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DUFFY'S CULTURAL COUTURE
Friday, 8 April 2016
Family Fun Day of Free Art and Entertainment at HAM
Topic: ART NEWS


 

 
 Family Fun Day of Free Art and Entertainment at HAM

 
 
 
Enjoy an afternoon of arts and entertainment at the Hunterdon Art Museum’s annual HAM It Up! community day on Sunday, May 1 from 1 to 4 p.m.
 
This year’s free HAM It Up! event invites children and adults to participate in an assortment of family-fun art projects on the Museum’s Terrace. Guests can paint a wooden fish and add it to a large 3-D fish tank, or get inspired by the Raritan River to help create a mural on the Museum’s popular giant chalkboard. (Ever wonder what an octopus or whale would look like swimming in the Raritan River? Well, come draw them on the wall!)
Guests can also make jewelry, paper-bag hats and create Monet-inspired watercolor paintings. Easels will be set up on Lower Center Street where adults and children can stop and paint various still lifes.
 
HAM It Up! features live music with Raritan Valley Recovery, a talented acoustic band that performs a variety of traditional and contemporary music, and the award-winning Macheis Wind, whose music has been called brilliant and artistic. The Millstone River Morris Dancers will also entertain. 
 
Anyone who’s ever wanted to try spinning plates, ropes or a Chinese yoyo will enjoy visiting with performer Brenn Swanson. She’ll also teach everyone how to juggle and twist balloon animals.
 
Everyone can stop by and greet the alpacas from Bluebird Alpaca Farm of Peapack, NJ.
Flavorganics, lead sponsor of HAM It Up!, will offer samples of its organic syrups to please your palate. Additional HAM It Up! sponsors are Unity Bank and Citispot Tea and Coffee.
 
The event will be held rain or shine. Please note that much of Lower Center Street will be closed to traffic during the event.
 
Participating HAM faculty members are: Linda Schroeder, Joe Agabiti, Wendy Hallstrom, Amanda Esposito, Matt Esposito, Duffy Dillinger, Jim Pruznick and Leah Cahill.

For more information, visit the Museum’s website at www.hunterdonartmuseum.org or call 908-735-8415.


Posted by tammyduffy at 6:24 PM EDT
Friday, 1 April 2016
Hamilton Leadership Ignores Lead Laws
Topic: COMMUNITY INTEREST


 

 
  

Hamilton Leadership Ignores Lead Laws

 

By Tammy Duffy

 


 

 

 

The man-made drinking water crisis in Flint has made international headlines. For more than a year, state officials -- from Gov. Snyder to his appointed Flint emergency managers to the Michigan Department of Environmental Quality -- exposed an entire city to the risk of lead poisoning in their drinking water. It's a public health catastrophe with long-lasting consequences for the children under the age of six in Flint who will suffer neurological damage for the rest of their lives. 

 

A Hamilton resident, age 4, died in his sleep Sept. 25 from EVD68. In 2014, the United States experienced a nationwide outbreak of EVD68 associated with severe respiratory illness. For months prior to the death of a Hamilton resident, there was a nationwide epidemic occurring. The CDC was contacting the nation and health workers on how to help elevate this epidemic in towns. Several health departments and mayors in towns in Mercer county, not including Hamilton, were proactive in educating their schools, residents know what to do as it pertained to hand washing and cleanliness. The township of Hamilton was silent on this issue.  There were zero proactive measures made during the EVD68 outbreak. It was not until after the death of a 4 year old resident that the local health department and mayor made any type of announcement or educated the community.

 

During several of the press conferences, after the death of a resident, the mayor of Hamilton Township, stated, "Does anyone even know what EVD68 is?  This was a startling statement for residents. How can the leader of a town, when a nationwide epidemic is occurring not know about it?  This same leader was oblivious to the fact that there was a heroin epidemic in her own town and named her town, "the Big H" at another press conference. "The Big H" is the street name for heroin. What does this leader know about the lead crisis in America?  There is zero information on the township website to educate residents on what to do for their children as it pertains to lead in the water. Upon calling the HAMSTAT headquarters and the Department of Health in Hamilton we learned that there are nothing as well. The people we spoke to knew of no programs, mandatory testing or could speak to the results demonstrated in the NJ State Department of Health report. Is Hamilton the next Flint? Why are the children not being tested? Where is the plan to protect the residents?

 

N.J.A.C. 8:51A requires the protection of children less than six years of age from the toxic effects of lead exposure by requiring lead screening pursuant to N.J.S.A. 26:2-137.2 et seq. (P.L. 1995, c 328.  An EBLL: Elevated Blood Lead Level  is 10 µg/dL or greater.

 

The number of children tested for lead in NJ as 220,787, which represents an increase of 2.9% over the 214,478 children tested during SFY 2011. The SFY 2012 number of children tested also includes 103,380 children, or 48%, who are between six and 29 months of age, the ages at which all children must be tested under State law.

 

While 213,020 (99.5%) children tested during SFY 2012 had blood lead levels below the Centers for Disease Control and Prevention (CDC) threshold of 10 μg/dL, there were 1,155 (0.52%) children with a test result above this threshold, including 236 children, who had at least one test result of 20 μg/dL or greater. In 2014, only 83% of the investigations of Pb levels above 20 μg/dL  in NJ were completed. However, only 48% of the abatements were completed according to a Department of Health report from 2014.  The reports states that this lack of follow up are occurring due to the following issues:

 

  • difficulty in identifying and communicating with absentee property owners
  • lengthy enforcement actions and court proceedings against recalcitrant property owners;
  • delays in contracting with and scheduling work to be performed by State-certified lead abatement contractors; and,  inability of property owners to obtain financial assistance to pay for the cost of the required abatement

 

In New Jersey, all children are to be tested at both one and two years of age. At a minimum all children should have at least one blood lead test before their sixth birthday. Approximately 78% of children in New Jersey have had at least one blood lead test prior to reaching three years of age. In Hamilton the numbers are significantly lower. The numbers are as low as 14% of children being tested. There was a new gun range built in a residential neighborhood in Hamilton, costing more than $500,000 according to sources. There are two other ranges within 3 miles of the town that the township police could use. Why was this money spent on a range vs. the children to get them tested?

 

Lead is a heavy metal that has been widely used in industrial processes and consumer products. When absorbed into the human body, lead affects the blood, kidneys and nervous system. Lead’s effects on the nervous system are particularly serious and can cause learning disabilities, hyperactivity, decreased hearing, mental retardation and possible death. Lead is particularly hazardous to children between six months and six years of age because their neurological system and organs are still developing. Children who have suffered from the adverse effects of lead exposure for an extended period of time are frequently in need of special health and educational services in order to assist them to develop to their potential as productive members of society. The primary method for lead to enter the body is the ingestion of lead containing substances.

 

Lead was removed from gasoline in the United States in the early 1980’s. This action is credited with reducing the level of lead in the air, and thereby the amount of lead inhaled by children. However, significant amounts of lead remain in the environment where it poses a threat to children. Some common lead containing substances that are ingested or inhaled by children include:

 

·         lead-based paint

·         dust and soil;

·         tap water;

·         food stored in lead soldered cans or improperly      glazed pottery

·         traditional folk remedies and cosmetics     containing lead.

 

All children in New Jersey are at risk because lead-based paint and other lead-containing substances are present throughout the environment. Some children, however, are at particularly high risk due to exposure to high dose sources of lead in their immediate environment.

 

These potential high dose sources include:  leaded paint that is peeling, chipping or otherwise in a deteriorated condition; lead-contaminated dust created during removal or disturbance of leaded paint in the process of home renovation; and  lead-contaminated dust brought into the home by adults who work in an occupation that involves lead or materials containing lead, or who engage in a hobby where lead is used. Recently, there has been much attention focused by the media on the increasing number of foreign imports coming into the United States being tainted with dangerous levels of lead.

