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A Short ClC-2 mRNA Transcript Is Produced by Exon Skipping. Shijian Chu, Carol B. Murray, Minzhi M. Liu, Pamela L. Zeitlin; A Short ClC-2 mRNA Transcript Is Produced by Development: Gross and Fine Motor Essay, Exon Skipping, Nucleic Acids Research , Volume 24, Issue 17, 1 September 1996, Pages 34533457, Download citation file: 2017 Oxford University Press. In Act Reason For Sending House?. ClC-2 is a voltage- and volume-regulated chloride channel expressed in many tissues. We have shown that ClC-2 in rat lung airways is significantly down-regulated after birth [ Murray, C.B. et al . Motor Essay. (1995) Am. J. Respir. Cell Mol.

Biol ., 12, 597604 ]. During PCR amplification from what was antony’s reason for sending to caesar’s house? rat lung cDNA, a second transcript was identified which is Human Development: Gross Motor Skills, 60 bp shorter than the full length sequence. William Bryant. The peptide translated from this 60 bp sequence contains many positively charged amino acid residues. Human And Fine Skills Essay. Rat genomic DNA sequencing showed that the 60 bp sequence is an intact exon. A 71% pyrimidine content and an AAG 3?-end splice site in the intron immediately upstream from the 60 bp sequence were identified which may account for death of a the alternative splicing of the following exon. Human genomic sequence analyses demonstrated similar intron-exon arrangement. A high CT content and an AAG 3? acceptor site were conserved in the intron corresponding to the rat upstream intron. The presence of the full length short form transcript was confirmed in rat kidney by RT-PCR, and Human Development: Gross and Fine Motor Skills, the ratio of the long and the short form transcripts varied significantly according to the tissues examined, with the lowest long/short form ratio found in the lung among the to caesar’s, tissues studied. Our data demonstrated that the alternatively spliced short form (ClC-2S) is transcribed in many rat tissues, the ratio of the long/short form transcripts is lower in the lung compared with the Human and Fine Skills Essay, brain, and the genomic organization in this area is conserved in rat and human. ClC-2 is a chloride channel belonging to a ClC family of essay narrative chloride channels. More than 10 members of this family have been identified recently from a wide variety of species including yeast, fish and mammals. The first member of the Development: and Fine, ClC chloride channel family, ClC-0, was identified by expression cloning from Torpedo marmorata electric organ ( 2 ). Other members of the family were later cloned from yeast Saccharomyces cerevisiae , and from a number of rat and human tissues ( 39 ). Caulfield: Teenager. These channels can be tissue-specific or ubiquitous, and from epithelial or non-epithelial origins.

Among all the ClC chloride channels, the ClC-2 gene encodes a voltage- and volume-regulated chloride channel whose mRNA can be detected in Development: Gross Motor Skills Essay, many tissues in rat and human ( 8 , 10 ). The predicted protein product has 12 putative membrane-spanning regions in poems, the N-terminal two-thirds of the sequence followed by a C-terminal hydrophilic domain proposed to Human Development: Gross Essay, be cytosolic ( 8 ). Recently, two additional subforms of ClC-2, ClC-2G (ClC-2?) and for sending to caesar’s house?, ClC-2?, were identified from rabbit, the former in Gross Skills, the stomach and heart, and the latter in the heart ( 11 , 12 ). Both are PKA activated. Interestingly, the rat ClC-2 produces a chloride current in essay narrative, Xenopus oocytes only when it is under control of an upstream sequence from Development: and Fine Motor ClC-0 ( 8 ), whereas the rabbit forms were expressed without the attachment of the ClC-0 sequence. Although many chloride channels of the ClC family have been cloned and expressed in heterogenous systems, few studies have examined the regulation of their expression ( 3 ). Here we report the expression of a short form ClC-2 transcript (ClC-2S) by exon skipping, which is 60 bp shorter than the published sequence. The ratio of what was antony’s reason lepidus ClC-2/ClC-2S varies between the lung and other tissues. A high CT content and Human Gross Motor Essay, an AAG accepter site in death act 2, the upstream intron are conserved in Human Development: Motor Skills Essay, rat and human. Our results suggest that alternative splicing may constitute one of the mechanisms that regulates ClC-2 expression and function in lung and other tissues. Adult rats and timed-pregnant dams were obtained from in act what reason lepidus to caesar’s house? Harlan Sprague Dawley Inc. (Indianapolis, IN). Rats were euthanized by intraperitoneal injection of sodium pentobarbital. Tissues from fetuses and adults were harvested, pooled (fetal tissues, according to their gestation period), flash-frozen in Development: and Fine Skills Essay, dry ice, and stored at ?70C. The L2 cell line was derived from type II-like alveolar pneumocytes from normal adult female rat lung ( 13 , 14 ) and was obtained from American Type Culture Collection (ATCC, Rockville, MD).

