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She may be afraid that it will be painful valium causes erectile dysfunction extra super cialis 100mg cheap, and will likely be embarrassed about undressing (1) erectile dysfunction medication canada discount 100mg extra super cialis mastercard. In allaying such fears erectile dysfunction medication list order genuine extra super cialis on-line, it would be helpful to erectile dysfunction drugs cialis purchase extra super cialis amex direct the majority of the initial discussion toward the adolescent and to explain the exam completely. Speaking to the mother alone is useful for obtaining family history that may be pertinent and for uncovering any concerns that she may have. Patients in this age range are often modest about the changes taking place in their bodies, and it is often best to leave it up to the girl whether she wants her mother present during the exam. It is important to speak to the patient alone at some point because she may have information that she is reluctant to reveal in the presence of her mother. When attempting to solicit information about her menstrual cycles, it is best to ask specific questions regarding the frequency of menstrual flow, length of menses, and the amount of blood lost. When assessing the amount of blood lost, the patient should be asked how long it takes to soak through a tampon or pad, if she ever has to awaken in the night to change a pad, or if she has to use both methods at once. It is not enough to simply note how many pads or tampons the patient uses in a day because she may change pads as soon as one is soiled, wait until it is soaked, or change it according to her class schedule which dictates when she can make it to the restroom. Estradiol promotes the formation of uterine endometrial glandular cells and stroma. Menarche occurs when estrogen levels are sufficient to stimulate proliferation of the uterine endometrium. Estradiol also stimulates the development of the follicle and its levels increase in puberty until ovulatory cycles are established. Following menarche, plasma estradiol levels range from 50-200 pg/ml during the follicular phase, while progesterone levels range from 200-2500 ng/dl (average 750) during the luteal phase (2). The majority of cycles within the first 2 years after menarche are anovulatory, and there tends to be great variance in cycle interval, duration of flow, and amount of blood loss. Cycle intervals may be as long as 6 months and continue to be irregular for the first 15 cycles (2,4,5,6). Dysfunctional Uterine Bleeding In a normal cycle, an average of approximately 35 mL blood is lost (range 20-60 mL) (7). A good guideline may be to consider 8 pads or 12 tampons, well soaked, as the upper limit of normal; however even these estimates are user-dependent and may not correlate well with actual blood loss. A normal cycle interval ranges from 21-35 days, with less than 21 or more than 35 days considered abnormal (8). Until ovulatory cycles are established in the adolescent, endometrial proliferation occurs without progesterone regulation. The endometrium grows until the level of estrogen cannot sustain it, resulting in endometrial sloughing. In the adolescent, this results in cycles that are irregularly regular until regular ovulation is established. The time to develop ovulatory cycles is dependent on the age at which menarche occurs. The same study demonstrated that it may take 6-7 years to attain 90% or greater ovulatory cycles. Most importantly, although most menstrual cycles in early adolescence are anovulatory, truly abnormal bleeding is rare. Classification of Abnormal Uterine Bleeding in the adolescent (8): Menorrhagia (hypermenorrhea): Prolonged (more than 7 days) or excessive (>80 ml) of uterine bleeding occurring at regular intervals. Polymenorrhea: Regular episodes of uterine bleeding occurring at intervals of <21 days. Metrorrhagia: Uterine bleeding occurring at irregular intervals with variable amount of flow. Menometrorrhagia: Irregular and frequent bleeding, which may be excessive in amount and/or prolonged in duration. Oligomenorrhea: Irregular bleeding episodes occurring at intervals of 35 days to 6 months. Intermenstrual bleeding: Bleeding episodes occurring between regular menstrual periods. Hypomenorrhea: Decreased amount of uterine bleeding occurring at regular intervals. Dysfunctional uterine bleeding: Excessive uterine bleeding with no demonstrable organic cause. Although polyps, myomas, tumors, or endometriosis may be included in the differential, in contrast to the mature woman, diseases of the uterus are rarely the cause for irregular uterine bleeding in adolescents (10,11,12). A common clinical problem seen by physicians is the adolescent who presents with irregular intervals of bleeding that is normal in duration and amount of flow. For most of these adolescents, reassurance and observation are usually sufficient. The adolescent should be encouraged to keep a record of duration of menses, cycle interval, and amount of bleeding. Signs of chronic disease, polycystic ovary disease, endocrine abnormalities, or blood dyscrasias, if present, should be evident in the physical exam with corresponding symptoms obtained in the history. The evaluation of abnormal uterine bleeding in the adolescent also requires a thorough gynecological exam. If the bleeding is active, the site of bleeding should be Page 652 determined, as occasionally rectal or urethral bleeding may be mistaken for menstrual spotting. A speculum exam should be performed to inspect for signs of infection, trauma, foreign bodies, or evidence of contraceptive devices. Vaginal irrigation