 

This has been alarming especially when these imports consist of toys and other products used primarily by children. However, in New Jersey, today, the primary lead hazard to children comes from leadbased paint. In recognition of the danger that lead-based paint presents to children, such paint was regulated for residential use in New Jersey in 1971, and banned nationwide in 1978. There are numerous dollar stores in the township of Hamilton that carry many of these lead contained toys that the children are playing with. 

This ban has effectively reduced the risk of lead exposure for children who live in houses built after 1978, but any house built before 1978 may still contain leaded paint. The highest risk for children is found in houses built before 1950, when paints contained a very high percentage of lead. There are nearly one million housing units in New Jersey, 30% of the housing in the state, which were built before 1950. Every county in the State has more than 9,000 housing units built before 1950 and more than 2.5 million housing units built prior to 1980

 


 


 

New Jersey Takes Childhood Lead Poisoning Seriously By Acting Health Commissioner Cathleen D. Bennett Every day in New Jersey, in local health departments, community health centers, doctors’ offices, WIC clinics and in home visits with at-risk populations, health professionals test children for elevated lead levels and educate families about preventing lead poisoning, which can cause behavior and learning problems, lower IQ, hyperactivity, slowed growth, hearing problems, anemia and kidney damage. New Jersey is one of 17 states that require universal lead screening of all children at ages 1 and 2.

 

Other states target screening only to children at increased risk for lead exposure. New Jersey’s approach is far more protective. More than 205,600 children were screened for lead last year. And the number of children with elevated blood lead levels has dramatically declined over the past 20 years.

 

There were 27,295 cases in 2000 compared to 3,426 so far this year. That is a public health success story. More than 100 WIC clinics in New Jersey ask every mother and caregiver if their child has been tested for lead. If they have not, they are referred to a clinic or to their physician for testing. If their child’s test shows elevated levels, they are counseled on the importance of nutritious foods rich in Iron, Vitamin C and Calcium and warned about potential sources of lead exposure such as chipping paint and imported products. Each year, the Department of Health provides $11 million to the Department of Children and Families to support its evidence-based home visitation programs, which bring nurses, community health workers and, in some cases, trained parents into the homes of at-risk families to provide information and referrals on child health and safety issues including strategies to reduce exposures to lead. New Jersey’s poison control center, the New Jersey Poison Information and Education System (NJPIES), has used state funding for years to educate the public on lead poisoning and to counsel callers to its 24/7 hotline (1-800-222-1222). It has also issued numerous warnings about non-traditional sources of lead including imported candies, jewelry, cosmetics, spices, pottery and home remedies. The Department also funds continuing medical education so that health care providers understand how to identify lead poisoning. Yet, there is zero information in Hamilton to educate the residents.

 

After Superstorm Sandy devastated New Jersey—heightening the risk of lead exposure due to extensive debris from thousands of destroyed homes and businesses--the Department of Health asked the federal government for and received $5.4 million for a Lead Poisoning Prevention Initiative.

 

According to a report by the  N.J. Department of Health from 2014, the township of Hamilton demonstrated they had 1,814 children who were in the age bracket of 6 to 26 months of age. Only 22% of these children were tested for lead. These results demonstrate one of the lowest in the state out of the large municipalities evaluated.

 

  • 392 children in this age bracket were found to have lead levels below 5 BLL (µg/dL)
  • 9 children in this age bracket were found to have lead levels between 5-9 BLL (µg/dL)
  • 1 child in this age bracket were found to have lead levels above10 BLL (µg/dL)
  • Only 22% of the children were tested

 

 

N.J.A.C. 8:51A requires the protection of children less than six years of age from the toxic effects of lead exposure by requiring lead screening pursuant to N.J.S.A. 26:2-137.2 et seq. (P.L. 1995, c 328. So why is the Township of Hamilton ignoring this law?  Why are only 22% of the children being evaluated in Hamilton township, Mercer County?

 

According to a report by the  N.J. Department of Health from 2014, the township of Hamilton demonstrated they had 5,480 children who were in the age bracket of less than 6 years of age. Only 14.9% of these children were tested for lead in Hamilton township, Mercer County. These results demonstrate one of the lowest in the state out of the large municipalities evaluated.

 

  • 749 children in this age bracket were found to have lead levels below 5 BLL (µg/dL)
  • 18 children in this age bracket were found to have lead levels between 5-9 BLL (µg/dL)
  • 1 child in this age bracket were found to have lead levels above10 BLL (µg/dL)
  • 1 child in this age bracket was found to have lead levels between 20-44 BLL
  • Only 14.9% of the children were tested

 

 

New Jersey law (N.J.S.A. § 24:14A-6) requires Local Boards of Health to investigate all reported cases of childhood lead poisoning (N.J.A.C. § 8:51) within their jurisdiction and to order the abatement of all lead hazards identified in the course of the investigation. The procedures for conducting environmental investigations in response to a lead-poisoned child are specified in N.J.A.C. § 8:51.

 

The Local Board of Health must conduct an inspection of the child’s primary residence and any secondary address, such as a child care center, the home of a relative or babysitter, or wherever the child spends at least 10 hours per week. If the child moves, the property where the child resided when the blood lead test was performed must be inspected. The environmental inspection includes a determination of the presence of lead-based paint and leaded dust; the identification of locations where that paint is in a hazardous condition such as peeling, chipping, or flaking; and, as appropriate, the presence of lead on the dwelling’s exterior or soil. The inspector, with the public health nurse, speaks to the child’s parent/guardian and completes a questionnaire to help determine any other potential sources of exposure to lead. In addition, the Local Board of Health arranges for a home visit by a public health nurse to educate the parent/guardian about lead poisoning and the steps that he or she can take to protect the child from further exposure. The public health nurse also provides ongoing case management services to assist the family, including but not limited to, receiving follow-up testing, medical treatment, and social services that may be necessary to address the effects of the child’s exposure to lead.

 


 

 

 

 

 


Posted by tammyduffy at 8:02 AM EDT
Thursday, 31 March 2016
BEWARE OF CROWDFUNDING SCAMS: KICKSTARTER AND INDIEGOGO
Topic: COMMUNITY INTEREST


 

 

BEWARE OF CROWDFUNDING SCAMS: KICKSTARTER AND INDIEGOGO

 

By Tammy Duffy

 

Crowdfunding, whether the target is financing a philanthropic initiative, an art project or a business proposal – is a sexy concept and has turned Kickstarter into a household name.

 

By pooling the resources of investors or donors with relatively tiny amounts of money to put to work, in numbers large enough to offset that small per capita sum – has helped get movies into development and launched new products.

 

The approach is akin to angel investing, with the key differences being that investors will get publicly traded stock and that angel investors tend to be savvy, experienced folks not looking at the deals they fund as a way to strike it rich. Most of them are already wealthy, having made millions as entrepreneurs or executives and who now are risking a relatively tiny portion of their net worth. Moreover, these angels typically are investing in a business in which they have some kind of specialized knowledge: An e-commerce angel might have been an early investor in eBay or Amazon.com, for instance, while someone putting a few thousand dollars into a health-care technology company is likely to have spent his career in that business and be familiar with what’s in hot demand and what technologies are likely to work.

 

But Kickstarter's most-buzzed-about projects -- the ones that blow through their funding goals and draw in thousands of backers -- have a spottier track record. Anecdotal reports abound of flawed products (try Googling "jellyfish death trap"), overambitious creators who can't pull off what they promised, and epic delays. An investigation found that 84% of Kickstarter's 50 top-funded projects missed their estimated delivery dates or never happen.

