The cytokine storm Essay Example

The cytokine storm Essay Example The cytokine storm Essay The cytokine storm Essay Glossary TNF-Alpha = Tumour Necrosis Factor-Alpha IL-6 = Interleukin-6 IL-8 = Interleukin 8 ARDS = Acute Respiratory Distress Syndrome SAP = Severe Acute Pancreatitis MOF = Multiple Organ Failure IG = Immunoglobulin FDA = Food and Drug Administration TLR = Toll-Like Receptors Deoxyribonucleic acid = Deoxyribonucleic Acid ACTH = Adrenocorticotrophic Hormone Describe the molecular footing of the status hypercytokinaemia ( A ; lsquo ; cytokine storm ) and describe in item, the pharmacological medicine of drug intercessions that may be used to handle the status Cytokine storm is straight caused by a flustered ratio of proinflammatory to anti-inflammatory cytokines which interact and can be fatal to the patient. ( 1 ) Proinflammatory cytokines can move locally by increasing the vascular permeableness of the tissue or in concurrence with chemokines advancing the physiological responses when tissue harm or a viral infection is encountered. ( 2 ) An addition in the grade of organ disfunction has been found to correlate with high degrees of the cytokines TNF-a, Il-6 and Il-8. These are proinflammatory cytokines which play an of import function in the cytokine storm. Cytokine storm must be treated instantly as it can turn out fatal through several conditions such as ARDS, sepsis, SAP, ARDS and MOF. ( 3 ) High degrees of cytokines have been observed in patients who have contracted the H5N1 virus bespeaking that this deregulating of the cytokine tract is what causes the ARDS associated with H5N1. ( 4 ) Cytokine storms can besides be triggered throu gh pharmacological intercessions ; TGN1412 was given to six voluntaries in a drug test plan in 2006 with dramatic consequences. Within an hr and a half there was a immense addition in the figure of proinflammatory cytokines in the trial subjects taking to a cytokine storm. Several pharmacological intercessions are available to battle the spread of the cytokine storm. Interfering with one cytokine s tract has proven to be uneffective and merely when a big proportion of cytokines are inhibited is the status improved. ( 5 ) However the immune system is huge in its complexness and hence In order to utilize a pharmacological intercession to cut down the cytokine storm a specific country of the cytokine cascade must be targeted. Inflammatory cytokines are released by T-cells and hence a pharmacological intercession to cut down the figure of T-cells in patients enduring from cytokine storms is a logical measure. CD4+ T cells produce cytokines that promote inflammatory effects within a assortment of cells, CD8+ cells destroy the host being cells that have become infected. ( 2 ) When antigen molecules binds to the t-cells this causes OX40 production to be increased. OX40 is a receptor protein for TNF-a cytokines. The addition in production of OX40 besides upregulates the production of OX40L. OX40 creates a survival signal which prevents the t-cells from programmed cell decease. ( 6 ) A interruption in this survival signal can be achieved by utilizing a human created soluble merger protein known as OX40-IG, this prevents the suppression of the programmed cell death of t-cells therefore diminishing the figure of t-cells nowadays. ( 7 ) One of the concluding inflammatory go-betweens in the inflammatory cytokine cascade is TNF-a, it promotes cutaneal redness, regulates the programmed cell death of active cells in the immune system and besides provides a positive feedback cringle whereby it stimulates the production of more cytokines. Macrophages besides provide a big beginning of TNF-a along with the kidneys which have shown to increase degrees of TNF-a when redness is present. The angiotonin II system may move as a cytokine in its ain right modulating the production of TNF-a. A test on rats has shown that when angiotonin II was administered the rats showed an over look of TNF-a and other inflammatory cytokines such as IL-6. Following this find a test on rats with elevated TNF-a degrees due to nephritis was carried out. An ACE inhibitor called quinapril was administered to the rats, the increased TNF-a look by the kidneys was reduced demoing that the Angiotensin II system does play a portion in modulating TNF-a degre es. ( 8 ) Recently the H5N1 avian strain and the H1N1 strain of the grippe virus have been at the head of media attending as they trigger cytokine storms and can be fatal to the patient. The mechanism of action by which grippe viruses trigger hypercytokinaemia is non to the full understood nevertheless it has been hypothesised that TLR receptors detect the presence of a foreign virus and upregulate the production of TNF-a and IFN-b/c and many other proinflammatory cytokines. ( 1, 10 ) Corticosteroids are produced in the cerebral mantle of the adrenal secretory organs above the kidneys and are released in response to increased concentration of proinflammatory cytokines. They help to command the positive feedback cringle that fuels the cytokine storm and hence cut down the proliferation of farther cytokines. ( 11 ) One theory besides suggests that some sections of the viral DNA are similar to that of ACTH taking to a decrease in the release of hydrocortisone from the