ࡱ                >  	               X          Z          W    g	                  bjbjVV                  	 4.  r< r<       :                                                                                 d      d      d                 x      x      x  8     $     4   x      H  b          "   *      *      *                        {H     }H      }H      }H      }H      }H      }H  $   ^J    M  \   H                     d                              @                     H                          *              *    H                         p     R   *      d      *      {H                                                                          {H                        C  D  B  "                                                                   oG      *          Pe              ^   D  &           gH     H  0   H      	E  f  lM      U    lM  L   oG                                                                              lM              d      oG       Z   a  @           4                                                          H      H                                      g                                                       H                                                                                                                  lM                                                                                                                           :     	                                                                                                                                                                                                                                                                                                                                                                                                                                      WESLEY COLLEGEINSTITUTIONAL REVIEW BOARD (IRB)For the Protection of Human SubjectsApplication for Review Must be typed, signed, and delivered to Chair, Wesley College IRB	Part IPrincipal Investigator (PI):		    Office #:		    Phone #:	Investigator(s) - indicate faculty, staff, or student status as appropriate		Name:		Address:						Phone (h)				Phone (w)	Title of Proposal:		Check all of the appropriate categories and mark all of the appropriate blanks:_______	Will children be used as subjects:1 = yes		2 = noIf yes, supply assurance that consent will be obtained from the child and the parent/guardian or explain alternative approaches._______	Will confidential material be recorded or reviewed?		1 = yes		2 = no_______	Will licensed drugs, medicinal herbs or diagnostic reagents be administered to human subjects?	1 = yes		2 = no_______	Will investigational devices be used (invasive medical equipment)?	1 = yes		2 = no_______	Will project involve research on pregnant women and/or their fetus?	1 = yes		2 = noStudy location(s): Identify subjects to be recruited: Age range of Subjects: Project will involve: 	Males only	      Females only 	       Males and FemalesSource of patient population 							or*Source of non-student, normal volunteers Include in the research plan a description of the recruitment procedure and specify any remuneration provided.  Proposed ads for recruiting subjects/patients are to be reviewed by the IRB prior to publication in newspapers or posting on bulletin boards.Number of subjects (experimental and controls) expected to be enrolled: Specific research questions(s) to be addressed by this protocol:Parts II, III, and IV of the application should be detailed in an attachment of NO MORE THAN THREE PAGES and provided in consecutive order.  Submission of a more extensive description is not an acceptable fulfillment of the requirement and will be returned without review.  Supporting data, relevant publications, etc. may be included as an appendix.II.   RATIONALE:	State the problem, the present knowledge relevant to it, and the aims of the proposed study as relating to the research questions.  III. PROTOCOL:	Briefly describe the experimental design.  Identify all procedures and carefully distinguish those which are experimental from those which are routine clinical care.  Briefly describe the experimental design, including methods to assess results.  