 

84% is a large number of potential scams occurring.

 

Like many of the projects it launched, Kickstarter is in some ways a victim of its own runaway success. Indiegogo does not have any better of a track record.  They both hide behind the cloak of their terms and conditions and take zero responsibility for what is going on. 

 

Kickstarter, founded in 2009 to fund "creative projects," the site wasn't intended to hatch things like new gadgets that require multi-million-dollar manufacturing lines in Asia. It began as a way for artistic types to raise a few thousand dollars for their gallery shows, records, and books.

 

"We had a lot of musicians and artists at first, and that's still 95% of the platform," says Kickstarter co-founder Yancey Strickler. "But we've always had a broad definition of 'creativity,' and that's led to some contemporary definitions of the word. Maybe it's not what Beethoven was doing, but if they had 3-D printers in his time, he probably would have been into it."

 

Such quips are common from Strickler, who looks like Central Casting's vision of a startup founder. He's got the requisite thick-rimmed glasses, casually floppy brown hair, and an omnipresent half-grin whenever he talks about the platform he created.

 

Thanks to the rise of crowdfunding, some amazing, otherwise impossible product ideas have made it to the masses. Risky, wildly imaginative, and innovative are some of the adjectives used to describe the most notable projects. At the time of writing this, Kickstarter has provided the means for $1.89 Billion in pledges towards 99,475 successful projects. Though Indiegogo’s statistics are kept private, you can bet their pledges are substantial as well.

 

A dark side to this is emerging, however; some of these campaigns are leaving their investors high and dry. Scammers are seeing these platforms as a way raise tons of money and then disappear without a trace. There are now numerous poorly-executed projects floating around the web, and even more exploited investors floating around right behind them. Just like investing in the “real world”, it has become critical that you perform your due diligence as a backer before throwing your money at the next big thing.

 

Thankfully we are seeing efforts to mitigate these dangers, from backers, authorities and the platform makers themselves.  Last year, a few developments set a new tone for accountability. Kickstarter hired Mark Harris, a well known tech journalist, to investigate the high-profile failure known as Zano. Zano raised an incredible $3.4 Million to bring their video recording drone project to the public. They failed not only to deliver on the actual product, but also failed to provide adequate transparency as to where the funds went or why backers still hadn’t received their drones.

 

To help the overall cause, last spring the FTC successfully pursued and settled charges with a different scammer who canceled his project and then used backers’ money to pack up and move.

 

Though most crowd funding supporters will agree that the defensive moves mentioned above do set a positive precedent in protecting backers, they are simply not practical in each case. Not every project is fortunate enough to be properly investigated, and even “verified” LinkedIn and Facebook accounts may not be effective to ensure you’re dealing with someone who is who they claim to be, or selling a product that exists in the form they suggest.

 

Take a good look at the prototype being offered. You must ask yourself: what credentials does the project creator possess? Besides having access to the technical resources, do they have the ability to manage the project from conception to fruition? What does your gut tell you about the project you’re looking to back? Or ask them – what do they tell you? If it seems too good to be true or too far out there, it likely is.

 

On the flipside, not every delayed project is automatically a scam either. Anyone who has worked in design, manufacturing, or development will tell you that “things” happen. Delays caused by issues sourcing specialized parts, inconsistencies in manufacturing quality, or shifting shipment timelines may all be genuine reasons to postpone a project. What is not acceptable, however, is refraining from explaining the reason(s) to backers and failing to keep them informed on how issues are being resolved.

 

It is up to you as a consumer and potential backer to invest wisely, just as if you were pouring capital into some risky new stocks. There is a bit of risk inherent with each project you back because there is only so much Kickstarter, Indiegogo, or GoFundMe can do in each case to ensure legitimacy, and even less to ensure success. Understandably, no one wants to spend their hard-earned cash on something that will never materialize. On the bright side, there’s still always Amazon.

 

Some Kickstarter scams:

 

Stone Tether: 6,927 backers pledged $366,199 to help bring this project to life.

Juicebee: 758 backers pledged $57,852 to help bring this project to life.

Agent Watch: 5,685 backers pledged $1,012,742 to help bring this project to life.

Coolest Cooler: 62,642 backers pledged $13,285,226 to help bring this project to life.

 

Indiegogo scam: Triton Gills: 2,409 backers pledged $878,180

 

Let the buyer beware.

 

 


Posted by tammyduffy at 7:32 PM EDT
Tuesday, 22 March 2016

 
 

 

 
 
Court: Sex Offenders Can Volunteer With Church Youth Groups


 
 A New Jersey appeals court has ruled that sex offenders subject to Megan's Law community notification requirements are not barred from volunteering with church-related youth programs.
 

In a published opinion issued March 22, a three-judge Appellate Division panel affirmed a trial judge's decision to dismiss a criminal charge against a convicted Somerset County sex offender, identified only as S.B., who is a volunteer with his church's youth group.

 

Appellate Division Judge Marie Lihotz, joined by Judges William Nugent and Carol Higbee, said the Legislature purposefully excluded church groups from the statute, N.J.S.A. 2C:7-1 to -23, that bars sex offenders from holding "a position or otherwise participate, in a paid or unpaid capacity, in a youth serving organization."

 

A Somerset County grand jury indicted S.B., who has a conviction for sexual assault involving a victim under the age of 18, for violating the statute, which is a third-degree crime punishable by a prison sentence of between three and five years.

 

S.B. is a congregant at the Eternal Life Christian Center in Somerset, according to the appeals court's opinion. He is a youth leader, counselor, mentor and chaperon for children ranging in age from 12 to 17 for the church's No Limits Youth Ministry. As such, he supervises children at outings, movie nights, concerts, youth group meetings and day camps.

 

Somerset County Superior Court Judge Julie Marino dismissed the indictment last June, finding that the youth ministry did not meet the definition of a "youth serving organization." The Somerset County Prosecutor's Office appealed.

 

"The sole question for our determination is whether a youth ministry associated with a church, where defendant is a congregant volunteer, is a 'youth serving organization' defined to 'mean a sports team, league, athletic association or any other corporation, excluding public schools, which provides recreational, educational, cultural, social, charitable or other activities or services to persons under 18 years of age,'" Lihotz said, quoting the relevant portion of the statute. "We conclude it is not and affirm."




Posted by tammyduffy at 8:06 PM EDT
Monday, 21 March 2016
Board of Education To Stop Cameras From Rolling
Topic: COMMUNITY INTEREST


 

 
 I wanted to make you aware of a very important issue -
The BOE is meeting tonight and policy #0168 will be voted on. This policy is to turn off the cameras for all future meetings. They also will no longer be available on the district website or via Cable Access channels. It was suggested to just turn off the cameras just for the public portion but that was shot down.
If this is changed to audio how will it be disseminated to the public since we do not have a radio station? If it is placed on the district website audio will be very confusing to listen to since there are so many BOE members talking.
The vote will allow the public to record the meeting via audio or camera as long as the Board Secretary is given five days advance notice. Why would we want the public to have this access? The BOE should maintain complete control.
There is no doubt that grand standing can occur from the public due to the cameras. However, one could argue that many people do not speak because there are cameras. The best solution is to just turn the cameras off for the public portion. In an era where communication is a necessity why limit our access to the Board meetings? Many people do not have the time to attend the meetings and they watch via the website or cable. Now that will no longer be available.

Posted by tammyduffy at 8:21 PM EDT
Saturday, 19 March 2016
3D Breast Tomosynthesis, Not What it is Cracked Up To Be!
Topic: COMMUNITY INTEREST


 

 

 

3D Breast Tomosynthesis

Not What it is Cracked Up To Be!