may be used to obtain these samples in the patient who will not tolerate a speculum exam. A bimanual pelvic exam is used to check for cervical motion tenderness, adnexal tenderness, and masses. A single-finger digital palpation is adequate for most adolescents, but if the hymenal orifice is still too small for a single-digit exam, a rectoabdominal bimanual palpation may be done instead. Surgical interventions, such as a hysteroscopy and D&C are diagnostic methods of last resort (13). After organic, systemic, and iatrogenic causes are ruled out, the abnormal bleeding may be diagnosed as dysfunctional uterine bleeding (8). Most adolescents with irregular bleeding in the first two years following menarche do not require long term management (10). If anovulation is the suspected etiology, the initial hormonal intervention should be progestin therapy to initiate a secretory change of the endometrium and produce a controlled withdrawal bleed. Progestin stops endometrial growth and organizes endometrial sloughing so that menses will occur following progestin withdrawal, rather than at random times. Estrogen treatment causes the regrowth of endometrium over raw, denuded areas where previous bleeding occurred. It is often clinically useful in controlling acute bleeding episodes, but progestin therapy is also required if the etiology of the bleed is anovulation. Combination estrogen/progestin oral contraceptives are the treatment of choice in adolescents, and also serve the dual benefit of preventing pregnancy if the adolescent is sexually active (8). Dysmenorrhea Dysmenorrhea is defined as cramping pain in the lower abdomen that occurs in conjunction with menstruation. If the pain is due to pelvic pathology or alterations in normal pelvic anatomy, the pain is classified as secondary dysmenorrhea, whereas primary dysmenorrhea occurs in the absence of any known pelvic pathology. Secondary dysmenorrhea is uncommon in adolescents, but primary dysmenorrhea is the most common gynecologic problem in young women, with reported rates as high as 75-90% (14,15,16). The incidence increases with sexual maturity, with one study reporting a 38% incidence at Tanner stage 3, increasing to 66% at Tanner stage 5. Dysmenorrhea also increases with chronological age from 39% in 12 year olds to 72% in 17 year olds. Symptoms of primary dysmenorrhea are usually noted beginning 1-3 years after menarche. Pain that begins within 6 months or 3 years after menarche is more indicative of secondary dysmenorrhea. Patients typically report intermittent, cramping suprapubic pain that may radiate to the lower back or thighs. The pain may begin a few days before menstruation and continue for as long as 7 days following the start of flow.

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It is recommended that they have a comprehensive ophthalmologic examination at 6 months to impotence may be caused from quizlet buy extra super cialis on line one year of age impotence in xala purchase 100mg extra super cialis with mastercard. Premature infants are at the same risk for developing anemia of infancy as are term infants smoking and erectile dysfunction statistics extra super cialis 100mg overnight delivery. In addition erectile dysfunction smoking cheap extra super cialis master card, premature infants are at higher risk for protracted anemia, because they are born with lower body iron stores. This situation is further compounded by significant phlebotomy losses in the neonatal period related to hospitalization after birth. Anemia of prematurity may at least partially be overcome by the use of erythropoietin, which is used to stimulate erythropoiesis. In this respect, the iron supplementation during therapy should be at the levels used in the treatment of anemia at any other age (up to 6 mg/kg/d of elemental iron). The primary source of immunity for the neonate is passively derived antibodies from the mother and this tends to occur primarily in the third trimester. Thus, the relative amount of antibody transferred is affected by the duration of gestation. All of these factors contribute to the increased risk of infections in this population. This mandates close monitoring for infectious complications, both during hospitalization, in the immediate neonatal period, and in subsequent months during the first year of life. Given their propensity for infections, the American Academy of Pediatrics recommends that all childhood immunizations be administered to premature infants at the appropriate chronological age. Despite lower titers of antibody response in these infants, there is no recommendation for additional doses of specific immunizations. The most current recommendation is published in the Red Book 2003 of the American Academy of Pediatrics. These infants will also benefit from receiving influenza immunization at 6 months chronological age during the cooler winter months (3). The premature infant is ready for discharge when he/she is able to fulfill the following criteria: 1) ability to appropriately regulate their temperature without the need for technological support, 2) ability to ingest adequate calories to achieve consistent growth, and 3) to have demonstrated other parameters of global physiologic stability (the absence of clinically significant apnea, bradycardia, or hypoxemia). In addition, and most importantly, it is critical that the parents/caregivers feel comfortable with the care of the infant in the home environment. Thus, the process of discharge of the infant is a continuum that begins several days to weeks prior to the actual discharge of the infant. Many of these infants will have additional needs and it is important