April 28, 2017

Agreements Regarding the Application of the Ethics Committee Establishment
Requirements to Students in Relation to Human Subject Research within theKanazawa University Institute of Human and Social Sciences
Based upon the Kanazawa University Institute of Human and Social Sciences
Human Subject Research Ethics Guidelines (hereafter referred to as the “EthicsGuidelines”) and the Requirements on the Establishment of the Ethics Committee atthe Institute of Human and Social Sciences Ethics Committee, Kanazawa University(hereafter referred to as the “Requirements”), the following is agreed upon in regardto research carried out by students of the College of Human and Social Sciences, theGraduate School of Human and Socio-Environmental Studies, the Graduate School ofProfessional Development in Teacher Education, and the School of Law.
1. In the event that students carry out human subject research as set forth in theEthics Guidelines, the advising instructor shall notify the students of the Ethics
Guidelines and instruct them to ensure strict adherence.
2. The advising instructor shall make the decision as to whether the research
conducted by the student requires a review application to the Ethics Committee, basedon the Research Review Application (Ethics Committee Establishment RequirementsForm 2 [Student-Use]) completed by the student and in accordance with Ethics
Guidelines 4 and Article 13 of the Requirements.
3. After the decision on the necessity of review is made, the advising instructor shallcheck/confirm the student-made research review application form drafted inaccordance with the specified form. In addition, after receiving the confirmation by
the advising instructor, the student shall submit the review application with thespecified form attached.
(By rule, student application reviews are conducted once a month. Every month theapplications submitted by the third Wednesday of the month are subject to reviewing
by the Review Committee. The results of the review shall be notified to the applying
student through the advising instructor in the following month.)

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Form
Student Checklist for Human Subject Research Ethics Review
Application

Affiliation (Undergraduate):(Graduate School):

Academic Field
ProgramCourse (Specialization)

Major

CourseApplicant’s Name:

Research Subject:

Items to Check

1

This research requires a review by the Ethics Committee(related to Article 13 of the Ethics Committee Establishment
Guidelines).

2

Respect is given to the dignity of life and individuals, fundamental
human rights, and consideration is given to ensure the research isexecuted through methods and procedures that are scientificallyand socially acceptable (related to Ethics Guidelines 3[1]).

3

The research observes the ethical rules of the academic societies andorganizations it is associated with. It also adheres to national and otherrelated regulations and the Kanazawa University (National UniversityCorporation) Personal Information Management Regulations (related toEthics Guidelines 3[2].

4The collection and extraction of personal information and data isperformed using safe and assured methods. Effort is given to minimize
providers’ physical and mental burden and pain (related to Ethics
Guidelines 3[3]).

5Consideration is given to the responsibility to provide explanations to theproviders of personal information and data (related to Ethics Guidelines
5).

Advising instructor
is to write a check foreach item confirmed
and a dash for thoseareas not applicable.

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Consideration is given regarding the receipt of consent from providers of
personal information and data (related to Ethics Guidelines 6).

7

Consideration is given to the management of information and data receivedfrom providers (related to Ethics Guidelines 7).

8(In the event that personal information and data is collected and extracted
through a commission given to a third party)
Consideration is given to ensure the third party adheres to the Ethics
Guidelines and if necessary, to ensure that direct explanations are given
to the providers regarding the purpose of the research and other issues(related to Ethics Guidelines 9).

9(In the event that money or other articles are given to the providers of
personal information or data as an expression of thanks)
Consideration is given so that the amounts are set within the scope ofthat which is socially acceptable, and to the proper management ofpayments and receipts (related to Ethics Guidelines 11).

