Policy Interventions for Healthcare Inequality

Policy Interventions for Healthcare Inequality Abstract The primary purpose of this study was to determine the disparities in access to health care and analyse the rationale of the types of policy intervention solutions globally to address the contemporary health issue in education and training, tax benefits and payments to caregivers, respite care, business regulations combining work and care giving, and financial support and provision of pension credits for care giving. The study was descriptive in nature. The data were analysed and interpreted. Introduction Having a broad variety factors that plays a role in health disparities, it is very demanding and challenging to clarify the determinants of health disparities. For individuals who are challenged with sociodemographic status, physical disabilities and affected by inevitable circumstances such as calamities or disasters are crucially to escalate likelihood of health disparities that may lead their later life to health-related problems. Given the fact that people under these situations are most unfavourable groups in society with regards to income, education, employment, living condition or occupation, health disparities is more anticipated to exist. In this instance, it is essential to obtain which factors bring about to the health disparities. This study is looking forward to initiate further interest in health disparities among policy makers. Particularly, this may help health care professionals better understand the present picture of health disparities and its causes. Correspondingly, the prevention and elimination of health disparities of the population and their outcome improved quality of life will be regarded. The purpose of this study was to identify the determinants of health disparities in health care access and to produce policy intervention solutions based on education and training, tax benefits and payments to caregivers, respite care, business regulations combining work and care giving and financial support and provision of credits for care giving. To achieve these purposes, the occurrence and determinants of the health disparities were investigated in these scopes: lack of insurance coverage, lack of financial resources, structural barriers, shortage of health care providers, linguistic barriers, health literacy, discrimination and age. Theory This study is anchored to the assumption that disparities in care can greatly affect the access of health care. This is explained in the diagram below: Figure 1. Theoretical Framework for Disparities in Access to Health Care According to Anderson (1995) in the behavioural model of health services operation, population characteristics feature three main components: (1) predisposing characteristics, (2) enabling resources, and (3) need. The predisposing characteristics embody the following elements: (a) demographic aspects, such as gender, age, or marital status, (b) social structure, such as race/ethnicity, education, religion, or occupation and (c) health benefits, such as knowledge about disease, values about health and illness, and attitude toward health services. The predisposing characteristics affect enabling resources in family, person and community. Personal or family enabling resources involved knowledge regarding access to and utilisation of health care and manner to access health care, while community enabling resources integrate available health facilities and personnel. The above-mentioned enabling resources have an effect on one’s perceived and evaluated health need. How people belief or think of their health status is referred to as perceived health need, while indication of professional judgment relevant to people’s health illnesses or conditions and their stand in need for medical treatment is referred as evaluated health need. The foregoing population characteristics – predisposing characteristics enabling resources, and health need will exert influence on one’s personal health practices; use of health services; and health behaviour. Lastly, one’s health behaviour impacts health outcomes: (perceived) health status and (evaluated) consumer satisfaction. In Andersen’s (1995) phase 4 of the behavioural model environmental factors –external environment and healthcare system – having been lately included, and these factors affect the population characteristics as well as health outcomes. The impact the disparities of access to health care would have on national and international healthcare policy. In the study, health disparities throughout different nations including New Zealand were analysed in access to health care. On top of that, the determinants and existence of such disparities have been focused on. It ought to indicate that access to health care itself affects one’s health needs, enabling resources and predisposing characteristics. Nevertheless, further attention is here centered on the direct impacts of the determinants on health care access. Considering the dynamic and intricate structure of health care access, social demographic characteristics are broadly addressed to determinants of access to health care. The association between access to health care and health status is examined in detailing the determinants. Based on Healthy People 2020 definition of health disparity is â€Å"a precise type of health difference that is intently associated with economic, social and/or environmental unfavourable circumstance. Health disparities unfavourable influence groups of people who have consistently undergo considerable obstacles to health stands on their ethnic or racial group; socioeconomic status; religion; age; gender; sensory, cognitive, physical disability; mental health; gender identity or sexual orientation; geographic location; or other characteristics typically connected to exclusion or discrimination. A range of sociodemographic characteristics, such as lack of insurance coverage, lack of financial resources, structural barriers, scarcity of providers, linguistic barriers, health literacy and age are involved in access to health care. These sociodemographic characteristics are correlated with not only one another notwithstanding further determinants in different