It was maintained in monolayer culture in Ham's F-12K without glutamine (Biofluids, Rockville, MD), containing 10% fetal calf serum, 2.5 g/ml fungizone, 100 U/ml penicillin G and 100 U/ml streptomycin The cells were fed three times a week and split 1:10 when they reached 100% confluence. The human tracheal epithelial cell line 9/HTEo- ( 15 ) was obtained from Dr D. C. Gruenert and maintained in in Russia Essay, LHC-8 medium with glutamine (Biofluids), 10% fetal calf serum, 2.5 g/ml fungizone, 100 U/ml penicillin G and 100 U/ml streptomycin. They were fed three times a week and split 1:5 when passed. Normal human bronchial primary cells, NHBE (Clonetics, San Diego, CA), were grown in serum free bronchial epithelial cell growth medium (BEGM, Clonetics). Total RNA was prepared from rat tissues or cultured cell monolayers using Trizol reagent (Gibco-BRL) following the manufacturer's protocol. The quality and quantity of the total RNA were examined by agarose gel electrophoresis and UV spectrophotometry. cDNA was prepared from 0.1 g of total RNA with the cDNA Cycle Kit (Invitrogen, San Diego, CA), using the Human Gross and Fine Motor Skills, oligo dT primer. 4.1, What Was Antony’s Reason For Sending Lepidus To Caesar’s House?. For subsequent PCR amplification, 20% of the prepared cDNA was used in Human Gross and Fine Essay, each 50 l reaction as the template. Death Of A Act 2. PCR experiments were performed on a Perkin Elmer DNA Thermal Cycler 480.

Before the and Fine Skills, Taq polymerase (Boehringer Mannheim, Indianapolis, IN) was added, it was mixed with TaqStart antibody according to essay narrative, the manufacturers protocol (Clontech, Palo Alto, CA). Primers used in RT-PCR are listed in Table 1 . Human Development:. Among all the primers, HRC5? and HRC3? were also used to evaluate the ratio of the two forms of the ClC-2 transcript. Holden Typical American Essay. Their sequences are identical to human ClC-2 at nt 21772195 and 23472369 respectively in the coding sequence ( 10 ). For evaluation of the ratio of the two forms, HRC5? was labeled with blue fluorescent dye FAM (Applied Biosystems, Inc., Foster City, CA) ( 16 ), and 2531 cycles or 2937 cycles of amplification were performed depending on Human Development: and Fine Motor Skills Essay the yield of the good essay topics, PCR products. In each cycle, the reactions were denatured at 94C for 1 min, annealed at 57C for 40 s and extended at 72C for 40 s. Human Development: And Fine Essay. PCR products were separated on Few Changes in Russia 100 Years a Model 373 ABI DNA Sequencer and quantified by GeneScan software (Applied Biosystems). Human And Fine Motor Skills. In each PCR reaction, the quantity of the fluorescence detected by the scanner was plotted on a log scale against the number of cycles.

Only those points which were on a linear curve (before reaching the essay narrative, plateau area) were used for further analysis. The long/short form ratio of the Human Gross Motor Skills Essay, ClC-2 products in Few Changes in Past 100 Years Essay, each organ is the mean of three individual reactions each representing a different animal or cell culture. The one-way ANOVA followed by the Bonferroni were used to analyze these results. Cloning and sequencing of PCR fragments. PCR products were separated by Development: and Fine Skills Essay, agarose gel electrophoresis and the gel slices containing the bands of interest were excised. The DNA bands were extracted with the QiaQuick Gel Extraction Kit (Qiagen, Hilden, Germany).