I have confirmed the above items.
Advising Instructor

Advising Instructor’s Opinions and Notes

SEALYEARMONTH DAYPoints to Note when Preparing and Reviewing an Institute of Human and Social
Sciences Human Subject Research Ethics Review Application FormApril 28, 2017
Institute of Human and Social Sciences Ethics Committee

Applicants are required to adhere to the following points when they apply forthe review by the Committee. The advising instructors are also highly expected toreview and check the contents of the application submitted by the student
applicants in reference to the points shown below. To the extent that it does notinterfere with the implementation of the research, please write in detailed terms foreach item on the Application Form. Entry boxes for each item may be enlarged toaccommodate all the necessary information.
Name of Information Manager*The name of the manager of personal information and data must be written (inparticular, the name of the actual person serving as the manager must be clearlystated, when there is more than one joint researcher). (-> Check Item 7 of the Form)

Research Overview*In addition to the purpose and goals of the research, the accumulation andextraction methods for personal information or data must be written in detailedterms. (-> Check Item 2 of the Form)*When collecting personal information or data using questionnaires or othermeans, describe the research plan in as detailed terms as possible so that
reviewers can properly evaluate the validity and reliability of the constructive
concepts on question items and other considerations.

Additionally, if possible, thequestionnaire sheet(s) should also be submitted. (-> Check Item 2 of the Form)

Test Subject Particulars*Numbers, age, sex, and other information of subjects must be clearly stated indetailed terms.

In particular, when providers are less than 15 years old or have aphysical or mental disability, such facts must be added.

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Ethical Considerations and Other Issues Related to the Possible Types ofInvasiveness that May Arise Through the Research as well as the Presence ofDisadvantages and Dangers (***) (Including Information and Data Storageand Management Methods)*Methods of collection and extraction of personal data and information described in
the Research Overview must clearly state whether they include the possibility ofphysical, mental or social harm to the providers, and, if they do carry such a risk,
whether it is socially permissible to implement them. (-> Check Item 4 of the Form)*By rule, research goals and contents, disadvantages and dangers, theanonymization or lack of anonymization of information and data, etc. must be
fully explained to providers in writing or orally before obtaining the consent form(in the case of a questionnaire, it must be written that the providing of answers
is automatically seen as providing consent). Furthermore, in the event thatproviders are less than 15 years old or have physical or mental disability, it may, asneeded, be necessary to obtain a consent form from that individual’s proxy. (->Check Items 5 and 6 of the Form)*In investigative research utilizing interviews, participant observation, andquestionnaires, researchers must explain verbally, in documentation, or in thequestionnaire that research participation is conducted through the free will ofproviders, that providing answers is voluntary, that it is possible to withdraw or refuse
to provide answers midway, and that no disadvantageous consequences will result forproviders.
(-> Check Item 5 of the Form)*In the event that questionnaires require the participants to write down theirname, explanations must be provided verbally, in document form or on thequestionnaire stating the reason for including written names, and also no damage
will be suffered by providers as a result of providing one’s name. (-> Check Item
5 of the Form)*It must be clearly stated whether the collected and extracted personal
information or data will be anonymized (if anonymized, whether it is linkableanonymizing* or non-linkable anonymizing**). (-> Check Item 7 of the Form).
*The required period and appropriate storage management method for collected
or extracted personal information and data must be clearly stated. (-> Check Item3

7 of the Form)*When implementing joint research with companies, local governments or similar
entities, the collection and handling of personal information must be clearlyspecified in the Joint Research Application, Joint Research Plan and Joint ResearchContract. (-> Check Item 8 of the Form)(*Linkable Anonymizing: Information that makes it possible to identify aparticular individual is removed from the original data, and is anonymized byassigning new codes or numbers.

In retaining and managing a correspondence

table of symbols and relevant individuals, linking is possible.)(**Non-Linkable Anonymizing: Anonymization utilizing a method in which acorrespondence table of relevant individuals and their new assigned codes ornumbers is not retained, making it impossible to discern a particular individualfrom the original data.)
Notes:*Remuneration to providers, when it is given, must not be excessive in terms ofmoney or goods, and a statement must be included saying that payment andreceipts are managed appropriately. (-> Check Item 9 of the Form)*When a student makes an application, it must be written that the student hasread and understood the Human Subject Research Ethics Guidelines of theInstitute of Human and Social Sciences, Kanazawa University.

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