Thursday, December 26, 2019
The Challenges of Implement a Minimum Wages Policy
Creating a so called ââ¬Å"culture of complianceâ⬠among employers (Skidmore 1999: 435) is a low-cost strategy for facilitating the self-enforcement of minimum wage. This strategy implies the construction of persuasive arguments in favor of the minimum wage and the appeal to common values and beliefs such as, for instance, the principle of ââ¬Å"fair pay ââ¬â fair playâ⬠. Here, two main strategies for building commitment among employers can be identified. First, persuasive processes at the interpersonal level may take place. A strategy of interpersonal persuasion was used, for example, in the interaction between labor inspectors and managers in British and US-American coal mines from the Sixties to the Eighties, when ââ¬Å"open and frank discussionsâ⬠asâ⬠¦show more contentâ⬠¦Monitoring Through Labor Inspections Both the management and the enforcement approach highlight the importance of monitoring non-compliance. Transparency prevents free riding and allows actors to take targeted measures to defend their rights. Labor inspections seem to be the main instrument for ensuring monitoring: they are provided by law in the almost one hundred countries included in the ILO Minimum Wage Database. From reports and academic studies, two main problems seem to prevent labor inspections from being an effective enforcement tool. First, labor inspectors are at risk of corruption, also because they are often underpaid (Skidmore 1999: 428). Furthermore, inspectors receive a fairly high salary, which can be integrated through performance-based rewards (Almeida Carneiro 2009: 7). Secondly, labor inspections are costly, and governments do not invest enough funds for financing them. Employers also consider monitoring structures a cost burden and are not ready to commit to their financing (Gallina 2005: 15; Skidmore 1999: 428). Beyond labor inspections, an important method of monitoring compliance is the self-monitoring, record-keeping and self-reporting by the workers. Allowing individual workers and unions to denounce non-compliant employers constitutes a form of monitoring additional to labor inspections and, most of all, it gives workers the opportunity to enforce their rights by themselves, as weShow MoreRelatedPresident Obama Speech On Income Inequality And Economic Mobility1270 Words à |à 6 Pagesalso stated that ââ¬Å"this is the defining challenge of our time (The White House, 2013).â⬠The ââ¬Å"challengeâ⬠he was referring to the ability of the economy to work for all working Americans. Currently, with the income distribution inequali ty facing the United States, one could argue that the economy is not functioning for everyone. President Obama feels that in order to decrease the income inequality and improve mobility, the government must step in and put policies in place. Without government interventionRead MoreAs the owner of WooWoo limited there still exist challenges especially when it comes to dealing1300 Words à |à 6 Pageslimited there still exist challenges especially when it comes to dealing with the companyââ¬â¢s human resource. The sales are doing well but as the management we need to evaluate any strategies that we can implement to further motivate our employees. The first step is to pin point the problems currently being encountered in the human resource department and the level we want to achieve in the future. After evaluation of the problem, I will conduct research on modern workable policies that can be employedRead MoreThe Minimum Wage Should Be Legal905 Words à |à 4 PagesRise in mini mum wage has several impacts apart from unemployment. The minimum-wage workers would have to pay more taxes and receive fewer benefits if they are subjected to rise of minimum wage. The federal marginal rate for tax is 32 percent on an average for low earning members. This would amount to almost one third of the income of a worker. The tax rate is quite high for low paid workers. The rise of minimum wage would also reduce some of the advantages and leverages that the low-wage workersRead MoreThe Impact Of National Minimum Wage On South Africa s Income Inequality Essay1525 Words à |à 7 PagesThe impact national minimum wage would have on South Africaââ¬â¢s income inequality should it be implemented. South Africa is still considered one of the countries which still consist of high income inequality. Economists argue that inequality is the most unavoidable part of the economic development and that it continues to increase in developing countries due to economic growth (Keeton, 2014). Inequality is a problem in countries such as South Africa, because it shifts the attention from bigger andRead MoreMiimum Wage and Power to the People1746 Words à |à 7 PagesThree ââ¬â Power to the people The third and final alternative minimum wage is to allow the local people