area. Considering health insurance coverage and status issues play an important part in access to health care and these matters are similarly concomitant to other sociodemographic components, analysis on sociodemographic characteristics is frequently focus on health insurance issues. In the absence of health insurance, patients are most apparently to delay medical care; it appears to go without needed medical care, and probably to go in the absence of prescription medications. Despite the fact that the insufficiency of financial funds is a barricade to health care access for many nations, the influence on access become evident to be pronounced for minority populations. Structural barriers include excessive time spent in the waiting room, an inability to schedule appointments quickly or during convenient hours and poor transportation, each of which influence persons willingness and to acquire needed care. In rural areas, high cities and communities with great congregation of minority populations, access to medical care may be restricted because of the shortage of, specialists, primary care practitioners and diagnostic facilities. Furthermore, language differences (most especially those non-English proficient minorities) impede access to medical care. Health literacy is about patients having problems understanding, obtaining and processing basic health information. To give an instance, patients with a deficient comprehension of good health may not knowledgeable when it is needed to attempt to find care for definite symptoms. Although issues with health literacy are not confined to minority groups, the situation may further utter in these groups due to educational and socioeconomic factors. Age may as well be a determinant in health disparities for particular reasons. As numerous older individual draw breath on fixed incomes this can create paying for health care expenses burdensome. Besides, they unlikely encounter other hurdle such as lack of transportation or weaken mobility that makes accessing health care services difficult for them physically. Moreover, they cannot have the possibility to access health information through the internet over their age. This may place older individuals at an unfavourable position in terms of retrieving important information regarding their health and by means to protect it. Communication is vital for the delivery of effective and appropriate care and treatment, despite of a patient’s culture, and miscommunication may result to improper use of medications, incorrect diagnosis and failure to undergo follow-up medical care. The relationship of patient’s provider is reliant on the capacity of both individuals to efficiently communicate. Culture and language both involved in significant task in communication in the course of a medical consultation. Among the patient populace, minorities appears considerable amount of difficulty in conveying concerns and understanding with their physicians. In stand of the Health Care Quality Survey conducted by the Commonwealth Fund (2001), American patients during interview responded that nineteen percent (19%) of the time they experience difficulty communicating with their health providers which included feeling doctor listened, understanding doctor, and had questions yet did not enquire. As oppose to the Hispanic population comprise the relatively large problem communicating with their health provider, thirty-three percent (33%) of the time. It is fact that communication is associated to health outcomes, as communication enhanced so certainly patient satisfaction which result to enhanced compliance and will progress health outcomes. The result of incapacity to communicate with care providers has influence the quality of care. Language takes significant role in communication and determined attempt need to take hold to make sure perfect communication involving patient and provider. Those non-English speakers that utter the need of an interpreter in the time of clinical visits proclaim having one. In the absence of interpreters in the course of clinical visit add up to the communication barrier. Moreover, incapacity of providers to convey information with deficient English proficient patients results to, more invasive procedures, over prescribing of medications and more diagnostic procedures. Poor communication is a factor to compliance of medical services and health outcomes. Heaps of health-related environments make available interpreter services for their deficient English proficient patients. It is indeed been helpful when health providers do not communicate the similar language as the patient. But, there is ascending affirmation that patients require communicating with a language concomitant physician to sustain the desirable medical care, be satisfied with the care experience and bond with the physician. Further communication difficulty upshot from a decrease or reduce of cultural proficiency by health providers. It is also a great value for health providers to be aware of patients’ health practices and beliefs unescorted judgments or reactions. Comprehending a patients’ perspective of health and disease is essential for treatment and diagnosis. So health providers required to assess patients’ health practices and beliefs to refine quality of care. The health decisions made by the patients can be influenced by cultural beliefs, sceptical Western medicine, and hierarchical and familial roles, every single one of these a white health provider may not be familiar with. Another disparity could be discrimination. This is where health care providers likewise consciously or unconsciously handle certain ethnic and racial patients distinctively from other patients. It may be because of stereotypes that health providers may have concerning racial/ethical groups. Physicians are more possibly to set down negative cultural stereotypes among their minority patients. It may happen despite of high regard for personality characteristics, income and education. Meanwhile the United States of America favour the term health disparity, some other countries more usually utilise such terms as health inequity or health inequality (Carter Pokras Baquet, 2002). Specifically, the word health inequalities