what is pressure group

a pressure group is a group of people with a common interest coming together to achieve a common goal

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Business growth, economies of scale, diseconomies of scale, changes in aims and objectives, globalisation, ethical considerations, environmental influences, pressure groups, tariffs, trade blocs, imports, exports, loan capital, share capital, retained profit, fixed assets, public limited companies, mergers, takeovers,

President Xi Jinping, who is also general secretary of the Communist Party of China Central Committee and chairman of the Central Military Commission, visits Luoyang Bearing Group Co on Monday afternoon during his inspection of Luoyang, Henan province. During the visit, Xi called for continuous efforts to make the manufacturing industry even stronger to advance Chinese modernization. YAN YAN/XINHUA President Xi Jinping has stressed the importance of keeping businesses, employment, the market and expectations stable in the face of a complex international environment, saying that China will respond to various uncertainties with the certainty of its high-quality development. Xi, who is also general secretary of the Communist Party of China Central Committee and chairman of the Central Military Commission, made the remarks on Tuesday as he wrapped up a two-day fact-finding trip to Central China's Henan province. Speaking to provincial Party and government officials at a work briefing on Tuesday in Zhengzhou, the provincial capital, Xi said that high-quality development is essential to Chinese modernization. Faced with the complex external environment, it is necessary to firm up confidence, unwaveringly manage China's own affairs well, and steadfastly expand high-level opening-up, he said. He also urged Henan, one of the country's economic powerhouses, to further consolidate the foundation of its real economy, and promote the development of new quality productive forces suited to local conditions and led by technological innovation, in order to enhance the capacity of its modern industrial system to support high-quality development. When visiting Luoyang Bearing Group Co in the city of Luoyang on Monday, Xi said: "China has always adhered to the path of developing the real economy. From the past reliance on imported matches, soap and iron, to now becoming the world's largest manufacturing country with the most complete industrial categories, we have taken the right path." As a traditional manufacturing enterprise specializing in bearings, Luoyang Bearing Group's products are widely used in fields such as aerospace, construction machinery, wind power generation, rail transit, port machinery and ships. After learning about the company's efforts to accelerate the development of advanced manufacturing, Xi said that China must continue to strengthen the manufacturing sector, adhere to the principles of building self-reliance and strength, and master core technologies in key fields. "The hope is placed on you," he told the on-site workers. He also called for efforts to strengthen collaboration between industries, universities and research institutes, and cultivate a large number of high-quality talent. Despite internal challenges and increasing external shocks, China's manufacturing industry has withstood pressure and maintained stable growth. In April, the manufacturing sector saw its value-added output climb 6.6 percent year-on-year, with that of equipment manufacturing and high-tech manufacturing up 9.8 percent and 10 percent, respectively, according to data released by the National Bureau of Statistics on Monday. Advanced manufacturing is the high ground in global industrial competition and the main battlefield for technological innovation. Xi has repeatedly emphasized the need to upgrade the country's modernized industrial system, supported by advanced manufacturing. In a resolution adopted at the third plenary session of the 20th CPC Central Committee in July last year, it was clearly stated that China will move faster to advance new industrialization, promote the growth and expansion of advanced manufacturing clusters, and make the manufacturing sector higher-end, smarter and more eco-friendly. On Monday, Xi also visited the White Horse Temple, the first Buddhist temple in China, and the Longmen Grottoes, a UNESCO World Heritage site. Contact the writers at mojingxi@chinadaily.com.cn