in the community vote on a living wage. This alternative would put all the power in the hands of the people; allowing them to decide what is best for their neighborhoods. If the people are allowed to vote in such matters, they will be permitted to use their voice and at the very least express their concerns with the gaps in minimum wage and cost of living in their community. However, there are drawbacksRead MoreThe Implementation Of The Minimum Wage1356 Words à |à 6 Pagesapproach; and it constitutes the basis for the argument that an effective system for implementing minimum wage should combine soft mechanisms (such as persuasion and capacity building) and hard mechanisms (e.g. sanctioning), as well as measures to empower workers. 3.1 Disambiguation of terms: Compliance, Implementation and Enforcement The scope of this paper is to illustrate how compliance with the minimum wage can be achieved. In the present framework, the term ââ¬Å"complianceâ⬠is used as in Youngââ¬â¢s definition:Read MoreThe Poverty Of Americans Are Affected By Poverty1464 Words à |à 6 PagesAmericans that deny the fact that the country is in a state of despair, the only likely way out is to change how the government assists the deprived and to educate the unknowing. Policy makers have the ability to implement new initiatives that would decrease if not eliminate the underclass within America. By implementing new policies such as more flexible jobs as well as aiding with savings, this could entice the underclass to build wealth and instill a sense of hope and fortune, something the poor haveRead MoreThe General Macro Environment And Industry Attractiveness1101 Words à |à 5 Pages which usually pertain to governmental policy. The following represent current political external factors that are present in the macro retail environment in which Kohlââ¬â¢s competes: 1. A potentially high instability of politics (potential threat) 2. Past political support for globalization with the Obama administration, uncertainty abounds with an incoming Trump administration (potential threat or opportunity) 3. Political pressure for increased minimum wage (threat) 4. Governmental support for e-commerceRead MoreSingapore Case Study845 Words à |à 4 Pagesdevaluations which led to high inflation among other problems that spread throughout Asia. While many economies were severely impacted, Singaporeââ¬â¢s political leaders were able to effectively implement changes in government policies as a response, primarily through the effective use of exchange rate and wage instruments, allowing the nation to survive the crisis. (15) However, in the decade that followed, Singapore faced a series of events that challenged its entire economic model. From the globalRead MoreStructural Adjustment Policies Require Borrowing Countries1513 Words à |à 7 PagesAnswer1: Structural adjustment policies require borrowing countries to implement certain policies in order to obtain loans from World Bank and IMF. These policies include both internal as well as external changes. Typical stabilization policies comprise of balance of payment deficit, deregulation and budget deficit reduction. Typical adjustment policies include reduction of trade barriers, privatization, cut in social spending, increased free trade. Situation in Greece is totally opposite to that
Wednesday, December 18, 2019
Plato s Allegory Of The Cave And Paulo Freire s The ...
Platoââ¬â¢s ââ¬Å"Allegory of The Caveâ⬠and Paulo Freireââ¬â¢s ââ¬Å"The ââ¬ËBankingââ¬â¢ Concept of Educationâ⬠both contend that education is a process of freeing the chains of deception and false images that make us prisoners in the cave of ignorance. I agree with both Plato and Freire in saying that without education, like the prisoners, our perception of reality is distorted by our lack of knowledge. In Platoââ¬â¢s essay, ââ¬Å"Allegory of The Caveâ⬠Plato creates a story about three prisoners in a cave, through this he further makes his point that without knowledge our view of the truth is askew. Plato explains that the three hostages have been shackled in the dark cave their whole lives unable to see the real world. The only piece of actuality they can see are shadows of people crossing in front of the opening of the cave. These figures can drive anyone insane without having any real truth to what the images could be. Without any awareness of the real world just outside of the cave they are forced to adapt and therefore accept their own reality. Plato goes on to say that, ââ¬Å"the truth would be literally nothing but the shadows of the imagesâ⬠(122). The obscurities are significant because they are the only apprehension the prisoners have, they have nothing to compare it to. The actuality of it to the captives is something other than the truth would be outside of the cave. The forms on the wall are only just shadows, but to them that is everything they have ever known. Plato through his legend portraysShow MoreRelatedTo What Extent Does Education Liberate People Within The Social Classes2662 Words à |à 11 PagesThis essay will discuss to what extent does education liberate people within the social classes. It will also discuss how Paulo Freireââ¬â¢s theory on how education can liberate people, furthermore considering how the Amish community may fail to be liberated through education. The definition of educa tion is ââ¬Ëthe act or process of imparting or acquiring general knowledge, developing the powers of reasoning and judgment, and generally of preparing oneself or others intellectually for mature lifeââ¬â¢. Also
