Examine the extent to which Aneurin Bevan succeeded in overcoming the Essay

Examine the extent to which Aneurin Bevan succeeded in overcoming the obstacles which he encountered in achieving his vision for a national health service in th - Essay Example However, the NHS as an institution for providing better health services, despite all its constraints, became hugely popular with doctors and patients. Today it forms an integral part of British health and medical services. This, from a long term perspective, may be seen as Bevan’s lasting contribution to his country, and affords him an important place in the annals of its public health system. In the British post war general election Labour secured a thumping majority. This enabled the government to commence the implementation of the promises made to the British electorate in their party Election Manifesto; these promises, among others, included improved housing facilities and reforms in industry, education and health. In the sphere of health services, the Manifesto had stated that â€Å"(these facilities) should be available free for all. Money must no longer be the passport to the best treatment.† (Labour Party Manifesto 1945) It was Aneurin Bevan, (1897-1960) the Health Minister in premier Clement Atlee’s cabinet who was charged with the main responsibility of implementing the Labour Party vision. The task was tough, despite the party’s majority in the government, and there were several obstacles in the implementation of this plan. Bevan himself was clear about the goal to be achieved for the British Health System: simply put, none should be denied medical help and treatment on the grounds that he/she couldn’t afford to pay for it. He brooked no dilution of this ideal, and took a non-compromising stand on it. (Remember his famous one-liner that those who favoured the middle of the road, only got run over?) When Bevan articulated his vision, Britain already had a National Health Insurance Act1 But Bevan highlighted its inadequacies, pointing out that The National Health Insurance System provided medical care only for 21 million persons, while

Long Term Impact of Parental Divorce Essay Example for Free

Long Term Impact of Parental Divorce Essay This is an interesting study about how divorce can affect adulthood. At the age of sixteen, all students from one town completed a questionnaire. All the students were given a follow up questionnaire at thirty two years of age. Coming from a divorced family affects women more than men. This could be because of the close relationship between mother and daughter. Several studies have showed that parental divorce increases the risk of divorce for offspring. Children that have divorced parents have a lower self-esteem than those who do not. Divorce negatively affects children in the personal and social development in adolescence, which reduces the quality of intimate relationships in adulthood. The reason the quality of intimate relationships are lowered, is because parent-child relationships have been found to play an important role in perceptions of social support in adulthood. Many women have big issues with the trust factor that needs to accompany an intimate relationship. Women are less likely to get married, and the women that do marry are more likely to get divorced. This does not affect boys as much because boys do not need the parent-child relationship as much as girls. If doing a research paper on the topic of social development in adulthood, this would be a good article to get information. The article is a peer reviewed journal, making it a reliable source. The study was also done over a long period of time. It is important for other to see how divorce parents could be having an effect on their social development as an adult. Many women may not see the significant coming from divorced parents maybe affecting their relationships in adulthood. This journal along with other could only give a better look into problems in social development in adulthood.

