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9780521529075

Genetics, Health Care and Public Policy: An Introduction to Public Health Genetics

by
  • ISBN13:

    9780521529075

  • ISBN10:

    0521529077

  • Edition: 1st
  • Format: Paperback
  • Copyright: 2007-06-11
  • Publisher: Cambridge University Press

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Summary

Genetics, Health Care and Public Policy is an introduction to the new discipline of public health genetics. It brings together the insights of genetic and molecular science as a means of protecting and improving the health of the population. This book sets out the basic principles of public health genetics for a wide audience of readers from those providing health care to those involved in establishing health policy. It provides one-stop introductory coverage of this rapidly developing and multidisciplinary field.

Author Biography

Alison Stewart is Head of Policy and Knowledge Management at the Public Health Genetics Unit, Cambridge Philippa Brice is Science Policy and Dissemination Manager at the Public Health Genetics Unit, Cambridge Hilary Burton is Consultant in Public Health Medicine at the Public Health Genetics Unit, Cambridge Paul Pharoah is Senior Clinical Research Fellow in the Department of Oncology, University of Cambridge Simon Sanderson is Clinical Lecturer in Primary Care Genetics at the Institute of Public Health, University of Cambridge Ron Zimmern is Director of the Public Health Genetics Unit, Cambridge

Table of Contents

Forewordp. xiii
Acknowledgementsp. xiv
Introductionp. 1
The definition of public health geneticsp. 1
Genetic and environmental factors as determinants of healthp. 3
Genetic disease, complex disease and the combined effects of genetic and environmental factorsp. 6
The emergence and development of public health geneticsp. 9
Advances in epidemiology and its application to public healthp. 9
The rise of genetic epidemiologyp. 9
The growth of genetic sciencep. 10
The impetus for public health geneticsp. 11
Community geneticsp. 13
Attitudes to public health geneticsp. 14
An international public health genetics network: the Bellagio initiativep. 15
About this bookp. 18
Further reading and resourcesp. 20
Principles of public healthp. 20
The emergence of public health geneticsp. 20
The human genome project and 'genomic medicine'p. 20
Community geneticsp. 21
Current developments in public health geneticsp. 22
Genomics and global healthp. 22
Genetic science and technologyp. 23
Basic molecular geneticsp. 23
Genes and the genomep. 25
Chromosomesp. 25
The 'central dogma': DNA makes RNA makes proteinp. 26
Gene structure and expression in more detailp. 27
The complexity of the genetic programmep. 28
Genetic variation: mutation and polymorphismp. 31
Cell division and the maintenance of the genomep. 33
Meiosis and recombination: the formation of sex cellsp. 34
Inheritance patternsp. 35
Genes and diseasep. 37
Mendelian ('single-gene') diseasesp. 38
Mitochondrial disordersp. 39
Chromosomal disordersp. 40
Diseases caused by disorders in epigenetic mechanismsp. 41
Mendelian subsets of common diseasesp. 42
Multifactorial diseasep. 43
Cancerp. 44
Some complexities of the relationship between genes and diseasep. 46
Penetrancep. 46
Inherited and new mutationsp. 46
Genetic heterogeneityp. 47
Variable expressivityp. 47
Genetic technologyp. 48
Cutting and joining pieces of DNAp. 48
Separating pieces of DNA in a mixturep. 48
Detecting specific sequences: hybridisationp. 48
Fluorescent in situ hybridisation (FISH)p. 49
DNA cloning and clone librariesp. 50
The polymerase chain reactionp. 51
DNA sequencingp. 51
DNA microarraysp. 53
Markers and mapsp. 53
The human genome projectp. 55
Mapping human genetic variation: SNPs and haplotypesp. 56
The post-genome challengep. 57
Identifying genes and studying gene functionp. 57
Proteomicsp. 57
Comparative genomicsp. 59
Bioinformaticsp. 59
Systems biologyp. 60
Epidemiological and biomedical informaticsp. 60
Further reading and resourcesp. 61
Basic geneticsp. 61
Genes and diseasep. 61
Genomics and the human genome projectp. 63
The post-genome challengep. 63
Fundamentals of genetic epidemiologyp. 65
An overview of classical epidemiologyp. 65
Causation and associationp. 65
Measuring the occurrence of illnessp. 67
Measuring associations in analytical epidemiologyp. 69
Cohort and case-control studiesp. 70
Interactionp. 73
Genetic epidemiology and human diseasep. 74
Genetic variation and disease susceptibilityp. 74
Clustering in families and the familial relative riskp. 75
Using heritability to assess genetic and environmental contributionsp. 76
Determining the genetic model of inheritance: segregation analysisp. 79
Identifying specific genetic determinants related to disease susceptibilityp. 80
Linkage and linkage analysisp. 80
Association analysisp. 84
Evaluating the characteristics of disease-susceptibility genetic variantsp. 96
Identifying whether gene variants are pathogenic variantsp. 97
Estimating disease allele frequencyp. 97
Estimating penetrancep. 98
Gene-gene interactionsp. 99
Gene-environment interactionsp. 100
Study designs for gene-environment interactionsp. 100
Gene-environment interactions and Mendelian randomisationp. 101
Further reading and resourcesp. 103
Classical epidemiologyp. 103
Genetic epidemiologyp. 103
Systematic review and meta-analysisp. 105
Genetics in medicinep. 106
