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Trial registered on ANZCTR
Registration number
ACTRN12613000234718
Ethics application status
Not yet submitted
Date submitted
25/02/2013
Date registered
27/02/2013
Date last updated
27/02/2013
Type of registration
Prospectively registered
Titles & IDs
Public title
TRialing Individualised Interventions to prevent FunctionaL decline in at-risk older adults (TRIIFL): A nested randomized controlled trial
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Scientific title
The effectiveness of an individualised community-based intervention program, compared to usual care, to prevent functional decline in at-risk older adults.
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Secondary ID [1]
282024
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Nil
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Universal Trial Number (UTN)
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Trial acronym
TRIIFL
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Functional decline
288472
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Condition category
Condition code
Other
288818
288818
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0
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Conditions of unknown or disputed aetiology (such as chronic fatigue syndrome/myalgic encephalomyelitis)
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
In line with a patient-centred philosphy an individualised lifestyle intervention program will be provided, following comprehensive assessment and functional goal setting by trained physiotherapists and/or occupational therapists. The intervention will be structured to meet individuals' needs and so the frequency of contacts per week and the overall duration of the program will vary (3 to 14 weeks). Intervention could include attendance at day therapy centres, exercise, fitness, balance-retraining and/or socialisation, organisation of home help or community care packages, motivational interviewing or counselling.
NOTE: This RCT will be nested within a larger longitudinal cohort study that will evaluate functional decline over 13 months in older people who present to an Emergency Dept with non-catastrophic illness. All participants will be assessed at 1, 4, 7 13 months. Those participants assessed at 1 month follow-up to be at risk for functional decline (Score of <55 on the Mental Componenet Score of the SF-12) will enter the RCT.
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Intervention code [1]
286608
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Lifestyle
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Intervention code [2]
286609
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Prevention
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Intervention code [3]
286610
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Early detection / Screening
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Comparator / control treatment
No intervention, simply observed.
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Control group
Active
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Outcomes
Primary outcome [1]
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Functional decline.
Functional decline will be assessed as change from baseline measures for the following :
One or more falls increase from the baseline rate.
More than one event of hospitalisation from the baseline rate.
Functional change ie Decrease of one point in any item of the ADL instrument, or 2+ points decrease from baseline total iADL score, or any decrease in baseline score in the domains of home activities, doing laundry, shopping and getting places.
Scores decreasing from above median at baseline in either physical or mental domain, to below median in the SF12.
Any decrease in AQoL_4D.
Change to a more assistive gait aid (eg a one point stick to a four-pronged stick).
Change in living arrangements to more supported care.
Increased carer involvement.
Greater type and frequency of use of formal community services, or informal supports.
More frequent GP attendances.
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Assessment method [1]
288957
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Timepoint [1]
288957
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At 4, 7 and 13 months
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Secondary outcome [1]
301435
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Functional ability as assessed through face-to-face survey at baseline (recruitment), and via telephone followups, using: Short Form-12 Health Survey (SF12),
Activities of Daily Living (ADLs),
Instrumental Activities of daily Living (IADL)
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Assessment method [1]
301435
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Timepoint [1]
301435
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At baseline, 1, 4, 7 and 13 months
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Secondary outcome [2]
301436
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Mobility status and falls rates assessed from participants' self-reporting during face-to-face survey at baseline (recruitment), and via telephone at followups.
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Assessment method [2]
301436
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Timepoint [2]
301436
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At baseline, 1, 4, 7 and 13 months
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Secondary outcome [3]
301437
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Quality of life assessed using the Assessment of Quality of Life Instrument (AQoL). Face-to-face survey at baseline (recruitment), and via telephone at followups.
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Assessment method [3]
301437
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Timepoint [3]
301437
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At baseline, 1, 4, 7 and 13 months
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Secondary outcome [4]
301438
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Hospitalisation rates assessed through participants' self-reporting during face-to-face survey at baseline (recruitment), and via telephone at followups
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Assessment method [4]
301438
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Timepoint [4]
301438
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At baseline, 1, 4, 7 and 13 months
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Secondary outcome [5]
301439
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Formal community supports will be assessed from participants' self-reporting during face-to-face survey at baseline (recruitment), and via telephone at followups.
Data will include type of supports in use (eg home nursing, domestic help, shopping), frequency of visits
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Assessment method [5]
301439
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Timepoint [5]
301439
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At baseline, 1, 4, 7 and 13 months
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Secondary outcome [6]
301456
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Informal carer supports as assessed from participants' self-reporting during face-to-face survey at baseline (recruitment), and via telephone at lowups. This would include details of type of care provided (eg shopping, laundry, personal care) and frequency of visits.