Report on rituximab as a biologic

Report on rituximab as a biologic Rituximab is a chimeric monoclonal antibody that has been one of the most prevalent biologics on the market, and has made some very significant sales over the last few years. It was originally designed in 1986 by IDEC pharmaceuticals. The drug is now being marketed under the brand names Rituxin and MabThera, dependant on the region. The antibody is chimeric in nature and is comprised of murine and human regions. It contains heavy and light variable regions of a murine origin and constant heavy and light regions of human origins meaning the Fc domain is of human origins, and so can invoke Fc receptor binding (see figure 1). The antibody is produced artificially and the gene construct of the murine and human domains are engineered and inserted into vectors, and then expressed in mammalian cells line. The mammalian cell line of choice for this specific drug is the Chinese Hamster Ovary cells (CHO cells); these provided the corrected folded drug in sufficient quantities. The use of the mammalian cell line ensured that firstly the antibodies had the correct codon usage, glycosylation, amino acids and folding, as these are mammalian cells so are able to carry out these tasks to closer specification as human cells. http://www.nature.com/onc/journal/v22/n47/images/1206939f1.jpg Figure 1: representation of the rituximab antibody. Taken from http://www.nature.com/onc/journal/v22/n47/fig_tab/1206939f1.html The filtrate from the suspension had to be purified to obtain the rituximab that will be used for clinical applications. There are two methods used to perform this task. First of all Ion-exchange chromatography, this method allows the removal to toxic products, cell mass, some viruses and unimportant protein products. The second step of purification that is used is affinity chromatography; affinity chromatography is then used to remove the specific antibody with high resolution and specificity. As a mammalian cell line was used for the expression there is a slight chance that possible viruses can pass through the purification process and be found in the final product, so a few processes were introduced to remove these possible contaminants. The media was autoclaved and human transferrin was removed, the ion exchange chromatography also helps remove some retroviruses. The drug reaches a purity of around 99%, and has a shelf stability of 2 years. The FDA originally approved Rituximab in 1997 for use against B-Cell non-Hodgkin lymphoma that had become resistant to all other forms of treatment (chemotherapy). Since its approval for use against lymphoma, it has been approved and is used off label for use against other diseases. It is seen to have an efficacy against autoimmune (AI) diseases, transplant rejection treatment and severe ulcerative colitis. Rituximab is known as an anti-CD20 antibody, meaning that it acts on and binds to the CD20 molecule. CD20 molecules are found in large amount on the surface of activated B-cells. The reason for targeting these cells is that the activated B-cells are generally the ones that are causing the problems in the disease discussed earlier. However, CD20 is also expressed, in smaller amounts, on most other B-cells so there is a certain amount of collateral damage to the immune system, which in some cases has led to an increase risk of catching serious infections. CD20 is a very weird antigen, it has no known natural ligand and its function is still very much unknown, opinions are that it helps maintain calcium concentrations across the membrane. After being binding to the CD20 at amino acid positions 170-13 and 183-183, it is seen to halt the cell cycle and induce apoptosis. There are two methods that carry out this apoptotic response, the first being the indirect killing of the cell. This involves a mechanism called anti-body dependant cell cytoxicity (ADCC). ADCC is mechanism where one the FAB part of the antibody has bound to the receptor on the surface the Fc domain changes formation and can now bind to an FC receptor. Fc receptors are found on other cells within the immune system, such as NK cells, the binding of the FC domain to one of these cells induces a killing response from the activated immune cell recruited. The Fc domain also has the ability to activate complement, so the biding of specific blood proteases, induces lysis of the cell. There is also a less well-understood mechanism that rituximab uses to kill activated B cells. This is by directly inducing apoptosis upon binding, why this occurs is not fully unde rstood, from studies it can be seen that the binding of rituximab to the CD20 causes a down regulation of MHC, a down regulation of the B-cell receptor and flux down pathways that induce apoptosis. In a recent study it can be seen that 50% increase of 30%. So that is a huge increase in the amount of patients who were currently unresponsive to available treatments. As can be seen from these results the introduction of rituximab was a real breakthrough in the field, and provided a method of treatment for those people who had no other option. As motioned earlier the drug is frequently used off label by clinicians. Rituximab has been seen to have very promising result when used to treat MS and some other AI diseases. There have also been recent developments into the treatment of severe ulcerative colitis, and rituximab is currently in phase III trials for use against ulcerative colitis where existing treatments are currently not effective. Rituximab was and is still a huge commercial success; grossing $5.68 billion in 2009 (a 9% increase on the previous year) it was one of the best selling biologics. With all the possible applications of this drug it does mean that there is still a commercial future for the drug. Rituximab is currently being marketed by Roche, Biogen and other companies have exclusivity for marketing in Japan, China and India This can be seen with how often clinicians use the drug off label to treat diseases that the FDA didnt originally approve it for. The shear wide-ranging applications of the drug are one of the main reasons for its commercial success. The drug was also a huge boost to the clinicians tools to fight against diseases which had become resistant or unresponsive to the existing gold standards, such as in B cell lymphoma and RA as discussed above. There is also still future prospects for this drug with phase III trials currently underway for the use of the drug against severe ulcerative c olitis and possible uses in replaced rejection treatment plans, so it seems that this drug is likely to be a block buster for some time to come.