What is a crime A crime is generally defined as an act or omission that is prohibited by criminal law Two critical ingredients of a crime are: 1) the commission of an act (Actus reus) 2) the mental intent to commit the act (Mens rea) A crime occurs when a person Commits an act or fails to commit an act when under a legal responsibility to do so Has the intent or mens rea to commit the act Does not have a legal defence or justification for committing the act and Violates a provision in criminal law The Social construction of crime Important to distinguish between behaviours that may be considered deviant by society and crimes Deviance is behaviour that is contrary to the norms and values of the larger society Crime is behaviour that breaks the law Deviance includes: Criminal behaviour and Wide range of other behaviours not against the law: May be frowned upon by the larger society What is viewed as deviant changes over time Crime includes: Social construction of crime Legal status of behaviours is not determined by behaviour itself but result of social response to the behaviour/persons/groups engaged in it Criminologists often conduct historical analyses to understand how social, economic and political environments may influence legislation Moral entrepreneurs Often play a key role in criminalizing certain activities Individuals, groups or organizations, seek action against certain groups of people/behaviours and bring pressure on legislators to enact criminal statutes The Origins and Application of the Criminal Law Differing perspectives on where criminal laws come from/ applied via the criminal justice system are reflected in two models 1) Value consensus model 2) Conflict Model Value consensus model Behaviours are defined as criminal/punishment imposed, reflect opinions/limits of tolerance Application of law, society reaffirms acceptable behaviours/social cohesion Conflict Model Crime and punishment reflect the power some groups have to influence, formulation/application of criminal law rich/privileged have an advantage in influencing law reform/criminal justice system The Canadian Legal System Is a common law system, with exception of Quebec which has a civil law system (Based on the French Code Napoleon) Common law is law based on custom, tradition, practice and generally unwritten Precedent is a judicial decision may be use as a standard in subsequent similar cases Canadian Courts Canadian courts organised in a hierarchy Supreme court of Canada is the highest court Stare decisis- principle whereby higher courts set precedents that lower courts must follow “To stand by what was decided” Like cases should be treated alike All courts below SSC bound to apply that same ruling in subsequent cases Criminal Law Body of law deals with conduct considered so harmful to society as a whole that it is prohibited by statute and prosecuted and punished by the government Functions of the Criminal Law In Canadian society, Criminal law provides the following functions Acts as a mechanism of social control Defines the parameters of acceptable behaviour Reduces the risk of personal retaliation Assists in general and specific deterrence Prosecutes criminalized behaviour Protects groups interests Principles of Canadian Law The Rule of Law The requirement that governments as well as individuals be subjected to Traced back to the English Magna Carta The essence of the rule of law is that No one person is above the law All persons are bound by the law All are entitled to protection by the law The law should be observed and enforced equally There is a standard to which criminal justice officials must adhere and will be held accountable Criminal Law Vs. Civil (Tort) Law Summary Crime is a social construction and is a reflection of changing time and mores Criminal law is not static and what behaviour legislatively defined as criminal can change overnight There are instances in which controversy arises when the criminal law is applied to issues of ethics, morality and religion The criminal law was identified as one type of public law and the functions of the criminal law were set out The rule of law and the charter of rights and freedoms are two key parts of the foundation of the criminal justice system There are several principles that also provide the foundation for Canadian law The role, principles origins and application of the criminal law were examined and a number of case studies were presented to illustrate the dynamic nature of the criminal law in a diverse society

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)