that all of these needs and appropriate community resources are identified prior to discharge. At the time of discharge, the routine mandated screening for hearing and metabolic diseases should be completed with the results forwarded to the primary care physician. The long term outcome of premature infants is inversely related to gestational age (better outcomes in older infants), and directly related to the clinical course in the neonatal period, and the associated morbidities and diagnoses during their hospitalization. In general, these infants need close neurodevelopmental monitoring and early interventions for identified problems. They are at increased risk for repeated hospitalization for various residual problems of prematurity such as bronchopulmonary dysplasia, failure to thrive, and feeding problems. Developmental outcome is also related to the home environment and the ability of the family to properly nurture the infant. Unfortunately, the stress associated with parenting a high-risk infant often leads to dysfunctional family dynamics. In addition, these infants are frequently born into families who are already high-risk. On a positive note, if an optimal nurturing environment is provided, there is evidence to suggest that it can result in a significant improvement in overall long term outcome. True/False: Morbidity associated with prematurity is a significant contributor to the infant mortality rate. Strategies to reduce thermal stress at birth should include (mark all correct answers): a. Keeping the delivery room warm and performing the stabilization under a preheated radiant warmer. They are born with adequate glycogen stores but have immature homeostatic mechanisms to mobilize glucose. They are born with inadequate glycogen stores but have mature homeostatic mechanisms to mobilize glucose. They are born with inadequate glycogen stores and have immature homeostatic mechanisms to mobilize glucose. Feeding difficulties in premature infants are usually secondary to (choose one): a. In contrast to term infants, the following statements are true regarding physiologic jaundice in the premature infant in the neonatal period (choose one): a. The following statements regarding the persistence of ductus arteriosus are true in the premature infant (choose one): a. Obstructive secondary to collapse of the upper airway structures and closure of the glottis. True/False: the weight of the premature infant is an absolute criterion for discharge from the hospital. His face is symmetrical with normal palpebral fissures, normal red reflexes, patent nares, normal ears, no clefts, and no neck masses. His abdomen is soft and round with normal bowel sounds, no masses and no organomegaly. Over the next several hours, the infant develops progressively more distress and a greater oxygen requirement. This chapter will cover the common problems which cause respiratory distress in the newborn within the first week of life. Based on the clinical presentation, onset and gestational age, the most likely diagnosis can be determined. The constellation of signs and symptoms can be the result of pulmonary, cardiac, metabolic, infectious, renal, gastroenterological and neurologic pathologic processes. Newborns with disorders involving any one of these organ systems may present with varying degrees of tachypnea, retractions, grunting, cyanosis, lethargy and tachycardia. The most significant discriminatory findings are the onset of the illness and the degree of distress exhibited by the infant. Typically, the infant becomes tachypneic immediately after birth and has mild respiratory distress. If followed closely, infants remain stable for several hours and/or begin to improve. The chest radiographs reveal hyperinflation with clear lung parenchyma except Page 91 for perihilar linear densities and fluid in the fissures. The pathophysiological mechanism is the delayed resorption of fetal lung fluid which eventually clears over the next several hours to days. As a consequence, meconium aspiration is considered to be a relatively common event. In addition, while many infants have the onset of symptoms at birth, some infants have an asymptomatic period of several hours before respiratory distress becomes apparent. Infants with aspiration syndromes may require more oxygen, and have greater degrees of tachypnea, retractions and lethargy. The pathophysiologic mechanism is the obstruction of large and small airways with the aspirated material (meconium, blood, amniotic fluid contents). Pulmonary hypertension may be develop when meconium aspiration occurs in conjunction with varying degrees of in utero asphyxia. Pulmonary hypertension, which often results from hypertrophic pulmonary vascular muscular tissue, is a severe condition characterized by cyanosis from right to left shunting across the atrial septum and patent ductus arteriosus. As the disease process progresses, the symptoms and severity of hypoxemia increase over the subsequent hours. The duration of distress with mild to moderate aspiration syndromes is from several hours to days. Aspiration can occur in utero or during the intrapartum period as well as during the early postpartum period. Since meconium aspiration is the most common problem, much effort has been made over the last 30 years to prevent this disease by reducing intrapartum and postpartum aspiration. Thorough suctioning of the oropharynx with a large bore catheter upon the delivery of the head is typically performed by the obstetrician. The pediatrician, needs to assess the quality of the meconium (thin, moderate or thick) and the state of the newborn before determining what is needed after birth.