 

 

 

 

 

This article is the direct dialogue from a patient, who has a genetic ability to create microcalcification clusters, during her recent mammogram.  This patient also has a rare genetic mutation. The mutation is also evident in almost everyone from her father's side of the family.  They all have tested positive for the Met 30 gene.

The patient walks into the imaging center for her annual mammogram. She is actually 18 months late for her follow-up exam. She sees signs all over the waiting room, WE HAVE TOMO! As she is taken back to the room, the x-ray technician explains to her that they have a new mammo system that can do breast tomosynthesis. The patient is very well versed in this topic and says, "No, I do not want it, there is too much dose. The benefits are yet to be seen for my type of history."

 

The technician goes on to say," But it gives you a more complete exam. If we have to do extra pictures or magnification views , the dose from that is about the same as the tomo."  The technician was extremely pushy as it pertained to the tomo. There were signs all over the office about tomo, even in the dressing room. The signs explained that if you choose to have this done there is an extra charge, a charge that insurance may not pay for.  This is not a unique scenario, hospitals and breast centers that have tomosynthesis as pushing it hard.

 

Patient says," No, I will pass."

 

They go into the room and the mammogram is performed on a new GE system with tomo. No tomo is performed. At the end of the exam the technician says to the patient," I give you a lot of credit for pushing back on me about the tomo. This new system with tomo cannot see microcalcifiations. You still have to do magnification views even with the tomo. It's not a good test." If you would have said, "Yes, do the tomo." , we then have to charge you. The liklihood that your insurance would pay is unlikely. If, however, the doctor reads your films, and because this is a diagnostic mammo and not a screening mammo, says do tomo......there is no cost.

 

Does this make sense to you? A patient who has no idea what tomo is 9 times out of 10 has the right to order the test and be charged for it. If the doctor orders it, there is no charge. We thought this was unique for this facility. It is not. This is how it works everywhere. We called 60 sites.

So ladies, always say no......to tomo.....in the event a doctor wants to do it, let him/her order it, this way you are not charged. However, once you read this article, you will opt out of getting tomo, even if its free.  Many sites have not stopped charging for it due to the fact they have seen such a decrease in patients saying yes up front. Ladies unite....just say no.

  

The patient then smiled at the xray technologist. Knowledge is power, less dose and the patient gets a better exam in the end. This patient also does her due diligence on who is reading her exam.  You could have the best system in the world; but if a blind radiologist or someone how finished last in their class is reading your films, you could die. Every single woman who schedules her mammogram needs to ask, "Who will be reading my films that day?". They need to research the doctors and every year make sure their "wonder doc" reads their films.

 

The American public is being duped that this new technology, breast tomosynthesis  is the best thing since sliced bread. Insurance companies are being duped, or are they? This could be why many insurance companies won't pay for it.

 

Digital tomosynthesis (pronounced toh-moh-SIN-thah-sis) creates a 3-dimensional picture of the breast using X-rays. Digital tomosynthesis is approved by the U.S. Food and Drug Administration, for some medical device vendors, but is not yet considered the standard of care for breast cancer screening. Because it is relatively new, it is available at a limited number of hospitals and outpatient centers. There are not many PACS (picture archiving systems) that can display the digital tomo images. It is too much data. A special workstation is needed in this case, which leashes the doctor during the reading of these exams.  This creates havoc on the workflow of a hospital or imaging center.

 

Digital tomosynthesis of the breast is different from a standard mammogram in the same way a CT scan of the chest is different from a standard chest X-ray. Or think of the difference between a ball and a circle. One is 3-dimensional, the other is flat.

Mammography usually takes two X-rays of each breast from different angles: top to bottom and side to side. The breast is pulled away from the body, compressed, and held between two glass plates to ensure that the whole breast is viewed. Regular mammography records the pictures on film, and digital mammography records the pictures on the computer. The images are then read by a radiologist. Breast cancer, which is denser than most healthy nearby breast tissue, appears as irregular white areas — sometimes called shadows.

 

Mammograms are very good, but they have some significant limitations:

The compression of the breast that's required during a mammogram can be uncomfortable. Some women hate it, and it could deter them from getting the test.

The compression also causes overlapping of the breast tissue. A breast cancer can be hidden in the overlapping tissue and not show up on the mammogram.

 

Mammograms take only one picture, across the entire breast, in two directions: top to bottom and side to side. It's like standing on the edge of a forest, looking for a bird somewhere inside. To find the bird, it would be better to take 10 steps at a time through the forest and look all around you with each move.

 

Digital tomosynthesis is a new kind of test that's trying to overcome these three big issues. It takes multiple X-ray pictures of each breast from many angles. The breast is positioned the same way it is in a conventional mammogram, but only a little pressure is applied — just enough to keep the breast in a stable position during the procedure. The X-ray tube moves in an arc around the breast while 11 images are taken during a 7-second examination. Then the information is sent to a computer, where it is assembled to produce clear, highly focused 3-dimensional images throughout the breast.

 

Early results with digital tomosynthesis are promising. It does not work on fatty breasts at all. Yet, owners and manufacturers of these machines are aggressively marketing this test as the holy grail of cancer detection for al patients.  This is not the case.  Researchers believe that this new breast imaging technique will make breast cancers easier to see in dense breast tissue and will make breast screening more comfortable. This reminds me of when CAD (computerized added diagnosis) first came out for mammography. Will tomo be the new CAD? Many facilities hardly use their CAD devices anymore, they do not trust their accuracy and create more false positives. This drives up health care costs.

 

Why is the FDA approving this technology and allowing the behaviors to exist in the marketing of this product? Why is the FDA not doing follow up studies on these new technologies to see if they are draining the healthcare system?  If they add cost and do not make a positive impact on the health of patients then why have it? Once a device is approved its approved.  There is rarely follow up unless something bad happens to a patient from the device. This new technology is being actively marketed by vendors and mammography facilities as the best thing since sliced bread...however, bread it is not. 

 

Prior to making the mammogram appointment the patient was adamant about who would read her mammogram. This is an important step in the process. If the Stevie Wonder of mammogram readers reads your films, cancer could be your next experience. The patient fully trusting the doctor who is reading her films, sat in the dressing booth awaiting her results.

 

The doctor came out, who is very well respected in the world of mammography and radiology said, "No additional films are needed, you are all good. This new tomo system we have cannot see microcalcifications with the tomo, its not a good technology," the doctor said.

 

So why can't they see the microcals using a technique that takes "slices" and dices of your breast?  They cannot see the edges, they are all blurry of the calcifications. This is not good.

 

3d breast tomo manufacturers vary the arc of movement (typically 11-60°), the number of individual exposures (typically 9-25), use of continuous or pulsed exposure, stability or movement of the detector, exposure parameters, total dose, effective size of pixels, X-ray source/filter source, single or binned pixels, and patient position. These theoretical and engineering decisions may lead to different clinical outcomes and different reading recommendations for the different manufacturers. Of particular importance is the assessment of microcalcifications and whether one attempts to accurately depict microcalcifications by DBT. Because of the limited angle of scanning, the images are only “quasi” 3D. The x-y plane perpendicular to the x-ray beam has the highest resolution. There is less resolution in the parallel plane or z axis. One may reconstruct the data set for the radiologist to read by displaying different thicknesses. For example, if a 60 cm compressed breast is reconstructed at 1 mm thickness, there will be 60 slices for the physician to review. If the images are reconstructed at 0.5 mm thicknesses, there will be 120 images to be reviewed. If the images are reconstructed at 10 mm thick “slabs” using maximum intensity projection (MIP) thick slices, there will be 6 images to review.

 

This below is a snapshot from one vendors product brochure that is available on the web.

