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Trial registered on ANZCTR
Registration number
ACTRN12620000822987
Ethics application status
Approved
Date submitted
26/06/2020
Date registered
18/08/2020
Date last updated
8/10/2021
Date data sharing statement initially provided
18/08/2020
Type of registration
Prospectively registered
Titles & IDs
Public title
Effect of an Augmented Trauma-Focused Cognitive Behaviour Therapy on Posttraumatic Stress Disorder
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Scientific title
Randomised Controlled Trial of Trauma-Focused Cognitive Behaviour Therapy versus Augmented Trauma-Focused Cognitive Behaviour Therapy on Posttraumatic Stress Disorder
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Secondary ID [1]
301631
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Nil
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Posttraumatic Stress Disorder
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Depression
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Condition category
Condition code
Mental Health
316071
316071
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0
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Anxiety
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Mental Health
316072
316072
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0
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Depression
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Mental Health
316358
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0
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Other mental health disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
There are two arms to this trial. Arm 1: Trauma-Focused Cognitive Behaviour Therapy. Arm 2: Augmented Trauma-Focused Cognitive Behaviour Therapy. Therapy is administered once-weekly 60 minute sessions by clinical psychologists over 11 weeks delivered. Trauma-Focused Cognitive Behaviour Therapy teaches the person skills in arousal reduction, exposure to trauma memories, restructuring of unrealistic thoughts, and relapse prevention. This will occur will via one-on-one sessions. All sessions will be audiotaped and fidelity checks of 10% of sessions for each treatment condition will be independently rated by independent experts. The duration of the study for any participant will conclude after a 2-year follow-up assessment, resulting in participation duration of 118 weeks.
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Intervention code [1]
317937
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Behaviour
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Comparator / control treatment
The comparator condition is Augmented Trauma-Focused Cognitive Behaviour Therapy. This therapy is administered once-weekly 60 minute sessions by clinical psychologists over 11 weeks delivered. Augmented Trauma-Focused Cognitive Behaviour Therapy teaches the same skills in as Trauma-Focused Cognitive Behaviour Therapy. It also teaches skills in positive event scheduling, rehearsal in promoting pleasurable experiences, and training in imagining positive aspects of future events. This will occur will via one-on-one sessions. The duration of the study for any participant will conclude after a 2-year follow-up assessment, resulting in participation duration of 118 weeks.
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Control group
Active
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Outcomes
Primary outcome [1]
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Posttraumatic stress disorder as measured by the Clinician Administered PTSD Scale.
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Assessment method [1]
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Timepoint [1]
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Pretreatment (week 1), posttreatment (week 12), primary follow-up (week 38), and long-term follow-up (week 118).
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Secondary outcome [1]
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Depression as measured by the Beck Depression Inventory.
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Assessment method [1]
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Timepoint [1]
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Pretreatment (week 1), posttreatment (week 12), primary follow-up (week 38), and long-term follow-up (week 118).
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Secondary outcome [2]
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Alcohol use as measured by the Alcohol Use Disorder Identification Test.
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Assessment method [2]
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Timepoint [2]
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Pretreatment (week 1), posttreatment (week 12), primary follow-up (week 38), and long-term follow-up (week 118).
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Secondary outcome [3]
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Quality of life as measured by the WHO-QOL BREF.
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Assessment method [3]
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Timepoint [3]
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Pretreatment (week 1), posttreatment (week 12), primary follow-up (week 38), and long-term follow-up (week 118).
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Secondary outcome [4]
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Hedonia as measured by the Pleasure Scale.
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Assessment method [4]
384218
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Timepoint [4]
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Pretreatment (week 1), posttreatment (week 12), primary follow-up (week 38), and long-term follow-up (week 118).
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Eligibility
Key inclusion criteria
• Satisfied PTSD criteria as defined by DSM-5 and measured by the Clinician-Administered
PTSD Scale
• Aged at least 18 years
• Sufficient English language ability
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Minimum age
18
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
• Current psychosis
• Imminent suicidal risk
• Current substance dependence
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Study design
Purpose of the study
Treatment
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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)
Participants will be adults meeting diagnostic criteria for PTSD. Participants wishing to participate will be randomly allocated according to a random numbers system administered by an individual who independent of the study and who works at a site that is independent from the trial centre.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Simple randomisation using a randomisation table created by computer software (i.e. computerised sequence generation)
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people assessing the outcomes
The people analysing the results/data
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
Analyses will focus primarily on intent-to-treat analysis. Using SPSS version 24, hierarchical linear mixed models (HLM) will be used to study differential effects of each treatment condition because this method effectively handles missing data by calculating estimates of trajectories. For the folow-up analyses between the two conditions, analyses will focus on linear time effects, treatment conditions, and interactions. Fixed effects parameters were tested with the Wald test (t-test, p <.05, two-sided) and 95% confidence intervals. Cohen’s (d) effect size was calculated for all analyses. The primary outcome measure will be the Clinician-Administered PTSD Scale at 6 months . The primary outcome timepoint will be the 6 months assessment.