If the protocol involves use of questionnaires or interview instruments, a copy of these documents must be filed with this application.IV. RISKS:	Describe major and minor risks and their expected frequencies.  Consider physical, psychological, and socio-economic risks.  Detail any measures that will be taken to minimize and deal with the risks. In studies without therapeutic benefit to subjects, both minor risks and possible late side effects from participation in the study should be included.V.  CONSENT	Consent must be obtained from all participating subjects (or their parents/guardians).      PROCEDURES:   If you believe that consent cannot reasonably be obtained for this study, justify this request in detail.  Submit an original and one copy of the proposed consent document.  Consent applications must be typed on the enclosed form.  Guidelines for writing a consent form are attached to this application form.  If you do not anticipate any financial support, and the project involves clinical procedures conducted primarily for research purposes, provide an explanation of the expected source of payment for these procedures.  The IRB seeks reassurance that patients will not be put into financial risks from participation in the research study.	_____________________________					_____________	Signature of Primary Investigator					 Date	_____________________________					_____________	Signature of Supervising Faculty (if not PI)				 DatePAGE  PAGE  1		Rev. 9.1.2010      DO NOT WRITE IN THIS BLOCKStudy Number   _____________Approval            _____________Approved by      _____________Risk 		  ____________Completed, typed forms should be mailed or dropped off:Wesley College Chair, Institutional Review Board (IRB)                                                                                                                                                                                                                                                                                                                        &  )  l  m  n                                            dVDVVV  #he hH >*CJ OJ QJ ^J aJ hH CJ OJ QJ ^J aJ  4j    hp hH CJ OJ QJ U^J aJ mH nH u  hp hH CJ OJ QJ ^J aJ   he hH CJ OJ QJ ^J aJ  he CJ OJ QJ ^J aJ   he h}w CJ OJ QJ ^J aJ  he 5CJ OJ QJ ^J aJ h}w 5CJ OJ QJ ^J aJ hH 5CJ OJ QJ ^J aJ #hp hH 5CJ OJ QJ ^J aJ       0  U  V  n                                      	  	  Q	  R	  Z	                                                                                                                                                                                                                                                                                                                                                         gdH    $a$gdH        	  	  	  	  P	  T	  U	  j	  k	  z	  {	  	  	  	  	  w  x  y      C  D  E  F  H  I  J  K  p  q  r  s                           	    #  5  6  9  :                      ´     #hp hH >*CJ OJ QJ ^J aJ he CJ OJ QJ ^J aJ  h CJ OJ QJ ^J aJ   hp h CJ OJ QJ ^J aJ   hp hH CJ OJ QJ ^J aJ  hH CJ OJ QJ ^J aJ ?Z	  [	  f	  k	  l	  m	  {	  |	  	  	  	  	  	  	  	  	  
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hx= 0J  j    hx= 0J Uh  j    h Uhk	  .j    h}w CJ OJ QJ U^J aJ mH nH u he CJ OJ QJ ^J aJ  h CJ OJ QJ ^J aJ  h	 CJ OJ QJ ^J aJ  hH CJ OJ QJ ^J aJ  #hp hH 5CJ OJ QJ ^J aJ  hp hH CJ OJ QJ ^J aJ  hG CJ OJ QJ ^J aJ $                    L                                                                                                                                                                                                                                                                                                                                                                   $d N    gdH    gdH    p^p`gdH                               ?  @  V  W                                                                                                                                                                                                                                                                                                                                           gdH   h]hgd	      h]hgdx=    &`#$gdkT                                      D  U  V  ~                ɸɑ                                                                                                                                                  hk	  h  h}w  hH  h) 5 hH OJ QJ ^J  hH OJ QJ ^J   h hH CJ OJ QJ ^J aJ  h  he  hG  h1?  h	  hpa 0J mH nH u
