The WTO Comes to Dinner: U.S. Implementation of Trade Rules Bypasses Food Safety Requirements

A Special Report By Public Citizen's Global Trade Watch and Critical Mass Energy and Environment Program. A review of U.S. government "system" audits of five nations (Brazil, Mexico, Argentina, Australia and Canada) reveals that the U.S. Department of Agriculture (USDA)'s Food Safety and Inspection Service (FSIS) deemed "equivalent" systems with sanitary measures that differ from FSIS policy, and in some cases, violate the express language of U.S. laws and regulations. Because FSIS has refused to respond to Public Citizen Freedom of Information Act requests for correspondence and other documentation regarding these equivalency decisions, it is impossible to determine what is the current status of these issues and whether they have been resolved by regulators. - The U.S. law requiring meat to be inspected by independent government officials was violated by Brazil and Mexico and they retained their eligibility to export to the United States. - The USDA's zero tolerance policy for contamination by feces was repeatedly violated by Australia, Canada and Mexico. - U.S. regulations requiring monthly supervisory reviews of plants eligible to export be conducted on behalf of USDA by foreign government officials were violated by Argentina, Brazil, Canada and Mexico, several of whom are seeking to avoid this core requirement of U.S. regulation. Monthly reviews are vitally important to remind the meat industry that the meat inspector who works the line in the plant is backed by the weight of the government and to double-check the work of meat inspectors on a regular basis. - Even though U.S. regulations requiring that a government official -- not a company employee -- sample meat for salmonella microbial contamination, the USDA approved company employees performing this task as part of an equivalency determination with Brazil and Canada. - Even though U.S. regulations require certain microbial testing to be performed at government labs, the U.S. approved testing by private labs as part of the equivalency determination with Brazil, Canada and Mexico. - Unapproved and/or improper testing procedures and sanitation violations have been re-identified by FSIS year after year for Australia, Brazil, Canada and Mexico, but the countries have retained their eligibility to export to the United States. - After its regulatory systems was designated "equivalent," Mexico began using alternative procedures for salmonella and E. coli that had never been evaluated by FSIS, yet the country retained its eligibility to import to the United States. - Australia and Canada were allowed to export to the United States while using their own methods and procedures for such matters as E. coli testing, postmortem inspection, monthly supervisory reviews and pre-shipment reviews while awaiting an equivalency determination from FSIS. - FSIS auditors and Canadian food safety officials continue to disagree about whether particular measures have already been found "equivalent" by FSIS, yet Canadian imports remained uninterrupted. - The regulatory systems of Brazil and Mexico have been rated equivalent even though the countries plead insufficient personnel and monetary resources to explain their inability to carry out all required functions

Determinants of Technical Barriers to Trade: The Case of US Phytosanitary Restrictions on Mexican Avocados, 1972-1995

International Relations/Trade,

State of New York Public Employment Relations Board Decisions from October 11, 2001

10_11_2001_PERB_BD_DecisionsOCR.pdf: 257 downloads, before Oct. 1, 2020

Echocardiography curriculum development for physician assistants using entrustable professional activities

BACKGROUND: With the projected increase of cardiovascular disease in the aging population, a higher demand for echocardiography use is predicted. However, there is a shortage in the supply of cardiologists, to the point that a 2009 American College of Cardiology survey report called it a "cardiology workforce crisis". The report also recommends a more aggressive use of PAs and NPs as one of the solutions to fill the shortage. Currently, echocardiography is not routinely included in the scope of practice for PAs in cardiology. While PAs attain strong basic science knowledge and clinical training experience in PA school, they typically do not receive additional formal postgraduate training. PAs have limited training opportunities to train in echocardiography and receive certification of recognition, but a formally standardized training program and certifying examination geared specifically for PAs are yet to be developed. This study seeks to develop a pilot curriculum in training echocardiography which can be standardized for utilization across various regions and medical subspecialties. The curriculum draws on the concept of Entrustable Professional Activities (EPA), which is being actively used in graduate medical education. HYPOTHESIS: After participating in the proposed pilot curriculum which involves online didactic learning and supervised hands-on clinical training, trained PAs will be able to reach proficiency in echocardiography operation and interpretation at level 4 supervision according to the EPA guidelines. METHODS: This study proposes a pilot curriculum with framework based on the EPA titled “performing and interpreting echocardiography” by PAs. The curriculum involves didactic and clinical training in echocardiography, with the goal to achieve mastery of level 4 supervision (minimal supervision). 2 subjects will be recruited from a teaching medical institution in the Greater Boston area with an IAC accredited echocardiography laboratory. After the 12-month training, participants will take ASCeXAM/ReASCE Online Practice Exam Simulation offered by the ASE. Upon 1) achievement of individualized EPAs as assessed by supervisor, and 2) simulation exam score of >80%, participants will earn a STAR in echocardiography. CONCLUSION: The study is the first step to establishing an effective training curriculum that will eventually be a basis for creating a certifying exam in echocardiography, designed specifically for PAs. As this study merely suggests a new curriculum, future studies should focus on identifying strengths and weaknesses of the curriculum after implementation and expansion to multiple sites, and gather data to use for continual improvement of the training curriculum