Tuesday, December 10, 2019
Case Study of Mrs Valerie-Free-Samples for Students-Myassignment
Question: Analyse the vital signs and Pathology report to understand the reasons for abnormalities and their impact. Answer: Introduction: Evidence based practice is the process of integrating best evidence in nursing practice to address specific clinical issues of patient and improve their health outcome. A nurse has the duty and responsibility to carry out patient assessment, interpret patients information and engage in critical decision making to determine the appropriate nursing intervention or specific clinical condition (DiCenso, Guyatt, Ciliska, 2014).The process of assessment and planning of nursing intervention is demonstrated in this essay through the case of Mrs. Valerie Jackson. She is a 65 year old patient who has been recently diagnosed with cardiac arrthymia. She had been transferred to the HDU for open large bowel resection. Based on patients current symptoms and pathological information, the essay explains the reasons for the condition by means of discussion on the pathophysiology of cardiac arrhythmia. Secondly, the essay analyses the vital signs and pathology report to understand the reasons for abno rmalities and their impact. Based on this discussion, the specific assessment needs of patient are determined and three nursing interventions to improve Valeries condition is discussed. Pathophysiology of presenting problem: Mrs. Valerie has been diagnosed with cardiac arrhythmia. It is a condition associated with abnormal heart rhythm. In some case, the heart beat is too fast that normal rate-100 beats per minute (tachycardia) or too slow than normal rate- 60 beats per minute (bradycardia). This change in heart beat is seen due to the change in the normal sequence of electrical impulses (Schwartz, 2014). These impulses generate eratically resulting in too fast or too slow heart beat. The pathophysiological explanation for this is explained by the process of enhanced or suppressed automaticity and triggered activity. Automaticity is the normal property of all myocytes and this property gets hampered due to ageing, ischemia, effect of certain medications and other factors (Tse, 2016). The advancing age of Valerie might be a reason for change in property of automaticity. The condition of suppressed automaticity leads to dysfunction of sinus node and the enhanced automaticity leads to multiple arrhythmia (Y abluchansky et al., 2016). This condition can be identified in patient by the symptoms of dizziness, loss of consciousness, shortness of breath and chest discomfort. Triggered activity is another condition or mechanism behind cardiac arrhythmia. It is the initiation of impulse on the basis of afterdepolarization. However, triggered activity occurs when both early depolarization and after depolarization initiates at the same time. This form of abnormal impulse excitation results in reentrant excitation (Antzelevitch et al., 2014). In contrast with the condition of cardiac arrhythmia, normal cardiac rhythm is seen when spontaneous impulse is generated from the sinoatrial node and transmitted to the myocardium (Ruthruff Lien, 2016). Hence, in normal condition, impulse formation and transmission to the atrial and ventricular mycocardium occurs in a synchronous pattern. However, myocardial disease and certain cardioactive drugs disrupts the normal cardiac rhythm and changes the activity of the sinus node. Major changes is observed in automaticity of the myocardium that results in compromised cardiac function and adverse symptoms in patients like Vale ria (van der Lende et al., 2015). Interpretation of rhytm: The examination of the rhythm strips of Mrs. Valerie indicates the condition of sinus tachycardia or abrupt increase of heart rhythm. This is defined by a value greater than 100 beats/minute. The event is traced by the PQRST wave on the rhythm strip. P wave represents the discharge of the SA node and depolarization of the atria. The pattern of the wave indicates condition of tachycardia in Mrs. Valerie and this might have occurred because of increase in demand of oxygen due to stress, infection or blood loss. Mrs. Valerie might be