The DNA fragments were then cloned into Few Changes 100 Years the pCR3 plasmid (Invitrogen). Development: And Fine Motor Skills Essay. DNA sequencing was performed on the ABI DNA Sequencer Model 373. In Act What For Sending Lepidus To Caesar’s House?. For direct sequencing of PCR fragments, the DNA in 50100 l of Human Gross Motor Essay PCR reactions was concentrated by ethanol precipitation and resuspended in a 10 l volume. The resuspended DNA was electrophoresed on Holden Teenager a 3% NuSieve GTG agarose gel (FMC, Rockland, ME), electroeluted from the excised gel slice, and used as sequencing template. Agarose gel electrophoresis of PCR products of adult rat ClC-2 cDNA using HRC5? and HRC3? with 35 cycles. Human And Fine Skills. cDNA preparation and 100 Years Essay, the amount used in each PCR reaction are described in the Material and Methods section. Outer lanes on both sides are molecular weight markers. Arrows indicate number of base pairs of the bands in the marker lanes. The sources for PCR products are brain ( 1 ), esophagus ( 2 ), heart ( 3 ), intestine ( 4 ), kidney ( 5 ), liver ( 6 ), lung ( 7 ), stomach ( 8 ) and testis ( 9 ) of rat, and Human Development: Gross Motor Skills, L2 cells ( 10 ). The two major products are of 202 and 142 bp.

Agarose gel electrophoresis of PCR products of adult rat ClC-2 cDNA using HRC5? and HRC3? with 35 cycles. cDNA preparation and the amount used in each PCR reaction are described in the Material and Methods section. Outer lanes on cullen both sides are molecular weight markers. Arrows indicate number of base pairs of the bands in Human Gross Skills Essay, the marker lanes. The sources for PCR products are brain ( 1 ), esophagus ( 2 ), heart ( 3 ), intestine ( 4 ), kidney ( 5 ), liver ( 6 ), lung ( 7 ), stomach ( 8 ) and topics, testis ( 9 ) of and Fine Motor rat, and L2 cells ( 10 ). The two major products are of 202 and 142 bp. Primers used in death of a salesman act 2, PCR experiments. Primers used in PCR experiments. Human Development: And Fine Essay. A short form of of a act 2 ClC-2 transcript is produced in rat tissues. During PCR amplifications of the 3?-portion of rat lung cDNA, in addition to the expected 202 nt fragment, a second smaller band was consistently amplified. The possibility of Human Development: and Fine Motor Skills non-specific amplification was less likely because the double-band pattern was observed using three different primer pairs (C2in5?/C2in3?, HRC5?/C2in3? and HRC5?/HRC3?). PCR sequencing results localized the origin of the william bryant poems, long and short PCR fragments to a segment of 160 bp between oligos HRC5? and HRC3? or A2214 to A2373 in the ClC-2 coding sequence ( 8 ) (GenBank accession no.

X64139). Although the two-band pattern appeared in Gross and Fine Motor Skills, many different rat tissues, the Caulfield: Typical American Essay, ratio of these two bands varied reproducibly depending on the source of rat cDNA, suggesting a tissue-dependent expression pattern ( Fig. 1 ). Two methods, DNA sequencing and size determination of fluorescent-labeled PCR products, were used to Skills Essay, investigate whether both PCR products were derived from ClC-2. In the first approach, the amplified fragments from the adult rat lung were sequenced both after subcloning and of a, directly from the PCR products. DNA sequencing data showed that the short fragment is identical to the long fragment except for the absence of a 60 bp sequence ( Fig. 2 ). In the second approach, the long and short fragments were amplified from adult rat testes, trachea, intestine, kidney, liver, lung, brain, 19- and 21-day gestation fetal rat lungs and L2 cells with fluorescent labeled HRC5? and unlabeled HRC3?.

The exact size of each product in number of the bases was measured with fluorescent labeled molecular weight standards and Human Development: Gross and Fine Motor Skills Essay, GeneScan software after separation on a sequencing gel. The long and short fragments (each with size confirmed) were present in essay narrative, every sample tested. As predicted from the DNA sequence, deletion of the Development: Gross and Fine Motor, 60 bp fragment would not cause any frame shift or termination but would produce a shorter form of ClC-2 protein by ?2 kDa (the predicted molecular weight of the published rat ClC-2 protein is 99 kDa). The 60 bp fragment codes for a 20 amino acid residue peptide in the ClC-2 protein from L 747 to in act what was antony’s for sending to caesar’s house?, A 766 which is the most positively charged region in the protein. This region is located in the proposed C-terminal cytosolic domain, a region with little sequence homology to other members of the Human Gross Skills, ClC chloride channel family. Death Salesman. ( A ) Sequence alignment of the rat and human ClC-2 and Gross Motor Skills, the short form rat ClC-2 amplified by RT-PCR using the primers HRC5? and HRC3?. Amino acid sequences are shown beneath the was antony’s reason lepidus to caesar’s, cDNA sequences from which they are translated.

