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Trial registered on ANZCTR
Registration number
ACTRN12616000704493
Ethics application status
Approved
Date submitted
24/05/2016
Date registered
27/05/2016
Date last updated
27/05/2016
Type of registration
Prospectively registered
Titles & IDs
Public title
Measuring Individual Stress Levels In A Workplace Environment Using The Circadian Heart Rate
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Scientific title
Measuring Individual Stress Levels In A Workplace Environment Using The Circadian Heart Rate
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Secondary ID [1]
289286
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none
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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:
Stress
298874
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Condition category
Condition code
Mental Health
298945
298945
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0
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Other mental health disorders
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Intervention/exposure
Study type
Observational
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Patient registry
False
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Target follow-up duration
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Target follow-up type
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Description of intervention(s) / exposure
The aim of this study is to assess whether measures of circadian heart rate (CHR) can provide objective indications of stress and distress in the workplace. CHR is monitored at baseline and after a period of 8 weeks with a ‘Zephyr BioHarness 3 BTLE’ monitor worn with a strap around the participant's torso. At each assessment point the participant wears this device for up to 24 hours (wearing for a minimum of the sleep period, and for one hour either side of the sleep period). Measures of CHR will be compared with data obtained from self-report questionnaires and clinician interview (M.I.N.I.) to evaluate cross-sectional and predictive validity.
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Intervention code [1]
294838
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Not applicable
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Comparator / control treatment
No control group.
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Stress will be measured with the circadian heart pattern derived from the participant ECG data file recorded on the ‘Zephyr BioHarness 3 BTLE’ monitor. This device records the participant’s body temperature, respiration rate, actigraphy and ECG signal. The participant wears this device for up to 24 hours (wearing for a minimum of the sleep period, and for one hour either side of the sleep period). Overnight recordings are commonly used to measure CHR due to limited external confounds when sleeping (e.g., rigorous exercise). The target population are mining workers who we are going to recruit and assess onsite.
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Assessment method [1]
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Timepoint [1]
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Baseline and 8 week follow-up
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Secondary outcome [1]
324077
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Physical Activity assessed using Brief Physical Activity Assessment Scale (Marshall et al., 2005)
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Assessment method [1]
324077
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Timepoint [1]
324077
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Baseline and 8 week follow-up
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Secondary outcome [2]
324078
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Sleep Quality assessed using Bergen Insomnia Scale (Pallesen et al., 2008)
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Assessment method [2]
324078
0
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Timepoint [2]
324078
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Baseline and 8 week follow-up
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Secondary outcome [3]
324079
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Alcohol drinking behaviour assessed using AUDIT-C (Bush et al., 1998)
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Assessment method [3]
324079
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Timepoint [3]
324079
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Baseline and 8 week follow-up
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Secondary outcome [4]
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Participant's coping strategies assessed using a list of strategies that people have previously identified to regularly use to prevent and manage depression. These strategies have been specifically nominated by men in a previous qualitative study (Fogarty et al 2015) and have been used in a national online survey investigating Australian men’s use of positive coping strategies (Proudfoot et al., 2015).
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Assessment method [4]
324080
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Timepoint [4]
324080
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Baseline and 8 week follow up
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Secondary outcome [5]
324081
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Self-report measure of depression using Patient Health Questionnaire (PHQ-9; Kroenke et al., 2001)
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Assessment method [5]
324081
0
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Timepoint [5]
324081
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Baseline and 8 week follow-up
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Secondary outcome [6]
324082
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Self-report measure of anxiety using Generalized Anxiety Disorder Scale (GAD-7; Spitzer et al., 2006)
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Assessment method [6]
324082
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Timepoint [6]
324082
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Baseline and 8 week follow-up
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Secondary outcome [7]
324083
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General wellbeing assessed using WHO-5 Well-being Index (WHO, 1998)
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Assessment method [7]
324083
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Timepoint [7]
324083
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Baseline and 8 week follow-up
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Secondary outcome [8]
324084
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Workplace discrimination assessed using the Everyday Discrimination Scale (Williams et al., 1997).
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Assessment method [8]
324084
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Timepoint [8]
324084
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Baseline and 8 week follow-up
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Secondary outcome [9]
324085
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Job satisfaction using the 12-item short Job Content Questionnaire (as used in HILDA study)
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Assessment method [9]
324085
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Timepoint [9]
324085
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Baseline and 8 week follow-up
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Secondary outcome [10]
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Emotional resilience assessed using the Brief Resilience Scale (Smith et al., 2008)
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Assessment method [10]
324086
0
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Timepoint [10]
324086
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Baseline and 8 week follow-up
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Secondary outcome [11]
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Work-life balance assessed using Work-Family Balance Scale (Hill et al., 2001)
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Assessment method [11]
324087
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Timepoint [11]
324087
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Baseline and 8 week follow-up
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Secondary outcome [12]
324088
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Screening for major depressive disorder, panic disorder, psychotic disorders, generalised anxiety disorder and posttraumatic stress disorder with the M.I.N.I. International Neuropsychiatric Interview (M.I.N.I.).
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Assessment method [12]
324088
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Timepoint [12]
324088
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Baseline and 8 week follow-up
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Secondary outcome [13]
324089
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Workplace satisfaction assessed using the Physical Work Environment Satisfaction Questionnaire (Carlopio, 1996)
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Assessment method [13]
324089
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Timepoint [13]
324089
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Baseline and 8 week follow-up
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Secondary outcome [14]
324156
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Workplace bullying assessed using the Workplace Bullying Question (Kivimaki et al., 2000).