Rewritten Pyramus and Thisbe Myth :: essays research papers

Pyramus was the cute boy next door, and Thisbe the prettiest girl in the entire neighborhood. They lived right next door to each other. Their parents were in a dispute over rent money; Thisbe’s father was the manager of the apartments and Pyramus’s parents had been late on their payments for a few months now. The kids were not allowed to talk or to see each other. One thing, however, they could not forbid- their young and carefree love that pound in each others hearts. They conversed by signs and glances, and the fire burned more intensely for being covered up. In the wall that parted the two apartments there was a crack, caused by the buildings old structure. No one had observed it before, but the lovers discovered it. What love can discover. As they stood, Pyramus on one side, Thisbe on the other, they would whisper to each other innocent non-sense. "Damn this freaking wall," they said, "Why do you keep us apart?† Such words they uttered on different sides of the wall; and when the night came and they must say goodnight, they would tell the other of how they are kissing the wall and imagining it was other. Next morning, when the sun had resin above the tallest skyscraper, and the city filled with busy noise and smog, they unveiled their plan to see each other. They had agreed to sneak out at night, they would wait till the routine police car had passed their block, and then each would run and meet at the old winery and wait till the other arrived. All was agreed on, and they waited impatiently for the sun to go down b eneath the buildings and night to rise up from them. Then cautiously Thisbe opened her back window- unsuspected by her parents, put a white scarf around her, waited for the police car to pass and escaped. As she sat alone in the dim light under one of the old street lights, she saw a drunk old man approaching her. With a thirst in his eyes Thisbe fled the sight, and sought refuge in the back alleys of the streets. As she fled she dropped her scarf. The drunken old man was hurt and was going to ask Thisbe for some help but just found a scarf on the ground and wiped his wound with it. Pyramus, late only because he had stopped at a local gas station to get some snacks for his dear love, finally arrived at the old winery.