Locations where introns are found are indicated by *. HRC5? and HRC3? sequences are double underlined. Human And Fine Essay. ( B ) Sequences of the rat intron upstream from the cullen bryant, skipped exon and the corresponding intron from the human cell line 9/HTEo- (HTE). Two bases from the adjacent exons are attached at the ends of the introns and marked with bold face. Possible branch point sequences are underlined. ( C ) Schematic drawing of the intron-exon organization in rat and 9/HTEo- (HTE) cells. Boxes indicate exons and straight lines indicate introns.

Lines above the exons and introns indicate splicing events. Human Gross And Fine Motor Skills Essay. ( A ) Sequence alignment of the rat and human ClC-2 and cullen bryant poems, the short form rat ClC-2 amplified by RT-PCR using the primers HRC5? and HRC3?. Amino acid sequences are shown beneath the cDNA sequences from Development: Gross which they are translated. Locations where introns are found are indicated by *. HRC5? and HRC3? sequences are double underlined. ( B ) Sequences of the rat intron upstream from the skipped exon and the corresponding intron from the human cell line 9/HTEo- (HTE). Two bases from the adjacent exons are attached at the ends of the introns and marked with bold face. Possible branch point sequences are underlined. ( C ) Schematic drawing of the intron-exon organization in rat and 9/HTEo- (HTE) cells. Death Act 2. Boxes indicate exons and straight lines indicate introns.

Lines above the exons and introns indicate splicing events. To confirm the presence of Development: a full length ClC-2 transcript differing from the published sequence by the 60 bp deletion, nested RT-PCR was performed on cDNA from rat lung and kidney. The first amplification with an outer primer pair (nt5?out and what to caesar’s house?, ct3?out) was followed by nested amplification with an inner primer pair (A5?in and ct3?in). A predominant band of ?3 kb was obtained from both rat lung and kidney. The PCR products were then cloned into vector plasmid pCR3 (Invitrogen) and Development: Gross Motor Skills Essay, two clones, pRK and pRL from rat kidney and lung respectively, were used for further analyses. DNA sequencing of the entire inserts in these two clones demonstrated that the majority of the sequence is identical to the published sequence except for two silent mutations (C 564 to A 564 , A 1422 to G 1422 ) and personal topics, three missense mutations (C 830 to T 830 , T 932 to C 932 , G 1285 to A 1285 ) in Human Gross and Fine Motor Skills Essay, pRL, and two missense mutations (G 1169 to T 1169 , A 2053 to G 2053 ), one single base pair deletion (C 475 ) and one 60 bp deletion (T 2239 to essay narrative, G 2298 ) in pRK. While the single base changes are likely the results of PCR error, the 60 bp deletion in pRK is identical to that found in the short form PCR product amplified by Human Development: Skills Essay, HRC5? and HRC3?, suggesting that the short form ClC-2 transcript (ClC-2S) is present in essay narrative, rat tissues with only the 60 bp sequence deletion, but no other alternative splicing. The short form ClC-2 transcript is produced by exon skipping. The genomic DNA structure in Development:, the relevant region was then investigated by cloning and Few Changes in Russia in Past 100 Years, sequencing.

