LEADER 02517oam 2200577I 450 001 9910709715703321 005 20190812140654.0 035 $a(CKB)5470000002473093 035 $a(OCoLC)1106017387 035 $a(EXLCZ)995470000002473093 100 $a20190628j201806 ua 0 101 0 $aeng 135 $aurbn||||||||| 181 $ctxt$2rdacontent 182 $cc$2rdamedia 183 $acr$2rdacarrier 200 10$aCapabilities and practices of offsite response organizations for protective actions in the intermediate phase of a radiological emergency response /$fprepared by: T. Park, D. Hoell, M. Denneny ; Todd Smith, NRC technical monitor ; Sergio Gonzalez and Lindsey Cooke, NRC project managers 210 1$aWashington, D.C. :$cUnited States Nuclear Regulatory Commission, Office of Nuclear Regulatory Research, Office of Nuclear Security and Incident Response,$dJune 2018. 215 $a1 online resource (various pagings) $cillustrations 300 $a"NUREG/CR-7248." 300 $a"Manuscript completed: October 2017; date published: June 2018." 300 $a"Performing organization: The Cadmus Group LLC"--Bibliographic data sheet. 320 $aIncludes bibliographical references (pages 8-1-8-4). 606 $aNuclear accidents$zUnited States 606 $aEmergency management$zUnited States 606 $aNuclear energy$zUnited States$xSafety measures 606 $aEmergency management$2fast 606 $aNuclear accidents$2fast 606 $aNuclear energy$xSafety measures$2fast 607 $aUnited States$2fast 615 0$aNuclear accidents 615 0$aEmergency management 615 0$aNuclear energy$xSafety measures. 615 7$aEmergency management. 615 7$aNuclear accidents. 615 7$aNuclear energy$xSafety measures. 700 $aPark$b T$c(Of the Cadmus Group),$01417575 702 $aHoell$b D$c(Of the Cadmus Group), 702 $aDenneny$b Matthew J. 712 02$aU.S. Nuclear Regulatory Commission.$bOffice of Nuclear Regulatory Research, 712 02$aU.S. Nuclear Regulatory Commission.$bOffice of Nuclear Security and Incident Response, 712 02$aCadmus Group. 801 0$bGPO 801 1$bGPO 801 2$bGPO 801 2$bOCLCF 801 2$bGPO 906 $aBOOK 912 $a9910709715703321 996 $aCapabilities and practices of offsite response organizations for protective actions in the intermediate phase of a radiological emergency response$93526430 997 $aUNINA LEADER 10920nam 2200721Ia 450 001 9910973712103321 005 20251017110056.0 010 $a9786610196401 010 $a9781280196409 010 $a1280196408 010 $a9780309585057 010 $a0309585058 010 $a9780585002170 010 $a0585002177 035 $a(CKB)110986584751234 035 $a(SSID)ssj0000106665 035 $a(PQKBManifestationID)11133871 035 $a(PQKBTitleCode)TC0000106665 035 $a(PQKBWorkID)10111055 035 $a(PQKB)10378841 035 $a(MiAaPQ)EBC3376113 035 $a(Au-PeEL)EBL3376113 035 $a(CaPaEBR)ebr10055107 035 $a(OCoLC)814272375 035 $a(Perlego)4734152 035 $a(DNLM)760601 035 $a(EXLCZ)99110986584751234 100 $a19931206d1994 uy 0 101 0 $aeng 135 $aurcn||||||||| 181 $ctxt$2rdacontent 182 $cc$2rdamedia 183 $acr$2rdacarrier 200 00$aAssessing genetic risks $eimplications for health and social policy /$fLori B. Andrews ... [et al.], editors 205 $a1st ed. 210 $aWashington, D.C. $cNational Academy Press$d1994 215 $axiv, 338 pages $cillustrations 300 $aBibliographic Level Mode of Issuance: Monograph 311 0 $a9780309086608 311 0 $a0309086604 311 0 $a9780309047982 311 0 $a0309047986 320 $aIncludes bibliographical references and index. 327 $aASSESSING GENETIC RISKS -- Copyright -- Preface -- ADDITIONAL VIEWS OF THE CHAIRMAN -- Acknowledgments -- Contents -- Executive Summary -- PROMISE AND PROBLEMS IN GENETIC TESTING -- COMMITTEE ON ASSESSING GENETIC RISKS -- GENETIC TESTING AND ASSESSMENT -- Newborn Screening -- Carrier Identification -- Prenatal Diagnosis -- Testing for Late-Onset Disorders -- Testing of Children or Minors -- LABORATORY ISSUES IN GENETIC TESTING -- Genetic Tests for Rare Disorders -- CLIA88 -- Genetic Tests and the FDA -- GENETIC COUNSELING -- Basic Tenets of Genetic Counseling -- Tailoring Counseling to the Client -- PUBLIC EDUCATION -- PROFESSIONAL EDUCATION -- FINANCING OF GENETIC TESTING SERVICES -- SOCIAL, LEGAL, AND ETHICAL ISSUES IN GENETIC TESTING -- Voluntariness -- Informed Consent -- Confidentiality -- Genetic Discrimination in Health Insurance -- Genetic Discrimination in Employment -- RESEARCH AND POLICY AGENDA -- Policy Oversight -- Research Policy -- Need for Additional