are more commonly used in New Zealand, Europe and Great Britain. According to Harper Lynch (2005) health disparity includes elements of both health inequality and health inequity. Moreover, inequality is a difference that can be observable and measurable; on the other hand inequity encompasses an ethical judgment participate in resolution of the difference. Moreover, in relation to global health disparities discussed, three of the ten (10) facts about health inequalities in Aotearoa New Zealand based on New Zealand Medical Association and University of Otago prepared by Tony Blakely and Don Simmers (June, 2011) has similarly contribute to the access of health care. These include: (1) Almost all other countries, there is inclination of increasing mortality or exacerbating health right from one side of the affluent to deprived, socio-economic hierarchy, or from rich to poor and most educated to least educated. The socioeconomic differences have made mortality rates broadened in corresponding terms until year 2000, yet have inclined to be stable after all. A close basis of expanding disparity in life expectancy via income about 2000 is indeed apparent. Those people in the top-level of incomes have a 5-6 year satisfaction in life expectancy in contrast to the lowest. New Zealand is level at about average for rich countries in the realistic magnitude of socioeconomic inequalities in mortality. (2) An unequal division of social determinants such as housing conditions, employment, and income conditions is crucial to driving health inequalities. Unemployment and economic conditions ameliorate between 1994 and 1998, and there is a fall of child poverty. In distinction to, 1998-2004 rates diversified be conditional on the measure, afterwards with Working for Families child poverty momentum cut down from 2004-2007. (3) Behavioural predisposing factors and health services as well come up with inequalities of health. Tobacco is exceptionally significant, as to healthy eating. Health services is further substantial, primarily as the efficacy of supportive care and treatments to both decrease morbidity and mortality happen to be more effective and more great in number. Discuss and critically analyse the rationale or justifications for putting into place each of the below listed types of policy intervention solutions globally to address the contemporary health issue highlighted in disparities of access to health care Education and Training Institutions should consider conducting research to determine up-to-date and effective policy and program solutions to lessen or diminish health disparities. It is essential to conduct outreach to expand the diversity such as racial/ethnic, disability, income in health care and public-related health careers. They should put forward preventive services (such as vision, oral care, hearing screenings and mental health services) for all children and elderly, particularly those at risk. Lastly, they have to develop and carry out local plan of action to reduce psychosocial, environmental conditions and health that take hold of access to health care. Tax Benefits and Payments to Caregiver Increase tax benefits and refunds for those who have below minimum wage workers and use data to spot populations at greatest risk and partner with communities to implement government programs and policies on mitigations that addresses highest priority health needs. Government should allocate good payment, health benefits and remuneration to caregivers because they are the first line of health providers in terms of access to health services needed by the people. Respite Care This type of care should be available and accessible every time the concerned individual needed it such as caring for disabled individual and older clients. Expand the communication and cultural competence of health care providers in the respite care service. Train and hire further qualifies staff from marginalised ethnic and racial minorities and people with disabilities. Intensify care systematisation and quality of care like integrated care teams. Business Regulation combining Work and Care giving Health markets should comply with statutory policies and regulations concerning medical costs, availability of health services and health care professionals, equal treatment of patients especially those who belong to minority group and children, pregnant woman, chronic conditions or disabilities and elderly, and lastly, consider the community’s needs and demands of health care. Financial Support and Provision of Pension Credits for Care giving. Involved all professionals from a variety of sectors (such as labor, health, education, environment and transportation) with community representatives to make sure that community health needs are recognised and that needs and barriers are attended. Expand cheaper or affordable health services that will ameliorate favourable chances for health care coverage and access as component of efforts to lessen disparities among individuals who are deprived of health. Conclusion It is a fact that health is vital to human existence. A person cannot perform his activities of daily living without being on a state of wellness. In this study, there are numerous factors that brought about disparities of access to health care. The essential qualities of health disparities evaluated were lack of insurance coverage, lack of financial resources, structural barriers, shortage of health care providers, linguistic barriers, health literacy, discrimination and age. Most of the population affected by these circumstances are minority groups, children, pregnant woman, chronic conditions or disabilities and elderly. To deliver policies further productive and effective to eliminate and prevent health disparities, understanding of scientific facts in determinants of health disparities is vital. In addition, it highlights the prominence of factors outside the immediate authority of the health sectors particularly the social welfare, labour, housing, market sectors, local government and education, in shaping the health of the population. On the other note, accomplishment in alleviating disparities in health leads to positive results for the individual, society and economy.