hx= 0J  j    hx= 0J UhkT  hx= 2 :px= / =!"#$%                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              j                                                                                                                                                                                                                                                                                                                                                                                                              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  0  @  P  `  p                   2  (         0  @  P  `  p                      0  @  P  `  p                      0  @  P  `  p                      0  @  P  `  p                      0  @  P  `  p                      0  @  P  `  p      8  X        V  ~      OJ PJ QJ _HmH	nH	sH	tH	    <  ` <          N o r m a l       CJ _HmH	sH	tH	8 @  8         	 H e a d i n g   1     $@&  5 B @  B         	 H e a d i n g   2     $
&F @&  5\              D A` D          D e f a u l t   P a r a g r a p h   F o n t     V i  V          T a b l e   N o r m a l     :V   4   4 
l a      ( k  (           N o   L i s t         0 U` 0          	 H y p e r l i n k    >*B*2 B@ 2          	 B o d y   T e x t      CJ$ F V`F           F o l l o w e d H y p e r l i n k    >*B*ph  H @ "H   /     B a l l o o n   T e x t      CJ OJ QJ ^J aJ 4 @ 24   x=    H e a d e r      !   . )@ A.   x=    P a g e   N u m b e r     4    R4   	    F o o t e r      !   PK     !         [Content_Types].xmlN0EH-J@%ǎǢ|ș$زULTB l,3;rØJB+$G]7O٭V<a(7IR{pgL=r85v&uQ뉑8CX=$␴?6NJCFB.ʹ'.+YT^e55 ð_g -;Ylݎ|6^N`?[   PK     ! ֧   6     _rels/.relsj0}Q%v/C/} (h"O
= C?hv=Ʌ%[xp{۵_Pѣ<1H0ORBdJE4b$q_6LR7`0̞O,En7Lib/Seе   PK     ! ky         theme/theme/themeManager.xmlM
 @}w7c(Ebˮ CAǠҟ7՛KY,e.|,H,lxɴIsQ}#Ր ֵ+!,^$j=GW)E+&
8   PK     ! 0C)       theme/theme/theme1.xmlYOo6w toc'vuر-MniP@I}úama[إ4:lЯGRX^6؊>$!)O^rC$y@/yH*񄴽)޵߻UDb`}"qۋJחX^)I`nEp)liV[]1M<OP6r=zgbIguSebORD۫qu	gZo~ٺlAplxpT0+[}`jzA V2Fi@qv֬5\|ʜ̭NleXdsjcs7fW+Ն7`gȘJj|h(KD- dXiJ؇(x$(:;˹!I_TS1?E??ZBΪmU/?~xY'y5g&΋/ɋ>GMGeD3Vq%'#q$8K)fw9:ĵ
x}rxwr:\TZaG*y8IjbRc|XŻǿI
u3KGnD1NIBs
RuK>V.EL+M2#'fi~Vvl{u8zH
*:(W☕~JTe\O*tHGHY }KNP*ݾ˦TѼ9/#A7qZ$*c?qUnwN%Oi4=3N)cbJuV4(Tn
7_?m-ٛ{UBw<w_$#[Ի8{(/$Ϫ0h݋F۴®{L)#7i%=A:s$),Qg20ppf\}DU4p
M{DB%Jâ+{lC]=5
2FhsF+Y\Ɉnì:3E[69`&45Z!*5k8`Fmw-"d>znʜ"ZxJZp;{/<P;,)''KQk5qpN8KGbeSd̛\17	pa>SR!3 K4'+rzQ
TTIIvt]Kc⫲K#v5+|D~O@%\w_nN[L9KqgVhn
R!y+Un;*&/HrT	>>\t=.Tġ
S; Z~!P9giCڧ!#	B,;X=ۻ,I2UWV9$lk=Aj;{AP79|s*Y;̠[MCۿhf]o{oY=1kyV V5E8Vk+֜\80X4D)!!?*|fvu"xA@T_q64)kڬuV7t'%;i9s9x,ڎ-45xd8?ǘd/Y|t&LILJ`& -Gt/    PK     ! ѐ     '   theme/theme/_rels/themeManager.xml.relsM
0wooӺ&݈Э56?$Q,.aic21h:qm@RN;d`o7gK(M&$R(.1r'JЊT8V"AȻHu}|$b{ P8g/]QAsم(#L[    PK-      !                       [Content_Types].xmlPK-      ! ֧   6               0  _rels/.relsPK-      ! ky                     theme/theme/themeManager.xmlPK-      ! 0C)                   theme/theme/theme1.xmlPK-      ! ѐ     '             	  theme/theme/_rels/themeManager.xml.relsPK      ]  
    <?xml version="1.0" encoding="UTF-8" standalone="yes"?>
<a:clrMap xmlns:a="http://schemas.openxmlformats.org/drawingml/2006/main" bg1="lt1" tx1="dk1" bg2="lt2" tx2="dk2" accent1="accent1" accent2="accent2" accent3="accent3" accent4="accent4" accent5="accent5" accent6="accent6" hlink="hlink" folHlink="folHlink"/>                                                                	                         .                 	            9   9   9   9   9   <                             Z	  g                                            <   !!  8                         @              T                (    	                    
          b   
      
  C                   "   ?                             P   
      
           "   ?                            B    
        S              	   ?                     f   $  