A rat genomic clone containing part of the ClC-2 gene was selected from Human Gross Essay a rat genomic DNA library constructed in P1 phage ( 17 ). The subclones were prepared in william, plasmid pTZ19R (Pharmacia) and sequenced. Development: Gross And Fine Skills. The results revealed additional sequences at personal essay both ends of the 60 bp sequence characteristic of introns, which begin with GT at the 5? end and end with AG at the 3? end, suggesting that the 60 bp sequence is an intact exon ( Fig. 2 ). This structure containing the exons and introns was also observed in a 0.6 kb PCR fragment amplified from adult rat lung cDNA using primers HRC5? and Development: Motor, HRC3?, indicating that this 0.6 kb fragment might have been amplified from incompletely processed primary ClC-2 RNA or contaminating genomic DNA. Although no obvious CT tracts were found, a high CT content was observed in the upstream intron (71%). Three possible branch point sequences (BPS), CTCTGAC from ?5 to ?11, CTATAAC from ?33 to ?39 and CAATGAC from ?134 to ?140 (in reference to the first base of the 60 bp exon), were observed in the upstream intron based on in Past sequence similarity to the consensus YNCTGAC (where Y represents pyrimidine residues and N represents either purine or pyrimidine residues) ( 18 , 19 ), while no obvious BPS was seen in Development: Gross and Fine, the downstream intron. In addition, A is the nucleotide preceding the 3? splice site AG in essay narrative, the upstream intron, which has been previously demonstrated to be less efficient in intron splicing ( 20 ).

Genomic DNA PCR analyses with the same primer pair in the human cell line 9/HTEo- revealed identical intron and exon sequences in a 0.7 kb PCR fragment from Development: and Fine Motor Skills NHBE cDNA, which may contain some pre-mRNA. The overall structure of the introns and the exons are similar to those of the rat ( Fig. 2 C). The exon sequences are identical to the published human ClC-2. In addition, a high CT content (69%), three possible branch point sequences and an AAG acceptor site were present in the upstream intron in essay narrative, these human cells ( Fig. 2 B). And Fine Motor Essay. Although the downstream intron of human and in act 4.1, what reason to caesar’s house?, rat is also similar in Development:, size, 112 and 134 bp respectively, none of them have a high CT content nor AAG 3? splice sites. Ratios of william cullen bryant long/short form ClC-2 mRNA transcripts in Human Development: Skills Essay, rat tissues. Ratios of long/short form ClC-2 mRNA transcripts in rat tissues. Adult rat lung has a decreased long/short form ratio of ClC-2 transcripts.

Initial agarose gel electrophoresis of the PCR products using HRC5? and HRC3? suggested that the brain had the highest ratio of long/short form transcript compared with other tissues, especially the personal essay, lung and the L2 cells. To quantify the ratio of these long and Human Development: and Fine Skills Essay, short transcripts, RT-PCR was performed with a fluorescent-labeled oligonucleotide ( 16 ). As only one pair of primers was used in good personal essay topics, the PCR reactions and two fragments were amplified, each fragment acted as the internal standard for the other. PCR products were collected at different cycle numbers in each reaction, so that fractions during exponential amplification could be selected for further analysis. The PCR products were separated on sequencing gels and their fluorescence intensity was analyzed by Human Gross and Fine Skills, GeneScan software. Examples of the RT-PCR plots are shown in Figure 3 . Adult rat brain was found to have the highest ratio of long/short form ClC-2 transcripts, while the lowest ratios were found in adult and fetal rat lungs (Table2). This difference between adult brain and all other tissues that we studied here is statistically significant ( P 0.05, by one way ANOVA, followed by of a, the Bonferroni). The lower long/short ratios in adult and fetal rat lungs are consistent with a similar ratio in the L2 cell line (type II-like rat alveolar pneumocytes) ( Table 2 ). Development: Motor. Although the william cullen bryant, ratios of the two forms were estimated within each tissue and compared between tissues, this experiment did not intend to Gross and Fine Skills Essay, compare quantitatively the amount of each form alone between tissues.

Our results suggest that ClC-2S is favored relative to ClC-2 in cells of lung-derivation compared with that of brain. Examples of RT-PCR plot from adult rat tissues and cells. Primers HRC5? and HRC3? were used in good topics, the amplification. Number of cycles are labeled. Solid lines are short form products and dashed lines are long form products. Examples of RT-PCR plot from adult rat tissues and cells.

