What was the primary purpose of the Homestead Act of 1862?

Establishing Native American reservations

Which act required that all public facilities and services be accessible to individuals with disabilities?

Americans with Disabilities Act (ADA)

Which governmental policy aimed to improve the quality of education for minority students in the 1960s?

Elementary and Secondary Education Act

Individuals with Disabilities Education Act

What was the main objective of the War on Poverty initiated in the 1960s?

To reduce poverty in the United States

Which policy established federal support for public education, particularly in science and mathematics, during the Cold War?

Elementary and Secondary Education Act

What was the major goal of the Voting Rights Act of 1965?

To eliminate barriers to voting for African Americans

To restrict voting to landowners

What was one major outcome of the Voting Rights Act of 1965?

Increased voter registration among African Americans

Decreased voter turnout overall

Creation of the Electoral College

Implementation of the ballot measure system

What event prompted the introduction of the Voting Rights Act?

The Selma to Montgomery marches

The signing of the Civil Rights Act

What impact did the Voting Rights Act have on voter participation in the United States?

It significantly increased voter turnout among minorities.

It restricted voting rights to only citizens over 30

It eliminated the need for registration

It decreased overall voter turnout

What major change did the Voting Rights Act implement regarding literacy tests?

It banned literacy tests as a requirement to vote.

It required literacy tests only for non-English speakers

It made literacy tests mandatory for all voters

It allowed states to set their own literacy standards

What was a primary purpose of the Servicemen's Readjustment Act of 1944, commonly known as the GI Bill of Rights?

To provide veterans with education and housing benefits

To establish a national healthcare system

To create new job opportunities in foreign countries

Which of the following benefits was NOT provided by the GI Bill of Rights?

Unemployment insurance for lifetime

Tuition assistance for education

Financial support for starting a business

How did the GI Bill of Rights impact higher education in the United States?

Increased college enrollment significantly

Restricted access to education for minorities

Eliminated tuition costs for all students

Decreased funding for public colleges

What was one significant outcome of the Immigration and Nationality Act of 1965 (Hart-Celler Act)?

It abolished the national origins quota system.

It limited immigration exclusively to European countries.

It made it easier for illegal immigrants to gain citizenship.

It established strict immigration quotas based on nationality.

Which group benefited the most from the Immigration and Nationality Act of 1965 (Hart-Celler Act)?

Individuals from Asia and Latin America.

Individuals from Europe exclusively.

What was the primary aim of the Immigration and Nationality Act of 1965 (Hart-Celler Act)?

To eliminate discrimination in immigration policies based on national origin.

To establish a lottery system for immigration.

To create new pathways for refugees only.

To increase the number of immigrants from Europe.

How did the Immigration and Nationality Act of 1965 (Hart-Celler Act) change the demographic composition of the United States?

It increased immigration from non-European countries.

It restricted immigration to people from Africa only.

It favored immigration from only Central and South America.

It decreased the overall number of immigrants.

What was one significant impact of the Immigration and Nationality Act of 1965 (Hart-Celler Act) on U.S. society?

It contributed to the growth of cultural diversity in the U.S.

It led to the establishment of a national language.

It decreased the number of immigrants seeking asylum.

It caused a uniformity in cultural practices across the country.

What was a primary objective of the Immigration Reform and Control Act of 1986?

To provide legal status to certain undocumented immigrants

To increase restrictions on legal immigration

To deport all undocumented immigrants

To abolish immigration altogether

What was a significant consequence of the Immigration Reform and Control Act of 1986?

It legalized over 2.7 million undocumented immigrants

It reduced the number of refugees allowed into the U.S.

It eliminated all visa categories

It mandated employer sanctions for hiring undocumented workers

What was a major goal of the amnesty provisions in the Immigration Reform and Control Act of 1986?

To allow undocumented immigrants a chance to apply for legal residency

To reduce workplace protections for immigrants

To grant citizenship automatically to all immigrants

To increase deportation rates for undocumented individuals

What is the primary goal of affirmative action policies?

To promote equal opportunities for historically marginalized groups

To eliminate all forms of competition

To prioritize economic status over race

Which of the following is a common argument in favor of affirmative action?

It helps to rectify historical injustices

It ensures that everyone gets the same outcome

It only benefits wealthy individuals

It eliminates the need for education

What is one significant impact of affirmative action in higher education?

Increased enrollment of minority students

Limitations on financial aid for all students

Reduced diversity among faculty

What is a potential benefit of affirmative action for society as a whole?

It fosters a more inclusive and diverse environment

It standardizes education for all students

It eliminates all social inequalities

It restricts opportunities for certain groups

Which of the following best describes a goal of affirmative action in the workplace?

To eliminate biases in hiring and promotions

To maintain the status quo in employment practices

To hire only individuals from minority groups

To guarantee job positions regardless of qualifications

What was the purpose of the Freedom Riders during the Civil Rights Movement?

To challenge segregated bus terminals

To organize sit-ins at restaurants

To establish new civil rights laws

What was the main goal of the March on Washington for Jobs and Freedom in 1963?

To advocate for civil and economic rights for African Americans

To celebrate African American culture

What was the primary goal of the Congress for Racial Equality (CORE)?

To promote civil rights and racial equality through nonviolent protest

To support segregation in the South

To establish a separate nation for African Americans

Which famous event did the Congress for Racial Equality (CORE) help organize in 1963?

The March on Washington for Jobs and Freedom

What was a key strategy used by the Congress for Racial Equality (CORE) during the Civil Rights Movement?

Political lobbying at the federal level

What was one of the main goals of the NAACP when it was established?

To fight against racial discrimination and promote civil rights

To establish separate schools for Black students

To create a military unit for African Americans

What was the first major victory of the NAACP in the fight against segregation?

