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Trial registered on ANZCTR
Registration number
ACTRN12611001123932
Ethics application status
Approved
Date submitted
21/10/2011
Date registered
27/10/2011
Date last updated
31/10/2011
Type of registration
Retrospectively registered
Titles & IDs
Public title
The effect on birth outcomes of discussions in early pregnancy, emphasising the importance of eating fish.
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Scientific title
The effect on birth outcomes, especially birthweight, head circumference and other indices of fetal wellbeing, of discussions with women attending a UK antenatal clinic at 20 weeks' pregnancy or less , during which the benefits of eating fish during pregnancy were emphasised.
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Secondary ID [1]
273217
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Nil
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Universal Trial Number (UTN)
U1111-1125-2646
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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:
Encouraging healthy pregnancy outcomes
278980
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Condition category
Condition code
Reproductive Health and Childbirth
279155
279155
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0
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Normal pregnancy
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
One informal one-to-one discussion of 15 - 20 minutes, between the researcher and pregnant women at 20 or fewer weeks gestation, covering lifestyle and diet, in which the benefits of eating fish, especially oily fish, were emphasised. The interviewees were all attending antenatal clinic at a UK hospital for the first time in that pregnancy and had no apparent complications of this pregnancy to date. The intervention was in addition to the standard antenatal care offerd by the hospital clinic.
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Intervention code [1]
269547
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Lifestyle
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Comparator / control treatment
Controls, identified by blind randomisation, received the standard antenatal care offered by the hospital clinic.
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Control group
Active
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Outcomes
Primary outcome [1]
279794
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Percentage of babies with birthweight below 2500g.
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Assessment method [1]
279794
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Timepoint [1]
279794
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After the last participant had given birth
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Secondary outcome [1]
294443
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Percentage of babies of 4200g or greater birthweight
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Assessment method [1]
294443
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Timepoint [1]
294443
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After the last participant had given birth
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Secondary outcome [2]
294444
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Mean birthweight (g)
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Assessment method [2]
294444
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Timepoint [2]
294444
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After the last participant had given birth
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Secondary outcome [3]
294445
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Mean head circumference (cms)
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Assessment method [3]
294445
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Timepoint [3]
294445
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After the last participant had given birth. Head circumference was measured at birth by the attending midwife.
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Secondary outcome [4]
294446
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Mean body length (cms)
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Assessment method [4]
294446
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Timepoint [4]
294446
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After the last participant had given birth. body length was measured at birth by the attending midwife.
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Secondary outcome [5]
294447
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Percentage of babies born under 37 weeks gestation
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Assessment method [5]
294447
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Timepoint [5]
294447
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After the last participant had given birth
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Secondary outcome [6]
294448
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Mean birthweight adjusted for gestational age and gender
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Assessment method [6]
294448
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Timepoint [6]
294448
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After the last participant had given birth
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Secondary outcome [7]
294449
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Mean head circumference adjusted for gestational age and gender
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Assessment method [7]
294449
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Timepoint [7]
294449
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After the last participant had given birth
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Secondary outcome [8]
294450
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Percentage of babies with birthweight below 1500g
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Assessment method [8]
294450
0
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Timepoint [8]
294450
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After the last participant had given birth
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Eligibility
Key inclusion criteria
Women up to and including 20 weeks gestation, making their first visit to the antenatal clinic in their current pregnancy
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Females
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Can healthy volunteers participate?
Yes
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Key exclusion criteria
Patients under 18 years old unless accompained by a responsible adult who could sign consent
Epileptics
Women with a recent psychiatric history
Patients taking part in existing studies, where inclusion may adversely affect either project
Women with a poor obstetric or medical history
Known drug users
Non-English speaking women if a translator was not available
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Study design
Purpose of the study
Educational / counselling / training
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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)
The hospital files of pregnant women who were to make their first visit to the antenatal clinic at the hospital were checked by the researcher, and all eligible women were given information and consent forms by the antenatal clinic receptionists upon registration at the clinic reception desk. The researcher then approached these women individually and asked if they would take part in the study, if necessary reading the letter to them or providing further explanation. Women who did not wish to participate were thanked for reading the letter and were not made to feel uncomfortable about their refusal. Those who signed the consent forms were given a numbered, opaque envelope to open that contained a letter informing them that they were, or were not to be interviewed. Consent forms were noted with ‘intervention’ or ‘control’ and the number of the envelope, and were filed in the patients’ hospital notes.
