebook application and iPhone counterpart, the “Active-Team” application, or “A-Team” for short, ultimately aims to improve the health and well-being of the South Australian community.