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Trial registered on ANZCTR
Registration number
ACTRN12614000732684
Ethics application status
Approved
Date submitted
14/05/2014
Date registered
10/07/2014
Date last updated
18/12/2017
Type of registration
Prospectively registered
Titles & IDs
Public title
The Aboriginal Cardiovascular Omega-3 Randomised Controlled Trial
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Scientific title
The effect of omega-3 supplementation on adverse cardiovascular (CV) events among Indigenous Australians with stable coronary artery disease: A randomized controlled trial
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Secondary ID [1]
284601
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Nil
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Universal Trial Number (UTN)
Nil
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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:
atherosclerosis
291903
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factors associated with thrombus formation
291904
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heart rate variability
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Coronary Artery Disease
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Condition category
Condition code
Cardiovascular
292248
292248
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0
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Coronary heart disease
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Cardiovascular
292249
292249
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0
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Other cardiovascular diseases
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Arm 1
a. AlaskOmega® 400200 TG 1000mg (Bioriginal, Nehterlands) (containing 400mg EPA and 200mg DHA per capsule), ensuring the patients receive 1800 mg of n-3 LCPUFA
b. softgel oral capsule
c. 3 capsules once daily for minimum 6 months
All study drugs will be given to participants in a 28-day Webster pack. Participants will have their monthly supply delivered to them (at home or clinic) by a member of the clinical team. The study participant will be asked to return the used and unused containers at each visit. Accountability of IP consumption will be evaluated by a member of the clinical team through subject interview and the counting of unused study drug. Compliance (percent) = (the number consumed) ÷ (the number prescribed) x 100. Lost or discarded IP should not be included in the calculation. This information will be recorded on a standard reporting form and monitored across the program. If compliance is less than 80%, subjects will receive additional instructions about treatment regimens.
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Intervention code [1]
289374
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Treatment: Drugs
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Comparator / control treatment
Arm 2
placebo
a. 1000 mg oil blend containing palm oil, gelatin, glycerol, sunflower oil, rapeseed oil, mixed tocopherols and a small amount of fish oil (for taste) to aid blinding
b. softgel oral capsule
c. 3 capsules once daily for minimum 6 months.
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Control group
Placebo
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Outcomes
Primary outcome [1]
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The impact of Omega 3 (n-3 PUFA) supplementation on non-HDL-C levels assessed by serum assay
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Assessment method [1]
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Timepoint [1]
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6 months after randomisation
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Secondary outcome [1]
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Assessment of the impact of Omega 3 (n-3 PUFA) supplementation on reducing blood levels of triglycerides, total cholesterol, and LDL cholesterol assessed by serum assay
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Assessment method [1]
308223
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Timepoint [1]
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6 months after randomisation
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Secondary outcome [2]
309174
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Assessment of the impact of Omega 3 (n-3 PUFA) supplementation on increasing HDL cholesterol levels assessed by serum assay
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Assessment method [2]
309174
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Timepoint [2]
309174
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6 months after randomisation
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Secondary outcome [3]
309175
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Assessment of the impact of Omega 3 (n-3 PUFA) supplementation on improving lipid functionality as measured by cholesterol efflux and plasma cholesteryl ester transfer protein [CETP] activity.
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Assessment method [3]
309175
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Timepoint [3]
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12 months after randomisation
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Secondary outcome [4]
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6 months after randomisation
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Assessment method [4]
309176
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Timepoint [4]
309176
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6 months after randomisation
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Secondary outcome [5]
309177
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6 months after randomisation
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Assessment method [5]
309177
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Timepoint [5]
309177
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6 months after randomisation
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Secondary outcome [6]
309178
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6 months after randomisation
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Assessment method [6]
309178
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Timepoint [6]
309178
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6 months after randomisation
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Secondary outcome [7]
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Assessment of the impact of Omega 3 (n-3 PUFA) supplementation on reducing the cumulative rate of combined Major Adverse Cardiac Events - including death, non-fatal myocardial infarction or unstable angina, non-fatal stroke, revascularisation (e.g. coronary artery bypass graft, percutaneous coronary intervention) and cardiac related hospital admissions.
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Assessment method [7]
309179
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Timepoint [7]
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6 months after randomisation
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Eligibility
Key inclusion criteria
* Men or women, self-identified as Indigenous
* Aged over 18 years
* Have confirmed Coronary Artery Disease [CAD] (according to nationally consistent definitions):
* Prior hospitalisation for myocardial infarction/acute coronary syndrome
* Prior revascularisation
* Proven coronary stenosis >50%
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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
* Non-residents of South Australia or Alice Springs, NT.
* Patients with significant neurological/cognitive impairment that prevents consent
* Hypersensitivity or documented allergy to the study drug
* Known bleeding disorder or end-stage renal disease requiring dialysis
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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)
central randomisation by computer
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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
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people administering the treatment/s
The people assessing the outcomes
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 4
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
All analyses will be performed on an intention-to-treat basis. Comparison of baseline and end-point data will involve chi-square analysis (with calculation of OR and 95% CI) for discrete variables, Student’s t test for normally distributed continuous variables and Mann-Whitney tests for non-normally distributed variables. Kaplan-Meier survival curves will be constructed using time-dependent, all-cause survival and event-free survival data. Survival and event-free data will be further analysed (log-rank and Breslow test) for any differences in the number and/or timing of events. Where applicable, study end-points will be calculated as the frequency of events/patient/month of follow-up. The change from baseline markers will be analysed by a mixed-model, repeated measures ANOVA. The model will include effects of treatment, time period, and treatment-by-time interactions and changes from baseline to 12 months compared by a two-sample t-test.