adrenal secretory organs and hence doing adrenal insuffiency in patients. However steroids must be administered early in the status to be effectual and must be administered in concurrence with an antiviral such as osteltamivir. Methylprednisolone has been administered in some instances of avian grippe nevertheless there are few human tests that have been conducted. There will therefore demand to be more conclusive grounds for steroids as a believable intervention for cytokine storms before any decisions can be drawn. ( 1 ) An suppression of TNF-a could hence be effectual in cut downing the spread and inflammatory effects of the cytokine storm. Three different tnf-a alpha inhibitors are presently available and are approved by the FDA. Etanercept is the first of the three as it provides it s curative action by adhering to TNF-a molecules at one adhering site, this inhibits the TNF-a molecules from adhering to their specific receptors and leaving a biological signal. The 2nd and 3rd drugs are monoclonal antibodies and have two adhering sites on TNF-a. These two drugs may do a cascade which destroys immune cells by cell mediated lysis. Infliximab contains a little sum of mouse protein which may do the hosts immune system to let go of antibodies in response potentially take downing it s efficaciousness. Adalimumab maps in the same manner as Remicade nevertheless merely human protein is present therefore it may be a more feasible attack. ( 9 ) OX40 has already been established as a major subscriber to the proliferation of TNF-a and hence different attacks to cut down its efficaciousness are in advancement. A lipid-lowering medicine named Zocor has been shown to diminish OX40 and OX40L degrees and hence increase the programmed cell death of T-cells in cytokine storm patients. This lessening in OX40 degrees has been attributed to a alteration in written text of messenger RNA and interlingual rendition of proteins. Simvastatin is a HMG-CoA reductase inhibitor which inhibits the formation of mevalonate ( an interferon ) . Simvastatin has been shown to trip PPAR receptors, this tract was investigated to make up ones mind whether this agonist mechanism was take downing OX40 degrees or whether mevalonate was doing the decrease in OX40 degrees. Mevalonate and a PPAR adversary GW9662 where used in the probe. When mevalonate was used the degrees of OX40 became elevated nevertheless with GW9662 the degrees were non altered. This show ed that the mevaolonate tract is likely what causes this lessening instead than PPAR receptor activation. Further research into HMG-CoA reductase inhibitors such as Zocor will hold to be carried out before the mechanism of action becomes clear nevertheless simvastatin appears to be a promising new attack for covering with cytokine storms. ( 12-13 ) Bibliography Carter MJ. A principle for utilizing steroids in the intervention of terrible instances of H5N1 avian grippe. J Med Microbiol. 2007 July 1, 2007 ; 56 ( 7 ) :875-83. Richard Coico GS. Immunology: A short course2009. Hirasawa H, Oda S, Matsuda K, Watanabe E. Clinical facet of hypercytokinemia-induced pathophysiology in critical attention. International Congress Series. [ Department of the Interior: Department of the interior: 10.1016/S0531-5131 ( 03 ) 00883-5 ] . 2003 ; 1255:39-40. de Jong MD, Simmons CP, Thanh TT, Hien VM, Smith GJD, Chau TNB, et Al. Fatal result of human grippe A ( H5N1 ) is associated with high viral burden and hypercytokinemia. Nat Med. [ 10.1038/nm1477 ] . 2006 ; 12 ( 10 ) :1203-7. Droebner K, Reiling SJ, Planz O. Role of Hypercytokinemia in NF- { kappa } B p50-Deficient Mice after H5N1 Influenza A Virus Infection. J Virol. 2008 November 15, 2008 ; 82 ( 22 ) :11461-6. Maxwell JR, Weinberg A, Prell RA, Vella AT. Danger and OX40 Receptor Signing Synergize to Enhance Memory T Cell Survival by Suppressing Peripheral Deletion. J Immunol. 2000 January 1, 2000 ; 164 ( 1 ) :107-12. Humphreys IR, Walzl G, Edwards L, Rae A, Hill S, Hussell T. A Critical Role for OX40 in T Cell-mediated Immunopathology during Lung Viral Infection. J Exp Med. 2003 October 20, 2003 ; 198 ( 8 ) :1237-42. Ruiz-Ortega M, Ruperez M, Lorenzo O, Esteban V, Blanco J, Mezzano S, et Al. Angiotensin II regulates the synthesis of proinflammatory cytokines and chemokines in the kidney. Kidney Int. 2002 ; 62 ( S82 ) : S12-S22. Jackson JM. TNF-alpha ; inhibitors. Dermatologic Therapy. 2007 ; 20 ( 4 ) :251-64. Garc A ; iacute ; a-Sastre A. Antiviral response in pandemic grippe viruses. Emerg Infect Dis. 2006 ; 12 ( 1 ) :44-7. PADGETT DA, LORIA RM, SHERIDAN JF. Steroid Hormone Regulation of Antiviral Immunity. Annalss of the New York Academy of Sciences. 2000 ; 917 ( NEUROIMMUNOMODULATION: Position AT THE NEW MILLENNIUM ) :935-43. Liu B, Yu G, Yang Z, Sun L, Song R, Liu F, et Al. Simvastatin Reduces OX40 and OX40 Ligand Expression in Human Peripheral Blood Mononuclear Cells and in Patients with Atherosclerotic Cerebral Infarction. The Journal of International Medical Research. 2009 ; 37:601-10. Zhang X, Jin J, Peng X, Ramgolam VS, Markovic-Plese S. Simvastatin Inhibits IL-17 Secretion by Targeting Multiple IL-17-Regulatory Cytokines and by Suppressing the Expression of IL-17 Transcription Factor RORC in CD4+ Lymphocytes. J Immunol. 2008 May 15, 2008 ; 180 ( 10 ) :6988-96.