The Supreme Court ruling in Brown v. Board of Education

5.10 Changes in American Culture Brought About by Governmental Policies

“There’s No Such Thing as Sound Science” by By Christie Aschwanden was a lead science writer for FiveThirtyEight. FiveThirtyEight, Science, Dec. 6, 2017 Science is being turned against itself. For decades, its twin ideals of transparency and rigor have been weaponized by those who disagree with results produced by the scientific method. Under the Trump administration, that fight has ramped up again. In a move ostensibly meant to reduce conflicts of interest, Environmental Protection Agency Administrator Scott Pruitt has removed a number of scientists from advisory panels and replaced some of them with representatives from industries that the agency regulates. Like many in the Trump administration, Pruitt has also cast doubt on the reliability of climate science. For instance, in an interview with CNBC, Pruitt said that “measuring with precision human activity on the climate is something very challenging to do.” Similarly, Trump’s pick to head NASA, an agency that oversees a large portion the nation’s climate research, has insisted that research into human influence on climate lacks certainty, and he falsely claimed that “global temperatures stopped rising 10 years ago.” Kathleen Hartnett White, Trump’s nominee to head the White House Council on Environmental Quality, said in a Senate hearing last month that she thinks we “need to have more precise explanations of the human role and the natural role” in climate change. The same entreaties crop up again and again: We need to root out conflicts. We need more precise evidence. What makes these arguments so powerful is that they sound quite similar to the points raised by proponents of a very different call for change that’s coming from within science. This other movement strives to produce more robust, reproducible findings. Despite having dissimilar goals, the two forces espouse principles that look surprisingly alike: Science needs to be transparent. Results and methods should be openly shared so that outside researchers can independently reproduce and validate them. The methods used to collect and analyze data should be rigorous and clear, and conclusions must be supported by evidence. These are the arguments underlying an “open science” reform movement that was created, in part, as a response to a “reproducibility crisis” that has struck some fields of science.1 But they’re also used as talking points by politicians who are working to make it more difficult for the EPA and other federal agencies to use science in their regulatory decision-making, under the guise of basing policy on “sound science.” Science’s virtues are being wielded against it. What distinguishes the two calls for transparency is intent: Whereas the “open science” movement aims to make science more reliable, reproducible and robust, proponents of “sound science” have historically worked to amplify uncertainty, create doubt and undermine scientific discoveries that threaten their interests. “Our criticisms are founded in a confidence in science,” said Steven Goodman, co-director of the Meta-Research Innovation Center at Stanford and a proponent of open science. “That’s a fundamental difference — we’re critiquing science to make it better. Others are critiquing it to devalue the approach itself.” Calls to base public policy on “sound science” seem unassailable if you don’t know the term’s history. The phrase was adopted by the tobacco industry in the 1990s to counteract mounting evidence linking secondhand smoke to cancer. A 1992 Environmental Protection Agency report identified secondhand smoke as a human carcinogen, and Philip Morris responded by launching an initiative to promote what it called “sound science.” In an internal memo, Philip Morris vice president of corporate affairs Ellen Merlo wrote that the program was designed to “discredit the EPA report,” “prevent states and cities, as well as businesses from passing smoking bans” and “proactively” pass legislation to help their cause. The sound science tactic exploits a fundamental feature of the scientific process: Science does not produce absolute certainty. Contrary to how it’s sometimes represented to the public, science is not a magic wand that turns everything it touches to truth. Instead, it’s a process of uncertainty reduction, much like a game of 20 Questions. Any given study can rarely answer more than one question at a time, and each study usually raises a bunch of new questions in the process of answering old ones. “Science is a process rather than an answer,” said psychologist Alison Ledgerwood of the University of California, Davis. Every answer is provisional and subject to change in the face of new evidence. It’s not entirely correct to say that “this study proves this fact,” Ledgerwood said. “We should be talking instead about how science increases or decreases our confidence in something.” The tobacco industry’s brilliant tactic was to turn this baked-in uncertainty against the scientific enterprise itself. While insisting that they merely wanted to ensure that public policy was based on sound science, tobacco companies defined the term in a way that ensured that no science could ever be sound enough. The only sound science was certain science, which is an impossible standard to achieve. “Doubt is our product,” wrote one employee of the Brown & Williamson tobacco company in a 1969 internal memo. The note went on to say that doubt “is the best means of competing with the ‘body of fact’” and “establishing a controversy.” These strategies for undermining inconvenient science were so effective that they’ve served as a sort of playbook for industry interests ever since, said Stanford University science historian Robert Proctor. The sound science push is no longer just Philip Morris sowing doubt about the links between cigarettes and cancer. It’s also a 1998 action plan by the American Petroleum Institute, Chevron and Exxon Mobil to “install uncertainty” about the link between greenhouse gas emissions and climate change. It’s industry-funded groups’ late-1990s effort to question the science the EPA was using to set fine-particle-pollution air-quality standards that the industry didn’t want. And then there was the more recent effort by Dow Chemical to insist on more scientific certainty before banning a pesticide that the EPA’s scientists had deemed risky to children. Now comes a move by the Trump administration’s EPA to repeal a 2015 rule on wetlands protection by disregarding particular studies. (To name just a few examples.) Doubt merchants aren’t pushing for knowledge, they’re practicing what Proctor has dubbed “agnogenesis” — the intentional manufacture of ignorance. This ignorance isn’t simply the absence of knowing something; it’s a lack of comprehension deliberately created by agents who don’t want you to know, Proctor said.2 In the hands of doubt-makers, transparency becomes a rhetorical move. “It’s really difficult as a scientist or policy maker to make a stand against transparency and openness, because well, who would be against it?” said Karen Levy, researcher on information science at Cornell University. But at the same time, “you can couch everything in the language of transparency and it becomes a powerful weapon.” For instance, when the EPA was preparing to set new limits on particulate pollution in the 1990s, industry groups pushed back against the research and demanded access to primary data (including records that researchers had promised participants would remain confidential) and a reanalysis of the evidence. Their calls succeeded and a new analysis was performed. The reanalysis essentially confirmed the original conclusions, but the process of conducting it delayed the implementation of regulations and cost researchers time and money. Delay is a time-tested strategy. “Gridlock is the greatest friend a global warming skeptic has,” said Marc Morano, a prominent critic of global warming research and the executive director of ClimateDepot.com, in the documentary “Merchants of Doubt” (based on the book by the same name). Morano’s site is a project of the Committee for a Constructive Tomorrow, which has received funding from the oil and gas industry. “We’re the negative force. We’re just trying to stop stuff.” Some of these ploys are getting a fresh boost from Congress. The Data Quality Act (also known as the Information Quality Act) was reportedly written by an industry lobbyist and quietly passed as part of an appropriations bill in 2000. The rule mandates that federal agencies ensure the “quality, objectivity, utility, and integrity of information” that they disseminate, though it does little to define what these terms mean. The law also provides a mechanism for citizens and groups to challenge information that they deem inaccurate, including science that they disagree with. “It was passed in this very quiet way with no explicit debate about it — that should tell you a lot about the real goals,” Levy said. But what’s most telling about the Data Quality Act is how it’s been used, Levy said. A 2004 Washington Post analysis found that in the 20 months following its implementation, the act was repeatedly used by industry groups to push back against proposed regulations and bog down the decision-making process. Instead of deploying transparency as a fundamental principle that applies to all science, these interests have used transparency as a weapon to attack very particular findings that they would like to eradicate. Now Congress is considering another way to legislate how science is used. The Honest Act, a bill sponsored by Rep. Lamar Smith of Texas,3 is another example of what Levy calls a “Trojan horse” law that uses the language of transparency as a cover to achieve other political goals. Smith’s legislation would severely limit the kind of evidence the EPA could use for decision-making. Only studies whose raw data and computer codes were publicly available would be allowed for consideration. That might sound perfectly reasonable, and in many cases it is, Goodman said. But sometimes there are good reasons why researchers can’t conform to these rules, like when the data contains confidential or sensitive medical information.4 Critics, which include more than a dozen scientific organizations, argue that, in practice, the rules would prevent many studies from being considered in EPA reviews.5 It might seem like an easy task to sort good science from bad, but in reality it’s not so simple. “There’s a misplaced idea that we can definitively distinguish the good from the not-good science, but it’s all a matter of degree,” said Brian Nosek, executive director of the Center for Open Science. “There is no perfect study.” Requiring regulators to wait until they have (nonexistent) perfect evidence is essentially “a way of saying, ‘We don’t want to use evidence for our decision-making,’” Nosek said. Most scientific controversies aren’t about science at all, and once the sides are drawn, more data is unlikely to bring opponents into agreement. Michael Carolan, who researches the sociology of technology and scientific knowledge at Colorado State University, wrote in a 2008 paper about why objective knowledge is not enough to resolve environmental controversies. “While these controversies may appear on the surface to rest on disputed questions of fact, beneath often reside differing positions of value; values that can give shape to differing understandings of what ‘the facts’ are.” What’s needed in these cases isn’t more or better science, but mechanisms to bring those hidden values to the forefront of the discussion so that they can be debated transparently. “As long as we continue down this unabashedly naive road about what science is, and what it is capable of doing, we will continue to fail to reach any sort of meaningful consensus on these matters,” Carolan writes. The dispute over tobacco was never about the science of cigarettes’ link to cancer. It was about whether companies have the right to sell dangerous products and, if so, what obligations they have to the consumers who purchased them. Similarly, the debate over climate change isn’t about whether our planet is heating, but about how much responsibility each country and person bears for stopping it. While researching her book “Merchants of Doubt,” science historian Naomi Oreskes found that some of the same people who were defending the tobacco industry as scientific experts were also receiving industry money to deny the role of human activity in global warming. What these issues had in common, she realized, was that they all involved the need for government action. “None of this is about the science. All of this is a political debate about the role of government,” she said in the documentary. These controversies are really about values, not scientific facts, and acknowledging that would allow us to have more truthful and productive debates. What would that look like in practice? Instead of cherry-picking evidence to support a particular view (and insisting that the science points to a desired action), the various sides could lay out the values they are using to assess the evidence. For instance, in Europe, many decisions are guided by the precautionary principle — a system that values caution in the face of uncertainty and says that when the risks are unclear, it should be up to industries to show that their products and processes are not harmful, rather than requiring the government to prove that they are harmful before they can be regulated. By contrast, U.S. agencies tend to wait for strong evidence of harm before issuing regulations. Both approaches have critics, but the difference between them comes down to priorities: Is it better to exercise caution at the risk of burdening companies and perhaps the economy, or is it more important to avoid potential economic downsides even if it means that sometimes a harmful product or industrial process goes unregulated? In other words, under what circumstances do we agree to act on a risk? How certain do we need to be that the risk is real, and how many people would need to be at risk, and how costly is it to reduce that risk? Those are moral questions, not scientific ones, and openly discussing and identifying these kinds of judgment calls would lead to a more honest debate. Science matters, and we need to do it as rigorously as possible. But science can’t tell us how risky is too risky to allow products like cigarettes or potentially harmful pesticides to be sold — those are value judgements that only humans can make.