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
1/09/2020
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Actual
21/09/2020
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Date of last participant enrolment
Anticipated
11/09/2023
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Actual
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Date of last data collection
Anticipated
17/11/2025
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Actual
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Sample size
Target
128
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Accrual to date
14
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Final
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Recruitment in Australia
Recruitment state(s)
NSW
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Recruitment hospital [1]
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Westmead Hospital - Westmead
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Recruitment postcode(s) [1]
30648
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2145 - Westmead
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Funding & Sponsors
Funding source category [1]
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Government body
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Name [1]
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NHMRC
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Address [1]
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16 Marcus Clarke St,
Canberra ACT 2601
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Country [1]
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Australia
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Primary sponsor type
University
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Name
UNSW Sydney
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Address
Anzac Pde, Kensington, NSW, 2052
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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NA
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Address [1]
306525
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NA
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Country [1]
306525
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
306287
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UNSW Human Research Ethics Committee
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Ethics committee address [1]
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UNSW HREC UNSW Sydney Sydney NSW 2052
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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18/05/2020
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Approval date [1]
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14/09/2020
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Ethics approval number [1]
306287
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Summary
Brief summary
Posttraumatic stress disorder (PTSD) is the most common psychiatric disorder that develops following exposure to a traumatic event, such as interpersonal violence, combat, life-threatening accidents, or natural disasters. It is characterised by severe and persistent stress reactions including: intrusive memories and nightmares of the trauma, hypervigilance, difficulty sleeping, emotional withdrawal, pervasive negative emotions, and avoidance of places, activities, and situations that are reminiscent of their trauma. The treatment of choice for posttraumatic stress disorder (PTSD) is trauma-focused psychotherapy. Trauma-focused psychotherapy typically commences with psychoeducation about the trauma responses, and then focuses on three major strategies: anxiety management, exposure, and cognitive restructuring. Despite support for this therapeutic approach, meta-analyses indicate that at least one-third of patients do not respond to this treatment. Whilst extant treatments have shown success in reducing negative affect, they have had limited effect on increasing positive affect.This may be because extant treatments have focused solely on addressing symptoms reinforced by the withdrawal/defensive system and ignored the need to increase approach/appetitive responding, that results in increased positive affect. Modifying TF-CBT to include strategies that specifically target the approach/appetitive system may address a gap in available treatments that fail to address symptoms of dysphoria and anhedonia. Positive Affect Training aims to restore positive moods in participants alongside traditional extinction learning which reduces over-activation of the withdrawal/defensive motivation system associated with negative affect. To address the gap in augmenting the benefits of TF-CBT, this trial aims to test whether modifying TF-CBT to augment it with strategies to address anhedonia via Positive Affect Training will result in greater treatment gains relative to TF-CBT.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Prof Richard Bryant
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Address
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School of Psychology
University of New South Wales
Sydney NSW 2052
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Country
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Australia
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Phone
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+61 293853640
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Fax
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+61 293853641
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Email
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[email protected]
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Contact person for public queries
Name
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Richard Bryant
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Address
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School of Psychology
University of New South Wales
Sydney NSW 2052
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Country
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Australia
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Phone
103379
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+61 293853640
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Fax
103379
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+61 293853641
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Email
103379
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[email protected]
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Contact person for scientific queries
Name
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Richard Bryant
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Address
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School of Psychology
University of New South Wales
Sydney NSW 2052
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Country
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Australia
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Phone
103380
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+61 293853640
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Fax
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+61 293853641
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Email
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
Yes
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What data in particular will be shared?
All of the individual participant data acquired throughout the trial, including all assessments, as well as related data dictionaries will be available.
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When will data be available (start and end dates)?
Data will be available following publication of the study outcomes. There is no end date for when this data will be available.
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Available to whom?
Researchers wishing to conduct reanalyses of the data.
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Available for what types of analyses?
Meta-analyses or reanalyses of subgroups
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How or where can data be obtained?
By emailing the Principal Investigator (email:
[email protected]
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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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