Reflection on Learning and Teaching Adults with depression Essay

Reflection on Learning and Teaching Adults with depression - Essay Example This means that they may not be in a position to take the appropriate diet and thus find themselves deficient of essential nutrients that their body requires. This means that their bodies may not recover from the mental problems and will also develop other nutrition related ailments that will cause them more problems to their health. This teaching session was based on wellbeing and nutrition and was being offered to five adults over the age of 65 suffering from depression and who are at risk of malnutrition. Aims and Outcomes All initiatives have aims that they wish to accomplish. In conducting the teaching session we aimed at several things. First the teaching session was aimed at giving the people information as concerns their health and well-being. It is important that sick people get to understand what they are suffering from so that they are better able to deal with their problems. Many authors say that psychological well-being of a person is very important to their recovery. Th us when people understand what they are suffering from, it is easier for them to positive about the things they are told to do and in so doing they are able to get well as soon as possible. This teaching therefore aimed at informing about the effects that depression brings on adults and how they could avoid being depressed and the available options in place that could help them. Second aim after information concerning the illness was teaching them on the various interventions that are available for them as patients suffering from depression. Our core concern was the people’s well-being and thus they needed to know what interventions are there to ensure that they can cope with the mental problem. A variety of options were given to them here including specialized hospitals, possible medications and primary interventions such as a stress free environment. The third aim was getting them to learn about their nutrition and how it was important to their development as patients. Depr essed patients tend to think a lot and lack appetite and thus the resultant effects may not be good. These people require close monitoring so that they can take food and in the right quantities so that they do not starve or take unbalanced diet. Our intended outcomes for the initiative was a detailed understanding by the patients on the ailment that they are suffering from, the various interventions that are available for them and the various nutritional requirements that they need it order to recover from their ailments. Due to the lack of concentration by the patients, it is important to teach them using tools that attract their attention and thus a lot of animations were used and a number of role playing tasks were also used to enable the patients concentrate while learning at the same time. It was also important that the patients be put in a room to avoid their minds wandering away in an open environment. Professional ethics were also to be observed such that the session was sup posed to be carried out with the consent of the patients and this was something that was difficult to get given the condition of the patients. Evaluation of sources of information used Nice (2010:17) describes depression as â€Å"