1. Battle of Lexington At the Battle of Lexington in 1775, British soldiers and colonial militia faced each other on the village green. A shot was fired, but no one knows for sure who fired first. Even so, this moment is often called the beginning of the American Revolution. Why is the Battle of Lexington still considered the start of the American Revolution, even though it is unclear who fired the first shot? A. It marked the first time colonists and British soldiers fought in open battle B. It proved that colonists planned the war long before the fighting began C. It showed that British soldiers were fully responsible for starting the war D. It confirmed that colonists had already declared independence from Britain 2. Battle of Concord After the fighting at Lexington, British troops marched to Concord to destroy colonial supplies. Instead, colonial militia gathered and fought back, forcing the British to retreat toward Boston. Why is the Battle of Concord considered an important turning point in the early American Revolution? A. It showed that colonial militias could organize and successfully push back British troops B. It proved that the British army had already lost control of all the colonies C. It confirmed that the colonies had officially declared independence from Britain D. It demonstrated that foreign countries were already helping the colonial forces 3. Second Continental Congress Much of the early violent conflict between colonists and British soldiers took place in Boston. After fighting broke out at Lexington and Concord near Boston, colonial leaders met at the Second Continental Congress in 1775 to decide what to do next. Which answer best describes the main actions taken by the Second Continental Congress? A. They created an army, chose a leader, and tried to avoid war with Britain B. They declared independence, wrote the Constitution, and ended the war C. They raised taxes, formed a monarchy, and supported British rule D. They ended slavery, gave women rights, and expanded voting laws 4. Olive Branch Petition In 1775, colonial leaders sent a letter called the Olive Branch Petition to King George III of Britain. Based on this situation, what was the main purpose of the Olive Branch Petition sent to the king? A. To ask the king to restore peace between both sides B. To declare independence from Britain and begin a new nation C. To request help from foreign countries in the war effort D. To organize protests against British taxes across the colonies 5. Battle of Bunker Hill On June 17, 1775, during the Battle of Bunker Hill in Boston, colonial forces fought against the British on a hill overlooking the city. The fighting was intense and led to heavy losses on both sides. Which statement best explains why the Battle of Bunker Hill was an important battle in the war? A. The colonists won the battle, showing they were stronger than British forces B. The colonists won the battle, showing the British that the war would be short and easy for the colonists C. The British won the battle, showing the war would be difficult and costly for both sides D. The British won the battle, showing British forces could defeat the colonists easily 6. Pamphlets During the American Revolution, pamphlets were short printed writings that were inexpensive to produce and often written in everyday language so many colonists could read them. How did these features of pamphlets most affect their role in the American Revolution? A. They helped spread ideas widely, allowing more colonists to form and share opinions B. They limited ideas to educated leaders, keeping most colonists uninvolved C. They replaced newspapers entirely, becoming the only source of information D. They prevented disagreement, causing most colonists to think the same way 7. Thomas Paine’s Common Sense In 1776, Thomas Paine published Common Sense, a widely read piece of writing about the relationship between the colonies and Britain. How did this pamphlet most influence colonial thinking during the American Revolution? A. It encouraged colonists to support independence from Britain B. It convinced colonists to remain loyal to the British government C. It explained how colonial armies should organize attacks D. It described laws colonists were expected to follow 8. Declaration of Independence In July 1776, the Declaration of Independence listed complaints against King George III and explained the colonists’ ideas about government and rights. How do these parts of the Declaration of Independence work together to support the colonists’ decision? A. They connect ideas about rights to real examples, justifying separation from Britain B. They describe past events in detail, showing how the war had already ended C. They list future plans for government, explaining how leaders would be chosen D. They organize military actions, showing how the colonies planned to win 9. Washington Crosses the Delaware and Battle of Trenton In December 1776, George Washington led his army across the Delaware River and launched a surprise attack on Hessian mercenaries in Trenton. Which statement best explains why Washington’s crossing of the Delaware and the attack on Trenton was an important turning point in the war? A. It defeated British forces completely, ending the war in a short time B. It boosted morale, helping discouraged soldiers choose to keep fighting C. It brought foreign allies into the war, adding support for the colonies D. It led to independence, allowing the colonies to form a new nation 10. Battle of Saratoga In 1777, American forces defeated the British at the Battle of Saratoga, a major event during the American Revolution. Which statement best explains why the Battle of Saratoga was an important turning point in the war? A. It brought French support, helping Americans gain a strong advantage in the war B. It ended the war quickly, forcing Britain to surrender all control in the colonies C. It improved army training, helping soldiers become more skilled in future battles D. It changed leadership roles, causing new generals to take control of the army 11. Battle of Yorktown In 1781, American forces surrounded British troops at Yorktown, leading to a major moment in the American Revolution. Which statement best explains why the Battle of Yorktown was an important event in the war? A. French forces helped the Americans win, leading to the end of major fighting in the war B. Italian forces helped the British win, leading to a final victory over the American army C. German forces switched sides and helped the Americans win, leading to a final defeat for British troops D. French forces helped the British win, leading to a complete end of the war in the colonies 12. Treaty of Paris After the Battle of Yorktown, British public opinion turned against the war, and peace negotiations began. In 1783, American leaders signed the Treaty of Paris, which included agreements between the United States and Britain. Which statement best explains how the Treaty of Paris reflected the outcome of the American Revolution? A. Both sides made agreements, recognizing independence B. Americans gained independence, taking land without agreements C. British leaders kept control, ending the war with power D. Both sides refused compromise, continuing the war