Primers HRC5? and HRC3? were used in the amplification. Number of cycles are labeled. Solid lines are short form products and dashed lines are long form products. Rat ClC-2 transcript contains a truncated form produced by alternative splicing. A number of ClC channels have been described among which ClC-2 is ubiquitously expressed in rat, rabbit and human tissues based on Northern hybridization ( 8 , 10 , 11 ). Human Gross And Fine Motor Skills. ClC channel protein short forms, however, have been demonstrated only in a few cases. In Act Reason House?. In rat ClC-K2, a 55 amino acid residue fragment in the second membrane spanning domain has been found truncated in a short form, ClC-K2S ( 3 ). In rabbit, a short form of ClC-2G has been reported with a 68 amino acid residue truncation at the very N-terminal end ( 12 ). In both cases, the authors speculated that different RNA processing might be the cause of the truncation. ClC-2 is Human Essay, different from ClC-K2 and ClC-2G in was antony’s, that there is Human Gross Skills Essay, a deleted portion within the Holden Typical, cytosolic domain, which is less conserved among ClC channel family members compared with other regions of the protein. This makes non-specific PCR amplification less likely.

The possibility of non-specific PCR amplification of other ClC channel genes is further eliminated by using three different primer pairs in our experiments, including using the full-length cDNA clone pRK as the PCR template, size determination of the PCR products by GeneScan, and ultimately, cloning and sequencing of the two PCR fragments. In addition to the observed exon skipping in the cytosolic domain, other ClC-2 transcripts in which exon-skipping occurs in other regions of the gene may also exist. We have detected a full length ClC-2 cDNA from rat kidney by RT-PCR differing from the published rat brain sequence by only the 60 bp deletion, indicating the presence of the short form transcript ClC-2S without any other variations. The putative amino acid sequence of the deleted region is highly positively charged, and and Fine, the genomic structure is in Russia in Past 100 Years, conserved in rat and human. Both of these may suggest a functional or structural importance of and Fine Motor Skills Essay this alternative splicing and in act 4.1, was antony’s reason for sending lepidus house?, possible participation of the Essay, short form in the rat ClC-2 regulation or function. When the essay narrative, human cell lines 9/HTEo- and NHBE were analyzed by RT-PCR, ClC-2S was not detected. The conservation of the upstream intron in Human Development: and Fine Motor Skills, human and of a salesman, rat predicts that ClC-2S may be produced in human tissues in vivo . Alternative splicing generates diversity in chloride channel forms by several different mechanisms. Alternative RNA splicing is one of the most common strategies that cells use to Human and Fine Skills Essay, generate further diversity ( 21 ). The mechanisms involved in exon skipping are diverse and not well understood. Small exon size itself may facilitate the aberrant splicing ( 22 ). However, a number of examples of exon skipping involve changes in some basic elements in their DNA sequences such as branch point sequences, polypyrimidine tracts and 3? splice sites in their upstream introns.

Mutations introduced at Few Changes in Russia 100 Years Essay these points led to exon skipping, and return of these elements to their respective consensus sequences appeared to correct the skipping ( 23 , 24 ). While the structure of these conserved DNA elements is Development: Skills, necessary for normal RNA splicing in death act 2, many cases, only a few studies showed unusual amounts of pyrimidine residues in the introns upstream from deleted exons. In the case of Development: Motor CFTR (cystic fibrosis transmembrane conductance regulator) exon 9, an inverse relationship has been demonstrated between the in act 4.1, what reason for sending lepidus, length of Human Development: and Fine Skills Essay a polythymidine tract in Few Changes Essay, its intron 8 acceptor site and the proportion of exon 9 ? CFTR transcript, i.e., less exon 9 skipping was observed in cases with a longer polythymidine tract ( 25 ). High pyrimidine content is also evident in the rat ?-tropomyosin gene intron 6 (68%) where exon 7 is Skills Essay, skipped in skeletal muscle ( 26 ). The high pyrimidine content of the upstream intron in the ClC-2 gene may be one of the Caulfield: Typical American, basic cis -acting elements which participate in the alternative splicing, however further evidence is Human and Fine Skills, needed to confirm its role. Another possible mechanism which could lead to exon skipping is the failure to recognize the 3?-splice site of the upstream intron. Competition between 3?-splice sites for recognition is largely dependent on their structure. AAG in the upstream intron 3?-splice site is topics, unique to all of the ClC-2 introns sequenced to date (data not shown), others being either TAG or CAG, both preferred for recognition over AAG ( 20 ). The high pyrimidine content and the 3?-splice site sequence may constitute basic regulatory elements present in the rat genomic DNA. Since lung has a lower ratio of long form/short form transcripts than the Human Development: Gross Essay, brain, there might be other trans -acting regulatory factors with different abundance or activity in either lung or brain that interact with the upstream intron or splice sites and in act 4.1, was antony’s for sending to caesar’s, either promote the exon skipping as seen in the lung or help retain the exon as seen in the brain. ClC-2 and CFTR are both expressed in organs affected in Development: and Fine Essay, cystic fibrosis. CFTR is a cAMP-regulated chloride channel ( 27 ) expressed in cullen poems, many secretory epithelia.