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Consanguinity is in vitro manipulation of some oncogenes/tumor common and genetic diseases are equally common suppressor genes and assessing the effect of in Saudi Arabia erectile dysfunction pump how do they work discount extra super cialis 100mg amex. Adrenal Cancer is another area our impression as practicing endocrinologists that that we got interested in recently and did some these disorders are quite common erectile dysfunction statistics in canada order extra super cialis 100mg free shipping. Comparison of differentiated thyroid presented last year in the International Endocrine cancer in children and adolescents ( 2-fold-change/p < 0. A panel of 164 and 138 blood and the 138-protein dataset in bone marrow differentially expressed protein datasets derived are common to both body compartments. We have had more than 2 were distinctively separated into four response years follow up of these patients and the same subtypes using unsupervised hierarchical cluster dataset of potential protein biomarkers could still analysis as illustrated in the figure below. Some of the identified proteins were implicated in hematological diseases as potential biomarkers using Ingenuity Pathway Analysis. The figure was generated using J-Express differentially expressed in bone marrow will also software program. The We have identified protein signatures capable exact role of fascin in breast cancer cells has of prediction of molecular response and choice not been fully understood. These proteins might be valuable once validated, Stem Cells in Health and Disease. Baku to complement the currently existing parameters World Forum of Young Scientists, Baku, for reliable and objective prediction of disease Azerbaijan. A manuscript has been submitted to British Novel role for fascin in regulating the Journal of Cancer, Dec 2015, status as under function of breast cancer stem cells. Fascin is an volume-6-31-aug-14/) actin-bundling protein that has been reported to regulate cells morphology and motility. Four (4) oral presentations, 1 of them at an restricted expression in specialized normal cells, international conferences: 316 Stem Cell & Tissue Re-Engineering Program Revealing a novel regulator of breast cancer proposal is to establish a fascin knockout mouse stem cells: implication for targeted therapy. Genotyping protocol has been established to Faisal Specialist Hospital and Research differentiate between wild type, heterozygous Center Experience. Flow cytometry setting has been optimized to speaker May 26th 31st, 2014) characterize stem cells from breast and bone the role of actin cytoskeleton in the function marrow as well as immune cells from spleen, of Breast cancer stem cells. Given the disconnect regulating chemoresistance and metastasis of between the pathogenic mechanism and the breast cancer cells. In addition, work in progress disease phenotype, as well as the risks involved has shown a direct role for fascin in regulating the with kidney biopsy as an invasive procedure, a expression and function of breast cancer stem robust non-invasive tool is needed to identify new cells, a small subset of breast cancer cells that pathogenic markers that can distinguish between are widely believed to be responsible for tumor two different kidney diseases with different relapse and metastasis. The main aim of this underlying etiologies but manifest with the same 317 the Research Centre Figure 10. The histograms represent the means of normalized optical density of protein expression standard deviations. The lowest group means (broken bar) and highest group means (solid bars) were indicated, while *indicates statistical difference with P-value < 0. This will be critical to both guide (global and segmental) sub-classification to either treatment, as well as to identify new therapy. Over the past decade, proteomics has emerged as a powerful tool in mechanistic, diagnostic, Our findings on this project are detailed in a and therapeutic application. The other limiting factor was using urine alone which would make identifying a potential biomarker cumbersome and tracing it back to its site of origin very difficult. In this project, we are combining proteomics data from the kidney biopsy of lupus nephritis with urine of the same patient at the time of the biopsy. This will identify potential markers that exist in both tissue and urine eliminating nonspecific proteins that leak out as a result of renal failure. This study will be the first work to use combined tissue/urine proteomics in lupus nephritis and it will bring together basic scientists and clinicians towards discovery of novel biomarkers for routine diagnostics. It will ultimately result in the establishment of center of excellence for clinical proteomics and genomics research with potential for clinical application in routine