Chapter 22 Antihypertensive Drugs Hypertension Defined (JNC-8) Pharmacology Overview 7 main categories of drugs to treat HTN Adrenergic drugs (old friend) Angiotensin-converting enzyme (ACE) inhibitors Angiotensin II receptor blockers (ARBs) Calcium channel blockers (CCBs) Diuretics Vasodilators Direct renin inhibitors A. Adrenergic Drugs: 5 Subcategories and where they act A1. Adrenergic neuron blockers (central and peripheral)- we won’t talk about this A2. Alpha1 receptor blockers (peripheral) A3. Alpha2 receptor agonists (central) A4. Beta receptor blockers (peripheral) A5. Combined α and β receptor blockers (peripheral) A2. Peripherally Acting Adrenergic DrugAlpha1 Blockers (we’ve met these) Doxazosin, prazosin, alfuzosin Block alpha1-receptors which causes BP to decrease Reduces peripheral vascular resistance and BP by dilating both arterial and venous blood vessels Main Use: benign prostatic hyperplasia (BPH) Alpha1 Blockers REMEMBER Tamsulosin (Flomax)* is an α1 blocker BUT *Tamsulosin is not used to control BP, just for BPH. A3. Centrally Acting Adrenergic DrugsAlpha 2 agonist Clonidine and methyldopa 1- Stimulate alpha2-adrenergic receptors. in the brain Decreases sympathetic outflow from the CNS which decreases NE production 2. Stimulate alpha2-adrenergic receptors in kidneys remember alpha 2 opposes alpha 1 Dilates peripheral blood vessels → lowers peripheral resistance → Results in decreased BP So ….Clonidine (Catapres) Used primarily for its ability to decrease blood pressure in an urgent setting Also use in opioid withdrawal as previously discussed Oral (multiple times a day), and topical patch formulations Do not stop abruptly as it may lead to rebound hypertension In reality, Clonidine and methyldopa Not prescribed as first-line home antiHTN drugs High incidence of unwanted adverse effects: orthostatic hypotension, fatigue, and dizziness MIGHT be uses as adjunct drugs after other drugs have failed, in conjunction with other antiHTN such as diuretics A4. Adrenergic Drugs Selective Beta 1 Blockers Metoprolol, Atenolol Reduction of HR through β1 receptor blockade (remember adrenergic blocking of this receptor???) HR results in BP Cause reduced secretion of renin = BP A4. Adrenergic Drugs Selective Beta1 Blockers Nebivolol (Bystolic) Uses: hypertension and HF Action: blocks β1 receptors and produces vasodilatation, which results in a decrease in SVR High doses loses selectivity and blocks both β1 and β2 Less sexual dysfunction All BB- Do not stop abruptly; must be tapered over 1 to 2 weeks A4. Adrenergic Drugs NONSelective Beta Blockers Propranolol Acts equally on β1 and β2 Other uses include situational anxiety associated with public speaking, test taking As mentioned on previous slide, nebivolol at high doses becomes beta nonselective A5. Dual-Action Adrenergic Drugs α1 and β Receptor Blockers Dual antihypertensive effects of reduction in heart rate (beta1 receptor blockade) and vasodilation (alpha1 receptor blockade) Examples are carvedilol (common) and labetalol (not as common) A5. Dual-Action Adrenergic Drugs α1 and β Receptor Blockers Carvedilol (Coreg) Widely used drug that is well tolerated Uses: HTN, mild to moderate HF in conjunction with digoxin, diuretics, and ACE inhibitors Contraindications: severe bradycardia or unstable HF, bronchospastic conditions such as asthma, and various cardiac conduction problems Adrenergic Drugs Indications - HTN But also for Glaucoma (topical) BPH: doxazosin, prazosin, and terazosin (2 for 1) Management of severe HF when used with cardiac glycosides and diuretics Contraindications Acute HF- have to stabilize first MOAIs- yeah doesn’t everything interact with MAOIs? Peptic ulcers Severe liver/kidney disease Asthma (with beta blockers) Adrenergic Drugs: Adverse Effects Orthostatic hypotension 1st-dose syncope Rebound hypertension with abrupt discontinuation Most common: Dry mouth, drowsiness, constipation, sedation Interactions- always check for specific drug interactions Can cause additive CNS depression with alcohol, benzodiazepines, opioids Question #1 When administering an alpha-adrenergic drug for hypertension, it is most important for the nurse to assess the patient for the development of what response? Hypotension Hyperkalemia Oliguria Respiratory distress Answer A Hypotension This is a key point in patient education These drugs have strong vasodilating properties and may cause severe hypotension, especially at the beginning of therapy. B. Angiotensin-Converting Enzyme Inhibitorsaka ACE Inhibitors or ACEi Large group of safe and effective drugs Currently are 10 ACEi Often used as first-line drugs for HF and hypertension May be combined with a thiazide diuretic, loop diuretic, or Calcium Channel Blocker (CCB) You need to understand the basics ACE Inhibitors: Review RAAS ACE converts angiotensin I, formed through the action of renin, to angiotensin II Angiotensin 2 is a potent vasoconstrictor and also induces aldosterone secretion by the adrenal glands Aldosterone stimulates sodium resorption (H20 follows Na Both act to raise BP which causes kidneys to reduce renin production ACEi= Great drug to treat HTN BUT contraindicated in pregnancy (2nd,3rd trimester due to fetal renal damage) and breastfeeding first few weeks after birth B. ACE Inhibitors - PRIL Lisinopril (Prinivil) super common, often the 1st drug Enalapril (Vasotec) also common Captopril (Capoten) great if liver disease present Benazepril (Lotensin) Fosinopril (Monopril) Perindopril (Aceon) Quinapril (Accupril) Ramipril (Altace) Trandolapril (Mavik) Primary Effects of the ACE Inhibitors Prevent Na (and H2O) resorption by inhibiting aldosterone secretion (volume reduction) (GO BACK TO RAAS DIAGRAM) blood volume decreases work of the heart preload, or the left ventricular end-diastolic volume which is important in HF ACE SUMMARY OF ACTIVITY 1) Prevent vasoconstriction caused by angiotensin 2 (2) Prevent aldosterone secretion  less sodium and water resorption Cardioprotective Effects of ACEi They slow progression of left ventricular hypertrophy (ventricular remodeling) after MI so considered cardioprotective