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Assessment method [14]
324156
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Timepoint [14]
324156
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Baseline and 8 week follow-up
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Eligibility
Key inclusion criteria
All Fortescue employees at three worksites (Cloudbreak, Port Hedland and the Perth administrative centre), in Western Australia, will be invited to participate
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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?
Yes
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Key exclusion criteria
Employees who have difficulty reading and understanding English
Employees who are currently suicidal (a score of 2 or more on question ix of PHQ-9)
Employees who do not meet any of the threshold scores in the self-report mental health/stress questionnaires will not be offered the intervention.
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Study design
Purpose
Screening
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Duration
Cross-sectional
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Selection
Convenience sample
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Timing
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Statistical methods / analysis
Based on pilot results, we show that accuracy of the algorithm using a conservative approach is between 70 and 80%. So for further calculations we will use a conservative representative accuracy of 70%
If the accuracy is 70%, then for severe cases, in order to show with statistical confidence (in a 2 by 2 contingency table) that correctly estimating severe levels of stress with an accuracy of 70% is unlikely to occur due to chance, (i.e. 95% confidence interval does not include 50%), would require 15 participants who present with a severe level of stress.
It is important to note that the 2by2 contingency table is forcing the algorithm to make a choice between severe stress and not severe stress (which includes normal, mild and moderate stress).
Given that the point prevalence of severe stress in the general population is estimated to be around 10%, this would mean that we would require a sample of 150 people in order to recruit 15 participants suffering from severe levels of stress.
The CHR output metrics will be compared with self-report and clinician interview data as follows:
1. Cross-sectionally against the measures of depression and anxiety (quantitative discrete variables), and diagnoses (quantitative discrete variables) using agreement statistics for dichotomous variables and ROC curves for continuous variables. We will evaluate an interaction with coping responses
2. Cross sectional measures of ‘normals’ against those who consider themselves stressed, depressed, or anxious on self report scales.
3. Longitudinally by validating changes in the participant’s CHR status with changes in symptoms and stressors.
4. User acceptability, feedback response and comfort ratings will be collected through questions embedded in the App.
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
1/08/2016
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Actual
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Date of last participant enrolment
Anticipated
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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
150
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
WA
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Funding & Sponsors
Funding source category [1]
293666
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Commercial sector/Industry
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Name [1]
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Medibio Ltd
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Address [1]
293666
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Suite 605, Level 6
50 Clarence Street
Sydney NSW 2000
[GPO Box 4492, Sydney NSW 2001]
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Country [1]
293666
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Australia
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Primary sponsor type
Individual
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Name
Nick Glozier
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Address
Level 5, Professor Marie Bashir Centre
The University of Sydney
67-73 Missenden Road
Camperdown NSW 2050
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Country
Australia
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Secondary sponsor category [1]
292501
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None
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Name [1]
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None
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Address [1]
292501
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None
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Country [1]
292501
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
295105
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The University of Sydney Human Research Ethics Committee
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Ethics committee address [1]
295105
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Level 6, Jane Foss Russell The University of Sydney NSW 2006 Australia
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Ethics committee country [1]
295105
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Australia
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Date submitted for ethics approval [1]
295105
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Approval date [1]
295105
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15/03/2016
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Ethics approval number [1]
295105
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2016/113
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Summary
Brief summary
Despite mental disorders being the leading cause of sickness, absenteeism and work incapacity in most developed countries, mental health has not been given due attention by most employer organisations. Recent evidence suggests that many mental health problems are preventable with adverse psychosocial work environments known to be a risk factor for mental disorders. Most of these adverse stressors are experienced initially through the development of “work stress” with some later deteriorating into frank mental disorder. There is a key issues in this context. Whilst the use of pen and paper technology based questionnaires is commonplace to screen for stress there are concerns over their false positive rate and predictive ability. Measures of Heart rate variability (HRV), the beat-to-beat temporal changes in the heart rate (HR), may provide an alternative measure for stress assessment. These beat-to-beat changes are commonly used as a quantitative marker depicting the activity of the autonomic nervous system (ANS), and thus related to mental stress. It has been suggested that changes in heart rate over 24 hours, or circadian heart rate (CHR) changes, may present adjunct information for stress assessment as circadian dysregulation is present in varying degrees in all psychiatric illnesses. As such, it has been proposed that HR profiling algorithms might provide an objective and predictive measure of stress becoming a clinical illness. This study aims to assess whether measures of CHR can provide objective indications of stress and distress in the workplace. CHR and self-report measures will be collected at baseline and 8 week follow-up.
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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 Nick Glozier
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Address
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Level 5, Professor Marie Bashir Centre
The University of Sydney
67-73 Missenden Road
Camperdown NSW 2050
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Country
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Australia
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Phone
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+61 2 9515 1596
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Fax
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Query!
Email
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[email protected]
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Contact person for public queries
Name
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Ariane Dahlheimer
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Address
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Level 5, Professor Marie Bashir Centre
The University of Sydney
67-73 Missenden Road
Camperdown NSW 2050
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Country
66143
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Australia
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Phone
66143
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+61 2 9515 1440
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Fax
66143
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Query!
Email
66143
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[email protected]
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Contact person for scientific queries
Name
66144
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Michael Player
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Address
66144
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Level 5, Professor Marie Bashir Centre
The University of Sydney
67-73 Missenden Road
Camperdown NSW 2050
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Country
66144
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Australia
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Phone
66144
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+61 2 9515 1440
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Fax
66144
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Email
66144
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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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