Genetic testingp. 106
Diagnostic genetic testingp. 107
Carrier testingp. 108
Predictive genetic testingp. 108
Testing for genetic susceptibilityp. 109
Population screeningp. 110
Methods of genetic testingp. 111
Cytogenetic testingp. 112
DNA testingp. 112
Techniques for finding mutationsp. 114
Evaluation of genetic testsp. 121
Challenges for evaluating genetic testsp. 121
Genetics and disease preventionp. 123
Genotypic and phenotypic preventionp. 123
Identifying individuals at high genetic risk: family tracingp. 124
Susceptibility geneticsp. 125
Family history as a tool in prevention of common diseasep. 126
Ecogeneticsp. 127
Nutrigenetics and nutrigenomicsp. 129
Genetics and disease managementp. 130
Pharmacogeneticsp. 130
Molecular genetic profiling in diagnosis and disease managementp. 137
Gene therapyp. 138
Stem cell therapyp. 144
Genetics and infectious diseasep. 147
Further reading and resourcesp. 151
Genetic testing and screeningp. 151
Genetics and disease preventionp. 151
Genetics and disease managementp. 153
Genetics in health servicesp. 156
Organisation of clinical genetics services in the UKp. 156
The multidisciplinary clinical teamp. 157
The clinical genetics consultationp. 158
Cancer geneticsp. 161
Cardiac geneticsp. 162
Neurogeneticsp. 163
Genetic registersp. 163
Laboratory genetics servicesp. 164
Some services closely associated with genetics centresp. 167
Inherited metabolic diseasep. 167
Haemoglobinopathiesp. 168
Inherited bleeding disordersp. 169
The role of voluntary organisationsp. 170
Commissioning of genetics servicesp. 171
Population screening programmes for genetic conditionsp. 172
Antenatal Down syndrome screeningp. 173
Haemoglobinopathy screeningp. 174
Neonatal cystic fibrosis screeningp. 174
Neonatal screening for inborn errors of metabolismp. 175
Population carrier screening in specific communitiesp. 175
Genetics in mainstream medicinep. 176
Genetics in other specialist services: the multidisciplinary approachp. 176
Development of service models for cancer geneticsp. 177
National Service Frameworksp. 178
Genetics in primary carep. 179
The future of genetics in clinical servicesp. 181
Further reading and resourcesp. 182
Organisation and development of genetic servicesp. 182
Voluntary organisationsp. 183
Commissioning of genetics servicesp. 183
Population screeningp. 183
Genetics in mainstream medicinep. 184
Ethical, legal and social implications of geneticsp. 186
Genetic determinism and reductionismp. 186
Geneticisationp. 188
The legacy of eugenicsp. 189
Genetics and reproductive choicep. 191
Antenatal genetic testing and screeningp. 191
Limits to reproductive choice?p. 192
Genetics and assisted reproductionp. 194
Embryo research and embryonic stem cellsp. 195
Genetic informationp. 197
Genetic exceptionalismp. 198
Genetic databasesp. 199
Genetic discriminationp. 206
Genetic information and insurancep. 206
Genetic information and employmentp. 208
Justice and the 'genetic underclass'p. 210
Genetics and racial discriminationp. 211
Ethical and legal aspects of clinical geneticsp. 213
Confidentiality versus the duty to warnp. 213
The right not to knowp. 214
Consent to genetic testingp. 215
Public perceptions of geneticsp. 218
Further reading and resourcesp. 219
Genetic reductionism, geneticisation and eugenicsp. 220
Genetics and reproductive choicep. 220
Embryo research and embryonic stem cellsp. 221
Genetic informationp. 221
Genetic discriminationp. 222
Ethical and legal aspects of clinical geneticsp. 223
Public perceptions of geneticsp. 223
Policy implicationsp. 225
How government policy for genetics is developed in the UKp. 226
The advisory and regulatory system for geneticsp. 227
The international context for genetics policyp. 229
Policy for key issues in geneticsp. 233
Genetics in reproductive decision-makingp. 233
Consent to genetic testing and analysisp. 238
Privacy and confidentiality of genetic informationp. 240
Protection against unfair discriminationp. 247
Pharmacogeneticsp. 256
Regulation of gene-based and cellular therapiesp. 259
Clinical trials and research governancep. 264
General governance of clinical researchp. 265
Intellectual property and patentsp. 265
General policy issuesp. 269
The scientific and clinical research basep. 269
Public health policyp. 273
The role of the commercial sectorp. 274
Financial considerations and health economicsp. 276
Education and trainingp. 278
The publicp. 280
Concluding remarksp. 281
Further reading and resourcesp. 282
Policy development for genetics in the UKp. 282
The international contextp. 284
Genetics in reproductive decision-makingp. 284
Assisted reproductionp. 284
Consent to genetic testing and analysisp. 285
Protection of medical and genetic informationp. 285
Protection against unfair discriminationp. 286
Regulation of genetic testsp. 286
Pharmacogenetics: policy issuesp. 286
Advanced therapiesp. 287
Clinical trials and research governancep. 288
Intellectual property and patentsp. 288
General policy issuesp. 288
Scientific and clinical research policy, and relationships between the public and private sectorsp. 288
Health economicsp. 289
Education and trainingp. 289
Public involvementp. 289
Challenges for public health geneticsp. 290
Further readingp. 291
Books, reports and journal papersp. 291
Websites and web pagesp. 316
Indexp. 323
Table of Contents provided by Ingram. All Rights Reserved.

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