  T      Q      I    t         6        7        8        9        :        ;                                                                                        9      *urn:schemas-microsoft-com:office:smarttagsplace =      *urn:schemas-microsoft-com:office:smarttags	PlaceName   I	                                                                                                  	                             3                      l      X  X  4  4  C  D  E  F                      9  K                                W  W  ~                                                           4  4                                                                             klD 4t8q l*v Dq'm1 ez1m, SwEЉ DJP|` U xXZ  Za6 co$h 0lʤ> Nmpl 8]lz6 \4
}U x~              h      
   ^`h    H     .             h      
  p p^p`h    H    .             h      
  @L @^@`Lh    H    .              h      
   ^`h    H    .             h      
   ^`h    H    .             h      
  L ^`Lh    H    .              h      
   ^`h    H    .             h      
  P P^P`h    H    .             h      
   L  ^ `Lh    H    .              h      
  p p^p`h    H     .                         0 ^`0>* o(   .             h      
  L ^`Lh    H    .              h      
   ^`h    H    .             h      
   ^`h    H    .             h      
  L ^`Lh    H    .              h      
  P P^P`h    H    .             h      
     ^ `h    H    .             h      
  L ^`Lh    H    .                       
   ^`h    H     .                     
   ^`h    H    .                     
  pL p^p`Lh    H    .                      
  @ @^@`h    H    .                     
   ^`h    H    .                     
  L ^`Lh    H    .                      
   ^`h    H    .                     
   ^`h    H    .                     
  PL P^P`Lh    H    .              h      
   ^`h    H     .             h      
  p p^p`h    H    .             h      
  @L @^@`Lh    H    .              h      
   ^`h    H    .             h      
   ^`h    H    .             h      
  L ^`Lh    H    .              h      
   ^`h    H    .             h      
  P P^P`h    H    .             h      
   L  ^ `Lh    H    .              h      
   ^`h    H     .             h      
  p p^p`h    H    .             h      
  @L @^@`Lh    H    .              h      
   ^`h    H    .             h      
   ^`h    H    .             h      
  L ^`Lh    H    .              h      
   ^`h    H    .             h      
  P P^P`h    H    .             h      
   L  ^ `Lh    H    .              h      
   ^`h    H     .             h      
  p p^p`h    H    .             h      
  @L @^@`Lh    H    .              h      
   ^`h    H    .             h      
   ^`h    H    .             h      
  L ^`Lh    H    .              h      
   ^`h    H    .             h      
  P P^P`h    H    .             h      
   L  ^ `Lh    H    .              h      
   ^`h    H     .             h      
   ^`h    H    .             h      
  pL p^p`Lh    H    .              h      
  @ @^@`h    H    .             h      
   ^`h    H    .             h      
  L ^`Lh    H    .              h      
   ^`h    H    .             h      
   ^`h    H    .             h      
  PL P^P`Lh    H    .              h      
   ^`h    H     .             h      
  p p^p`h    H    .             h      
  @L @^@`Lh    H    .              h      
   ^`h    H    .             h      
   ^`h    H    .             h      
  L ^`Lh    H    .              h      
   ^`h    H    .             h      
  P P^P`h    H    .             h      
   L  ^ `Lh    H    .              h        80 8^8`0o(    .                         ^`o(   .                         $	 $	^$	`o(   .                         @ @^@`  .                         ^`  .                        L ^`L  .                          ^`  .                         ^`  .                        PL P^P`L  .                          ^`o(    )                     
   ^`h    H    .                     
  pL p^p`Lh    H    .                      
  @ @^@`h    H    .                     
   ^`h    H    .                     
  L ^`Lh    H    .                      
   ^`h    H    .                     
   ^`h    H    .                     
  PL P^P`Lh    H    .                      
   ^`h    H     .                      
   ^`h    H    .                     
  pL p^p`Lh    H    .                      
  @ @^@`h    H    .                     
   ^`h    H    .                     
  L ^`Lh    H    .                      
   ^`h    H    .                     