patient care in Saudi Arabia. This type of analysis allows an Additionally, and based on this work, one might objective sample classification and identification of outliers in sample groups based on quantitative expression profiles. Treatment proteomic analysis in lupus nephritis and prognosis in lupus nephritis were based 3. To validate potential biomarkers mainly on the findings in renal histopathology obtained by renal biopsy. Altogether we have more than be critical to both guide treatment, as well as to 50 recruited patients into the registry prospective identify new therapy. This study will be the first work to use combined tissue/urine proteomics in lupus nephritis and Currently optimization of urine processing is to bring together basic scientists and clinicians ongoing and it is anticipated sample proteomics towards discovery of novel biomarkers for and genetics analysis would soon follow suit. N #1 Female Retrospective Mass Spec/ Proteomics Used for publication/ sample is finished L. N #2 Female Retrospective Mass Spec/ Proteomics Used for publication/ sample is finished L. N #3 Male Retrospective Mass Spec/ Proteomics Used for publication/ sample is finished L. N #4 Female Retrospective Mass Spec/ Proteomics Used for publication/ sample is finished L. N #5 Female Retrospective Mass Spec/ Proteomics Used for publication/ sample is finished L. N #6 Female Retrospective Mass Spec/ Proteomics Used for publication/ sample is finished L. N #7 Female Retrospective Mass Spec/ Proteomics Used for publication/ sample is finished L. N #8 Female Retrospective Mass Spec/ Proteomics Used for publication/ sample is finished L. N #9 Female Retrospective Mass Spec/ Proteomics Used for publication/ sample is finished L. N #10 Female Retrospective Mass Spec/ Proteomics Used for publication/ sample is finished 320 Stem Cell & Tissue Re-Engineering Program L. N #11 Female Retrospective Mass Spec/ Proteomics Used for publication/ sample is finished L.

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Rather than march on foot out of Boston erectile dysfunction pill order generic extra super cialis from india, the British troops were packed onto barges and transported across the bay impotence hypnosis extra super cialis 100mg visa, where they were then forced to erectile dysfunction caused by vyvanse best purchase extra super cialis disembark in deep water erectile dysfunction tulsa cheap extra super cialis on line. The 700 wet and muddy troops formed up and began to make the seventeen-mile journey to Concord, passing through diffcult, swampy terrain. Instead, they were surprised and alarmed to see that everyone on the road to Concord already knew they were coming. Colonel Smith sent Major Pitcairn and his troops ahead, hoping that the speed of a quick march might still be somewhat of a surprise to the militia. Pitcairn arrived in Lexington to fnd the militia of seventy-seven awaiting the British on the green; the seventy-seven included the Minutemen, who had been quickly assembled after the warnings of Revere and Dawes. Evidently these colonials had planned a protest only; rather than ignoring the militia and continuing to march down the road adjacent to the green, however, the offcer leading the march, Marine Lieutenant Jesse Adair, decided to form up on the green Figure 7. Author: United States National Park Service Source: Wikimedia Commons Page | 315Page | 315 Chapter Seven: the road to revolution, 1754-1775 itself in order to disperse the militia. But the militia stood their ground, facing the hundreds of British troops, even as Major Pitcairn arrived and ordered the colonists to leave, shouting Disperse, you damned rebels!. Other than that, nothing is known about the person who, in the words of Ralph Waldo Emerson, fred the shot heard round the world, so called because it marked the beginning not only of the American Revolution, but the inspiration for the French Revolution as well. The British troops, tired from lack of sleep and the wet march and nervous at being in hostile territory, opened a volley on the militia. After fring their volleys, the British troops charged the remaining militia with bayonets. Eight militiamen were killed, including Captain Parkers cousin, Jonas Parker, who was bayoneted. Colonel Smith, who was still travelling with the slower troops, heard the sounds of the gunfre and hurried to Lexington. He brought the British back in line and then moved them off towards Concord, leaving the people of Lexington to tend to their own dead and wounded. Colonel Smith later sent the following account to General Gage, governor of Massachusetts: [When Pitcairn approached Lexington] a body of country people drawn up in military order, with arms and accoutrements, and, as appeared after, loaded; and that they had posted some men in a dwelling and Meeting house. They had intended to confront the British