The Vampire Diaries: The Awakening Chapter Thirteen

Elena stood within the circle of adults and police, waiting for a chance to escape. She knew that Matt had warned Stefan in time-his face told her that-but he hadn't been able to get close enough to speak with her. At last, with all attention turned toward the body, she detached herself from the group and edged toward Matt. â€Å"Stefan got out all right,† he said, his eyes on the group of adults. â€Å"But he told me to take care of you, and I want you to stay here.† â€Å"To take care of me?† Alarm and suspicion flashed through Elena. Then, almost in a whisper, she said, â€Å"I see.† She thought a moment and then spoke carefully. â€Å"Matt, I need to go wash my hands. Bonnie got blood on me. Wait here; I'll be back.† He started to say something in protest, but she was already moving away. She held up her stained hands in explanation as she reached the door of the girls' locker room, and the teacher who was now standing there let her through. Once in the locker room, however, she kept on going, right out the far door and into the darkened school. And from there, into the night. Zuccone! Stefan thought, grabbing a bookcase and flinging it over, sending its contents flying. Fool! Blind, hateful fool. How could he have been so stupid? Find a place with them here? Be accepted as one of them? He must have been mad to have thought it was possible. He picked up one of the great heavy trunks and threw it across the room, where it crashed against the far wall, splintering a window. Stupid,stupid . Who was after him? Everybody. Matt had said it. â€Å"There's been another attack†¦ They think you did it.† Well, for once it looked as if the barbari , the petty living humans with their fear of anything unknown, were right. How else did you explain what had happened? He had felt the weakness, the spinning, swirling confusion; and then darkness had taken him. When he'd awakened it was to hear Matt saying that another human had been pillaged, assaulted. Robbed this time not only of his blood, but of his life. How did you explainthat unless he, Stefan, were the killer? A killer was what he was. Evil. A creature born in the dark, destined to live and hunt and hide there forever. Well, why not kill, then? Why not fulfill his nature? Since he could not change it, he might as well revel in it. He would unleash his darkness upon this town that hated him, that hunted him even now. But first†¦ he was thirsty. His veins burned like a network of dry, hot wires. He needed to feed†¦ soon†¦ now. The boarding house was dark. Elena knocked at the door but received no answer. Thunder cracked overhead. There was still no rain. After the third barrage of knocking, she tried the door, and it opened. Inside, the house was silent and pitch black. She made her way to the staircase by feel and went up it. The second landing was just as dark, and she stumbled, trying to find the bedroom with the stairway to the third floor. A faint light showed at the top of the stairs, and she climbed toward it, feeling oppressed by the walls, which seemed to close in on her from either side. The light came from beneath the closed door. Elena tapped on it lightly and quickly. â€Å"Stefan,† she whispered, and then she called more loudly, â€Å"Stefan, it's me.† No answer. She grasped the knob and pushed the door open, peering around the side. â€Å"Stefan-† She was speaking to an empty room. And a room filled with chaos. It looked as if some great wind had torn through, leaving destruction in its path. The trunks that had stood in corners so sedately were lying at grotesque angles, their lids gaping open, their contents strewn about the floor. One window was shattered. All Stefan's possessions, all the things he had kept so carefully and seemed to prize, were scattered like rubbish. Terror swept through Elena. The fury, the violence in this scene of devastation were painfully clear, and they made her feel almost giddy. Somebody who has a history of violence, Tyler had said. I don't care, she thought, anger surging up to push back the fear. I don't care about anything, Stefan; I still want to see you. But where are you? The trapdoor in the ceiling was open, and cold air was blowing down. Oh, thought Elena, and she had a sudden chill of fear. That roof was so high†¦ She'd never climbed the ladder to the widow's walk before, and her long skirt made it difficult. She emerged through the trapdoor slowly, kneeling on the roof and then standing up. She saw a dark figure in the corner, and she moved toward it quickly. â€Å"Stefan, I had to come-† she began, and broke off short, because a flash of lightning lit the sky just as the figure in the corner whirled around. And then it was as if every foreboding and fear and nightmare she'd ever had were coming true all at once. It was beyond screaming at; it was beyond anything. Oh, God†¦ no. Her mind refused to make sense of what her eyes were seeing. No. No. She wouldn't look at this, she wouldn't believe it†¦ But she could not help seeing. Even if she could have shut her eyes, every detail of the scene was etched upon her memory. As if the flash of lightning had seared it onto her brain forever. Stefan. Stefan, so sleek and elegant in his ordinary clothes, in his black leather jacket with the collar turned up. Stefan, with his dark hair like one of the roiling