Standards -- Policy Research Needs -- 1 Setting the Stage -- RECOMBINANT DNA TECHNOLOGY, GENE MAPPING, AND IDENTIFICATION OF DISEASE-RELATED GENES -- Implications of Recombinant DNA Technology for Genetic Testing -- Other Recent Advances and Their Implications for Genetic Testing -- Limitations of Genetic Testing -- LESSONS FROM THE PAST -- Phenylketonuria -- Sickle Cell Anemia and Trait -- Tay-Sachs Disease and Trait -- Thalassemia -- UPDATING THE FINDINGS OF THE 1975 NAS COMMITTEE -- Aims of Testing and Screening -- Criteria for Testing -- Quality of Testing -- Conflicts of Interest -- Pilot Studies -- Auspices and Settings -- Standards of Care -- Age for Testing -- Education of the Public -- Ethical Issues -- Allocation of Resources -- Recognition of Human Diversity and Respect and Tolerance for People with Disabilities -- REFERENCES -- 2 Genetic Testing and Assessment. 327 $aBASIC HUMAN GENETICS AND GENETIC ANALYSIS -- Technologies for Detecting Genetic Disorders -- NEWBORN SCREENING -- CARRIER TESTING AND SCREENING -- PRENATAL DIAGNOSIS -- Critical Issues in Prenatal Diagnosis -- TESTING FOR LATE-ONSET DISORDERS -- Monogenic Disorders of Late Onset -- Huntington Disease -- Alzheimer Disease -- Hemochromatosis -- Familial Hypercholesterolemia -- Polycystic Kidney Disease -- Inherited Susceptibility to Cancers -- Testing for Multifactorial Genetic Disorders -- Coronary Heart Disease -- Hypertension -- Cancers of Complex Origin -- Diabetes -- Rheumatoid Arthritis -- Infectious Diseases -- Psychiatric Diseases -- CONCLUSIONS AND RECOMMENDATIONS -- Newborn Screening -- Carrier Testing and Screening -- Prenatal Diagnosis -- Testing for Late-Onset Disorders -- REFERENCES -- 3 Laboratory Issues in Human Genetics -- PROGRAMS AND REGULATIONS FOR ASSESSING THE QUALITY OF LABORATORIES PROVIDING GENETIC TESTS -- State Assessments of Laboratories Providing Genetic Tests -- Voluntary Quality Assurance and Proficiency Testing in Genetics -- Costs, Benefits, and Limitations of State and Voluntary Quality Assurance Programs -- Federal Regulation of Clinical Laboratories -- History -- Laboratories Covered by CLIA88 -- CLIA88 Regulations -- Genetic Tests Under CLIA88 -- Research Laboratories and Tests for Rare Disorders -- Interpretation of Laboratory Test Results -- ENSURING THE SAFETY AND EFFECTIVENESS OF NEW GENETIC TESTS -- Premarket Approval of Medical Devices -- Collection of Data for Test Validation -- Humanitarian Exemptions -- Investigational Use of New Devices -- Institutional Review Boards and Genetic Tests -- Inappropriate Use of Investigational Devices -- NEWBORN AND OTHER GENETIC SCREENING PROGRAMS -- FINDINGS AND RECOMMENDATIONS -- Ensuring the Quality of Laboratories -- Ensuring the Safety of New Tests -- REFERENCES. 327 $a4 Issues in Genetic Counseling -- BASIC COMPONENTS OF GENETIC COUNSELING -- Awareness of the Impediments to Effective Genetic Counseling -- Nondirectiveness -- Informed Consent -- Confidentiality -- Communicating Risks and Dealing with Uncertainty -- Recognizing Social and Cultural Differences -- THE CONTEXTS OF GENETIC COUNSELING -- Newborn Screening -- Determining Carrier Status -- Prenatal Diagnosis -- Screening for Late-Onset Disorders -- Multiplex Testing -- NEED FOR A MORE GENETICALLY LITERATE PUBLIC -- CONCLUSIONS AND RECOMMENDATIONS -- Components of Genetic Counseling -- Providing Genetic Counseling -- The Contexts of Genetic Counseling -- Newborn Screening -- Determining Carrier Status -- Prenatal Diagnosis -- Screening for Late-Onset Disorders -- Multiplex Testing -- NOTES -- REFERENCES -- 5 Public Education in Genetics -- BARRIERS TO OVERCOME -- WHAT DO PEOPLE KNOW? -- WHAT IS GENETICS EDUCATION? -- Formal Genetics Education -- Genetics Education for the Future -- DNA Learning Center -- Biological Sciences Curriculum Study -- Project Genethics -- University of Kansas Medical Center -- Informal Educational Interventions -- PUBLIC HEALTH EDUCATION -- BENEFITS AND BURDENS OF GENETICS KNOWLEDGE -- FINDINGS AND RECOMMENDATIONS -- NOTES -- REFERENCES -- 6 Personnel Issues in Human Genetics -- GENETIC SPECIALISTS -- Background Data on Genetics Professionals -- Training Programs -- Master's-Level Genetic Counselors -- Non-Master's-Level Counselors -- Certification and Accreditation of Genetics Specialists -- Related Genetics Certification and Training: Cytogenetics -- GENETICS INSTRUCTION IN MEDICAL SCHOOLS -- Continuing Medical Education -- Professional Statements, Guidance, and Proficiencies -- OTHER HEALTH PROFESSIONALS -- Nurses in Genetics -- Social Workers in Genetics -- Public Health -- FINDINGS AND RECOMMENDATIONS -- NOTE -- REFERENCES. 