 

  • SenoClaire uses ASiRDBT, a calcification artifact correction iterative reconstruction algorithm that delivers off-plane images much improved in terms of both in-plane and out-of-plane artifacts versus the traditional Filtered Back Projection (FBP) algorithm. 
  • SenoClaire’s 3D MLO sequence requires only nine exposures with an even distribution of the dose. 
  • The SenoClaire grid in 3D reduces scattered radiation while preserving dose and performance. 
  • The dual-track X-ray tube (Mo/Rh) delivers optimized X-ray spectra to penetrate the breast based on breast density and compressed breast thickness. Automatic Optimization of Parameters (AOP) helps you identify the densest breast regions and automatically selects the appropriate anode, filter, kV and mAs to ensure repeatable image quality at optimized radiation dose.

 

The dose is the same for each of the 9 exposures the systems takes. This is radically unacceptable. The system can only evaluate the breast in that instant of the exposure.  A standard technique and dose is used, no matter that the issue characteristics are at each angle that the system takes a picture. Again, this is radically unacceptable.  The exposure is cut off prematurely to rush to the next exposure.  God knows what data is actually collected. The systems specifications go on to say that they use Mo/Rh to best optimize the spectra, based on breast density and compressed thickness. This is a target filter combination utilized in mammography. The Mo/Rh will not correct for the use of the same dose for each angled projection. There are many target filter combinations used in mammography, Mo-Mo, Mo-Rh, W/Rh, etc.

 

This technology at best is completely contradictory and incomplete. A woman should not be subjecting herself to unnecessary dose to say, "I got my 3d mammo."  This is not to point the finger at one vendor, all of the systems currently in clinical use demonstrate these same type of contradictory, incomplete characteristics. The global public has been tricked into thinking 3d tomo for mammo is and should be standard practice. The mammmography facilities are pushing this hard.

  

A major consideration for DBT (digital breast tomosynthesis) manufacturers and regulators is the balance between dose and image quality. Because image quality tends to be directly related to dose, compromises are necessary. All manufacturers have produced equipment with dosing parameters less than current FDA limit of 300 millrads per exposure. Common conventional mammographic dose per view is 150-250 millirads. However, achieving lower doses is optimal. Variations in target filter, breast thickness, and breast density further complicate this analysis. However, if DBT could lead to reduction in recall rate or improvement in sensitivity and specificity, a minimally higher dose may be acceptable.

Reconstruction techniques include shift-and-add, tuned aperture computed tomography, matrix inversion, filtered back projection, maximum likelihood reconstruction, and simultaneous algebraic reconstruction technique. Certain reconstruction methods may be better for masses and other methods better for calcifications. They use one algorithm for all types of tissue, which is not stellar. 



These are old techniques, where is the innovation>  Once an facility decides to invest in the technology (there 3D technology is creating quite the competitive market between facilities, they feel as if they have to have it to get patients) they are biased to use the machine.

 

There is also only one algorithm used in the post processing of the images for all types of tissue with DBT. This is not optimal either.  The problem is "scale-space". Scale-space theory is a framework for multi-scale signal representation developed by the computer vision, image processing and signal processing communities with complementary motivations from physics and biological vision. It is a formal theory for handling image structures at different scales, by representing an image as a one-parameter family of smoothed images.

 

The creators of these machines need  a matched filter for each scale of concern, from tiny microcalcifications to bigger calcifications to smaller masses to larger masses - the optimal filter varies as a function of size. This is not what the current machines can do. None of them. So what use is the technology?  Corporations have spent millions of dollars to develop systems that are not optimal.

 

There are other technologies on the horizon that use honey-combed detectors, and other types of imaging, including the use of contrast, that have demonstrated in research some promising results. The current technologies and those in the works utilize a detector that have 50, 70 or 100 micron resolution in size.  None of which are useful for 3d breast tomo. One cannot obtain the crystal clear margins of a microcalcification using tomo at 50,70 and 100 micron resolution. There is some promise with contrast enhancement and spectral imaging, but its too early to say whether this is useful technology. However, there needs to be absolute proof that the true positive and true negative performance of the contrast enhanced systems  are  in comparison with (or in combination with) other settings/modalities.


One manufacturer is focused on spectral breast density measurements. A published white paper demonstrates that the results of the phantom study suggest that photon counting spectral mammography systems may potentially be implemented for an accurate quantification of volumetric breast density; the study resulted in a  root-mean-square (RMS) error of less than 2%, using the proposed  spectral imaging technique.

Accurate density estimation (purported risk estimation) is an intermediate  goal. The end goal remains high accuracy: true positives and true negatives. The intermediate goal may bias a decision not to investigate further (save a buck where possible), but the end goal is the holy grail,isn't it? I would want to see a benefit of using the former to get to the latter.  An alternative may be - go directly for the latter.

It is the shared goal is to save the most lives possible from breast cancer, the American College of Radiology (ACR) and Society of Breast Imaging (SBI) continue to recommend that women get yearly mammograms starting at age 40. New American Cancer Society (ACS) breast cancer screening guidelines, and previous data used by the United States Preventive Services Task Force (USPSTF) to create their recommendations, state that starting annual mammography at age 40 saves the most lives.

 

“The ACS has strongly reaffirmed that mammography screening saves lives. The new ACS guidelines show that if a woman wants to reduce, as much as possible, her risk of dying of breast cancer, she will choose yearly mammography starting at age 40. A recent study in the British Medical Journal confirms this, showing that early detection of breast cancer is critical for improving breast cancer survival, regardless of therapy advances. Moving away from annual screening of women ages 40 and older puts women’s lives at risk,” said Debra Monticciolo, MD, FACR, chair of the American College of Radiology Breast Imaging Commission.

 

The ACR and SBI agree with the ACS and others that overdiagnosis claims are vastly inflated due to key methodological flaws in many studies. Overdiagnosis is likely 1 to 10 percent — largely due to inclusion of ductal carcinoma in situ (DCIS). Few, if any, invasive cancers are over-diagnosed.

Pulished research shows that nearly all women who experience a false-positive exam endorse regular screening and want to know their status. The ACR and SBI agree with ACS that women 40 and older should have access to mammograms. We also recommend that women, 40 to 45, get screened and would expect that mammography critics would agree that Medicare and private insurers should be required to cover women 40 and older for these exams,” said SBI President, Elizabeth Morris, MD, FACR.

 

While ACS states that transitioning to biennial screening is an option for older women, they note that either one or two year intervals would be appropriate as a woman ages. The ACR and SBI strongly encourage women to obtain the maximum lifesaving benefits from mammography by continuing to get annual screening.

 

The ACR and SBI commend ACS for using the modern IOM guideline development process — which is more trustworthy than the antiquated USPSTF methods. The ACS performed an extensive evidence review, including randomized control trials, population-based observational studies, case-control studies and cohort studies. This goes beyond the USPSTF limited review of only selected studies that underestimate the lifesaving benefit of mammography screening. Many of those studies were decades old and used what would now be considered outdated equipment.

 

The ACS included individuals on its panel who have experience in breast cancer and sought input from breast cancer experts. The USPSTF methodology lacks transparency, has limited input from cancer experts and does not engage all stakeholders which are needed to form meaningful and trustworthy guidelines.

 

Reading mammograms is about picking out malignant abnormalities from a sometimes confusing field of patches and threads and spots. In up to 1 in 2 women, dense tissue makes it even more difficult. 

 

Women with dense breast tissue — the sort that can hide potentially deadly tumors from routine mammograms — must be notified in writing and encouraged to consider additional tests under a new state law that is effective Monday.

While mammograms remain the gold standard for detecting breast tumors, they're less reliable in almost half of women with dense breast tissue. Dense or fibrous tissue shows up as splotches of white on a mammogram — so do tumors.