storm clouds behind him. Stefan had been caught in that flash of light, half turned toward her, his body twisted into a bestial crouch, with a snarl of animal fury on his face. And blood. That arrogant, sensitive, sensual mouth was smeared with blood. It showed ghastly red against the pallor of his skin, against the sharp whiteness of his bared teeth. In his hands was the limp body of a mourning dove, white as those teeth, wings outspread. Another lay on the ground at his feet, like a crumpled and discarded handkerchief. â€Å"Oh, God, no,† Elena whispered. She went on whispering it, backing away, scarcely aware that she was doing either. Her mind simply could not cope with this horror; her thoughts were running wildly in panic, like mice trying to escape a cage. She wouldn't believe this, she wouldn'tbelieve . Her body was filled with unbearable tension, her heart was bursting, her head reeling. â€Å"Oh, God,no-† â€Å"Elena!† More terrible than anything else was this, to seeStefan looking at her out of that animal face, to see the snarl changing into a look of shock and desperation. â€Å"Elena, please. Please, don't†¦Ã¢â‚¬  â€Å"Oh, God,no !† The screams were trying to rip their way out of her throat. She backed farther away, stumbling, as he took a step toward her. â€Å"No!† â€Å"Elena, please-be careful-† That terrible thing, the thing with Stefan's face, was coming after her, green eyes burning. She flung herself backward as he took another step, his hand outstretched. That long, slender-fingered hand that had stroked her hair so gently- â€Å"Don't touch me!† she cried. And then she did scream, as her motion brought her back against the iron railing of the widow's walk. It was iron that had been there for nearly a century and a half, and in places it was nearly rusted through. Elena's panicked weight against it was too much, and she felt it give way. She heard the tearing sound of overstressed metal and wood mingling with her own shriek. And then there was nothing behind her, nothing to grab on to, and she was falling. In that instant, she saw the seething purple clouds, the dark bulk of the house beside her. It seemed that she had enough time to see them clearly, and to feel an infinity of terror as she screamed and fell, and fell. But the terrible, shattering impact never came. Suddenly there were arms around her, supporting her in the void. There was a dull thud and the arms tightened, weight giving against her, absorbing the crash. Then all was still. She held herself motionless within the circle of those arms, trying to get her bearings. Trying to believe yet another unbelievable thing. She had fallen from a three-story roof, and yet she was alive. She was standing in the garden behind the boarding house, in the utter silence between claps of thunder, with fallen leaves on the ground where her broken body should be. Slowly, she brought her gaze upward to the face of the one who held her. Stefan. There had been too much fear, too many blows tonight. She could react no longer. She could only stare up at him with a kind of wonder. There was such sadness in his eyes. Those eyes that had burned like green ice were now dark and empty, hopeless. The same look that she'd seen that first night in his room, only now it was worse. For now there was self-hatred mixed with the sorrow, and bitter condemnation. She couldn't bear it. â€Å"Stefan,† she whispered, feeling that sadness enter her own soul. She could still see the tinge of red on his lips, but now it awakened a thrill of pity along with the instinctive horror. To be so alone, so alien and so alone†¦ â€Å"Oh, Stefan,† she whispered. There was no answer in those bleak, lost eyes. â€Å"Come,† he said quietly, and led her back toward the house. Stefan felt a rush of shame as they reached the third story and the destruction that was his room. That Elena, of all people, should see this was insupportable. But then, perhaps it was also fitting that she should see what he truly was, what he could do. She moved slowly, dazedly to the bed and sat. Then she looked up at him, her shadowed eyes meeting his. â€Å"Tell me,† was all she said. He laughed shortly, without humor, and saw her flinch. It made him hate himself more. â€Å"What do you need to know?† he said. He put a foot on the lid of an overturned trunk and faced her almost defiantly, indicating the room with a gesture. â€Å"Who did this? I did.† â€Å"You're strong,† she said, her eyes on a capsized trunk. Her gaze lifted upward, as if she were remembering what had happened on the roof. â€Å"And quick.† â€Å"Stronger than a human,† he said, with deliberate emphasis on the last word. Why didn't she cringe from him now, why didn't she look at him with the loathing he had seen before? He didn't care what she thought any longer. â€Å"My reflexes are faster, and I'm more resilient. I have to be. I'm a hunter,† he said harshly. Something in her look made him remember how she had interrupted him. He wiped his mouth with the back of his hand, then went quickly to pick up a glass of water that stood unharmed on the nightstand. He could feel her eyes on him as he drank it and wiped his mouth again. Oh, he still cared what she thought, all right. â€Å"You can eat and drink†¦ other things,† she said. â€Å"I don't need to,† he said quietly, feeling weary and subdued. â€Å"I don't need anything else.