Cheating In School Essay Example | Topics and Well Written Essays - 1750 words

Cheating In School - Essay Example This report stresses that parents can contribute to their children lack of study due to busy schedules where they may end up typing their assignments or assisting them in their science projects. This type of behavior from parents sends the wrong message that if someone parents another person’s work is okay and the kids understand that getting higher grades is more important. In Kindergarten to the second grade, cheating is considered a very old school where it entails copying another classmate’s homework, also seeking someone work. Cheating sometimes is seen as a tool for getting ahead, and this makes students develop cheating skills to be successful. This paper makes a conclusion that cheating in school is increasing at a high rate due to lack of tough laws and regulations that deal with suspected students who have been accused of cheating. Schools have stipulated that cheating occur in different forms like plagiarism, copying in exams, assisting a student to do their exams or prohibiting a student not to finish their assignment. Curbing cheating should start at the elementary level so that kids can grow to know that cheating is wrong, and this creates a moral code in their lifetime. Some kids at the elementary level do not know that some form of cheating falls under categories of cheating and therefore it is the role of the teachers and parents to make sure that they inform such young children what exactly is cheating. This extends to submitting another person’s work as their own.

Strategic analysis of a company located in UAE Essay

Strategic analysis of a company located in UAE - Essay Example Furthermore, the aviation industry of the Middle East will also be evaluated. Based on the findings, the study will underline the key strategic issues faced by Etihad Airways. A conclusion will be drawn regarding the most important strategic issue faced by the company. Once the issue is identified the report will offer some suggestions by which the issues can be either controlled or fully curbed. Finally the implementation process of the strategy will be portrayed. Etihad Airways, the national airlines of the United Arab Emirates was established in the year 2003, by Royal decree. The operation of the company started in the month of November, 2003 (Abed, Vine, Hellyer and Vine, 2006, p.207). Nevertheless, the journey began with a ceremonial flight from the Abu Dhabi airport to Al Ain. It is presently headquartered at the Khalifa City A, Abu Dhabi, United Arab Emirates (Etihadairways, n.d.). The company operates with around 1300 flights in a week. Etihad Airways has its operation in 55 countries of the world. The company has a total fleet size of 67 airbuses and some Boeing aircrafts. According to the recent reports, the company has carried 8.3 million passengers in the year 2011. The data also reveals that the company has been able to achieve a staggering 17 % growth regarding the total number of passenger carries. The net revenue of the company was US$ 4.1 billion and the profit was US$ 14 million. It is also considered as one of the fastest g rowing airlines company in the history of aviation industry. The primary business of the company is to provide transportation services to the customers. However it also offers packaged holiday tours and tender international delivery services for its customers. In the passenger transportation service, the company has three products namely Pearl business class, diamond first class and coral economy class. The

Read April Morning and write an essay Example | Topics and Well Written Essays - 1000 words

Read April Morning and write an - Essay Example For example in chapter 1 in the Afternoon before the battle, women are portrayed as religious people. This happens when Adam’s mother is preparing supper and when Adam delivers some water to her she asks him why he does not read the bible just like his father used to do. According to Adams mother, Moses Cooper the father to Adam had memorized the book of Lamentations by age of 15 which is Adams age (Fast 8). Another encounter in which women are portrayed as religious is when granny is having a conversation with Adam. When granny asks Adam about if the Committeeman was connected to Sam Adams and Adam replies yes she concludes that Adam is a theist which also shows the religious role of women in the novel (Fast 16). In addition to this, the author cites a reverend as one of the characters in this book but does not show any instances where the character inspires people to be religious leaving the role for women only. Another example of the theme of religion expressed by women in this novel is when granny asks Adam, â€Å"If God gave a person brains, then shouldn’t he use them?† Ruth is also portrayed as a religious young lady (Fast 22). At her teen age youth she was religious and granny ask why Adam had participated in trying to shake Ruth Simmons’s faith. The author also portrays the religious nature of women in the novel when granny got into an argument with his son Moses when Moses said that, â€Å"The highest good was to doubt†. According to granny God was the greatest and hence could not be doubted (Fast 27). The author has also used women to show an understanding and caring character in this novel. Adam confesses that the only person who understands him is her grandmother and most of the time he will spend time with her and make stories (Fast 14). The author further illustrates women as peaceful and caring people when granny tries to control Moses Cooper from attacking his son