 

Digital breast tomosynthesis (DBT) is a new technique in the clinical breast imaging armamentarium that uses low-dose images obtained at multiple angles to reconstruct thinslice images through the breast. The Selenia Dimensions (Hologic) received United States Food and Drug Administration (FDA) approval on February 11, 2011, and other manufacturers are also developing breast tomosynthesis equipment.

 

Implementation of DBT into a clinical breast imaging practice requires consideration of image acquisition, interpretation, storage, technologist and radiologist training, patient selection, billing, radiation dosage, and marketing.

 

Patient positioning and breast compression are similar to conventional mammography. For each projection, the technologist positions the patient’s breast in mammographic compression just as for conventional mammography. The patient is instructed to hold her breath, and the x-ray tube source moves through a 15° arc with pulsed exposures to acquire 15 low-dose projection images, moving 1° between each projection image. One tomosynthesis unit uses a tungsten anode and aluminum filtration to obtain these 15 low-dose projection images. This takes approximately 4 seconds, and the grid is out during acquisition of the projection images. While the breast remains in compression, the patient is instructed to breathe out as the grid is returned and to breathe in and hold her breath while the conventional 2D full-field digital mammography (FFDM) image is acquired using a tungsten anode and rhodium filtration. For larger breasts, silver filtration is used for the FFDM images to provide better penetration without increasing exposure time. The compression paddle automatically releases and the patient is instructed to breathe normally. The entire process for acquisition of the 15 projection images and the conventional 2D image takes approximately 12 seconds, not significantly longer than the time required to perform FFDM alone. The technologist then positions the patient’s breast in compression for the next view. For a bilateral screening mammogram incorporating tomosynthesis, the patient is positioned and compressed four times to create bilateral craniocaudal and bilateral mediolateral oblique views using both tomosynthesis and conventional 2D FFDM imaging. With tomosynthesis, the use of radiopaque markers on skin lesions or nipples that are not in profile is no longer necessary. Some practices exclude women with implants from undergoing tomosynthesis imaging. Interpretation of DBT Images Raw data from the 15 tomosynthesis projection images obtained in each projection (craniocaudal and mediolateral oblique projections bilaterally) are reconstructed into a stack of tomosynthesis slices separated by 1 mm and oriented parallel to the plane of the mammography machine’s platform. These tomographic slices are displayed on the tomosynthesis vendor’s proprietary workstation for interpretation. The radiologist can scroll through each stack of images manually or in a dynamic cine mode. The number of tomosynthesis slices for interpretation is equal to the thickness of the patient’s breast in compression plus five. Five additional slices are added on the compression paddle side of each stack of images to ensure that the entire breast is imaged because the compression paddle’s location is mobile to accommodate various-sized breasts. On the platform-receptor side of the stack, no additional slices are necessary because the platform-receptor’s location is fixed. This is important to understand to avoid misinterpreting a skin lesion on the cranial aspect of the breast (in craniocaudal projection) as an ovoid asymmetry within the breast tissue because it will occur five slices “into” the top of the tomosynthesis stack. The slice on which the caves of Kopans and Rusby  are in focus identifies the skin surface. This can also occur on the superomedial aspect of the breast in mediolateral oblique projections. Not surprisingly, radiologists require additional time to interpret the tomosynthesis images in addition to conventional FFDM images.

 

A prospective study of 10 radiologists with at least 17 months of experience using DBT in their clinical practice found that DBT plus FFMD interpretation required an average of 47% longer than the time needed to interpret FFDM alone in a clinical screening mammography setting. Another study found an average reading time of 77 seconds for DBT examinations versus 33 seconds for FFDM examinations  and a third reported 91 seconds for DBT plus FFDM versus 45 seconds for FFDM alone. This approximate doubling of interpretation times must be considered before a practice implements DBT.

Although interpretation time for mammography using DBT plus FFDM increases relative to interpretation time for FFDM alone, the reduction in recall rates when DBT plus FFDM is used [3–5] decreases the amount of time that radiologists devote to interpreting the recall examinations from a given population of screening patients. This can be considered “time accounted” to compensate for the increased reading time required to interpret the screening mammograms of that population using DBT plus FFDM. When an interpreting radiologist annotates an area of concern on a DBT slice, a screen capture of that slice is sent to the PACS and is displayed as an additional single annotated tomosynthesis slice. There is no currently commercially available computer-assisted detection system for DBT imaging. Conventional mammographic computer-assisted detection is available on the 2D FFDM images from combination imaging

 

In accordance with Mammography Quality Standards Act (MQSA) requirements, radiologists must undergo 8 hours of training in this new technology before interpreting DBT images independently. Several continuing medical education companies now offer the required 8 hours of DBT training.

 

 


Posted by tammyduffy at 2:48 PM EDT
Updated: Saturday, 19 March 2016 3:06 PM EDT
Sunday, 13 March 2016
Lord and Taylor Spring Cosmetic Trend Show
Topic: COMMUNITY INTEREST


 

 

 

 

Lord and Taylor Spring Cosmetic Trend Show

 

By Tammy Duffy

 


 

 


 

 

 

During the early morning hours yesterday women were waiting in droves to enter Lord and Taylor at the Quaker Bridge Mall.  They were waiting to enter Lord and Taylor's Spring Cosmetic Trend Show.

 

When is comes to beauty, we can become obsessed. The must-try haircut, crisp cat-eye, and anti aging products that make us look like we are 20 again, become a part of our daily regime. This semiannual event has become the hit event of women in know and focused on looking young and beautiful.

 

There were numerous presentations given by the likes of Lancome, Estee Lauder, Bobbi Brown, Kiehl's, Chanel. Shiseido, Dior, Clinique, Borghese, Nars, Lancome, NuFace and many others. The women in attendance got the opportunity to compete for wonderful gift bags with values of over $200 each. The gift bags varied in contents from perfume, full product masks, $200 medical spa gift certificates, etc. Free samples of product literally flew through the air to the women during the presentations.

 

Estee Lauder started the educational component of the event. The first woman who could show they had an Estee Lauder  lipstick in their purse got a prize. The women in attendance were taught about a new digital tool that Estee Lauder has. This tool takes four digital photos of your skin to calculate the best shade of lipstick and foundation for every woman. You can go to their counter any time and have this evaluation performed. After the evaluation, you will walk away with a 10 day supply of foundation to try. There are many shades of red, this new digital tool finds the correct shade of red for every woman.

 

Elizabeth Arden shared some news with the women about their new product, Grand Entrance mascara.  They also spoke about, Superstart, Skin renewal booster. This is a product that is a universal skin booster with probiotic complex. It allows any anti aging product you use to go deeper into your skin. It contains glasswort and flaxseed and opens the water channels in the skin so your skin stays hydrated. At the event today, attendees got to receive at no cost ($90 value) Elizabeth Arden's signature Oxygen blast service. This service is designed to get you in and out of the chair and on your glowy way in 20 minutes or less.

 

During this process its best to go in bare faced. You will receive a double cleanse, a tone, the blast of the mineral and seaweed extracts that serve to get deep into your cellular layers, and then the follow-up blast of oxygen. The latter two elements are applied with an airbrush, and the aestheticians make sure that every pore gets a good dose of both. 

 

Apparently you can get this done over your existing make-up if you’re heading out on the town after work and want to look as though you’ve been lying around at your leisure all day. Your pores will thank you and your skin will glow like the heavens after this process.

 

One other item on display was the new Birdcage in Lord and Taylor.  Birdcage, is a  new concept “shop-in-shop” at Lord & Taylor at QB Mall. There are 11 Birdcage pop ups in the USA.  This boutique inside Lord and Taylor features carefully-curated pieces from all over the world. Currently on display are Lomography, crafty clutches, quirky-shaped jewelry, edgy home goods and beauty products. Throughout the season, Birdcage will feature trunk shows and events with emerging and established local brands that are sure to feed your retail loving soul.