327 $a7 Financing of Genetic Testing and Screening Services -- WHO PAYS FOR GENETIC TESTING AND COUNSELING? -- PRIVATE SOURCES OF PAYMENT FOR GENETICS SERVICES -- Self-Insurance by Employers -- Key Health Insurance Policy Barriers to Reimbursement for Genetics Services -- Survey of Attitudes of Health Insurers About the Use of Genetic Information -- The Impact of CPT Codes on Reimbursement -- PUBLIC SOURCES OF PAYMENT FOR GENETICS SERVICES -- Medicare -- Medicaid -- CHAMPUS -- State Genetics Services Programs -- Federal Support for Genetics Services Programs -- RECOMMENDATIONS -- NOTES -- REFERENCES -- 8 Social, Legal, and Ethical Implications of Genetic Testing -- KEY DEFINITIONS -- Autonomy -- Ethical Analysis -- Legal Issues -- Privacy -- Ethical Analysis -- Legal Issues -- Confidentiality -- Ethical Analysis -- Legal Issues -- Equity -- Ethical Analysis -- Legal Issues -- CURRENT PRACTICE OF PROTECTION IN GENETICS -- APPLYING THE PRINCIPLES TO GENETIC TESTING -- ISSUES IN GENETIC TESTING -- Autonomy -- Special Issues in the Screening and Testing of Children -- Voluntariness of Subsequent Uses -- Confidentiality -- Disclosing Genetic Information to Spouses -- Disclosing Genetic Information to Relatives -- Confidentiality and Discrimination When Third Parties Seek Genetic Information -- FINDINGS AND RECOMMENDATIONS -- Overall Principles -- Autonomy -- Informed Consent -- Multiplex Testing -- Voluntariness -- Screening and Testing of Children -- Subsequent Uses -- Confidentiality -- Disclosure to Spouses and Relatives -- Discrimination in Insurance and Employment -- NOTES -- 9 Research and Policy Agenda -- POLICY OVERSIGHT FOR GENETIC TESTING AND SCREENING -- National Policy Oversight -- National Advisory Committee and Working Group -- State Oversight: Role of State Commissions -- Research Policy for Studies Involving Genetic Testing. 327 $aNEED FOR ADDITIONAL STANDARDS FOR GENETIC TESTING -- Prenatal Diagnosis -- Predispositional Genetic Testing and Screening -- Testing of Minors -- Multiplex Testing -- RESEARCH NEEDS -- Assessment of ELSI Research and Policy Studies -- Pilot Studies -- Laboratory Quality Assurance -- Genetics Knowledge and Attitudes of Health Professionals -- Genetics Education and Counseling -- Informed Consent -- Psychosocial Factors in Genetic Testing -- Culturally Appropriate Genetic Testing and Counseling -- Development of Balanced Materials on Genetic Disorders -- Measuring the Effectiveness of Genetic Education and Counseling -- Public Education -- Computer Innovation in Genetics Education -- Cost-Effectiveness Analysis of Genetic Testing -- CRITICAL DEFICIENCIES IN DATA ON GENETICS SERVICES -- RESEARCH ON POPULATION GENETICS -- REFERENCES -- APPENDIX A Workshop Participants -- PARTICIPANTS IN THE FEBRUARY 1992 WORKSHOP ON LABORATORY ISSUES IN GENETICS -- PARTICIPANTS IN THE JUNE 1992 WORKSHOP ON ISSUES IN GENETIC SERVICES -- PARTICIPANTS IN THE SEPTEMBER 1992 MINI-WORKSHOPS ON GENETIC COUNSELING -- PUBLIC EDUCATION -- PRIVACY AND INSURANCE -- PARTICIPANTS IN THE SEPTEMBER 1992 PUBLIC FORUM ON ASSESSING GENETIC RISKS: ISSUES AND IMPLICATIONS FOR HEALTH -- APPENDIX B Committee Biographies -- Index. 606 $aMedical genetics$xSocial aspects 606 $aHuman chromosome abnormalities$xDiagnosis$xSocial aspects 606 $aMedical policy$zUnited States 615 0$aMedical genetics$xSocial aspects. 615 0$aHuman chromosome abnormalities$xDiagnosis$xSocial aspects. 615 0$aMedical policy 676 $a616/.042 701 $aAndrews$b Lori B.$f1952-$0438225 801 0$bMiAaPQ 801 1$bMiAaPQ 801 2$bMiAaPQ 906 $aBOOK 912 $a9910973712103321 996 $aAssessing genetic risks$94356892 997 $aUNINA