presenting with this condition because she had a bowel resection and it might have lead to blood loss (Baruscotti et al., 2016). Sinus Tachycardia is a condition of rhythm in which rate of impulse generating from the sinoatrial node increases. This kind of rhythm is mostly seen in patient with cardiovascular disease. The normal heart beat is seen in an individual due to the mechanism of systematic interplay between sympathetic and parasympathetic nervous sy stem (Ruthruff Lien, 2016).. However, this system is significantly affected by ageing. Due to ageing, the property of heart muscles cells and walls changes. The wall of the arteries becomes thicker and elasticity is lost (Ho Snchez-Quintana, 2016). Hence, damage to heart tissue might the reason for the abnormal heart rhythm in Mrs. Valerie. It is very likely that this condition might have occurred in patient due to advancing age. Strait Lakatta (2012) also gives the evidence that aging is one of the major risk factor for cardiovascular disease because of declining cardioprotective system. Ageing leads to many type of changes in older people. Firstly, structural changes in vascular wall and heart are seen due to aging. Secondly, functional changes reduce the ability to respond to workload and cardiac mechanism for protection from injury is become defective. These factors might be the reason for the presentation of bradycardia in heart rhythm strips. Discussion of normal or abnormal pathology results: The pathology results of Mrs. Valerie gave the following outcome: Sodium- 148 mmol/L Potassium- 3.1 mmol/L Chloride- 90 mmol/L Bicarbonate- 20mmol/L Magnesium- 0.50 mmol/L Phosphate- 0.60 mmol/L The normal level of sodium in blood is between 135mmol/L to 145mmmol/L, however Mrs. Valeries sodium level was 148 mmmol/L which is slight high. A high sodium level may lead to the condition of hypernatremia. This kind of electrolyte imbalance may be caused by dehydration, endocrine disease, hyperventilation and use of drugs like steroids and blood pressure lowering medication (Hauptman et al., 2013). Due to this condition, Mrs. Valerie may have symptoms of sweating, fever, dizziness and diarrhea. She might exhibit this condition due to decrease in water excretion. This might lead to hazardous complication in patient and heart rate variability. High salt is likely to increase blood pressure, decrease heart rate and increase the frequency of changes in heart rate (McNeely, Windham, Anderson, 2008). Hence, hypernatremia is a major clinical presentation for patients with high blood sodium levels. Symptoms may range from mild signs like nausea and vomiting to severe signs like seizures and coma. Magnesium and potassium plays an important role in the development of cardiac arrthythmia in patient. The magnesium and potassium level in blood of Mrs. Valerie was 3.3 mmol/L and 0.50 mmol/L respectively. Both values are below the normal threshold value as normal volume of magnesium and potassium in blood are 3.5 to 5.0 mmol/L and 0.7 to 1.10 mmol/L. Low magnesium level may lead to the clinical presentation of hypomagnesium in patient. Normal magnesium level is important for maintenance of heart and nervous system function. The condition may be caused by low magnesium in diet, renal damage, endocrine disorder and high excretion of magnesium from the body. Magnesium depletion is the major cause of diagnosis of arrhythmias in patient (Efstratiadis, Sarigianni, Gougourelas, 2006). Magnesium maintains intracellular concentration and the depletion of the same leads to cardiovascular impairments. Loop diuretics also result in loss of potassium and magnesium from the body which ultimately impairs cardiovascular functions (Agus, 2016). The pathological results of Mrs. Valerie also indicate low chloride and bicarbonate level as it was 90mmol/L and 20mmol/L. Both the values are below the normal value. This might also lead to electrolyte imbalance issue. Hypocholermia is also mainly caused by the effect of diuretics and laxatives. As Mrs. Valerie has open large bowel section, the electrolyte imbalance might be the reason for her decreased urine output. Low chloride level might lead to the condition of dehydration, high fever or no symptoms too. The fluctuation in the sodium level will have a major impact on the heart rate of Mrs. Valerie. This is because heart rate is regulated by the mechanism of sympathetic and parasympathetic system. Sodium outside the cell and potassium inside the cell functions to initiate nerve impulse (DeMorais Biondo, 2012). However, decreased sodium level causes low blood pressure and increased heart rate. Hence, the cardiac rhythm strip may change due to changes in sodium level. On the othe r hand, changes in bicarbonate level might lead to acidosis in patient. Urso, Brucculeri, Caimi, (2015) explains that electrolyte and acid base abnormalities cause fatal