Chillers

A chiller is a machine that removes heat from a liquid via a vapor-compression or absorption refrigeration cycle. A vapor-compression water chiller comprises the 4 major components of the vapor-compression refrigeration cycle (compressor, evaporator, condenser, and some form of metering device). These machines can implement a variety of refrigerants. Adsorption chillers use municipal water as the refrigerant and benign silica gel as the desiccant. Absorption chillers utilize water as the refrigerant and rely on the strong affinity between the water and a lithium bromide solution to achieve a refrigeration effect. Most often, pure water is chilled, but this water may also contain a percentage of glycol and/or corrosion inhibitors; other fluids such as thin oils can be chilled as well. Contents [hide] 1 Use in air conditioning 2 Use in industry 3 Vapor-Compression Chiller Technology 4 How Adsorption Technology Works 5 How Absorption Technology Works 5. 1 Industrial chiller technology Industrial chiller selection 7 Refrigerants 8 See also 9 References 10 External links [edit] Use in air conditioning In air conditioning systems, chilled water is typically distributed to heat exchangers, or coils, in air handling units, or other type of terminal devices which cool the air in its respective space(s), and then the chilled water is re-circulated back to the chiller to be cooled again. These cooling coils transfer sensible heat and lat ent heat from the air to the chilled water, thus cooling and usually dehumidifying the air stream. A typical chiller for air conditioning applications is rated between 15 to 1500 tons (180,000 to 18,000,000 BTU/h or 53 to 5,300 kW) in cooling capacity. Chilled water temperatures can range from 35 to 45 degrees Fahrenheit or 1. 5 to 7 degrees Celsius, depending upon application requirements. [1] [2] [edit] Use in industry In industrial application, chilled water or other liquid from the chiller is pumped through process or laboratory equipment. Industrial chillers are used for controlled cooling of products, mechanisms and factory machinery in a wide range of industries. They are often used in the plastic industry in injection and blow molding, metal working cutting oils, welding equipment, die-casting and machine tooling, chemical processing, pharmaceutical formulation, food and beverage processing, paper and cement processing, vacuum systems, X-ray diffraction, power supplies and power generation stations, analytical equipment, semiconductors, compressed air and gas cooling. They are also used to cool high-heat specialized items such as MRI machines and lasers, and in hospitals, hotels and campuses. The chillers for industrial applications can be centralized, where each chiller serves multiple cooling needs, or decentralized where each application or machine has its own chiller. Each approach has its advantages. It is also possible to have a combination of both central and decentral chillers, especially if the cooling requirements are the same for some applications or points of use, but not all. Decentral chillers are usually small in size (cooling capacity), usually from 0. 2 tons to 10 tons. Central chillers generally have capacities ranging from ten tons to hundreds or thousands of tons. Chilled water is used to cool and dehumidify air in mid- to large-size commercial, industrial, and institutional (CII) facilities. Water chillers can be either water cooled, air-cooled, or evaporatively cooled. Water-cooled chillers incorporate the use of cooling towers which improve the chillers' thermodynamic effectiveness as compared to air-cooled chillers. This is due to heat rejection at or near the air's wet-bulb temperature rather than the higher, sometimes much higher, dry-bulb temperature. Evaporatively cooled chillers offer efficiencies better than air cooled, but lower than water cooled. Water cooled chillers are typically intended for indoor installation and operation, and are cooled by a separate condenser water loop and connected to outdoor cooling towers to expel heat to the atmosphere. Air Cooled and Evaporatively Cooled chillers are intended for outdoor installation and operation. Air cooled machines are directly cooled by ambient air being mechanically circulated directly through the machine's condenser coil to expel heat to the atmosphere. Evaporatively cooled machines are similar, except they implement a mist of water over the condenser coil to aid in condenser cooling, making the machine more efficient than a traditional air cooled machine. No remote cooling tower is typically required with either of these types of packaged air cooled or evaporatively cooled chillers. Where available, cold water readily available in nearby water bodies might be used directly for cooling, or to replace or supplement cooling towers. The Deep Lake Water Cooling System in Toronto, Canada, is an example. It dispensed with the need for cooling towers, with a significant cut in carbon emissions and energy consumption. It uses cold lake water to cool the chillers, which in turn are used to cool city buildings via a district cooling system. The return water is used to warm the city's drinking water supply which is desirable in this cold climate. Whenever a chiller's heat rejection can be used for a productive purpose, in addition to the cooling function, very high thermal effectivenesses are possible. [edit] Vapor-Compression Chiller Technology There are basically four different types of compressors used in vapor compression chillers: Reciprocating compression, scroll compression, screw-driven compression, and centrifugal compression are all mechanical machines that can be powered by electric motors, steam, or gas turbines. They produce their cooling effect via the â€Å"reverse-Rankine† cycle, also known as ‘vapor-compression'. With evaporative cooling heat rejection, their coefficients-of-performance (COPs) are very high and typically 4. 