Unilateral Action by the Obama Administration

Unilateral Action by the Obama Administration Introduction One of the main features of the American system of government is the push and pull between the executive and legislative branches when it comes to the extension of powers of the federal government (Ellis, 2015: 403). Furthermore, the issue of the unilateral action taken by the executive in order to advance certain political issues has also been a source of great controversy throughout American political history. In the first part of the paper, there will be a treatment of differences between the perspective on unilateral action taken by the Obama administration and that espoused by Senator Ted Cruz. The second section of the paper tackles the level of impact of unilateral action as a tool for political change. The differences between the perspective on unilateral action taken by the Obama administration and Senator Ted Cruz Senator Ted Cruz (R-TX) compiled a list in which he outlines a series of important occasions in which President Obama implemented decisions regarding issues affecting public life through the use of executive fiat. Senator Cruz’s list outlined some general areas where President Obama used executive fiat, included provisions regarding the entitlement to stay in the country for certain groups of immigrants and the recognition of same-sex marriage in the state of Utah (Cruz, 2014). At the same time, Senator Cruz’s list also included the implementation of provisions regarding Obamacare, national security, measures that affected the American economy, appointments to positions in the federal government and the adoption of measures concerning free speech and privacy. In addition to this, the list compiled by Senator Cruz specified certain â€Å"abuses of power† allegedly committed by the executive that appears to be tantamount to mere political stances typical of any incumbent president (Cruz, 2014). At the very core of Senator Cruz’s stance, there is a clear indication regarding his disapproval on how these moves expanded the power of the federal government. The Senator backed up its claims by issuing a warning regarding the dangers of departing from the idea laid down by the Founding Father, which concerns the need to ensure that the United States will continue to be a â€Å"Republic of Laws, and not of Men† (Cruz, 2014). A cursory look at the list compiled by the White House shows that the president used executive order, as granted to him by the law, in order to put forward provisions that would advance his agenda on progressive issues (Presidents News Conference, 2014). For example, during 2014, which the White House branded as the â€Å"year of action†, there was a particular interest placed on equal employment opportunity, fair pay for workers and environmental issues (The American Presidency Project, 2014). The evidence presented in both lists suggests that although the executive took unilateral action on a number of issues deemed to be of paramount importance to the Obama administration, those were mostly dealt through the issuing of executive orders (White House statement, 2014). It appears that the main difference between the list of executive orders issued by the Obama administration and the list provided by Senator Cruz resides in the fact that the latter concentrates on minute actions that may not even be directly attributed to the President but to the different departments of the executive. There is, in this context, a highly tendentious element attached to the Senator’s list. The executive highlighted the need to collaborate with the U.S. Congress in the passing of legislation. However, the contents of the executive order issued by the president also have, in spite of the president’s pragmatic position, a clearly partisan slant, as seen in the interest placed on environmental and healthcare issues (Rudalevige in Rockman, Rudalevige and Campbell (eds.), 2011: 190). A close examination of both lists demonstrates that the one compiled by Senator Cruz is mostly centred on the unilateral actions taken by the White House without using executive orders. There is therefore a considerable difference between the two lists. This indicates the political element attached to the extension of the federal government and the way in which the U.S. Congress, in this case through the auspices of Senator Cruz, acts as a balancer in the quest of the executive to be the main determinant of the course of events in American politics. The impact of unilateral action on the continuation of the status quo From the examination of both lists, it transpires that the power of the executive in order to exert political change seems to be curtailed by the need to attain a good working relationship with the U.S. Congress; a fundamental feature of the U.S. system of government, based on the principle of checks and balances. At the same time, the discretionary use of executive powers remains a controversial area in U.S. politics (Ellis, 2015: 405). The ability of the executive to advance the causes that it deems necessary to the betterment of society is restrained by the electoral process, which places a great degree of scrutiny on the actions of the president. The Obama administration was able to pass Obamacare and speed up some of the measures pertaining to its implementation at a time when the Democrats had a majority in Congress (Rudalevige in Rockman, Rudalevige and Campbell (eds.), 2011: 183). For all the reasons cited above, it could be argued that unilateral actions can only in very spe cific circumstances become an instrument for the change of the status quo. Conclusion By way of conclusion, it could be posited that the controversy arising from the use of unilateral action on the part of the Obama administration (as seen in the report compiled by Senator Cruz) is indicative of the highly partisan nature of the issue. The findings of these investigations show that the use of discretionary powers by the executive is severely curtailed by the system of checks and balances and the influence exerted by public opinion on the actions of the executive. Bibliography Cruz, T., The Legal limit Report Number 4 The Obama Administrationss Abuse of Power, 2014 http://www.cruz.senate.gov/files/documents/The%20Legal%20Limit/The%20Legal%20Limit%20Report%204.pdf Accessed on 11/30/2014 Ellis, R. (2015) The Development of the American Presidency, Routledge, London Presidents News Conference, 1/8/2014 www.presidency.ucsb.edu/ws/?pid=105506 Accessed on 11/22/2014 Rudalevige, A. (2011) Rivals or a Team? Staffing and Issue Management in the Obama Administration in Rockman, B., Rudalevige, A. and Campbell, C. (eds.) The Obama Presidency: Appraisals and Prospects, CQ Press, Washington, DC The American Presidency Project, 2014, List of Executive Orders issues by President Obama www.presidency.ucsb.edu/executive_orders.php?year=2014Submit=DISPLAY Accessed on 11/28/2014 White House statement, 2014, What does a year of action mean, exactly? www.whitehouse.gov/year-of-action -Accessed on 11/26/2014