   ^`h    H    .                     
  PL P^P`Lh    H    .             h      
  	 	^	`h    H     .              h      
   ^`h    H    .             h      
  xL x^x`Lh    H    .              h      
  H H^H`h    H    .             h      
   ^`h    H    .             h      
  L ^`Lh    H    .              h      
   ^`h    H    .             h      
   ^`h    H    .             h      
  X L X ^X `Lh    H    .              h      
   ^`h    H     .                         	0 	^	`0o(   )                        \0 \^\`0o(   .              h      
   ^`h    H    .             h      
   ^`h    H    .             h      
  L ^`Lh    H    .              h      
   ^`h    H    .             h      
  P P^P`h    H    .             h      
   L  ^ `Lh    H    .             h      
  8 8^8`h    H     .             h      
   ^`h    H    .             h      
  	L 	^	`Lh    H    .              h      
   ^`h    H    .             h      
  x x^x`h    H    .             h      
  HL H^H`Lh    H    .              h      
   ^`h    H    .             h      
   ^`h    H    .             h      
  L ^`Lh    H    .              h      
   ^`h    H     .             h      
  p p^p`h    H    .             h      
  @L @^@`Lh    H    .              h      
   ^`h    H    .             h      
   ^`h    H    .             h      
  L ^`Lh    H    .              h      
   ^`h    H    .             h      
  P P^P`h    H    .             h      
   L  ^ `Lh    H    .              h      
   ^`h    H     .             h      
  p p^p`h    H    .             h      
  @L @^@`Lh    H    .              h      
   ^`h    H    .             h      
   ^`h    H    .             h      
  L ^`Lh    H    .              h      
   ^`h    H    .             h      
  P P^P`h    H    .             h      
   L  ^ `Lh    H    .    xX            Za            ez1            SwE            8]lz            U            Nmp            \4
}            4t8            k            x~            Dq'            0l            co$h            l            DJ                                                    	 	 	 	 	 	 	 	 	  	 L? 	 	 	 	 	 	 	  	 	 	 	 	 	 	 	 	  	 	 	 	 	 	 	 	 	  	 	 	 	 	 	 	 	 	  	 	 	 	 	 	 	 	 	  	 	 	 	 	 	 	 	 	  	 	 	 	 	 	 	 	 	 hֲ#I 	 	 	 	 	 	  	 	 	 	 	 	 	 	 	  	 	 	 	 	 	 	 	 	  	 	 	 	 	 	 	 	 	  	*BGJ 	 	 	 	 	 	  	 	 	 	 	 	 	 	 	  	 	 	 	 	 	 	 	 	  	 	 	 	 	 	 	 	 	8                7    uc c
 e p# ", 0 j1 T$2 54 x= 1? @ @ lC qC ZE ^S kT ,o[ 	b Pl u }w w{ } ~ $* I Ec   & R E D h $ H 	 /  z }> Xa  k	 r. S S P ( Z G  4 pa                 @                                         `   @      U n k n o w n                                   G  * Ax 	             T i m e s   N e w   R o m a n   5                       S y m b o l   3.  * Cx 	             A r i a l   3  * Ax 	             T i m e s   5.  . [` )            T a h o m a   A   $ B              C a m b r i a   M a t h   "  1 h    $&     Q  8          Q  8                                                                                                                                                                                                                                                                                                                                          24                                                                                       3Q                          HX    ?    u    2                   !                             x   x                                   I        B r u c e   E .   A l l i s o n  r u b i n o n a                     L                            	  
                                                                                                          Oh +'0   T                                   	            
                  (     4     <     D     L             I         Bruce E. Allison          Normal.dotm       rubinona          2         Microsoft Office 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                                               1 T a b l e                                                                                                    M      W o r d D o c u m e n t                                                                                        4.       S u m m a r y I n f o r m a t i o n                           (                                     G           D o c u m e n t S u m m a r y I n f o r m a t i o n           8                                        O           C o m p O b j                                                                                           r                                                                                                                               
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