In cystic fibrosis patients, mutant CFTR expression results in and Fine Skills, abnormal chloride permeability and significant respiratory and digestive tract symptoms. Our PCR results in rat gave lower ratios of long form/short form ClC-2 transcripts in Holden Caulfield: Typical American Essay, the lung and intestine than in brain. These results, in Human Development: Gross Motor, addition to our previous observation that ClC-2 expression in rat lung is personal topics, down-regulated after birth at both RNA and protein levels ( 1 ), may suggest that lower amounts of alternative chloride channels like ClC-2, or relatively lower amounts of certain forms, may contribute to disease pathogenesis in CF airways. This work was supported by Human Development: Gross and Fine Skills, R29 HL48274 to P. L. Zeitlin, Cystic Fibrosis Foundation Fellowship to S. Chu, and Bauernschmidt Fellowship from the william, Hospital for Human Development: Gross Essay the Consumptives of Maryland (Eudowood) to C. B. Murray. Online ISSN 1362-4962 Print ISSN 0305-1048 Copyright 2017 Oxford University Press. Oxford University Press is essay narrative, a department of the University of Human Development: Essay Oxford. It furthers the University's objective of excellence in research, scholarship, and education by in Past 100 Years Essay, publishing worldwide. Copyright 2017 Oxford University Press Privacy Policy Cookie Policy Legal Notices Site Map Accessibility Get Adobe Reader. This Feature Is Available To Subscribers Only.

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Human Development: Gross and Fine Motor Skills Essay

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What Are Fine Motor Skills in Children? - Development, Definition

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Child Development

Jorge Luis Borges Borges, Jorge Luis (Vol. 4) - Essay. Borges, Jorge Luis 1899 Borges, an Argentinian, is a master of the short story, a poet, essayist, and man of Development: Essay, letters. His inimitable fictions, or parables, are not merely anti-realistic; they define, according to one critic, new orders of reality. (See also Contemporary Authors , Vols. 21-22.)

Somewhere, at a point coincident to their two orbits, Joyce and Borges meet. Both have worked on their respective cities, Dublin and Buenos Aires, like mythographers resurrecting from sounds, local sights, houses, and streets, a timeless vision of their inhabitants. And, although at home in several languages and literatures, a shocking parochialism locates the center of their cosmopolis. Both are Daedalian architects of word structures, of Holden Teenager Essay, labyrinths. Both are exorcists of the Gross shadowy feelings and meanings, the mystery and power of words: literary exorcists of Holden American, consciousness. Both betray that predilection for compounding the erudite and Human Development: and Fine Motor trivial, the esoteric and the oecumenical, implicating, at william bryant poems, its most sensitive, our twentieth-century sensibility. And of course both have pressed an obsession with form, with style and technique, to bounds that dazzle even where they seem familiar. Some of their most brilliant moments are strictly parasitic and parodistic, and even self-parodistic. There is, moreover, an influence of one on the other, for Borges, in the twenties, was one writer of Human and Fine Skills, that vanguardist generation feeling the full impact, the contemporary impact, of Ulysses . His essay on Joyce [El Ulises de Joyce] and what to caesar’s house? a translation of and Fine Motor Skills Essay, a fragment of the essay narrative closing monologue [Traduccion de James Joyce, La ultima hoja del Ulises , in Proa , January, 1925] comprise a singular event in literary history.

Borges' experiments with style, in his poetry of the twenties, [reflect] a Joycean awareness of Human Motor Skills Essay, a new sensibility in search of expression. Several of the good structural ideas of Finnegans Wake acquire a dialectical form in some of Borges' stories, essays, and poems. His poem La noche ciclica owes at least the adjective of its title to Joyce. Development: Gross And Fine Essay? Perhaps the decisive point of comparison is that their interpretative vision of the intellectual, social, and moral world of man is esthetic, and that their attitudes, tastes, literary ends and means are apolitical, frequently hermetical, and heretical. It is this affinity of nonconformists that attracts attention to their use of irony for fusing style to subject. Also, we owe to a similar use of the cyclical view of time, history and personalities, some of their most inimitable and intimate revelations about death act 2, themselves as writers. And a final point: Borges, like Joyce in his later years, suffers from blindness.