The Rainmake - Film Review Essay -- essays research papers

John Grisham’s â€Å"The Rainmaker† is the sixth novel to film adaptation and is by far one of the more accomplished. Directed by Francis Ford Copolla, this intriguing courtroom drama reveals the ordeals of a young lawyer and associate entering the realm of unscrupulous money hungry company’s scams. â€Å"They were totally unqualified to try the case of a life time, but every underdog has his day†. To become a â€Å"Rainmaker† is Rudy Baylor’s (Matt Damon) ambition, to try the case of a lifetime and make the â€Å"big bucks† fall from the sky. Passing his bar exam with ease, this idealistic Memphis law school graduate, confidentially enters the eye-opening world of law and injustice in the 90’s. Kick-starting his career in an firm of ambulance chasing attorneys, headed by the shifty Bruiser Stone, Baylor’s business is initially sparse, until Deck Schifflet (Danny De Vito) an unlicensed, street-wise legal assistant attempting the bar for the sixth time, steps in and demonstrates to the inexperienced Baylor how it is done. Mrs. Birdie, (Teresa Wright) Baylor’s landlady, becomes his first case, a chirpy elderly lady wishing to leave her fortunes to a TV evangelist, much to the disdain of her family, whom Birdie wants to â€Å"cut,cut,cut† from her will. His second case is Kelly Riker, (Clare Danes) a young woman repeatedly assaulted by her husband Cliff (Andrew Schue). Riker catches Baylor’s eye in the hospital cafeteria, covered in bruises, attracting Baylor’s special interest to the case, as well as the safety of the defendant. The central case of the film is that of a mother’s battle against an insurance company who refuse to pay insurance for her only son Donny Ray (Johnny Whitworth) who is dying of Leukemia. Dot Black (Mary Kay Place) puts forward a strong case, with the assistance of Baylor, unveiling the injustice Insurance Company Great Benefits exhibits in shunning a lower class family out of much needed money insuring a young man’s health and well-being. A heartwrenching tale of injustice unfolds in this Memphis courtroom, accompanied appropriately with many a humorous action and anecdote. The fact that it is set in actual locations in the city of Memphis, Tennessee, gives this 20th Century film great authenticity. The home of Dot, Buddy and Donny-Ray Black is representative of typical lower working class citizens; a run-down American ranch style house with a wide front... ... courtroom. He also featured techniques such as cross cuts between the interrogation of the CEO and Schifflets search for Lemanczyk, and flash back sequences of the happy days when Donny Ray was healthy and the insurance company rep. was offering the Black family a â€Å"great† insurance deal. Voice Overs allowed the viewer to experience Baylor’s thoughts and sound effects like the thud of the baseball bat on Cliff Riker’s skull and use of rain and thunder in the murder scene, decorated the film and added to the suspense of the plot. Lighting in red tones gave warmth to the happier scenes and gray tinges shadowed the gloomier scenes. Music was predominantly instrumental with love themes during Baylor and Rikers intimate scenes and triumphant scores signifying the victory of the Black/Great benefits case. Costumes were thought out with Dot Blacks clothing coming from Good will stores to fasten that lower class citizen appearance. In Conclusion, the entire film was a well thought out production. â€Å"The Rainmaker† was an interesting, enjoyable and at times quite poignant film, and well worth a high, middle, and lower class citizens movie ticket buying money!!! Recommended viewing for all.