† He whipped around suddenly and felt passionate intensity rise in him again. â€Å"You said I was quick-but that's just what I'm not. Have you ever heard the saying ‘the quick and the dead,' Elena? Quick means living; it means those who have life. I'm the other half.† He could see that she was trembling. But her voice was calm, and her eyes never left his. â€Å"Tell me,† she said again. â€Å"Stefan, I have a right to know.† He recognized those words. And they were as true as when she had first said them. â€Å"Yes, I suppose you do,† he said, and his voice was tired and hard. He stared at the broken window for a few heartbeats and then looked back at her and spoke flatly. â€Å"I was born in the late fifteenth century. Do you believe that?† She looked at the objects that lay where he'd scattered them from the bureau with one furious sweep of his arm. The florins, the agate cup, his dagger. â€Å"Yes,† she said softly. â€Å"Yes, I believe it.† â€Å"And you want to know more? How I came to be what I am?† When she nodded, he turned to the window again. How could he tell her? He, who had avoided questions for so long, who had become such an expert at hiding and deceiving. There was only one way, and that was to tell the absolute truth, concealing nothing. To lay it all before her, what he had never offered to any other soul. And he wanted to do it. Even though he knew it would make her turn away from him in the end, he needed to show Elena what he was. And so, staring into the darkness outside the window, where flashes of blue brilliance occasionally lit the sky, he began. He spoke dispassionately, without emotion, carefully choosing his words. He told her of his father, that solid Renaissance man, and of his world in Florence and at their country estate. He told her of his studies and his ambitions. Of his brother, who was so different than he, and of the ill feeling between them. â€Å"I don't know when Damon started hating me,† he said. â€Å"It was always that way, as long as I can remember. Maybe it was because my mother never really recovered from my birth. She died a few years later. Damon loved her very much, and I always had the feeling that he blamed me.† He paused and swallowed. â€Å"And then, later, there was a girl.† â€Å"The one I remind you of?† Elena said softly. He nodded. â€Å"The one,† she said, more hesitantly, â€Å"who gave you the ring?† He glanced down at the silver ring on his finger, then met her eyes. Then, slowly, he drew out the ring he wore on the chain beneath his shirt and looked at it. â€Å"Yes. This was her ring,† he said. â€Å"Without such a talisman, we die in sunlight as if in a fire.† â€Å"Then she was†¦ like you?† â€Å"She made me what I am.† Haltingly, he told her about Katherine. About Katherine's beauty and sweetness, and about his love for her. And about Damon's. â€Å"She was too gentle, filled with too much affection,† he said at last, painfully. â€Å"She gave it to everyone, including my brother. But finally, we told her she had to choose between us. And then†¦ she came to me.† The memory of that night, of that sweet, terrible night came sweeping back. She had come to him. And he had been so happy, so full of awe and joy. He tried to tell Elena about that, to find the words. All that night he had been so happy, and even the next morning, when he had awakened and she was gone, he had been throned on highest bliss†¦ It might almost have been a dream, but the two little wounds on his neck were real. He was surprised to find that they did not hurt and that they seemed to be partially healed already. They were hidden by the high neck of his shirt. Herblood burned in his veins now, he thought, and the very words made his heart race. She had given her strength to him; she had chosen him. He even had a smile for Damon when they met at the designated place that evening. Damon had been absent from the house all day, but he showed up in the meticulously landscaped garden precisely on time, and stood lounging against a tree, adjusting his cuff. Katherine was late. â€Å"Perhaps she is tired,† Stefan suggested, watching the melon-colored sky fade into deep midnight blue. He tried to keep the shy smugness from his voice. â€Å"Perhaps she needs more rest than usual.† Damon glanced at him sharply, his dark eyes piercing under the shock of black hair. â€Å"Perhaps,† he said on a rising note, as if he would have said more. But then they heard a light step on the path, and Katherine appeared between the box hedges. She was wearing her white gown, and she was as beautiful as an angel. She had a smile for both of them. Stefan returned the smile politely, speaking their secret only with his eyes. Then he waited. â€Å"You asked me to make my choice,† she said, looking first at him and then at his brother. â€Å"And now you have come at the hour I appointed, and I will tell you what I have chosen.† She held up her small hand, the one with the ring on it, and Stefan looked at the stone, realizing it was the same deep blue as the evening sky. It was as if Katherine carried a piece of the night with her, always. â€Å"You have both seen this ring,† she said quietly. â€Å"And you know that without it I would die. It is not easy to have such talismans made, but fortunately my woman Gudren is clever. And there are many silversmiths in Florence.