Women allocated to the control group were thanked for their participation and assured that their baby’s birth details would be of importance to the study. The researcher explained to intervention group women that she would be talking to them about pregnancy and that she would find them after their ultrasound scans, while they were waiting to see the doctor. Women randomised to the intervention group were duly identified and collected from the waiting area of the antenatal clinic following ultrasound scans but before seeing the consultant.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Women agreeing to participate were randomised either to standard antenatal care plus a discussion or to standard antenatal care only. Letters allocating women to either intervention (I) or control (C) groups were placed in opaque sealed envelopes by someone unconnected with the trial. The envelopes were numbered consecutively in accordance with lists of randomly created blocks of 5, using the throw of a die, producing allocation sequences such as ICICI or IICIC. The 3:2 randomisation was chosen to maximise the researchers' time for interviewing in clinic.
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
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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
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/04/1998
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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
2837
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Accrual to date
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Final
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Recruitment outside Australia
Country [1]
3910
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United Kingdom
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State/province [1]
3910
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West Midlands
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Funding & Sponsors
Funding source category [1]
270042
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Commercial sector/Industry
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Name [1]
270042
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The Seafish Industry Authority
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Address [1]
270042
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Sea Fish Industry Authority. Seafish House, St Andrews Dock, Hull HU3 4QE
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Country [1]
270042
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United Kingdom
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Primary sponsor type
Commercial sector/Industry
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Name
The Seafish Industry Authority
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Address
Sea Fish Industry Authority.
Seafish House,
St Andrews Dock,
Hull
HU3 4QE
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Country
United Kingdom
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Secondary sponsor category [1]
269013
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Charities/Societies/Foundations
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Name [1]
269013
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Primal Health Research Centre
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Address [1]
269013
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72 Savernake Road, London NW3 2JR
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Country [1]
269013
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United Kingdom
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
271996
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Wolverhampton Health Authority Wolverhampton District Research Ethics Committee
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Ethics committee address [1]
271996
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Merged - now: West Midlands - Staffordshire NRES Prospect House Fishing Line Road Enfield Redditch B97 6EW
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Ethics committee country [1]
271996
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United Kingdom
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Date submitted for ethics approval [1]
271996
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01/10/1997
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Approval date [1]
271996
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19/11/1997
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Ethics approval number [1]
271996
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Project 399
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Summary
Brief summary
Research findings indicate that pregnant women should increase their intake of oily fish before, during and after pregnancy and that they should breastfeed. Despite this advice, no direct evidence exists that increased oily fish intake during pregnancy is beneficial to birth outcomes. In addition the possible effectiveness of personalised dietary advice given to women antenatally has been little-investigated. The nutritional advice approach differs from that of fish oil supplementation as eating fish is a dietary choice and oily fish may have effects differing from those of supplementation because of the many nutrients present in addition to omega-3 fatty acids. In an study carried out at Whipps Cross Hospital by Dr Michel Odent a single discussion session was held at or before 20 weeks gestation, at which stage of pregnancy, the brain growth spurt and rapid endothelial growth begin, that focused on an increased intake of oily fish and a reduced intake of trans-fatty acids. Trends to greater birthweight, head circumference, body length and to a lower incidence of low birthweight were observed. Thus the effect of giving advice to pregnant women to increase intake of oily fish was sufficiently positive to indicate the value of further study. Controlled prospective studies exploring the effect of encouraging consumption of oily fish and a reduction in the intake of trans-fatty acids have not been carried out. The benefits of improving maternal nutrition before and during pregnancy and throughout lactation are many. The health of the baby is dependent on maternal nutrition and there is evidence to suggest that small birth size is a major contributor to the cause of adult disease, including hypertension, coronary heart disease, type II diabetes and renal disease. Treating and caring for people with coronary heart disease costs Britain about £7billion each year, according to the British Heart Foundation, and the cost of caring for patients with type II diabetes is estimated by Diabetes UK to be £3.5billion annually. There are clear public health benefits in reducing the incidence of low birthweight and consequently the prevalence of these debilitating and costly diseases. It is hypothesised that a one-to-one informal discussion with pregnant women before 20 weeks gestation, emphasising the benefits to mother and fetus of oily fish consumption, will result in improved birth outcomes.
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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
33272
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Address
33272
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Country
33272
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Phone
33272
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Fax
33272
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Email
33272
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Contact person for public queries
Name
16519
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Dr Lesley Meeson
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Address
16519
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University of Wolverhampton Centre for Health and Social Care Improvement ML Building Deanery Row Off Molineux street Wolverhampton WV1 1DT
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Country
16519
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United Kingdom
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Phone
16519
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+44 (0) 1902 518631
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Fax
16519
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+44 (0) 1902 518600
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Email
16519
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[email protected]
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Contact person for scientific queries
Name
7447
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Dr Lesley Meeson
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Address
7447
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University of Wolverhampton Centre for Health and Social Care Improvement ML Building Deanery Row Off Molineux street Wolverhampton WV1 1DT
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Country
7447
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United Kingdom
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Phone
7447
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+44 (0) 1902 518631
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Fax
7447
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+44 (0) 1902 518600
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Email
7447
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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