Based on a two-sided alpha of 0.05, a total of 85 patients in each group (170 in total) will provide 90% power to detect a clinically significant 15% additional reduction in non-HDL cholesterol as the primary endpoint for those randomised to n-3 PUFA compared to placebo. 15% decreases in atherogenic lipid parameters are considered clinically relevant by contemporary trials and regulatory authorities for approval of lipid lowering drugs. We will aim to recruit a total of 220 participants (110:110) to allow for 25% loss to follow-up over the 12-month intervention period.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/10/2014
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Actual
1/05/2015
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Date of last participant enrolment
Anticipated
30/06/2017
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Actual
13/04/2017
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Date of last data collection
Anticipated
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Actual
13/11/2017
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Sample size
Target
220
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Accrual to date
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Final
89
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Recruitment in Australia
Recruitment state(s)
NT,SA
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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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National Health and Medical Research Council
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Address [1]
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National Health and Medical Research Council
GPO Box 1421
Canberra ACT 2601
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Country [1]
289231
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Australia
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Primary sponsor type
Other
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Name
South Australian Health and Medical Research Institute
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Address
North Terrace
Adelaide, SA 5000
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Country
Australia
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Secondary sponsor category [1]
287904
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None
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Name [1]
287904
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Address [1]
287904
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Country [1]
287904
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
291000
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Aboriginal Health Research Ethics Committee
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Ethics committee address [1]
291000
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Aboriginal Health Council of South Australia PO Box 981, Unley SA 5061
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Ethics committee country [1]
291000
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Australia
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Date submitted for ethics approval [1]
291000
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Approval date [1]
291000
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10/04/2014
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Ethics approval number [1]
291000
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04-14-556
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Ethics committee name [2]
291001
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Royal Adelaide Research Ethics Committee
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Ethics committee address [2]
291001
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North Terrace Adelaide, SA 5000
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Ethics committee country [2]
291001
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Australia
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Date submitted for ethics approval [2]
291001
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11/06/2014
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Approval date [2]
291001
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01/08/2014
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Ethics approval number [2]
291001
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Ethics committee name [3]
297429
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Central Australian Human Research Ethics Committee
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Ethics committee address [3]
297429
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Department of Health and Community Services PO Box 721 Alice Springs NT 0871
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Ethics committee country [3]
297429
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Australia
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Date submitted for ethics approval [3]
297429
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28/04/2016
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Approval date [3]
297429
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20/09/2016
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Ethics approval number [3]
297429
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HREC-16-381
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Summary
Brief summary
Heart disease is the single biggest cause of death for Aboriginal and Torres Strait Islander people and the main reason for the difference in life expectancy between Indigenous and non-Indigenous Australians. Indigenous Australians are 3 times more likely to suffer “heart attacks” than non-Indigenous Australians and are 1.5 times more likely to die as a result. Recent studies suggest that Omega 3 polyunsaturated fatty acids (PUFAs) may help prevent “heart attacks” in people who already have coronary artery disease. Coronary artery disease is caused by plaque building up along the inner walls of the arteries of the heart, which narrows the arteries and reduces the blood flow to the heart. Omega 3 oil is a polyunsaturated fatty acid (PUFA) found in some plants, seafood, and, to a lesser extent, eggs and meat. Omega-3 is seen as "essential" because the human body can't produce it and so we must get it from foods or supplements. Several studies around the world have shown a decrease in the risk of sudden cardiac death (SCD) associated with increased consumption of fish or fish oils. This study is likely to be very important for understanding the main cause of death and life expectancy gap for Aboriginal people, as well as providing evidence to guide policy and clinical practice. The purpose of this study is to test the effectiveness of Omega-3 Long Chain Polyunsaturated Fatty Acid supplementation in Aboriginal adults with established coronary artery disease (CAD) to determine effects on factors implicated in adverse cardiovascular (CV) events including: atherogenic and protective lipid factors, Inflammatory factors, factors associated with thrombus formation, arrhythmic risk as measured by heart rate variability, and major adverse cardiovascular events (MACE). The Aboriginal Cardiovascular Omega 3 (AC Omega 3) trial aims to find out if Aboriginal patients who have coronary artery disease will be better protected from having “heart attacks” by taking an Omega 3 oil supplement and if so how does it help do this.
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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 Alex Brown
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Address
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Wardliparingga Aboriginal Research Unit, SAHMRI
PO Box 11060, Adelaide, SA 5001
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Country
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Australia
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Phone
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+61 8 8128 4210
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Fax
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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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Alex Brown
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Address
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Wardliparingga Aboriginal Research Unit, SAHMRI
PO Box 11060, Adelaide, SA 5001
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Country
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Australia
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Phone
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+61 8 8128 4210
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Fax
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Email
48407
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[email protected]
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Contact person for scientific queries
Name
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Alex Brown
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Address
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Wardliparingga Aboriginal Research Unit, SAHMRI
PO Box 11060, Adelaide, SA 5001
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Country
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Australia
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Phone
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+61 8 8128 4210
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Fax
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Email
48408
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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.
Download to PDF