† Stefan was listening without comprehension, but when she turned to him he smiled again, encouragingly. â€Å"And so,† she said, gazing into his eyes. â€Å"I have had a present made for you.† She took his hand and pressed something into it. When he looked he saw that it was a ring in the same fashion as her own, but larger and heavier, and wrought in silver instead of gold. â€Å"You do not need it yet to face the sun,† she said softly, smiling. â€Å"But very soon you will.† Pride and rapture made him mute. He reached for her hand to kiss it, wanting to take her into his arms right then, even in front of Damon. But Katherine was turning away. â€Å"And for you,† she said, and Stefan thought his ears must be betraying him, for surely the warmth, the fondness in Katherine's voice could not be for his brother, â€Å"for you, also. You will need ft very soon as well.† Stefan's eyes must be traitors, too. They were showing him what was impossible, what could not be. Into Damon's hand Katherine was putting a ring just like his own. The silence that followed was absolute, like the silence after the world's ending. â€Å"Katherine-† Stefan could barely force out the words. â€Å"How can you give that tohim ? After what we shared-† â€Å"What you shared?† Damon's voice was like the crack of a whip, and he turned on Stefan angrily. â€Å"Last night she came to me. The choice is already made.† And Damon jerked down his high collar to show two tiny wounds in his throat. Stefan stared at them, fighting down the bright sickness. They were identical to his own wounds. He shook his head in utter bewilderment. â€Å"But, Katherine†¦ it was not a dream. You came tome †¦Ã¢â‚¬  â€Å"I came to both of you.† Katherine's voice was tranquil, even pleased, and her eyes were serene. She smiled at Damon and then at Stefan in turn. â€Å"It has weakened me, but I am so glad I did. Don't you see?† she continued as they stared at her, too stunned to speak. â€Å"This is my choice! I love you both, and I will not give either of you up. Now we all three will be together, and be happy.† â€Å"Happy-† Stefan choked out. â€Å"Yes, happy! The three of us will be companions, joyous companions, forever.† Her voice rose with elation, and the light of a radiant child shone in her eyes. â€Å"We will be together always, never feeling sickness, never growing old, until the end of time! That is my choice.† â€Å"Happy†¦ with him ?† Damon's voice was shaking with fury, and Stefan saw that his normally self-contained brother was white with rage. â€Å"With thisboy standing between us, this prating, mouthing paragon of virtue? I can barely stand the sight of him now. I wish to God that I should never see him again, never hear his voice again!† â€Å"And I wish the same ofyou , brother,† snarled Stefan, his heart tearing in his breast. This was Damon's fault; Damon had poisoned Katherine's mind so that she no longer knew what she was doing. â€Å"And I have half a mind to make sure of it,† he added savagely. Damon did not mistake his meaning. â€Å"Then get your sword, if you can find it,† he hissed back, his eyes black with menace. â€Å"Damon, Stefan, please! Please, no!† Katherine cried, putting herself between them, catching Stefan's arm. She looked from one to the other, her blue eyes wide with shock and bright with unshed tears. â€Å"Think of what you are saying. You are brothers.† â€Å"By no fault of mine,† Damon grated, making the words a curse. â€Å"But can you not make peace? For me, Damon†¦ Stefan?Please .† Part of Stefan wanted to melt at Katherine's desperate look, at her tears. But wounded pride and jealousy were too strong, and he knew his face was as hard, as unyielding, as Damon's. â€Å"No,† he said. â€Å"We cannot. It must be one or the other, Katherine. I will never share you withhim .† Katherine's hand fell away from his arm, and the tears fell from her eyes, great droplets that splashed onto the white gown. She caught her breath in a wrenching sob. Then, still weeping, she picked up her skirts and ran. â€Å"And then Damon took the ring she had given him and put it on,† Stefan said, his voice hoarse with use and emotion. â€Å"And he said to me, ‘I'll have her yet,brother .' And then he walked away.† He turned, blinking as if he'd come into a bright light from the dark, and looked at Elena. She was sitting quite still on the bed, watching him with those eyes that were so much like Katherine's. Especially now, when they were filled with sorrow and dread. But Elena did not run. She spoke to him. â€Å"And†¦ what happened then?† Stefan's hands clenched violently, reflexively, and he jerked away from the window. Not that memory. He could not endure that memory himself, much less try tospeak it. How could he do that? How could he take Elena down into that darkness and show her the terrible things lurking there? â€Å"No,† he said. â€Å"I can't. Ican't .† â€Å"You have to tell me,† she said softly. â€Å"Stefan, it's the end of the story, isn't it? That's what's behind all your walls, that's what you're afraid to let me see. But you must let me see it. Oh, Stefan, you can't stop now.† He could feel the horror reaching for him, the yawning pit he had seen so clearly, felt so clearly that day long ago. The day when it had all ended-when it had all begun. He felt his hand taken, and when he looked he saw Elena's fingers closed about it, giving him warmth, giving him strength. Her eyes were on his. â€Å"Tell me.† â€Å"You want to know what happened next, what became of Katherine?† he whispered. She nodded, her eyes nearly blind but still steady. â€Å"I'll tell you, then. She died the next day. My brother Damon and I, we killed her.†