but retreated when they saw Colonel Smiths full force on the road, a force which outnumbered theirs by almost three to one. Their commander, Colonel James Barrett, decided to surrender the town and moved his men out of Concord to a nearby hillside where they could watch the British. They were joined by militia from surrounding towns, which increased their number to several hundred. Page | 316Page | 316 Chapter Seven: the road to revolution, 1754-1775 the British combed the town for supplies as the militia looked on; most of the provisions had been removed, but the troops under Smith were able to seize and destroy some food and munitions. The British, now outnumbered, fell back across a bridge where command fell to Captain Laurie, a less experienced offcer. Laurie, with fewer than one hundred soldiers, was facing possibly as many as 400 colonials. The Americans killed fourteen British troops at the North Bridge, and, within an hour of fghting, Colonel Smith turned his troops back on the road to Boston. In 1775, it was narrow by todays standards and had in many places walls along its sides, confning the troops marching along it and forcing them to form columns. The militia and minutemen were able to leave their towns and villages and come near the road and wait for the long red line of British soldiers. Then they could take their shots, retreat into the shelter of the woods, and move down the road to fnd a new position from which to attack. The British, marching on foot and having to follow the road, could neither outrun nor hide from the colonists. They were exposed and had no cover from enemy fre for the full seventeen miles back through Lexington to Boston with the militia fring on them. A British soldier explained the situation thus: upon on our leaving Concord to return to Boston, they began to fre on us from behind the walls, ditches, trees, etc. In commenting on the shots exchanged at Lexington, Benjamin Franklin expressed outrage to a member of Parliament: [You] have doomed my country to destruction. You have begun to burn our towns and murder our people36 As if the situation at Lexington and Concord were not bad enough, news reached the southern colonies that a member of Parliament had suggested several months earlier, in January 1775, that a general emancipation of American slaves would humble the high aristocratic spirit of Virginia and the southern colonies. The actions at Lexington and Concord were accidents, but given the high tension of the times, they were all that was needed to spark a war. His Page | 317Page | 317 Chapter Seven: the road to revolution, 1754-1775 miscalculations concerning the people of Massachusetts Bay and the poor security and mishandling of his internal communications led to his failure to preserve the peace. Afterwards, he would be blamed by the colonists throughout New England, members of the British government, and even his own soldiers for the events of April 19, 1775. Although this act actually lowered the price of the tea in the colonies, making it cheaper than in the mother country, the colonists were enraged, and insisted that the tea ships return to England. When this did not happen, and after petitioning Governor Thomas Hutchinson with unsatisfactory results, a group of Indians boarded the tea ship in the Boston Harbor and threw its content overboard. At this point, there was no turning back, and in the next year and a half relations between mother country and colonies deteriorated. Britain responded to the action of Massachusetts with a series of acts designed not only to punish, but also to bring sweeping changes to the government and economic endeavors of the Bay colony. The Boston port was closed to traffc and even the long-revered New England town meetings were disbanded. In a spirit of cooperation refective of the Committees of Correspondence, the colonists, with the exception of Georgia, sent representatives to the First Continental Congress, whose purpose it was to respond formally to the Intolerable Acts by drafting a list of grievances and a statement of the rights of the colonists. The delegates agreed to meet in one years time to consider the Crowns response, but before this Second Continental Congress could assemble, the frst shots of the Revolutionary War had been fred at Lexington and Concord, and this Congress would become involved in leading the war effort and providing a government for the new American states. The colonists did not necessarily object to the principle of taxation, but rather how the tax money would be applied. Click here to see answers Page | 319Page | 319 Chapter Seven: the road to revolution, 1754-1775 7. British-American success in the French and Indian War had given the American colonists the expectation that they would be rewarded for their participation in the war and, among other things, allowed to enter into the area west of