Application for Ethics Approval for Projects Involving Animals for Research Or Teaching

CHARLES DARWIN UNIVERSITY

ANIMAL ETHICS COMMITTEE

Application for Ethics Approval for Projects Involving Animals for Research or Teaching

To be used by:

• Researchers applying for, or seeking renewal of, ethics clearance in order to undertake research involving the use of vertebrate animals;
• Research students undertaking research involving the use of vertebrate animals as part of their course of study;
• Coordinators of units with teaching activities which involve the use or care of animals.

Please refer to the Guidelines for Applications to the Animal Ethics Committee prior to completion of this form.

Please note: the AEC includes members from a range of different backgrounds,please avoid unnecessary scientific terminology and give a plain English description of scientific procedures.

SECTION 1: ADMINISTRATION

1. Title of Project

1. Researchers and Teachers: Summarise qualifications, experience, and contacts of all personnel who will be participating in the project. Detail the experience in procedures and with the species to be used. Research students should not be the first named investigator.

Name and Title of Chief Investigator’s/Instructor’s:

Position and Qualifications:

Address for Correspondence:

Telephone Number:

Email:

Fax:

AEC Permit ID:

(Each individual must apply for and hold an AEC Permit for the duration of approved teaching or research activities. See the Permit Application form and process at : Attach a copy of the permit to the application form. Project approvals will not be provided until such time as all associated individuals has supplied a copy of their permit.

Experience in procedures/species to be used:

When and where did you last attend an animal ethics training workshop:

Names and qualifications of all other professional and ancillary staff involved in the project and their proposed roles and length of experience.

(Use additional sheet of paper if insufficient room)

Other Investigator/Instructor Name and Title:

Position and Qualifications:

Address for Correspondence:

Telephone Number:

Email:

Fax:

AEC Permit ID:

Experience in Procedures/species to be used:

When and where did you last attend an animal ethics training workshop:

Other Investigator/Instructor Name and Title:

Position and Qualifications:

Address for Correspondence:

Telephone Number:

Email:

Fax:

AEC Permit ID:

Experience in Procedures/species to be used:

When and where did you last attend an animal ethics training workshop:

1. Reapplications & Renewals

(i) A renewal/reapplicationYes/No

(ii) Has an application for this project/experiment

previously been rejected by the AEC? Yes/No

If you answered YES to either of the above, please state the Animal Ethics Reference Number previously allocated to your project by the AEC: ______

1. Institutions involved in the Project(Tick as applicable):

( )Charles Darwin University, name of Faculty/School: ______

( )Menzies School of Health Research

( )Other, please specify: ______

1. Lead Institution’s NT Animal Welfare Authority Licence No: ______

(This is the institution’s licence to use premises for teaching or research activities. Licences are obtained from the NTG Animal Welfare Authority A copy should be attached to this application.)

Licence Expiry Date: ______

1. Type of Project

( )Teaching

( )Staff Research

( )Postgraduate Project (PhD, Masters, Grad. Dip. or Honours)

( )Other, please specify: ______

1. Animal Use Categories (please refer to the Standard Operating Procedures (SOP) on our website for the selected category)

( )Wildlife surveys (SOP: Addressing Animal Welfare in Fauna Surveys)

( )Other wildlife research

( )Animals in breeding and holding areas

( )Livestock for scientific or farming/agricultural activities

( )The use or care of animals for teaching purposes

( )The use of laboratory animals for research

( )Other, please specify: ______

1. Project Duration

Proposed commencement date:

Proposed completion date:

Duration of project (months):

9.Funding of Project

Source of funding:

Duration of funding: Starts

Expires

• Is this part of any grant application?: Yes/ No

If YES, state funding agency applied (ARC, NHMRC, etc):

• If the funding application is not successful, will the project still go ahead?Yes/ No
• Has an animal ethics application been lodged with any other organisation? Yes/ No

If YES, please list the name of the organisation and its Animal Ethics Committee

• Was the application: Approved / Rejected

10.Are the results to be published? Yes / No. If no, please explain why.

11.If this application involves the use of native, imported and/or specially protected species, then state:

Authority issuing the permit:

Permit Number and Expiry Date:

SECTION 2: JUSTIFICATION FOR ANIMAL USE

The “Australian Code of Practice for the Care and Use of Animals for Scientific Purposes” states that “Animal experiments may only be performed when the scientific merit justifies the use of animals”. Your answers in this section should be given in lay terms. The answers provided are crucial for the assessment of the scientific merit of the project and the justification of animal use.

