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Adverse Reactions to HIV Vaccines: Medical, Ethical, and Legal Issues
The purpose of this background paper is to describe the current state of development of HIV vaccines, and to discuss what is known about adverse reactions that may occur. The background paper provides an overview of ethical issues that arise in the conduct of HIV vaccine trials. The report also discusses alternatives to the current product liability system to encourage the development of HIV vaccines and to fairly compensate those who are harmed as a result of adverse reactions to the vaccine.
Cleaning Up Contaminated Wood-Treating Sites
This report reviews technologies available for hazardous waste cleanup at wood-treating sites throughout the United States. OTA found that there are many Superfund wood-treatment sites located in this country that are very similar in terms of the contaminants present and the options selected for cleanup.
Distributed Interactive Simulation of Combat
This background paper complements OTA’s background paper, Virtual Reality and Technologies of Combat Simulation, which focuses on the human-computer interface technologies used in simulations.
Federal Technology Transfer and the Human Genome Project
This report analyzes universities’, companies’, and researchers’ experiences and perspectives since enactment of federal laws to enhance technology transfer—especially as it pertains to research funded by the National Institutes of Health and the Department of Energy, the agencies funding U.S. efforts in the Human Genome Project.
Global Communications: Opportunities for Trade and Aid
This report examines the question of how telecommunication related aid policies might be designed to support both United States trade and foreign aid goals.
Improving the Prospects for Future International Peace Operations: Workshop Proceedings
In June 1995, OTA convened a workshop that brought together some of the world’s leading practitioners, academic experts, experienced diplomats, and leading technologists in order to study and discuss this issue. This report contains a summary of the results of the workshop, along with the original papers presented.
Selected Technology Issues in U.S. Aquaculture
This report discusses different aquatic species that are produced in the United States, including various animal and plant ornamentals, species for environmental remediation, industrial and pharmaceutical feedstocks, and products for biomedical research.
Effectiveness and Costs of Osteoporosis Screening and Hormone Replacement Therapy, Vol. I: Cost-Effectiveness Analysis
This paper assesses the medical benefits and costs of both screening and hormone replacement therapy. It is divided into two volumes. This volume presents the results of a model that estimates the cost per year of life gained from osteoporosis screening and hormone replacement therapy in postmenopausal women.
Effectiveness and Costs of Osteoporosis Screening and Hormone Replacement Therapy, Vol. II: Evidence on Benefits, Risks, and Costs
This paper assesses the medical benefits and costs of both screening and hormone replacement therapy. It is divided into two volumes. This volume provides the basis for the assumptions about the costs and effects of screening and hormonal replacement therapy used in the cost-effectiveness model.
The Lower Tiers of the Space Transportation Industrial Base
This background paper was prompted by a workshop held at OTA in early March 1995, at which a small group, representing a broad cross-section of lower-tier firms, discussed their views of the space transportation industry.
Electronic Surveillance in a Digital Age
This background paper reviews the progress of the industry and the law enforcement agencies in implementing the Act since its approval in October 1994.
A History of the Department of Defense Federally Funded Research and Development Centers
The focus of this paper is the history of Department of Defense (DoD) Federally Funded Research and Development Centers (FFRDCs) over the past 50 years, which forms part of the Office of Technology Assessment (OTA) study of defense modeling and simulation.
Hospital Financing in Seven Countries
This report discusses a seven-country study of hospital financing is an attempt to find lessons for the United States. The individual experiences over the past decade of the United States and six of its international peers—Canada, England, France, Germany, the Netherlands, and Sweden—in hospital financing and payment systems are reviewed by experts in each country.
Other Approaches to Civil-Military Integration: The Chinese and Japanese Arms Industries
The paper is divided into two sections, one on the PRC and one on Japan. Each section describes the structure and management of the respective defense industrial base and then compares it with its U.S. counterpart. The paper then assesses the degree to which lessons from the PRC and Japanese cases can be applied to the U.S. defense technology and industrial base (DTIB).
Health Care Technology and Its Assessment in Eight Countries
This paper discusses the experiences of Australia, Canada, France, Germany, the Netherlands, Sweden, and the United Kingdom—technology assessment with six technologies (or sets of technologies) including evaluation and management efforts and how the technologies diffused— are presented and compared.
The Department of Defense Kuwait Oil Health Fire Risk Assessment (The "Persian Gulf Veterans' Registry")
This paper describes briefly the work on DoD’s Kuwait Oil Fire Health Risk Assessment to date, including the results of a pilot study of health risks, and then answers the questions addressed to OTA in PL 102-585.