complications in patients with heart disorder. This is because of the alteration of the neurohumoral activation. This might lead to adverse event during diuretic therapy and play a major role in the development of cardiac arrhythmias too. Discussion on assessment criteria and nursing interventions On the examination of the pathological results of Mrs. Valerie and summary of her fluid balance after the open large bowel resection, it is understood that the patient is prone to many complications like loss of consciousness, changes in heart rate, decreased urine output and impaired cardiovascular functions. She is also at risk of fall due to symptoms of dizziness due to the electrolyte imbalance in her body. To manage her condition and promote health and wellbeing of patient, many nursing assessment is required. Firstly, the vital signs of patients needs to be closely monitored since the patients has high chance of fluctuations in vital signs due to electrolyte imbalance. Secondly, Mrs. Valeria is under nasogastric tube on free drainage, so the nurse needs to assess the position and potency of the tube. Patients with bowel resection are also prone to infection so checking the colour and amount of drainage from surgical site is necessary. In addition to manage the condition of card iac arrhythmia in patient, it is necessary to routinely assess the pulse rate and heart rate of patient. ECG tracing, vital signs assessment, need for more pathological test and hemodynamic monitoring will also be an important assessment criteria for nurse. The main issue present in Mrs. Valerie is the diagnosis of cardiac arrhythmia and the issue in fluid balance after bowel resection. To manage these issues, three nursing intervention is necessary for Mrs. Valerie. Firstly, the nurse needs to provide preoperative nursing intervention for the care of bowel resection. This is importance because patient is important to prevent infection in patient and promote quick recovery. The nurse will have to ensure the patency of the nasogastric tube as it will provide comfort to patient and result in healing. To prevention any type of infection after surgery, it is critical for the nurse to manage change in colour and amount of drainage. While on nasogastric tube, the patient is at high risk of sodium, potassium and chloride imbalance (Joseph, Vaughan, Strand, 2015). Hence, the nursing intervention of maintaining intravenous fluid is most important. This can be done by providing replacement fluids and adequate electrolytes to patient. After critically reviewing the blood results of Mrs. Valerie, great fluctuation in electrolyte level was found. As electrolyte imbalance is the factor that results in complications of heart rate and cardiovascular dysfunction, nursing interventions related to electrolyte balance is important. The care plan for electrolyte imbalance would be to monitor heart rate and respiratory rate regularly. The patient must be encouraged to take deep breath to avoid respiratory complications. Secondly, due to greater likelihood of symptoms of dizziness, the nurse has a role in assessment of consciousness and neuromuscular function (Williams Hopper, 2015).Mrs. Valerie particularly has problem of decreased output and taking steps regarding this is important. Based on the risk of different conditions like hypernatremia or hypomagnesia, providing the required electrolyte will be important. The third nursing intervention is related to the management of the condition of cardiac arrhythmia. For this, it is necessary to control the erratic fluctuation of heart rate in patient. In this situation, it will be necessary for the nurse to monitor pulse rate regularly. ECG tracing and evaluation of ECG by regular consultation with physician is also critical to manage adverse symptoms of patients. As the clinical issue of electrolyte imbalance is mainly caused by the effect of certain drugs, it will be necessary to closely assess each medication before giving to patient. Monitoring signs of drug toxicity is important to recognize irregular rhythm and control them (Jurgens et al., 2015) . Conclusion The essay evaluated the condition of Mrs, Valerie, a patient with cardiac arrhythmia and bowel resection through the discussion on the pathophysiology of the condition. The vital signs of patient post operation and pathological results gave indication about the range of risk and abnormalties in patient. The reasons for abnormality were adequately discussed with support from evidence. Based on the examination of electrolyte imbalance issue and other risk in patient, nursing interventions were adequately planned and summarized. This work form the basis of evidenced based practice as all issues and care plan has been supported with evidence based practice. References Agus, Z. S. (2016). Mechanisms and causes of hypomagnesemia.Current opinion in nephrology