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The 1992 World Administrative Radio Conference: Issues for U.S. International Spectrum Policy
This report examines the U.S. preparations process for WARC-92, highlighting efforts to integrate the needs and concerns of various interest groups. It also reviews the forces and trends affecting the United States as it approaches WARC-92, and is intended to inform future congressional oversight of the domestic and international radio communication policy process.
Adjusting to a New Security Environment: The Defense Technology and Industrial Base Challenge
This background paper, OTA sought information and advice from a broad spectrum of knowledgeable individuals and organizations whose contributions are gratefully acknowledged. As with all OTA studies, the content of this background paper is the sole responsibility of the Office of Technology Assessment and does not necessarily represent the views of our advisers and reviewers.
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.
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.
Affordable Spacecraft: Design and Launch Alternatives
This background paper examines several proposals for reducing the costs of spacecraft and other payloads and describes launch systems for implementing them. It is one of a series of products of a broad assessment of space transportation technologies undertaken by OTA at the request of the Senate Committee on Commerce, Science, and Transportation, and the House Committee on Science, Space, and Technology.
Alaskan Water for California?: The Subsea Pipeline Option
This background paper focuses on one technological option for increasing the supply of fresh water to the Southwest-that of building a freshwater subsea pipeline to transport water from Alaska to California. Originally a suggestion by Governor Walter Hickel of Alaska, the proposal has recently attracted attention in southern California.
American Military Power: Future Needs, Future Choices
This background paper outlines some of the issues of importance for making choices about the future nature and role of U.S. armed forces, and suggests how these choices will affect defense base requirements. The final report of the assessment, to be delivered in the spring of 1992, will address specific policy options arising from the strategic choices and tactical decisions discussed here.
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.
The Big Picture: HDTV and High-Resolution Systems
A report on High Definition Television (HDTV. During 1989, HDTV moved from obscurity to center stage in the ongoing debate over the role of the Federal Government in U.S. industrial competitiveness. HDTV and related High-Resolution System (HRS) technologies in the computer and communications sectors may significantly impact U.S. electronics manufacturing, accelerate fundamental restructuring of the U.S. communications infrastructure, and provide a host of valuable services.
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.
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.
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.
Bioremediation for Marine Oil Spills
This OTA background paper evaluates the current state of knowledge and assesses the potential of bioremediation for responding to marine oil spills. Our basic message is a dual one: we caution that there are still many uncertainties about the use of bioremediation as a practical oil spill response technology; nevertheless, it could be appropriate in certain circumstances, and further research and development of bioremediation technologies could lead to enhancing the Nation’s capability to fight marine oil spills.
Children's Dental Services Under the Medicaid Program
The report discusses the oral health of children eligible for Medicaid, the House Committee on Energy and Commerce and its Subcommittee on Health and the Environment requested OTA to determine whether children eligible for Medicaid are provided at least a minimum level of dental care. This study compares the dental manuals of seven State Medicaid programs with a set of “basic’ dental services (which comprise shared components of various well-accepted dental guidelines) to see if States allow these particular services.
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.
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.
Computer Software and Intellectual Property
This background paper examines existing intellectual-property protection for computer software-copyrights, patents, and trade secrets—and provides an overview of the often conflicting views and concerns of various stakeholders. It was prepared in response to a request from the Subcommittee on Courts, Intellectual Property, and the Administration of Justice of the House Committee on the Judiciary.
Coping With an Oiled Sea
In the aftermath of the Exxon Valdez oil spill in Alaska in March, 1989, a myriad of investigations were initiated to evaluate the causes of that accident and to propose remedies. The Office of Technology Assessment was asked to study the Nation’s oil spill clean-up capabilities and to assess the technologies for responding to such catastrophic spills in the future.
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.
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.
Dioxin Treatment Technologies
This paper presents the status of national efforts to cleanup dioxin-contaminated sites and the technologies that have been used, proposed, and researched. It covers thermal and nonthermal treatment techniques as well as approaches such as stabilization and storage. It discusses the development of these technologies as well as advantages and disadvantages of their use.
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.
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.
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.
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.
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.
Energy Use and the U.S. Economy
The background paper extends the analysis of energy use into new areas by explicitly looking at how energy use has changed with the expansion of the service sector, the explosion of international trade, and greater complexity of the U.S. economy as the structure of businesses changed in response to new technologies and competitive challenges. The increasing sophistication of the U.S. economy means that the role of energy is less likely to be directly identified and is instead more likely to be an indirect factor that was added many steps before in the complex network that connects producer to consumer. This report explicitly separates direct from indirect energy use.
The FBI Fingerprint Identification Automation Program: Issues and Options
This report focuses on key assumptions that will affect the sizing and procurement of the new FBI system, and on other related steps that appear necessary to ensure complete and up-to-date record systems. These include full implementation of a Federal/State/local partnership for maintaining and exchanging fingerprint and criminal history records; enactment of an interstate compact or Federal legislation setting out uniform rules for the exchange of such records; standards and funding for improving criminal history record completeness and disposition reporting; and privacy and security protections for electronic fingerprint and record information.
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.
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.
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.
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.
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.
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.
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.
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.
Identifying and Controlling Immunotoxic Substances
This background paper, which describes the state-of the- art of identifying substances that can harm the immune system, represents one response to the committee’s request. Chapter 2 provides basic information about the principal components of the immune system and the general consequences that stem from perturbations to it. Chapter 3 describes methods for evaluating chemical immunotoxicity and reports on some known or suspected immunotoxicants. Chapter 4 summarizes Federal research and regulatory activities related to immunotoxicity.
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.
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.
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.
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.
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.
Long-Lived Legacy: Managing High-Level and Transuranic Waste at the DOE Nuclear Weapons Complex
This report describes, documents, and analyzes available data about two key waste management problems at the Department of Energy Weapons Complex—those of high-level radioactive waste and transuranic waste. The paper is organized in two chapters—” Chapter 1: Managing High Level Waste’ and ‘Chapter 2: Managing Transuranic Waste. ” Each chapter contains a summary overview followed by a discussion and analysis of important areas in the waste management problem that the DOE faces at present and in its future operations.
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.
Managing Industrial Solid Wastes From Manufacturing, Mining, Oil and Gas Production, and Utility Coal Combustion
This background paper examines wastes generated by industrial activities that play a dominant role in our national economy-oil and gas production, mining and mineral processing, coal combustion, and manufacturing. In previous reports on municipal solid waste and medical waste, OTA examined other solid wastes not classified as hazardous.