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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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).
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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 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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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