ACE inhibitors have been shown to decrease morbidity and mortality in patients with HF Renal Protective Effects of ACEi ACE inhibitors: reduce glomerular filtration pressure by volume reduction Cardiovascular drug of choice for patients with diabetes since it helps protect kidneys by reducing pressure. Sometimes used low dose for kidney protection with DM without HTN B. ACEi Enalapril (Vasotec) Only ACEi available in both oral and IV Enalapril IV does not require cardiac monitoring Oral enalapril: prodrug (metabolized in liver) Improves patient’s chances of survival after an MI Reduces the incidence of HF B. ACEi Captopril (Capoten) Uses: prevention of ventricular remodeling after MI; reduce the risk of HF after MI Shortest half-life Must be administered multiple times throughout the day so this limits its use Not a prodrug so good for patient with liver disease Question #2 A patient with diabetes has a new prescription for the ACE inhibitor lisinopril. She questions this order because her provider has never told her that she has hypertension. What is the best explanation for this order? The doctor knows best The patient is confused This medication has cardioprotective properties This medication has a protective effect on the kidneys for patients with diabetes Answer D ACE inhibitors have been shown to have a protective effect on the kidneys because they reduce glomerular filtration pressure. This property makes them the cardiovascular drug of choice for patients with diabetes. Question #3 A patient with a history of pancreatitis and cirrhosis is also being treated for hypertension. Which drug will most likely be ordered for this patient? Clonidine Prazosin Diltiazem Captopril Answer D Captopril Captopril is not a prodrug; therefore, it does not need to be metabolized by the liver to be effective. This is an advantage in patients with liver disease. ACE Inhibitors: Adverse Effects *Dry, nonproductive cough, which reverses when therapy is stopped. This is a class effect Dizziness- Note: First-dose hypotensive effect may occur Headache & Fatigue Possible hyperkalemia ** Angioedema: rare but potentially fatal Not safe in pregnancy-are contraindicated during the second and third trimesters of pregnancy because of increased risk of fetal renal damage C. Angiotensin II Receptor Blockers(ARB) Considered an alternative to ACEi Less likely to cause a dry cough and hyper K+ that is common with ACE inhibitors Angiotensin II Receptor Blockers: Mechanism of Action Go back to RAAS diagram! ARBs affect primarily 2 places 1. Vascular smooth muscle - blocks vasoconstriction 2. Adrenal gland -Selectively blocks the binding of Ang 2 to certain Ang 2 receptors inhibiting secretion of aldosterone Lowers volume retention and BP Angiotensin II Receptor Blockers -ARTAN Losartan (Cozaar)- very common Eprosartan (Teveten) Valsartan (Diovan) Irbesartan (Avapro) Candesartan (Atacand) Olmesartan (Benicar) Telmisartan (Micardis) Azilsartan (Edarbi) C. ARB Losartan (Cozaar) Beneficial in patients with HTN and HF Used with caution in patients with kidney or liver dysfunction and in patients with renal artery stenosis ***Not safe for breastfeeding women and should not be used in pregnancy (Cat C 1st trimester, Cat D 2nd-3rd trimester), potential fetal toxicity Appear to be equally effective for the treatment of hypertension and well tolerated ARBs less likely to cause cough and hyperK+ but can still happen Evidence that ARBs are associated with lower mortality after MI than ACE inhibitors Never take ACEi and ARBs at the same time* 5. Calcium Channel Blockers (CCB) Primary use: HTN, angina, some dysrhythmias Cause smooth muscle relaxation by blocking the binding of calcium to its receptors, preventing muscle contraction Results in: Relaxed blood vessels to the heart Decreased peripheral smooth muscle tone Decreased SVResistance Decreased BP E. Diuretics First-line antiHTN in JNC 8 guidelines Decreases fluid volume The results from diuresis: preload, Peripheral resistance Overall effect  Decreased workload of the heart and decreased BP Thiazide diuretics are the most commonly used diuretics for HTN Ie hydrochlorothiazide (HCTZ), chlorthalidone We will discuss diuretics further in the chapter on diuretics F. Vasodilators Directly relax arterial or venous smooth muscle (or both) Results in: Decreased SVR Decreased afterload Peripheral vasodilation Indicated for treatment of HTN May be used in combination with other drugs F. Vasodilators Hydralazine (Apresoline) Orally: routine cases of essential hypertension Injectable: hypertensive emergencies BiDil: specifically indicated as an adjunct for treatment of HF in African-American patients F. Vasodilators Sodium Nitroprusside (Nitropress) *Sodium nitroprusside and IV diazoxide are reserved for the management of hypertensive emergencies. Contraindications: severe HF, known inadequate cerebral perfusion (especially during neurosurgical procedures) F. Vasodilators Adverse Effects Hydralazine: dizziness, headache, tachycardia, edema, dyspnea, N/V/D, vitamin B6 deficiency, rash Sodium nitroprusside: hypotension, bradycardia, decreased platelet aggregation, rash G. Direct Renin Inhibitors Aliskirin (Tekturna) Blocks the RAS pathway at the point of activation. Inhibiting renin production prevents the downstream production of Ang II (potent vasoconstrictor) Adverse effects: N/V, severe hypotension, hyponatremia, hyperkalemia… Contraindicated in patients with DM taking ACEi or ARB Miscellaneous Antihypertensives Eplerenone (Inspra) Newer class of drugs called selective aldosterone blockers (remember RAAS?) Reduces BP by blocking the actions of aldosterone at its corresponding receptors in the kidney, heart, blood vessels, and brain Indications: routine treatment of hypertension and for post-MI HF Contraindicated if serum potassium levels are high (above 5.6 mEq/L) A Special Form of HTNTreatment of Pulmonary Hypertension Sildenafil and Tadalafil Commonly used for erectile dysfunction Used for pulmonary hypertension but with different trade names Sildenafil: Revatio* (Viagra for ED) Tadalafil: Adcirca* (Cialis for ED)