0 or more. In recent years, application of Variable Speed Drive (VSD) technology has increased efficiencies of vapor compression chillers. The first VSD was applied to centrifugal compressor chillers in the late 1970s and has become the norm as the cost of energy has increased. Now, VSDs are being applied to rotary screw and scroll technology compressors. [edit] How Adsorption Technology Works Adsorption chillers are driven by hot water. This hot water may come from any number of industrial sources including waste heat from industrial processes, prime heat from solar thermal installations or from the exhaust or water jacket heat of a piston engine or turbine. The principle of adsorption is based on the interaction of gases and solids. With adsorption chilling, the molecular interaction between the solid and the gas allow the gas to be adsorbed into the solid. The adsorption chamber of the chiller is filled with solid material, silica gel, eliminating the need for moving parts and eliminating the noise associated with those moving parts. The silica gel creates an extremely low humidity condition that causes the water refrigerant to evaporate at a low temperature. As the water evaporates in the evaporator, it cools the chilled water. The use of a benign silica gel desiccant keeps the maintenance costs and operating costs of adsorption chillers low. edit] How Absorption Technology Works Absorption chillers' thermodynamic cycle are driven by heat source; this heat is usually delivered to the chiller via steam, hot water, or combustion. Compared to electrically powered chillers, they have very low electrical power requirements – very rarely above 15 kW combined consumption for both the solution pump and the refr igerant pump. However, their heat input requirements are large, and their COPs are often 0. 5 (single-effect) to 1. 0 (double-effect). For the same tonnage capacity, they require much larger cooling towers than vapor-compression chillers. However, absorption chillers, from an energy-efficiency point-of-view, excel where cheap, high grade heat or waste heat is readily available. In extremely sunny climates, solar energy has been used to operate absorption chillers. The single effect absorption cycle uses water as the refrigerant and lithium bromide as the absorbent. It is the strong affinity that these two substances have for one another that makes the cycle work. The entire process occurs in almost a complete vacuum. 1. Solution Pump – A dilute lithium bromide solution is collected in the bottom of the absorber shell. From here, a hermetic solution pump moves the solution through a shell and tube heat exchanger for preheating. 2. Generator – After exiting the heat exchanger, the dilute solution moves into the upper shell. The solution surrounds a bundle of tubes which carries either steam or hot water. The steam or hot water transfers heat into the pool of dilute lithium bromide solution. The solution boils, sending refrigerant vapor upward into the condenser and leaving behind concentrated lithium bromide. The concentrated lithium bromide solution moves down to the heat exchanger, where it is cooled by the weak solution being pumped up to the generator. . Condenser – The refrigerant vapor migrates through mist eliminators to the condenser tube bundle. The refrigerant vapor condenses on the tubes. The heat is removed by the cooling water which moves through the inside of the tubes. As the refrigerant condenses, it collects in a trough at the bottom of the condenser. 4. Evaporator â⠂¬â€œ The refrigerant liquid moves from the condenser in the upper shell down to the evaporator in the lower shell and is sprayed over the evaporator tube bundle. Due to the extreme vacuum of the lower shell [6 mm Hg (0. kPa) absolute pressure], the refrigerant liquid boils at approximately 39 °F (3. 9 °C), creating the refrigerant effect. (This vacuum is created by hygroscopic action – the strong affinity lithium bromide has for water – in the Absorber directly below. ) 5. Absorber – As the refrigerant vapor migrates to the absorber from the evaporator, the strong lithium bromide solution from the generator is sprayed over the top of the absorber tube bundle. The strong lithium bromide solution actually pulls the refrigerant vapor into solution, creating the extreme vacuum in the evaporator. The absorption of the refrigerant vapor into the lithium bromide solution also generates heat which is removed by the cooling water. The now dilute lithium bromide solution collects in the bottom of the lower shell, where it flows down to the solution pump. The chilling cycle is now completed and the process begins once again. [edit] Industrial chiller technology Industrial chillers typically come as complete packaged closed-loop systems, including the chiller unit, condenser, and pump station with recirculating pump, expansion valve, no-flow shutdown, internal cold water tank, and temperature control. The internal tank helps maintain cold water temperature and prevents temperature spikes from occurring. Closed loop industrial chillers recirculate a clean coolant or clean water with condition addititives at a constant temperature and pressure to increase the stability and reproducibility of water-cooled machines and instruments. The water flows