11.What is the aim of the project? What do you hope the project will establish or achieve?

12.Describe the project. Briefly, what are you proposing to do? (more details can be provided in question 24.1)

13.Comment on the significance of this project. Why is it important?

14.Why is it necessary to use/capture animals in this project?

15.Detail what consideration has been given to each of the 3Rs (Replacement, Reduction and Refinement) in developing this project.

16.Detail what alternatives to animals you have considered for this project and explain why these alternatives are unsatisfactory.

17.If the project repeats previously reported experiments/studies, please summarise the reasons why this repetition is necessary. If available, include references to justify this.

SECTION 3: NUMBER AND TYPE(S) OF ANIMALS

18.What animal species are to be used/captured? Provide common and scientific names, as well as strain, age, and sex. (Add rows as necessary.)

Common Name / Scientific Name / Strain / Age / Sex (M/F/Both)

19.How many animals will be needed or captured, and what will be their fate? Exact numbers or upper limit estimates must be given for each species or (if many species) family/order.

Scientific Name / Strain / Intended Outcome / Number per annum / Total Number (for 2 years max)

20.For field surveys:

(a) What type of traps will you be using?

(b) How many traps will you be using?

21.What impact will this have on the animal population?

22.Justify, in terms of experiment or teaching design, educational outcome or survey requirements, why you need to use/capture the number and type(s) of animals that you have requested. Statistical justification is helpful.

SECTION 4: ANIMAL SOURCE, MAINTENANCE & FATE

23.SOURCE

23.1For field-based projects: what is the exact geographical location of the study sites; for lab-based projects: from where will the experimental or teaching animals be obtained?

23.2If animals to be used have been subjects in previous experiments or studies, describe what was previously done to the animals (include project number).

24.ANIMAL HOUSING OR HOLDING, INCLUDING TEMPORARY HOLDING IN THE FIELD

24.1Where will the animals be contained?

24.2What is the maximum time that an animal will be held?

24.3Describe the type of container to be used (e.g. please state dimensions of cage or bag):

24.4What will be the maximum and minimum number of animals per container?

24.5If contained individually in a laboratory, justify why animals must be socially isolated.

24.6What measures will be taken to enrich the environment for animals during routine maintenance before and after experimental or teaching procedures?

25.FEEDING

25.1What and how often will animals be fed and watered?

25.2How frequently will animals be checked and how will their wellbeing be assessed (include frequency and methods used)?

25.3(For lab-based projects) If animals are to be contained before the experiment, who will look after animals prior to initiation of experimental or teaching procedures?

Weekdays:

Weekends/Holidays/ Emergency Shutdowns:

26.EFFECTS OF PROJECT ON ANIMAL WELL-BEING, PLANS TO MINIMISE DISTRESS AND MONITORING PROCEDURES

26.1Sequence of Events – Provide step-by-step details of what happens to the animals from the time you obtain them until their death or when they are no longer used for the project. A flow chart or table may assist in portraying this process.

26.2Identify and specify each factor and procedure used in this proposal that may compromise the animal’s well-being. State how adverse effects will be minimised. This list may include capture, handling, housing, as well as experiment (al) or teaching procedures. Details should include treatment substances, including anaesthetics and analgesics that are used, their dose and each route of administration.

26.3How will animal well being be monitored during procedures? (Include frequency of monitoring and methods used)

26.4Who will perform the experiment or teaching procedures stated in this application and where will these procedures be performed?

26.5How will animal well being be monitored following procedures? (Include frequency of monitoring and methods used)

26.6Who will monitor animals following start of experimental or teaching procedures?

During weekdays:

Nights (if applicable):

Weekends/Holidays/ Emergency Shutdowns:

27.FATE OF ANIMALS

27.1What is the final condition and fate of animals used/captured in this project?

27.2What criteria are used to conclude the animal’s involvement with the project? For example, reaching target body weight, furnishing a blood sample, etc.

27.3What course of action will you take if any animals are injured?

For further information:

27.4If animals are to be euthanised as part of the project or because they are seriously injured:

For further information, please consult the NHMRC publication: ‘Ways of minimising pain and distress in animals in research’ available from . Also available on the CDU AEC website is the link to ‘Recommended Euthanasia Techniques’

(Please note: this section is mandatory and ‘n/a’ will not be accepted as a valid response. Should administration of euthanising agents be proposed, the individual administering the agent must be licenced to do so.)