Make a multiple choice quiz for my year 8 science students based on the science in this transcript from a video: 3°C 0:04 It can be the difference between snow and sleet 0:08 Wearing a jacket or not 0:11 In your day-to-day life, it may not seem significant 0:15 But 3°C of global warming would be catastrophic 0:20 Heatwaves, droughts, extreme precipitation, even fire 0:25 3°C of warming is really disastrous 0:28 The scary thing is, the world is well on its way there 0:32 Since the industrial revolution, the Earth has warmed between 1.1°C and 1.3°C 0:40 This is a problem that babies you pass in the street will have to live with 0:46 Children born today... 0:47 ...are up to seven times more likely to face extreme weather than their grandparents 0:52 If global temperatures do rise by 3°C... 0:55 ...what would their world look like? Climate change is already having devastating effects 1:03 Rising sea levels 1:05 Desertification 1:07 Hollywood has always enjoyed imagining the end of the world 1:11 While blockbusters like this are clearly fiction... 1:14 ...this film will show the scenario we all face... 1:17 ...unless more drastic measures are taken to stop burning fossil fuels 1:30 In some parts of the world the effects of inaction are already clear 1:35 The slums of Bangladesh’s capital are filling up with climate migrants 1:41 Minara comes from Bhola District, an area in southern Bangladesh 1:46 There, like many other parts of the country... 1:49 ...rivers swollen by heavier rain and melting Himalayan glaciers... 1:53 ...are washing away people’s homes 1:56 Many, like her, have lost everything 2:00 Our home in Bhola had endless amounts of land 2:03 There was lots of space for farming, we had a spacious house 2:08 There were different types of fruits, vegetation and trees growing at home 2:12 We used to eat the fruit from our own trees 2:18 I can’t eat them now because they don't exist anymore 2:21 Since the river flooded for the third time, I had to flee to Dhaka 2:26 Life was much better back home 2:29 It was unbearable to live through, truly intolerable 2:33 We didn’t have the time to save anything at all 2:38 1.1°C to 1.3°C of global warming has already transformed Minara’s life 2:45 It’s one of the reasons why so many migrants like her... 2:47 ...are moving to the city each year... 2:50 ...nearly 400,000 according to the last estimate 2:53 And climate models show there could be much worse to come How climate modelling works 3:02 Climate scientist Joeri Rogelj... 3:04 ...has spent the last ten years modelling future climate scenarios... 3:08 ...for the United Nations 3:10 The models we use to carry out this exercise... 3:13 ...really represent the state of the art... 3:15 ...of our current knowledge of climate change and where we are heading 3:19 Joeri’s projections use data collected by hundreds of scientists around the world 3:26 Here this is the 3°C level... 3:28 ...and so there is at least a one-in-four chance that under current policies... 3:32 ...we would hit 3°C by the end of the century 3:36 This is just one of the scenarios Joeri looks at 3:40 Another one imagines that all policy promises are kept 3:44 The most optimistic assumes that all promises have been kept... 3:47 ...and net-zero targets are met 3:50 Where our best estimate ends up around 2°C at the end of the century... 3:54 ...there is still a one-in-20 chance that we end up with 3°C instead 3:59 One would not be entering a plane if there is a one-in-20 chance... 4:03 ...that the plane will crash Nowhere is safe from global warming 4:07 A rise of 3°C would affect everyone 4:10 Even wealthy cities in rich countries wouldn’t be immune to the consequences 4:15 European capitals like Paris and Berlin... 4:18 ...would bake under more extreme heatwaves 4:22 Frequent storm-surges in New York could turn parts of the city desolate 4:27 In many ways, cities magnify, intensify climate events 4:33 Cities are hotter than the places around them... 4:36 ...they tend to be more vulnerable to flooding 4:39 And you can get a really bad event in a city in a way that you can’t in the countryside 4:46 And because of their denser populations... 4:49 ...disasters in a city affect far more people 4:52 Some cities might be badly prepared for the changes coming 4:56 But they have the means to adapt 4:59 Cities tend to be wealthier than surrounding places 5:03 They have a lot of amenities 5:05 A city that has taken seriously the risks of a 3°C world... 5:08 …wouldn’t necessarily be a worse place to be in a 3°C world 5:12 But a city that hasn’t prepared for these sort of eventualities... 5:16 ...that might be a really nasty place The impact of prolonged droughts 5:20 So far, many developed cities have got off lightly... 5:24 ...but some rural parts of the world are suffering disproportionately 5:29 Smallholders—small-scale farmers—are particularly vulnerable to climate change 5:35 And there are over 600 million around the world 5:38 Smallholders with farms under two hectares... 5:40 ...produce around a third of the global food supply 5:46 Central America’s “Dry Corridor”... 5:48 ...supports a mix of smallholdings and medium-sized farms 5:53 Sandwiched between the Pacific Ocean and the Caribbean Sea... 5:56 ...the area is prone to droughts 6:08 Israel Ramírez Rivera is a smallholder in Guatemala 6:12 Here, climate change is making the dry seasons longer, and more severe 6:18 This is the biggest ear of maize that this plot could deliver 6:23 He depends on his crops of corn and beans 6:26 But they’re getting harder to grow 6:30 The surrounding mountains... 6:32 ...used to provide us with native food... 6:38 ...and now that isn’t an option anymore... 6:41 ...due to climate change and its effects 6:46 Nearly two-thirds of the smallholders in the Dry Corridor now live in poverty 6:52 The impact of all of this for us... 6:59 ...malnutrition among children 7:03 We’ve lost a few 7:07 For my crops especially, the midsummer heat is harder than before 7:16 The plant dries up and can’t provide us... 7:19 ...with the necessary food provision 7:24 Severe droughts in Central America... 7:26 ...are now four times more likely than they were last century 7:30 Many families from here have gone to the States 7:37 The economic despair and debts... 7:44 ...have pushed many people from this community to do this journey 7:53 Migration from Guatemala to the United States has quadrupled since 1990 7:59 Not all of this has been due to climate change 8:02 But longer droughts would force even more to move 8:05 In a 3°C world, annual rainfall in this region... 8:09 ...could drop by up to 14% 8:12 At 3°C, over a quarter of the world’s population... 8:16 ...could endure extreme droughts for at least a month of the year 8:19 Northern Africa could see droughts that last for years at a time Rising sea levels, storm surges and flooding 8:24 But for some, too much water will be the problem 8:29 10% of the world’s population lives on a coastline... 