the Allegheny and Appalachian Mountains. But the Crown had other ideas, and, rather than giving the colonists access to the land they had so recently fought for, the British government decided to tighten its reins on its American subjects. Salutary neglect, long the policy toward the colonies, was discarded as Parliament passed a series of acts designed to raise monies to defray the costs of protecting and maintaining the colonies. American leaders quickly created and publicized arguments in which they defned their rights under the British constitution. They argued vehemently against virtual representation, maintaining that they could only be taxed by a legislature that they themselves elected. Nor would they accept taxes that were designed to raise revenues rather than regulating trade, and internal taxes were equally unacceptable. In many ways, even in 1763, the year the French and Indian War ended, it was almost too late to achieve any type of consensus between the colonies and the mother country; the American experience of the former had led the colonists to take for granted ideas that were foreign to the British. Measures like the Sugar and Stamp Acts, which raised revenues and taxed the colonies internally, the Declaratory Act, which proclaimed the right of Parliament to legislate for the colonies in all cases whatsoever, and the Intolerable Acts, which punished Massachusetts for the Tea Party, only heightened the tension that was building. And while conditions worsened between mother country and colonies, there was developing in America a spirit of inter colony cooperation refected in the Committees of Correspondence and the First and Second Continental Congresses. The First Continental Congress, representing all of the colonies except Georgia, drafted a statement of American rights, and the Second Continental Congress would conduct a war against Britain and draft a Declaration of Independence. In the words of Thomas Paine, whose infuential work Common Sense was published in 1776, the cause of America was becoming in great measure the cause of all mankind. Which account do you believe is most accurately describes what actually occurred on April 19, 1775. From thence the troops proceeded in warlike array to the town of Concord, where they set upon another party of the inhabitants of the same province, killing several and wounding more, until compelled to retreat by the country people suddenly assembled to repel this cruel aggression. Our troops advanced towards them, without any intention of injuring them, further than to inquire the reason of their being thus assembled [when] one of them fredand three or four more jumped over a wall and fred from behind it among the soldiers; on which the troops returned it, and killed several of them. Date Event 1754-1763 French and Indian War 1754 Albany Congress; Plan of Union 1755 Battle of Wilderness 1759 Annus Mirabilis (Year of Miracles) End of the Seven Years War; Peace of Paris; 1763 Proclamation Line of 1763 1763-1764 Pontiacs War 1764 Sugar Act and Currency Act passed by Parliament the Stamp Act and Quartering Act (both create internal 1765 taxes) enacted by Parliament; Stamp Act Congress met in New York City Declaratory Acts; Riots in New York City over 1766 enforcement of the Quarting Act 1767 Townshend Acts passed; Colonial Resistance built Virginia Resolves introduced into the House of 1769 Burgesses; Royal Governor closed the House 1770 Boston Massacre; Townshend Acts repealed Gaspee Incident; Committees of Correspondence 1772 created in many colonies 1773 Tea Act went into effect; Boston Tea Party Coercive Acts and Quebec Act (Intolerable Acts) passed by Parliament; First Continental Congress assembled 1774 in September and approved Declaration of Rights and Grievances; Continental Association formed to enforce boycotts Lexington and Concord; Second Continental Congress convened; drafted the Olive Branch Petition; Patrick 1775 Henrys Give me Liberty or give me Death; Minutemen and Redcoats clash at Lexington and Concord Paines Common Sense Published; Second Continental 1776 Congress accepted the Declaration of Independence Page | 323 Chapter Seven: the road to revolution, 1754-1775 7. A Charming Field for an Encounter: the Story of George Washingtons Fort Necessity Washington: Offce of Publications, National Park Service, U. Crucible of War: the Seven Years War and the Fate of the Empire in British North America, 1754-1766. Page | 324Page | 324 Chapter Seven: the road to revolution, 1754-1775 Yale Law School. Alberts, A Charming Field for an Encounter: the Story of George Washingtons Fort Necessity (Washington: Offce of Publications, National Park Service, U. Weigley, the American Way of War: A History of United States Military Strategy and Policy (Bloomington: Indiana University Press, 1973) 3-18.

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