Honduras is a Central American nation bordered by Nicaragua, Guatemala, and El Salvador. The Caribbean Sea forms its northern coastline. The Pacific Ocean borders a small southern strip of land. Almanaque Nombre oficial: República de Honduras Área total: 112.090 km2 Población: 9.038.741 Ciudad capital: Tegucigalpa Moneda: lempira Lenguas: español, dialectos amerindios Early History Explorer Christopher Columbus came to Honduras in 1502 on his fourth trip to the New World. As was the case in North America, Honduras, in Central America, had been home to many native indigenous groups including the Sumu and Lenca. Some estimates suggest an indigenous population of up to 2,000,000 before the Europeans arrived. Among these indigenous groups were the Maya. Their civilization spread from the Yucatán area of Mexico to Honduras’ ancient city of Copán. Spain’s conquest of Honduras began in 1525, but it was not easy. It took until 1539 to fully conquer it. There were conflicts with the native population, who were forced into labor. Many died from disease and abuse. Others were enslaved and sent to the Caribbean islands. In addition, there were pirate attacks and in-fighting among the Spaniards. Phawat/Shutterstock Gold and silver deposits were discovered in Honduras in the 1530s, attracting more settlers. By the mid-16th century, mining was an important industry, mainly in the towns of Gracias and Comayagua. More native labor was needed, taking its toll on the dwindling indigenous population. As a solution, enslaved Africans were introduced in the 1540s. This was well before 1619, when enslaved Africans first arrived in Jamestown in the American colonies. The 17th century was filled with conflicts, primarily between the Spanish and the British. Britain wanted to establish colonies on the Caribbean coast of Honduras. They eventually seized the coast with help from the native Sambo and Miskito peoples. However, Spain later regained control. Independence In the early 1800s in Honduras, resentment toward Spain grew. One reason was that Honduras was subject to more taxes to help pay for conflicts that were happening between Spain and France. Other Spanish colonies were also increasingly resentful toward Spain. In 1776 in North America, the 13 colonies banded together to declare their independence from Britain. Similarly, Honduras joined other Central American provinces. Together, they declared independence from Spain on September 15, 1821. Honduras briefly became a part of Mexico, but in 1823, it became independent from Mexico. It then joined the United Provinces of Central America. This included other former Spanish colonies: Costa Rica, El Salvador, Guatemala, and Nicaragua. But the federation did not last, partially due to divisions in political beliefs. In 1838, Honduras declared its independence from the federation. By the early 1900s, the United States had economic interests in Honduras. American fruit corporations like the Standard Fruit Company and United Fruit Company began investing in Honduras to export bananas. To protect American investments, the United States became more involved in Honduras’ political affairs. When Nicaragua appeared to threaten the stability in Honduras, US President Taft sent forces to Honduras to protect American interests. The Great Depression caused economic havoc in the United States and elsewhere. In Honduras, this meant economic problems and political turmoil. During this time, General Tiburcio Carías Andino was elected president, in 1932. He worked to strengthen the military and pay off Honduran debt. Yet he also worked to gather and maintain his own power. He changed the constitution so that he could extend his term in office as president until 1949. His advanced age and pressure from the United States forced him to allow free elections in 1948. General Francisco Morazán In 1823, Honduras joined the United Provinces of Central America. In 1830, Tegucigalpa-born General José Francisco Morazán was elected president of the federation. He remained president until just before the federation disbanded in 1840. aalezk/Shutterstock Morazán favored liberal policies and the reduced power of the church. Morazán was a self-educated man. He recognized the importance of education and the need for schools in Honduras. He believed that girls and boys should have an equal opportunity for education. During his presidency, he tried to make improvements in education. He opened schools that were free to attend. In addition to improving education, he established a system of trial by jury. It was based on the Livingston Code, created in Louisiana. This was a set of reforms to the system of legal punishment. Today, Honduras celebrates the Day of the Honduran Soldier on October 3, Morazán’s birthday. This holiday honors Morazán for his fight for democracy, liberalism, and the nation. Modern Honduras The last half of the 20th century was a political rollercoaster. There were various coups (government takeovers), conflicts, and changing leaders. Starting in 1963, Honduras was primarily led by military governments. This continued for almost 20 years. In 1969, Honduras fought a four-day war with El Salvador. The conflict was over immigration and the shared border. Though the war was brief, the two nations didn’t sign a peace treaty until 1980. With the election of president Roberto Suazo Córdova in 1981, Honduras returned to a civilian government. In the 1980s Honduras was tangled in conflicts of Nicaragua and El Salvador, partly because of the United States. Nicaraguan Contras, who wanted to overthrow the Sandinista government in Nicaragua, were using US-approved bases in Honduras. The United States was also running training camps in Honduras for Salvadoran forces facing their own civil war. This sparked anti-American protests and a desire to reduce the US presence in Honduras. Over the next few decades, Honduras continued to experience political instability. In 2009, President Manuel Zelaya was removed from power by a military coup. People were upset because he called for a referendum to change the constitution. The international community condemned this coup. As a result, Honduras cut diplomatic ties with several countries. In 2010, the United States recognized President Porfirio Lobo Sosa as a democratically elected leader. He was followed by Juan Orlando Hernández in 2014. However, protests in 2015 called for his resignation over claims of campaign fraud. In 2017, Orlando Hernández was re-elected in a disputed election.

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