8:32 ...that’s less than 10 metres above sea level 8:35 For these coastal inhabitants, a 3°C world would spell disaster 8:40 By 2100, global sea levels could have climbed by half a metre from 2005 levels 8:46 Low-lying cities like Lagos would be especially vulnerable... 8:49 ...with up to up to a third of the population displaced 8:54 And in Fiji, rising waters are already upending lives 9:04 You can see the graveyard there, it’s all under water now... 9:08 ...due to this rising sea level and climate change 9:15 The village of Togoru in Fiji is being swallowed by the sea 9:19 Barney Dunn, the village headman, has seen over half the village disappear 9:24 Relatives’ houses have been abandoned, and family graves are now under water 9:29 We have been asked by the government to relocate... 9:32 ...but no one wants to relocate... 9:34 ...because we have our great-great-grandparents down there in the sea 9:39 This is the place we’ve been brought up in 9:41 ...it’s not easy to leave 9:44 Past attempts to build a seawall haven’t worked 9:48 But Barney sees building a new one as the village’s only hope 9:52 If they do that, maybe we can save whatever is left 9:56 But if we don’t have the seawall, then it will be keep eroding and time will come... 10:01 ...maybe in ten,15 years, Togoru will be all eroded 10:05 Rising seas also mean storms cause more floods 10:11 And many more countries could suffer 10:14 The Philippines and Myanmar are just two countries... 10:17 ...that will also see an increase in storm surges in a 3°C world 10:21 To escape, many will move… 10:24 …often, to urban areas Extreme heat and wet-bulb temperatures 10:27 Half the world’s population already lives in cities... 10:31 ...almost a third in slums 10:36 For them, a 3°C world could be deadly 10:40 Minara has moved to Dhaka to escape the impact of climate change 10:44 But life could get even worse for her 10:47 I’m struggling a lot nowadays 10:49 The heat during the day is unbearable 10:52 Even late at night it doesn’t cool down 10:57 The heat is getting more intense every day 10:59 I mean, it’s going to get much worse 11:03 I can barely survive it now, how will I live through it in the future? 11:08 Dhaka is getting hotter 11:11 In the last 20 years the average daytime temperature... 11:13 ...has crept up by nearly half a degree 11:17 Days that approach 40°C are now being reported 11:20 And high so-called wet-bulb temperatures are on the rise 11:26 A wet-bulb temperature is a measure of heat and humidity 11:30 Humans cool themselves by sweating… 11:32 But in these conditions, when relative humidity is near 100%... 11:36 ...sweat doesn’t evaporate well 11:38 So people can’t cool down… 11:41 ...even if given unlimited shade and water 11:45 At a high wet-bulb temperature, the body can’t lose heat... 11:49 ...and so it gets hotter and hotter... 11:51 ...and the body is designed to work at a given temperature 11:53 And if it gets too hot inside, you will die 11:58 The human limit for wet-bulb temperatures is 35°C... 12:02 ...around skin temperature 12:04 Dhaka will have a much higher chance... 12:05 ...of reaching dangerous wet-bulb temperatures... 12:07 ...if global warming reaches 3°C 12:12 You can’t really adapt to that 12:14 You have to get out. If the temperature is so high that you can’t work... 12:20 ...can’t do hard manual labour outside for significant parts of the year... 12:25 ...then many places will become functionally no longer part of the economy 12:33 Jacobabad in Pakistan, and Ras al Khaimah, in the United Arab Emirates... 12:37 ...have already recorded deadly wet-bulb temperatures 12:40 More of the tropics and the Persian Gulf... 12:43 ...as well as parts of Mexico and the south-eastern United States... 12:47 ...could all get to this threshold by the end of the century 12:50 Climate modelling might show us the weather Increased migration and conflict 12:52 But it doesn’t show us its other effects on society 12:56 Established migration patterns could change 12:59 Climate disasters may exacerbate reasons people cross borders 13:03 Within countries, more people will move to cities 13:07 In a 3°C world, tens of millions of people a year... 13:10 ...could be displaced by disasters made worse by climate change 13:15 When people are displaced by climate... 13:18 …they may well go to cities... 13:19 ...because cities are the places that attract people from the countryside already 13:25 A lot of people who can get to the developed world... 13:28 ...not least because the developed world tends to be less hot, will give that a go 13:35 As migration around the world increases... 13:38 ...there could be more competition for fewer resources 13:42 Water—already a highly contested resource—will be a focal point 13:47 Turkey’s new Ilisu dam has reduced the flow of water into Iraq 13:53 China lays claim to rivers vital to India and Pakistan 13:57 The prospect of a water-conflict makes people very uneasy 14:03 How national tensions would exacerbate those sorts of reactions... 14:08 ...in a 3°C world... 14:09 ...is the sort of thing that no one should really want to find out 14:14 I think you’d have to be incredibly sanguine... 14:16 ...not to think that the sort of climate extremes that we talk about... 14:19 ...in a 3°C world wouldn’t lead some places... 14:22 ...to the brink of societal collapse 14:25 Those lucky enough to escape unrest... Adaptation and mitigation are crucial 14:28 ...would still have to adapt to a radically different world 14:32 People can adapt to climate change in all sorts of ways, one of the most obvious ones... 14:37 ...is air conditioning 14:39 But other ways to adapt at a local or regional level... 14:42 ...I mean, one of the most obvious is diversifying agriculture 14:47 There are physical things you can do, like seawalls 14:52 The fact that people can adapt and that adaptation will reduce suffering... 14:57 ...doesn’t mean that it will eliminate suffering 15:00 Suffering is built into this whole process of heating up the planet 15:06 Adaptation will only get the world so far 15:09 The best way to deal with a 3°C world... 15:12 ...is not to go to a 3°C world 15:14 And that’s why increasing efforts on mitigation are important 15:17 It’s why working towards negative emissions... 15:20 ...that could bring down the temperature after it peaks are important 15:25 Once you get to a 3°C world, you are in real bad global trouble 15:33 The scale of change needed... 15:35 ...and the slow progress of governments so far... 15:38 ...means 3°C of warming is uncomfortably likely unless more is done 15:44 Despite existing pledges, greenhouse-gas emissions... 15:48 ...are still set to rise by 16% from 2010 levels by 2030 15:54 The need to act has never been clearer 15:57 There’s still time to reduce emissions, so that a 3°C world remains fiction... 16:02 ...rather than becoming fact