Hip Fracture Outcomes in People Age 50 and Over
This background paper is one of four documents resulting from OTA’s study of policy issues in the prevention and treatment of osteoporosis.
International Comparisons of Administrative Costs in Health Care
This paper examines what is known about administrative costs in the health care systems of the United States and several other countries. In addition to exploring the types of activities that constitute health care administration, it reviews studies that measure and compare these activities in different countries, and it explores the potential usefulness of such comparisons.
International Health Statistics: What the Numbers Mean for the United States
This paper reviews how the United States compares with other developed countries on available health status measures, evaluates the validity of the data used to make such comparisons, and describes how international comparisons might be interpreted in the context of health care reform.
Mental Disorders and Genetics: Bridging the Gap Between Research and Society
The report reviews data concerning the contribution of genetic factors to several severe mental disorders; described methodologies used in the studies, and broached several policy issues relevant to this area of research.
Studies of the Environmental Costs of Electricity
This report examines a set of environmental cost studies, compares and contrasts their methods and assumptions, and discusses how they could be made more useful to federal policy makers.
Virtual Reality and Technologies for Combat Simulation
This paper describes applications of synthetic-environment technologies in simulating combat. This background paper is the first of several publications of the OTA’S assessment of combat modeling and simulation.
Understanding Estimates of the Impact of Health Reform on the Federal Budget
This paper describes and evaluates the sources of variation in analysts’ estimates of the federal budget impacts of key reform provisions. The paper also discusses potential variations in the estimates of federal budget effects of the American Health Security Act and the Managed Competition Act, and of health reform proposals in general.
Climate Treaties and Models: Issues in the International Management of Climate Change
This paper seeks to place the issue of climate change within an international context. Specifically, it addresses the feasibility of forging treaty agreements among countries to achieve significant worldwide reductions in emissions of greenhouse gases.
Technical Options for the Advanced Liquid Metal Reactor
This paper discusses the history and status of the ALMR research program. It presents applications of this technology to the plutonium disposition problem and the possible advantages and disadvantages of its future development and deployment. It also discusses related issues such as waste management and concerns about proliferation of plutonium material.
Wage Record Information Systems
This background paper responds to section 408 of the 1990 amendments to the Perkins Act, which asks OTA to review activities to be undertaken by the National Occupational Information Coordinating Committee (NOICC) to encourage the use of wage records from state unemployment insurance systems for purposes of conducting policy studies or monitoring the outcomes of vocational education.
Psychiatric Disabilities, Employment and the Americans With Disabilities Act
The report focuses on mental disabilities, a broad rubric. In this background paper, OTA examines current knowledge about psychiatric disabilities and employment in the context of the ADA’s requirements and reviews Federal activities directly or indirectly aimed at supporting the ADA’s employment provisions.
Testing and Assessment in Vocational Education
The paper has six major purposes, in order to analyze the uses of tests used in vocational programs, particularly those designed to measure broad technical skills, identify trends in vocational assessment, and identify policy issues relevant to improving test development and quality.
Technologies Underlying Weapons of Mass Destruction
This paper reviews the technical requirements for countries to develop and build nuclear, chemical, and biological weapons, along with the systems most capable of delivering these weapons to distant or defended targets: ballistic missiles, combat aircraft, and cruise missiles.
Benefit Design in Health Care Reform: Patient Cost-Sharing
This paper examines the health services and economics literature to learn what is known about the effects of patient cost-sharing (that is, annual deductibles, coinsurance, copayments, and out-of-pocket maximurns) on patients’ use of health care services, on plan expenditures, and on patients’ health outcomes.
Biological Components of Substance Abuse and Addiction
This paper describes biological contributing factors to substance abuse and addiction. The second document being produced by this study will discuss the complex interactions of biochemical, physiological, psychological, and sociological factors leading to substance abuse and addiction.
Biopolymers: Making Materials Nature's Way
This report discusses a study that provides a basic introduction to biopolymer technology; profiles some of the more promising polymer materials; reviews research activities in the United States, Europe, and Japan; and describes the principal technical challenges and regulatory issues that may affect biopolymer commercialization efforts.
Impact of Legal Reforms on Medical Malpractice Costs
This report discusses the indirect cost of medical malpractice, commonly referred to as “defensive medicine,” that may add to overall health care costs. The cost of defensive medicine remains unknown and is subject to much speculation because there are no sound empirical data.
Potential Environmental Impacts of Bioenergy Crop Production
This report reviews how bioenergy crops could potentially affect soil quality and soil erosion, water quality, air quality, habitat for a variety of species, and the global environment.