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Assessment method [6]
301456
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Timepoint [6]
301456
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At baseline, 1,4,7,13 months
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Secondary outcome [7]
301457
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Living arrangements assessed from participants' self-reporting during face-to-face survey at baseline (recruitment), and via telephone at followups
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Assessment method [7]
301457
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Timepoint [7]
301457
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At baseline, 1,4, 7 and 13 months
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Secondary outcome [8]
301458
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General Practitioner (GP) visits (rate or number/month) as assessed from participants' self-reporting during face-to-face survey at baseline (recruitment), and via telephone at followups
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Assessment method [8]
301458
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Timepoint [8]
301458
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Baseline, 1, 4, 7, 13
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Eligibility
Key inclusion criteria
Aged 65 years or older.
Presented to an Emergency Department with non-catastrophic health conditions which will not result in admission to hospital for further care.
A score of <55 on the Mental Component Score of the SF12 instument one month after Emergency Department presentation.
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Minimum age
65
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Suffering communicable diseases requiring isolation.
Current mental health crisis.
Under detention.
Diagnosis of dementia.
Unable to communicate in English.
Profoundly deaf (such as would limit telephone communication at follow-up).
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Study design
Purpose of the study
Prevention
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Concealled allocation will randomly allocate participants to the intervention or control arm. Allocation will involve contacting the holder of the allocation schedule who is at a central administration site.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
A computerised random numbers sequence will be used.
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people assessing the outcomes
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Intervention assignment
Parallel
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Other design features
The RCT will be nested within a larger longitudinal cohort study
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
The study groups (arms) will be assessed at time of allocation for homogeneity in key socio-demographic characteristics and immutable factors (eg gender, age, schooling, postcode, diagnosis), and all baseline outcome measures.
Change over time in each outcome measure will be calculated using repeated measures ANOVA models, with study contact point, group and key demographic features as independent variables. Partial Least Squares models (PLS) using pathway analysis will be applied to the multiple outcome, immutable and mutable independent variables at each time point, to determine different spatial arrangements and the significant factors which impact on data clusters.
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
3/03/2014
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Actual
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Date of last participant enrolment
Anticipated
31/07/2014
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
570
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
SA
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Recruitment hospital [1]
676
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The Royal Adelaide Hospital - Adelaide
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Recruitment postcode(s) [1]
6416
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5001 - Adelaide
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Funding & Sponsors
Funding source category [1]
286798
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Self funded/Unfunded
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Name [1]
286798
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Address [1]
286798
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Country [1]
286798
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Australia
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Primary sponsor type
University
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Name
University of South Australia
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Address
North Tce, Adelaide, SA 5000
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Country
Australia
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Secondary sponsor category [1]
285588
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None
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Name [1]
285588
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none
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Address [1]
285588
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NA
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Country [1]
285588
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Australia
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Ethics approval
Ethics application status
Not yet submitted
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Ethics committee name [1]
288864
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University of South Australia Human Research Ethics Committee
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Ethics committee address [1]
288864
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North Tce, Adelaide SA. 5000
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Ethics committee country [1]
288864
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Australia
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Date submitted for ethics approval [1]
288864
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29/03/2013
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Approval date [1]
288864
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Ethics approval number [1]
288864
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Ethics committee name [2]
288865
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Royal Adelaide Hospital Human Research Ethics Committee
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Ethics committee address [2]
288865
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RAH, North Tce, Adelaide, SA. 5000
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Ethics committee country [2]
288865
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Australia
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Date submitted for ethics approval [2]
288865
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29/03/2013
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Approval date [2]
288865
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Ethics approval number [2]
288865
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Summary
Brief summary
The project will focus on older adults living independently in the community, and who are on the cusp of Functional Declune (FD). We will conduct a nested RCT within a 13 month longitudinal observational study. In the observational study we will apply a simple, previously untested quality of life screen to detect incipient Functional Decline, one month following an Emergency Dept presentation that did not result in an inpatient admission. Those individuals with low scores at the point of screening will enter the RCT, which will test the effectiveness of a novel, early, home-based, personalised program (compared with ‘usual care’) in arresting or slowing Functional Decline.
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Trial website
Nil
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Trial related presentations / publications
TBA
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Public notes
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Contacts
Principal investigator
Name
38134
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Prof Karen Grimmer
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Address
38134
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University of SA
North Tce
Adelaide, SA. 5000
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Country
38134
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Australia
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Phone
38134
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+61 8 83022769
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Fax
38134
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Email
38134
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[email protected]
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Contact person for public queries
Name
38135
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Julie Luker
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Address
38135
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University of SA
North Tce
Adelaide, SA. 5000
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Country
38135
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Australia
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Phone
38135
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+61 8 83022080
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Fax
38135
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Email
38135
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[email protected]
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Contact person for scientific queries
Name
38136
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Karen Grimmer
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Address
38136
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University of SA
North Tce
Adelaide, SA. 5000
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Country
38136
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Australia
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Phone
38136
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+61 8 83022769
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Fax
38136
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Email
38136
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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