1.1945-1949: The immediate years after the Second World War ● At the end of 1945, Mao Zedong had come to see the USA as the greatest threat to his aspirations. a. He understood that East Asians were looking to the USA as the true liberator from Japanese imperialism. b. The USA’s support for the Kuomintang(KMT) and the restoration of U.S. authority in formerly Japanese Manchuria clashed with the CCP’s plans to use the region for its own needs in the impending civil war between the CCP and the GMD. ■ To compound matters, while the KMT was recognised internationally as the official government in China, Mao and the CCP saw the party as a puppet of U.S. imperialism. ● While Mao saw the USA as the greater threat to the CCP’s plans, Soviet actions also frustrated him. a. The USSR provided minimal and incoherent support for the Chinese Communists in Yan’an and Manchuria. b. Stalin also attempted to extract territorial and economic concessions from the Guomindang government in the Friendship and Alliance Treaty China signed in August 1945 under American and Soviet pressure in exchange for Soviet entry into the Second World War against Japan. ● The emerging superpower conflict over Europe and over American intervention in the impending civil war in China led to Mao’s ideological perception of the 8838/01 H1 History Paper 1 Theme II: The Cold War and East Asia (1945-1991) \ Page | 8 USA as an aggressive imperialist power that was hostile towards other countries, especially the USSR and China. ● In 1946, Mao promoted the theory of the intermediate zone, which envisioned a global united front against American imperialism. a. Mao saw the emerging superpower conflict as an American-Soviet contest for the intermediate zones, the capitalist, colonial and semi- colonial countries of West Europe, Africa, and Asia. b. Mao believed that the USSR was the defender of world peace. c. The intermediate zone, which included China, would not be part of the socialist camp. d. Despite the tremendous potential that U.S. aid held for China’s reconstruction, Mao’s ideological worldview and the impending civil war against the Guomindang prevented him from seeking normalised relations with the USA. In 1949, Mao decided to lean towards the side of the USSR despite two decades of unreliable support from them. e. Mao saw the anti-bourgeois campaigns in East Europe as evidence that China should isolate capitalist-bourgeois forces within it.2 f. Stalin had expelled Yugoslavia from the socialist camp as its leader, Tito was seen to have directly challenged Stalin’s authority. ■ Mao thus saw it as imperative to stress close unity to the USSR lest he was seen as a second Josip Broz Tito. At the same time, Mao sought a loose partnership with the USSR because Mao believed that China should preserve a high measure of self- reliance and zili gengsheng (自力更生) (regeneration through one’s own efforts). ● When the People’s Republic of China was formed on 1 October, 1949, relations between China’s and the USSR’s communists had improved substantially. a. However, the Chinese Communist Party (CCP) was also aware that the USSR never treated Chinese interests as a priority. What the CCP failed to fully understand was that Stalin ruled East Europe much like it was his empire and how this would have implications for China. b. In Mao’s first visit to the USSR in December 1949, Stalin was non- committal regarding the interests raised by the Chinese, and treated Mao as an underling as he feared that closer relations with the PRC would cause the USSR to lose privileges gained from the KMT. _________________________ 2 What Mao did not realise at that point was that the anti-bourgeois campaigns in East European countries were part of Stalin’s intentional design to consolidate the power of communists in them. 8838/01 H1 History Paper 1 Theme II: The Cold War and East Asia (1945-1991) \ Page | 9 A note on Sino-American relations 2. Early 1950: The USA’s hands-off policy towards Taiwan begins to change ● By early 1950, the Truman administration had written off Taiwan and believed it was only a matter of time before the island fell to the PLA. ● Two events in early 1950 changed the USA’s position on East Asia. ○ The formation of the USSR-PRC alliance in February 1950 ○ The North Korean invasion of South Korea in June 1950 3. 1950: The Sino-Soviet Friendship, Alliance and Mutual Assistance Treaty ● Signed on 14 February, 1950. 3.1Implications for Sino-Soviet relations ● Stalin saw it as a means to get concessions that he had failed to get from the Kuomintang (KMT) government in 1945. ● For Mao and the newly founded People’s Republic of China (PRC), the alliance would provide security against U.S. imperialism and allow the PRC to get economic aid for reconstruction from the USSR. ● The Chinese realised soon after the 1950 treaty had been signed that the Soviet Union was intent on exploiting the agreement in its own favour. 8838/01 H1 History Paper 1 Theme II: The Cold War and East Asia (1945-1991) \ Page | 10 ● The Sino-Soviet alliance was officially directed against Japanese militarism and its allies, especially the USA. ● The Sino-Soviet alliance comprised three elements: party, military and economic relations. ○ Party: The Chinese Communist Party (CCP) was included in the customs of communist party internationalism, such as regular exchange of party delegations to congresses of the fraternal parties in Stalin’s socialist camp. ■ This move was meant to bring the PRC’s ideological beliefs about communism into greater alignment with the USSR’s. ○ Military: The alliance was supposed to provide the newly formed and weak PRC with a strategic deterrent and military aid against the USA on three fronts: Guomindang-held Taiwan, divided Korea, and Vietnam where France attempted to reestablish its colonial control. ■ Convinced that the USA would aggressively seek ways to undermine the CCP-led PRC through Taiwan, Korea and Vietnam, Mao sought an active defence. ● While in Moscow, Mao unsuccessfully asked Stalin to provide military assistance for the liberation of Taiwan. ● At the beginning of 1950, the PRC delivered large-scale military aid to Hanoi. The PRC was the first country to grant the communist-led Democratic Republic of Vietnam diplomatic recognition on 18 January 1950; Mao persuaded Stalin to do so on 30 January 1950. ● The PRC committed itself to North Korea, where Mao saw the commitment to North Korea both as a defence against U.S. imperialism and as support for a fellow communist country. ○ Economic: During Mao’s first stay in Moscow, Stalin had personally promised the delivery of fifty projects for primary industrialisation. ■ The agreement also led to a series of supplementary ones, such as a US$ 300 million loan that the PRC would repay with a mixture of strategic materials, rubber, agricultural products, goods for daily use and hard currency. ■ Significantly, Stalin used Soviet military and economic aid to extract concessions similar to those he failed to get from the Guomindang government in 1945. ■ The USSR and PRC would disagree on the pace and extent of the PRC’s planned development. ● In the last five weeks of Stalin’s life in early 1953, he attempted to pressure the PRC to reduce the planned 8838/01 H1 History Paper 1 Theme II: The Cold War and East Asia (1945-1991) \ Page | 11 development speed to a mere annual growth of 13-14 percent, and to plan individual projects in detail beforehand. These moves would potentially result in the PRC’s economy growing at a slower rate than initially projected. ● However, after Stalin’s death on 5 March 1953, the PRC’s Zhou Enlai decided to use his visit of condolence to the USSR to press forward negotiations. ○ When talks resumed in 1 April 1953, Beijing pressed for 150 Soviet industrial projects, but Moscow reduced them to 91 on the basis of insufficient data provided by the Chinese. ■ The economic disarray after China’s civil war and the economic pressures that came with the Korean War influenced recovery and reconstruction in the early years of the PRC. ● Despite the PRC being unable to tap into Soviet economic assistance immediately, mutual trade between China and the USSR nevertheless increased 6.5 times from 1950 to 1956. ● Together with the 50 projects promised by Stalin in 1950, the final version of the First FYP for the PRC included 141 Soviet and 68 East European projects in a total of 649 planned. Three thousand Soviet advisers sent to China in subsequent years were directly linked to the First FYP. ● By 1955, over 60 percent of China’s goods exchange was with the USSR. ● Soviet economic assistance to China added up to the largest foreign development venture in the socialist camp ever. ○ The total number of planned projects amounted to between 300 and 360 projects. ○ However, the number of total finished projects ranged between 134 and 150. ● Transfers of knowledge and expertise were important to China’s economic development. ○ A study on Soviet experts counts 1,445 political advisers and 9,313 technical specialists sent to China until their sudden withdrawal in mid-1960. ■ For political reasons, the gradual withdrawal of advisers began after late 1956.

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