 

The next Cosmetic Trend event will be in November 2016. Don't miss it!

 

 


Posted by tammyduffy at 10:16 AM EST
Saturday, 12 March 2016
Hamilton Township Health Department Receives an Unsatisfactory Rating For Their Food Safety Inspection Program
Topic: COMMUNITY INTEREST


 

 
 Hamilton Township Health Department Receives an Unsatisfactory Rating

For Their Food Safety Inspection Program

 

By Tammy Duffy, PhD 


 

Hamilton Township Food Inspection Data: Source Hamilton twp website

 

 

 

The township of Hamilton, Mercer County,  released food establishment inspection results on Friday. This is a new initiative where they state they are committed to maintaining the health safety of residents and visitors to Hamilton Township.  In order to promote Hamilton Township’s health safety the Division of Health conducts inspections of retail food establishments, public recreational swimming pools and spas, and youth camps located within Hamilton Township.  If the township is truly committed to public safety, they need to alter their approach, inspection process, inspection postings, inspectors professionalism immediately.

 

Let's first review some of the data which comes directly from the townships web site.  The data only goes back to July 2012 and only shows an overall result, no details. The actual reports are not on line. The residents will have no idea why an establishment failed.

 

The data starts at the same magical start point date July 2012.  This is the same date that one will find if you OPRA any data (which is digital in nature) from the township. Prior to this date townships officials destroyed all digital data on all computers in the township.  There is no historical data available. There was no certification of the destruction of the records which is required by law. The destruction of public documents is against the law and a prosecutable offense.

 

Overall results:

 

  • In 2012, there were only 23 sites inspected
  • In 2013, there were only 296 sites inspected
  • In 2014, 500 sites were inspected
  • In 2015, 672 sites were inspected
  • In 2016, thus far 127 have been inspected
  • In 2014, 184 inspections were done in first half of year, 316 in second half of year

 

The data is quite remarkable in that it demonstrates a hockey stick effect at the end of every year.  Does this mean that the risk to residents is higher in the first half of the year at any food establishment?  Why are the inspections not happening in a more stable timeframe? These results demonstrate a blatant disregard for public safety.

 

More questions to ponder.......

 

  • Why were there only 23 sites inspected in the second half of the year in 2012? Clearly, there were more than 23 food establishments in Hamilton then.
  • In 2014, there were 500 inspections, yet in 2013 only 296. Where there 204 new food establishments added in Hamilton in 2014? 
  • In 2015, there were 672 inspections, yet in 2015 there were only 500. Where there 172 new food establishments in 2015 added in Hamilton? Of course not.

 

 

We took the opportunity to call 30 restaurants on the list from various years and what we learned is quite remarkable. The restaurants have varying results from satisfactory, unsatisfactory to conditionally satisfactory. The restaurant owners were candid about the process and how they feel about this new initiative. There were a few repeated frustrations at all levels.

 

  • The inspectors that come are extremely unprofessional. They are rude to the establishments staff and owners.

 

  • The inspection process was different at all 30 establishments. The way in which the inspectors performed the inspections was different at each establishment.

 

  • The inspectors arrive with an "axe to grind" attitude and are failing establishments needlessly.

 

 

It is clear from the thirty restaurant owners we spoke to, that the process is significantly broken.  It is quite concerning that the inspections are done differently at each establishment. How can the township set an evaluation result which is "standardized" if the methodology utilized in the inspections is flawed?  This flawed approach will not produce results that are of any value to the residents or public safety.

 

The list that has been posted by the township is nothing more than a list. It does not demonstrate the entire report, so the entire story is not shared.  There methods appear to be extremely flawed. The hockey stick effect to the timing of the inspections does not meet the FDA required mandates.

 

We have seen this before with the constant touting of the crime reports being the lowest in the township since 1977. The residents want to see where the data is from 1977, clearly it data that far back does not exist anywhere else in the township. If the township shared all the data for the food inspections, residents would be able to make better informed decisions.

 

This new initiative appears to be more of a smear campaign towards small local businesses vs. educating the public. If the township clearly wants to be open about the process, share the entire health inspection reports, the certifications of all the inspectors and the calibration results of the tools utilized by the inspectors.

 

The FDA set standards for food inspections.  The ultimate goal to be achieved by a food establishment inspection is to prevent foodborne disease. Inspection is the primary tool a regulatory agency has for detecting procedures and practices which may be hazardous and taking actions to correct deficiencies. Food Code-based laws and ordinances provide inspectors scientifically based rules for food safety.

 

The regulatory agencies supply towns with guidance on planning, scheduling, conducting, and evaluating inspections. It also supports programs by providing recommendations for training and equipping the inspection staff, and attempts to enhance the effectiveness of inspections by stressing the importance of communication and information exchange during regulatory visits. Inspections aid the industry by:

 

(1) Serving as educational sessions on specific Code requirements as they apply to an establishment and its operation;

(2) Conveying new food safety information to establishment management and providing an opportunity for management to ask questions about general food safety matters; and

(3) Providing a written report to the establishment's permit holder or person in charge so that the responsible person can bring the establishment into conformance with the Code.

 

Inspectors must be properly equipped to perform the inspections in their assigned territory.  Basic staff training is very important to staff development and should be a well-defined and documented process. There is zero information supplied to the residents of Hamilton on how often the food inspectors are trained or if they have been trained.  There is no inspector certifications posted anywhere to ensure the public the inspectors are current on technology and inspection protocols.

 

Another important data point missing from the inspectors reports is proof of calibration of the devices in which they utilize during an inspection. If they are going to fail an establishment for their refrigerator temperatures being off by a few degrees, they better be able to prove that the device they used for their measurement, is not out of calibration. If they go on to say that an establishment must replace their entire refrigerator, the township inspectors better be able to prove their tools are calibrated. In the event their devices are not calibrated or they cannot prove they were, or the township has no certication on file of the inspector, the restaurant owner would have ever right to sue the township for financial hardships created by the inspectors.

 

Our advise to residents about this data is it is flawed. Before anyone gets upset that they just ate at a place that received anything but satisfactory result from a township health inspector, know that the township is failing at their approach to food inspections. The hockey stick effect, the unprofessional nature of the inspectors, the lack of certification data shared on the inspectors, the lack of certification data on the tools utilized by inspectors, etc are just a few of the flaws.  The list they posted is not a true representation of the entire story.

The township should take the time to review and optimize their own inspection team and process before handing out any more fines. Their current program gets a UNSATISFACTORY grade from the residents and jeopordizes public safety.

 

The responsibility for this belongs at the top of the leadership in Hamilton. It was also shared with us that during events in area restaurants the top leader in Hamilton demonstrates a behavior that is "treacherous towards her employees. When she does not get her way she behaves like a spoiled child." 

 

The cadence of behavior is set from the top in business and in towns. If the top leader behaves in a manner that is creating an environment of intimidation, this transcends to those who work in their environment.  This no doubt why these 30 restaurant we spoke to, are seeing the unprofessional, intimidating, rude behavior by the inspectors. They are walking to the cadence of the leadership in Hamilton. 