Qualitative and Quantitative Research Essay

Qualitative and quantitative research are two types of research, each type is presented in a different way and depends on different gathered material. Qualitative research is the collection of information about things and objects. For instance interviews, pictures and items would be items collected during qualitative research. Quantitative research involves the collection and analysis of numerical information that has been researched and collected. This type of research is best at the onset of a research product. It can help steer a research product in a specific direction, and its results are given in spoken word or in the form of images and videos. Qualitative research is focused on results that do not involve numbers. Its purpose is to observe and analyze how people react and think to the research topic and why they react and feel the way that they do. The purpose of this type of research is to gain results that show details about the problem and question at hand. Qualitative research usually answers questions about a broad idea or thought, and considers many details and possibilities. These results are usually gathered by using questionnaires, interviews, and focus groups. Qualitative evidence has conclusions that are based on a gathering of thoughts and ideas and can often present answers that are considered opinionated, and can be interpreted differently by different groups. This type of data offers results that deal with human emotions and thoughts. Although qualitative research does not use numerical data its results are very useful and can offer solid solutions and results. Quantitative research has an end result of numerical data that can give results in a numerical report. The research that is gathered in this type of research is measurable and is easier to compare to similar numerical results. The results contain numerical explanations for the questions that are being researched. Quantitative research is usually focused on direct details or specific questions that require specific and conclusive answers. This research is usually used in the end of a research project. This type of research uses questioners, survey or even measurements to collect numerical data, and its end results are presented in the form of charts and graphs. Quantitative data is considered to be more concrete proof or evidence that can be proven and show hard facts. My project for this class will more than likely consists of more quantitative data than qualitative. In my project I want to look into why the consumer feels a certain way. I know for sure that these answers can only be reached through research conducted through survey and personal questioners. Numerical data will not help me come to a conclusion about why the consumer base thinks or feels a certain way.

Create a Java Constant Variable (Static/Final Keywords)

A constant is a  variable  whose value cannot change once it has been assigned. Java doesnt have built-in support for constants, but the variable modifiers  static and final can be used to effectively create one. Constants can make your program more easily read and understood by others. In addition, a constant is cached by the JVM as well as your application, so using a constant can improve performance.   Static Modifier This allows a variable to be used without first creating an instance of the class; a static class member is associated with the class itself, rather than an object. All class instances share the same copy of the variable. This means that another application or main() can easily use it. For example, class myClass contains a static variable days_in_week: public class myClass {    static int days_in_week 7;} Because this variable is static, it can be used elsewhere without explicitly creating a myClass object: public class myOtherClass {      static void main(String[] args) {          System.out.println(myClass.days_in_week);    } } Final Modifier The final modifier means that the variables value cannot change. Once the value is assigned, it cannot be reassigned.   Primitive data types (i.e., int, short, long, byte, char, float, double, boolean) can be made immutable/unchangeable using the final modifier. Together, these modifiers create a constant variable. static final int DAYS_IN_WEEK 7; Note that we declared DAYS_IN_WEEK in all caps  once we added the final modifier. Its a long-standing practice among Java programmers to define constant variables in all caps, as well as to separate words with underscores. Java doesnt require this formatting but it makes it easier for anyone reading the code to immediately identify a constant.   Potential Problems With Constant Variables The way the final keyword works in Java is that the variables pointer to the value cannot change. Lets repeat that:  its the pointer that cannot change the location to which its pointing. Theres no guarantee that the object being referenced will stay the same, only that the variable will always hold a reference to the same object. If the referenced object is mutable (i.e. has fields that can be changed), then the constant variable may contain a value other than what was originally assigned.