(a)how will this be done? (for euthanising agents, include agent used, site of administration, and dose in grams per kilogram)

(b)where will the euthanasia take place?

(c)who will euthanise the animal(s) and what is their experience?

(d)could animal tissue be shared with other researchers for another research project?

27.5Will you be collecting any voucher specimens? Yes / No

If the answer is ‘Yes’, please provide the following information:

(a)Approximately how many voucher specimens?

(b)Why do you need the voucher specimens? You will need to justify the taking of each voucher specimen in your progress/final report.

(c)If the voucher specimens are taken for identification, are there no other means of identification?

(d)What do you estimate will be the impact on the population?

SECTION 5: TEACHING PROJECTS ( ONLY )

28Unit Name:Year Level of Course:

29Estimated number of students undertaking the unit during the semester?

30What is the maximum number of students to be supervised by each teacher during the teaching exercise involving live animals?

31Please specify the minimum and maximum number of animals to be used in a relevant time frame (eg. number of times per class or per week) by each student?

32Will the students be handling live animals?Yes / No

If you answered Yes, please explain what steps have been or will be taken to ensure that the students are trained in animal handling techniques, and adequately supervised while handling the animals:

33What are the maximum number of times each animals will be used?

34How would students be disadvantaged if the project/procedure was not conducted?

35What efforts have been made to minimize the use of animals for teaching?

36How will the attainment of educational objectives be assessed?

37Is the project compulsory for students? Yes / No

If you answered Yes, how and when were the students made aware of the requirement for this type of project?

SECTION 6: DECLARATION OF RESPONSIBILITIES

DECLARATION BY INVESTIGATORS

• I/We certify that the use of animals in this project will conform with the NT Animal Welfare Act (2007) and the general principles of the NHMRC’s “Australian Code of Practice for the Care and Use of Animals for Scientific Purposes” (2004).
• I/We accept responsibility for the conduct of all procedures detailed in this application and for the supervision of all personnel delegated to perform any such procedures.
• I/We confirm that all personnel have read this proposal and have agreed to comply with the procedures described and any conditions imposed by the Animal Ethics Committee and I/we am/are satisfied that the use of animals is justified on scientific, educational or diagnostic grounds.

Print Name:______Signed:______Date______Chief Investigator/Instructor

Print Name:______Signed:______Date______Other Investigator/Instructor

Print Name:______Signed:______Date______Other Investigator/Instructor

DECLARATION BY SUPERVISOR

As Supervisor of the Student Investigator, I certify that s/he has read Section 3 of the Code of Practice, which sets down the responsibilities of investigators and is competent to accept the responsibilities specified therein.

Print Name:______Signed:______Date;______

Declaration by CDU Head of Department or HEAD OF OTHER Institution

I have read this application and am satisfied that the use of animals is justified on scientific, educational or diagnostic grounds. I am satisfied that the Chief Investigator has appropriate qualifications and experience to carry out the work with minimum distress to the animals

Print Name:______Signed:______Date:______

Head of Department/Institution

ATTACHMENT A: DECLARATION FOR TEACHERS (SUPERVISOR/INSTRUCTOR)

Declaration for teachers/supervisors/instructors involving live animals. This form may be returned to the Animal Ethics Committee when signatures are obtained (usually at the commencement of the project – approval will be given on the understanding that this form will be submitted when practicable).

Animal Ethics Committee approval number: ......

Responsible investigator/teacher/instructor: ......

Please sign to certify the following:

I am familiar and will comply with all relevant Commonwealth and State or Territory legislation and the requirements of the Australian Code of Practice for the Care and Use of Animals for Scientific Purposes 7th edition 2004. I accept that I have a responsibility to ensure that the investigations and procedures proposed in this form are conducted fully within the conditions laid down by the Code and I undertake not to use any animals or carry out any procedures which have not been approved by the Committee. I accept that the responsible teacher/ investigator has ultimate responsibility for the project. I accept responsibility for explaining the ethical obligations, conditions and conduct to all students.

Full Name / Signature / Date

CDU Animal Ethics Committee

Animal Ethics Application Research and Teaching

Approved at meeting 3/11; 3rd May 2011

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