 

IDEA.....Maybe the township should put some of the body cameras they are buying for the police department, on the health inspectors. This will allow them to evaluate how they are doing their inspections and help optimize the issues with the process. 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


Posted by tammyduffy at 3:36 PM EST
Updated: Sunday, 13 March 2016 10:24 AM EST
Hamilton Township Health Department Receives an Unsatisfactory Rating For Their Food Safety Inspection Program
Topic: COMMUNITY INTEREST


 

 
 Hamilton Township Health Department Receives an Unsatisfactory Rating

For Their Food Safety Inspection Program

 

By Tammy Duffy, PhD 


 

Hamilton Township Food Inspection Data: Source Hamilton twp website

 

 

 

The township of Hamilton, Mercer County,  released food establishment inspection results on Friday. This is a new initiative where they state they are committed to maintaining the health safety of residents and visitors to Hamilton Township.  In order to promote Hamilton Township’s health safety the Division of Health conducts inspections of retail food establishments, public recreational swimming pools and spas, and youth camps located within Hamilton Township.  If the township is truly committed to public safety, they need to alter their approach, inspection process, inspection postings, inspectors professionalism immediately.

 

Let's first review some of the data which comes directly from the townships web site.  The data only goes back to July 2012 and only shows an overall result, no details. The actual reports are not on line. The residents will have no idea why an establishment failed.

 

The data starts at the same magical start point date July 2012.  This is the same date that one will find if you OPRA any data (which is digital in nature) from the township. Prior to this date townships officials destroyed all digital data on all computers in the township.  There is no historical data available. There was no certification of the destruction of the records which is required by law. The destruction of public documents is against the law and a prosecutable offense.

 

Overall results:

 

  • In 2012, there were only 23 sites inspected
  • In 2013, there were only 296 sites inspected
  • In 2014, 500 sites were inspected
  • In 2015, 672 sites were inspected
  • In 2016, thus far 127 have been inspected
  • In 2014, 184 inspections were done in first half of year, 316 in second half of year

 

The data is quite remarkable in that it demonstrates a hockey stick effect at the end of every year.  Does this mean that the risk to residents is higher in the first half of the year at any food establishment?  Why are the inspections not happening in a more stable timeframe? These results demonstrate a blatant disregard for public safety.

 

More questions to ponder.......

 

  • Why were there only 23 sites inspected in the second half of the year in 2012? Clearly, there were more than 23 food establishments in Hamilton then.
  • In 2014, there were 500 inspections, yet in 2013 only 296. Where there 204 new food establishments added in Hamilton in 2014? 
  • In 2015, there were 672 inspections, yet in 2015 there were only 500. Where there 172 new food establishments in 2015 added in Hamilton? Of course not.

 

 

We took the opportunity to call 30 restaurants on the list from various years and what we learned is quite remarkable. The restaurants have varying results from satisfactory, unsatisfactory to conditionally satisfactory. The restaurant owners were candid about the process and how they feel about this new initiative. There were a few repeated frustrations at all levels.

 

  • The inspectors that come are extremely unprofessional. They are rude to the establishments staff and owners.

 

  • The inspection process was different at all 30 establishments. The way in which the inspectors performed the inspections was different at each establishment.

 

  • The inspectors arrive with an "axe to grind" attitude and are failing establishments needlessly.

 

 

It is clear from the thirty restaurant owners we spoke to, that the process is significantly broken.  It is quite concerning that the inspections are done differently at each establishment. How can the township set an evaluation result which is "standardized" if the methodology utilized in the inspections is flawed?  This flawed approach will not produce results that are of any value to the residents or public safety.

 

The list that has been posted by the township is nothing more than a list. It does not demonstrate the entire report, so the entire story is not shared.  There methods appear to be extremely flawed. The hockey stick effect to the timing of the inspections does not meet the FDA required mandates.

 

We have seen this before with the constant touting of the crime reports being the lowest in the township since 1977. The residents want to see where the data is from 1977, clearly it data that far back does not exist anywhere else in the township. If the township shared all the data for the food inspections, residents would be able to make better informed decisions.

 

This new initiative appears to be more of a smear campaign towards small local businesses vs. educating the public. If the township clearly wants to be open about the process, share the entire health inspection reports, the certifications of all the inspectors and the calibration results of the tools utilized by the inspectors.

 

The FDA set standards for food inspections.  The ultimate goal to be achieved by a food establishment inspection is to prevent foodborne disease. Inspection is the primary tool a regulatory agency has for detecting procedures and practices which may be hazardous and taking actions to correct deficiencies. Food Code-based laws and ordinances provide inspectors scientifically based rules for food safety.

 

The regulatory agencies supply towns with guidance on planning, scheduling, conducting, and evaluating inspections. It also supports programs by providing recommendations for training and equipping the inspection staff, and attempts to enhance the effectiveness of inspections by stressing the importance of communication and information exchange during regulatory visits. Inspections aid the industry by:

 

(1) Serving as educational sessions on specific Code requirements as they apply to an establishment and its operation;

(2) Conveying new food safety information to establishment management and providing an opportunity for management to ask questions about general food safety matters; and

(3) Providing a written report to the establishment's permit holder or person in charge so that the responsible person can bring the establishment into conformance with the Code.

 

Inspectors must be properly equipped to perform the inspections in their assigned territory.  Basic staff training is very important to staff development and should be a well-defined and documented process. There is zero information supplied to the residents of Hamilton on how often the food inspectors are trained or if they have been trained.  There is no inspector certifications posted anywhere to ensure the public the inspectors are current on technology and inspection protocols.

 

Another important data point missing from the inspectors reports is proof of calibration of the devices in which they utilize during an inspection. If they are going to fail an establishment for their refrigerator temperatures being off by a few degrees, they better be able to prove that the device they used for their measurement, is not out of calibration. If they go on to say that an establishment must replace their entire refrigerator, the township inspectors better be able to prove their tools are calibrated. In the event their devices are not calibrated or they cannot prove they were, or the township has no certication on file of the inspector, the restaurant owner would have ever right to sue the township for financial hardships created by the inspectors.

 

Our advise to residents about this data is it is flawed. Before anyone gets upset that they just ate at a place that received anything but satisfactory result from a township health inspector, know that the township is failing at their approach to food inspections. The hockey stick effect, the unprofessional nature of the inspectors, the lack of certification data shared on the inspectors, the lack of certification data on the tools utilized by inspectors, etc are just a few of the flaws.  The list they posted is not a true representation of the entire story.

The township should take the time to review and optmize their own inspection team and process before handing out any more fines. Their current program gets a UNSATISFACTORY grade from the residents and jeopordizes public safety.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


Posted by tammyduffy at 3:36 PM EST
Thursday, 10 March 2016
MCCC’s AAWCC Chapter Celebrates Women’s History Month with Tribute to Harriet Tubman March 12
Topic: COMMUNITY INTEREST


 

 
MCCC’s AAWCC Chapter Celebrates Women’s History Month
with Tribute to Harriet Tubman March 12
 
 
 In celebration of Women’s History Month, the Mercer County Community College (MCCC) chapter of the American Association of Women in Community Colleges (AAWCC) will present “Miss Adda’s House,” an original play written and produced by Ron Perry of Hightstown.
 
The play is a tribute to Harriet Tubman, the conductor of the Underground Railroad. It will be presented Saturday, March 12 starting at 3:30 p.m. at Kelsey Theatre on the college’s West Windsor campus, 1200 Old Trenton Road. The Kelsey performance marks the play’s premiere.
 
Brown-Joseph is featured in the show along with other MCCC staff members Pam Price, Stefanie Williams, Tonia Harrison, Veronica Werner, Shana Burnett, Latasha White, and Monica Weaver.  
 
Special appearances include spoken word artist Hope Jarvis, an MCCC security guard, the praise dance team PUSH 5 of Florence, NJ, and Singers Elect of God of Newark.
 
Tickets are $5 and may be purchased at the Bursar’s office on the West Windsor campus, SC 256, or at the door on the day of the show. Proceeds will be added to a scholarship fund for MCCC students. 

Posted by tammyduffy at 6:57 PM EST

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