from the chiller to the application's point of use and back. If the water temperature differentials between inlet and outlet are high, then a large external water tank would be used to store the cold water. In this case the chilled water is not going directly from the chiller to the application, but goes to the external water tank which acts as a sort of â€Å"temperature buffer. † The cold water tank is much larger than the internal water tank. The cold water goes from the external tank to the application and the return hot water from the application goes back to the external tank, not to the chiller. The less common open loop industrial chillers control the temperature of a liquid in an open tank or sump by constantly recirculating it. The liquid is drawn from the tank, pumped through the chiller and back to the tank. An adjustable thermostat senses the makeup liquid temperature, cycling the chiller to maintain a constant temperature in the tank. One of the newer developments in industrial water chillers is the use of water cooling instead of air cooling. In this case the condenser does not cool the hot refrigerant with ambient air, but uses water cooled by a cooling tower. This development allows a reduction in energy requirements by more than 15% and also allows a significant reduction in the size of the chiller due to the small surface area of the water based condenser and the absence of fans. Additionally, the absence of fans allows for significantly reduced noise levels. Most industrial chillers use refrigeration as the media for cooling, but some rely on simpler techniques such as air or water flowing over coils containing the coolant to regulate temperature. Water is the most commonly used coolant within process chillers, although coolant mixtures (mostly water with a coolant additive to enhance heat dissipation) are frequently employed. [edit] Industrial chiller selection Important specifications to consider when searching for industrial chillers include the total life cycle cost, the power source, chiller IP rating, chiller cooling capacity, evaporator capacity, evaporator material, evaporator type, condenser material, condenser capacity, ambient temperature, motor fan type, noise level, internal piping materials, number of compressors, type of compressor, number of fridge circuits, coolant requirements, fluid discharge temperature, and COP (the ratio between the cooling capacity in RT to the energy consumed by the whole chiller in KW). For medium to large chillers this should range from 3. 5-7. 0 with higher values meaning higher efficiency. Chiller efficiency is often specified in kilowatts per refrigeration ton (kW/RT). Process pump specifications that are important to consider include the process flow, process pressure, pump material, elastomer and mechanical shaft seal material, motor voltage, motor electrical class, motor IP rating and pump rating. If the cold water temperature is lower than -5 °C, then a special pump needs to be used to be able to pump the high concentrations of ethylene glycol. Other important specifications include the internal water tank size and materials and full load amperage. Control panel features that should be considered when selecting between industrial chillers include the local control panel, remote control panel, fault indicators, temperature indicators, and pressure indicators. Additional features include emergency alarms, hot gas bypass, city water switchover, and casters. [edit] Refrigerants A vapor-compression chiller uses a refrigerant internally as its working fluid. Many refrigerants options are available; when selecting a chiller, the application cooling temperature requirements and refrigerant's cooling characteristics need to be matched. Important parameters to consider are the operating temperatures and pressures. There are several environmental factors that concern refrigerants, and also affect the future availability for chiller applications. This is a key consideration in intermittent applications where a large chiller may last for 25 years or more. Ozone depletion potential (ODP) and global warming potential (GWP) of the refrigerant need to be considered. ODP and GWP data for some of the more common vapor-compression refrigerants: Refrigerant ODP GWP R-134a 0 1300 R-123 0. 012 120 R-22 0. 05 1700 R401a 0. 027 970 R404a 0 3260 R407a 0 R407c 0 1525 R408a 0. 016 3020 R409a 0. 039 1290 R410a 0 1725 R500 0. 7 R502 0. 18 5600 [edit] See also HVAC Cooling tower Evaporative cooling Chemical engineering Mechanical engineering Architectural engineering Building services engineering [edit] References ^ American Society of Heating and Refrigeration Enginneers http://www. ashrae. org/publications/page/158 ^ Hydronika supplies 5 ton chiller units http://hydronika. com

Social Media Narrative Essay Essay Example

Social Media Narrative Essay Essay Example Social Media Narrative Essay Essay Social Media Narrative Essay Essay Faults D. J. (2009). Social Media: The new hybrid element of the promotion ix. Business Horizons 52: 357-365. The author portrays how social networking can be an approach to accumulate data about the clients. Advanced dialogs have the profit of being smart as in they can record the clients conduct on a particular site by utilizing web systematic devices. By recording and dissecting web examination over the clients Internet conduct on the online networking weapon, it is conceivable to make a guide of the clients inclination. Abridging different experimental studies, the author suggested that social networking offers a suture of ease and free specialized arrangements.