and hypertension,25(4), 301-307.lar block.Heart Rhythm,12(3), 498-505. Antzelevitch, C., Nesterenko, V., Shryock, J. C., Rajamani, S., Song, Y., Belardinelli, L. (2014). The role of late I Na in development of cardiac arrhythmias. InVoltage Gated Sodium Channels(pp. 137-168). Springer Berlin Heidelberg. Baruscotti, M., Bianco, E., Bucchi, A., DiFrancesco, D. (2016). Current understanding of the pathophysiological mechanisms responsible for inappropriate sinus tachycardia: role of the If funny current.Journal of Interventional Cardiac Electrophysiology,46(1), 19-28. DiCenso, A., Guyatt, G., Ciliska, D. (2014).Evidence-Based Nursing-E-Book: A Guide to Clinical Practice. Elsevier Health Sciences. Efstratiadis, G., Sarigianni, M., Gougourelas, I. (2006). Hypomagnesemia and cardiovascular system.Hippokratia,10(4), 147. Hauptman, P. J., Burnett, J., Gheorghiade, M., Grinfeld, L., Konstam, M. A., Kostic, D., ... Zannad, F. (2013). Clinical course of patients with hyponatremia and decompensated systolic heart failure and the effect of vasopressin receptor antagonism with tolvaptan.Journal of cardiac failure,19(6), 390-397. Ho, S. Y., Snchez-Quintana, D. (2016). Anatomy and pathology of the sinus node.Journal of Interventional Cardiac Electrophysiology,46(1), 3-8. Joseph, J., Vaughan, R., Strand, H. (2015). Effectiveness of nurse-performed endoscopy in colorectal cancer screening: a systematic review.Gastrointestinal Nursing,13(4). Jurgens, C. Y., Goodlin, S., Dolansky, M., Ahmed, A., Fonarow, G. C., Boxer, R., ... Fleg, J. L. (2015). Heart failure management in skilled nursing facilities.Circulation: Heart Failure,8(3), 655-687. van der Lende, M., Surges, R., Sander, J. W., Thijs, R. D. (2015). Cardiac arrhythmias during or after epileptic seizures.J Neurol Neurosurg Psychiatry, jnnp-2015. McNeely, J. D., Windham, B. G., Anderson, D. E. (2008). Dietary sodium effects on heart rate variability in salt sensitivity of blood pressure.Psychophysiology,45(3), 405-411. Olshansky, B., Sullivan, R. M. (2013). Inappropriate sinus tachycardia.Journal of the American College of Cardiology,61(8), 793-801. Ruthruff, E., Lien, M. C. (2016). Aging and Attention. Schwartz, P. J. (2014). Cardiac sympathetic denervation to prevent life-threatening arrhythmias.Nature reviews Cardiology,11(6), 346-353. Strait, J. B., Lakatta, E. G. (2012). Aging-associated cardiovascular changes and their relationship to heart failure.Heart failure clinics,8(1), 143-164. Tse, G. (2016). Mechanisms of cardiac arrhythmias.Journal of arrhythmia,32(2), 75-81. Urso, C., Brucculeri, S., Caimi, G. (2015). Acidbase and electrolyte abnormalities in heart failure: pathophysiology and implications.Heart failure reviews,20(4), 493-503. DeMorais, H. A., Biondo, A. W. (2012). Disorders of chloride: hyperchloremia and hypochloremia.Fluid, Electrolyte and Acid-Base Disorders in Small Animal Practice. 4th ed. Elsevier, St Louis, 80-91. Williams, L. S., Hopper, P. D. (2015).Understanding medical surgical nursing. FA Davis.nce Yabluchansky, M., Bogun, L., Martymianova, L., Bychkova, O., Lysenko, N., Makienko, N. (2016). Heart rhythm disturbances.
Monday, December 2, 2019
Toneisha Colson Essays (311 words) - , Term Papers
Toneisha Colson Erin Young Mentor PLA Losing A Child: Saying Goodbye to My Daughter Pain, so much pain I thought my appendix had ruptured, I was screaming and crying, so my father rushed me to John T. Mather Hospital, Port Jefferson, NY. I was rushed in the emergency room, the Emergency Room doctor examined me and then there was a flurried of activity in the room, nurses everywhere, doctors, noise and here I am 19 years old screaming in pain. The doctor looked at me with gloves on and said " Toneisha your about to deliver." I then said "Deliver what?" He then replied " A baby". And my life changed forever. It was 13 months of happiness, pain and despair all at the same time. You see my daughter Beverlyrose Lonette Colson was born unexpectedly and on Monday October 3 rd , 1991 she took her last breath in my arms and my heart broke and that was when I was angry with God and devastated. I did not know I was pregnant until I gave birth then. I was a new mom my parents were new grandparents and I was winging it for a little over a year. There are no instructions on how you grieve when you lose your child. This was what my uncle told me was an "Out of order " death, parents are not supposed to bury their children. When she passed away I needed help. I had to speak to therapists and doctors and even my grandmother who had lost a child when he was ten months . I took no classes I just asked my mother, aunts and grandmother on how to deal with a baby girl. My grandmother had ten children and seventeen grandchildren so she was my go too person when it came to questions. Toneisha Colson Erin Young PLA A
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