Development Assistance, Export Promotion, and Environmental Technology
This background paper provides an overview of developing country environmental problems and markets for environmental technologies and services. It discusses preliminary estimates on the amount and purposes of environmental aid provided by donor countries in 1991. The paper discusses the commercial implications of other countries’ aid for U.S. environmental firms, and the Helsinki package adopted by the OECD in late 1991 to limit commercial advantage from use of tied aid credits.
Adult Literacy and New Technologies: Tools for a Lifetime
Adult education needs are difficult to define and difficult to meet; what constitutes adequate literacy changes continually as the demands facing individuals grow more complex. This report is an attempt to identify those capabilities, along with limitations, and outline how new information technologies can be marshaled to meet the goal of a fully literate citizenry.
Advanced Network Technology
This background paper analyzes technologies for tomorrow’s information superhighways. Advanced networks will first be used to support scientists in their work, linking researchers to supercomputers, databases, and scientific instruments. The paper also describes six test networks that are being funded as part of the High Performance Computing and Communications Program.
Biomedical Ethics in U.S. Public Policy
This report reviews the history of four Federal bioethics initiatives: the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research, the Ethics Advisory Board, the President’s Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research, and the Biomedical Ethics Advisory Committee.
Hazards Ahead: Managing Cleanup Worker Health and Safety at the Nuclear Weapons Complex
This paper concludes that, thus far, Department of Energy has (DOE) and its contractors have devoted little attention to cleanup worker health and safety. They have not convinced workers and managers that a “new culture” of accountability in environment, safety, and health is truly ascendent.
Federal and Private Roles in the Development and Provision of Alglucerase Therapy for Gaucher Disease
This background paper describes the development of alglucerase, illustrates the role that both the Federal Government and private sector can have in making new therapies available for orphan diseases, and lays out some of the tradeoffs that can exist between developing new medical technologies and controlling health care costs.
Genetic Counseling and Cystic Fibrosis Carrier Screening: Results of a Survey
This paper presents results from a 1991 OTA survey of 431 genetic counselors and nurse geneticists. It was conducted to better understand the environment in which the average genetic counselor or nurse in genetics works, to describe the infrastructure and tools available to these professionals, to assess the state of practice in the provision of cystic fibrosis (CF) carrier screening, and to evaluate their attitudes regarding CF carrier screening.
Genetic Tests and Health Insurance: Results of a Survey
This background paper describes results from a 1991 OTA survey of U.S. health insurers’ attitudes toward genetic tests and genetic information— both how they currently view information from various sources (e.g., genetic tests, other medical tests, or family histories) in underwriting decisions and how they might reimburse consumers for genetic tests. It also reports data on the role health insurers expect genetic tests and genetic information will play in their business practices over the coming decade.
Science and Technology Issues in Coastal Ecotourism
This paper presents information on the ecotourism trends; identifies issues related to resource conservation, ecotourism development and management, and planning; and presents questions for possible further consideration.
U.S. Banks and International Telecommunications
This background paper on U.S. banks is one of several case studies prepared as part of a huger assessment of International Telecommunications Networks and U.S.-European Trade in Services.
Does Health Insurance Make a Difference?
This background paper reviews and evaluates the available literature linking health insurance coverage with the utilization and process of health care services and with individual health outcomes.
Remotely Sensed Data From Space: Distribution, Pricing, and Applications
This short background paper summarizes the discussion concerning data pricing and distribution from a one-day workshop convened by OTA on May 20, 1992.
Disposal of Chemical Weapons: Alternative Technologies
This background paper briefly describes the Army’s chemical weapons destruction program, discusses the factors that could affect a decision to develop alternatives, discusses the alternatives, and illustrates the difficulty of gaining public acceptance of complex technical systems.
Identifying and Controlling Pulmonary Toxicants
This Background Paper examines whether the agencies responsible for administering Federal environmental and health and safety laws have taken this concern for respiratory health to heart. This paper provides a partial response to the committees’ request for an assessment of noncancer health risks in the environment and follows OTA’s previous work on carcinogenic, neurotoxic, and immunotoxic substances.
Lessons in Restructuring Defense Industry: The French Experience
This background paper first describes the structure and management of the French defense-industrial base and then reviews a variety of strategies the French Government and industry are pursuing to rationalize the base, while preserving key technological assets and strengthening the competitive position of French defense contractors in world markets.
The Menopause, Hormone Therapy, and Women's Health
This background paper describes what is known about the natural progression of the menopause and its effect on women’s health, hormone treatment and prescribing practices, alternative approaches, and research needs.