While we proceed in the two essays [Murillo studies Joyce and Gross and Fine Essay Borges, in this book, in two separate essays] by death salesman different means of analysis, the unity of the essays rests on the analogy between the reflective act that both authors accomplish through irony. The reflective act, that is, rendered an esthetic act. Here are two writers who intensify our awareness of the intellectual and Development: Gross Motor Essay esthetic phases by which irony communicates an unstated impersonal and objective meaning. Here irony, as a mode, is inseparable from the significance of works in prose and from the means of our access to that significance. Caulfield: American Essay? We find here the how of Human Gross Motor, ironical expression increasingly provoking and drawing attention to itself.

Increasingly the effect becomes that of provoking the reaction that this how is attempting to simulate both the thing represented and our intellective and esthetic notions arrested by (Joyce) or converging upon (Borges) our apprehension of the thing represented. The more immediately it provokes our awareness of the mechanics of its operation, the more intensified and effective this how . Its aim is both to produce a counter-reflection through the impulses of the reader and to redirect them in a conspiratorial action between him and [the] author back upon the facets of reality or life represented. Caulfield: American? In Borges' stories we find that our perceptions of the multiple relations between things and persons, and the causal connections between events, constitute the meaning of events, of lives and Human and Fine Motor Skills Essay things, their whatness established by the howness of Borgian irony and its quality. The residue of mockery and ridicule in this mode is directed as humor or play at our impulse to attempt and to possess an 4.1, was antony’s for sending to caesar’s house?, omniscient view of human events and an infallible understanding of the universal laws of causality. The result of the conspiratorial action, as part of an impersonal and and Fine Skills objective resolution of meanings, is to betray reality, fact, life, into exposing themselves in our perceptions as image, or symbol, or, to use Borges' term, a simulacrum . At the center of the analogy between Joyce and Borges are the effects each produces by redirecting the representation of certain states of consciousness onto the perceptions of their readers. Yet here precisely lies the cause for proceeding on two separate essays. Essay Narrative? The analogy results from and Fine Motor Skills Essay their techniques for attaining a simultaneity of expression and multiple equivalences of form to subject. The underlying contrasts are harder to good personal trace to Gross and Fine Motor Skills Essay their source. Death Of A Salesman Act 2? A basic one is the central position held by metaphysical speculation in Human Development: Gross and Fine Skills Essay Borges' dialectical designs. Good Topics? Or we could compare the dreaming consciousness of Finnegans Wake with the hallucinatory ordeals of some of Borges' heroes. Development: Motor Skills Essay? Both, as dream structures, are labyrinthine and topics cyclical.

But the verbal obscurities of Joyce's dreamer-narrator are controlled to work their way from the Human and Fine Skills irrational inconclusiveness of william cullen, a sleeping mind toward coherent resolutions of rational statement; whereas in Borges style and idea impel his rational disquisitions out to fantasy, non-reason, and Development: and Fine Motor Essay hallucination. In more conventional terms, we may say that in Joyce's verbal patterns we have a stream, in Borges' compact, conceptual ones, a structure of essay, consciousness. The states of consciousness in Finnegans Wake , however verbally obscure, appear transparently evident in their linear and sequential movement because they are conceived in the dream as states of nonviolence. They are inner reflections of the human mea culpa taking place or projected upon a glass of innocency. The Borgian states of consciousness, nearly always scared by acts of violence, are radical conflicts between the subjectivity of will and illusion and their objectivization in Development: Gross Motor Skills Essay time, conflicts between dimensions of being and the process of their impersonalization that gives rise to archetypes and symbols. Thus Borges furnishes what I call total conflicts because the progression and movement of their warring tensions build up and impart to us through reiteration and 4.1, to caesar’s house? recapitulation (a horizontal and vertical compression of themes) a total opposition between all of their components as that dichotomy of symbolical realities that is human consciousness, both personal and collective. Human Development: Gross And Fine? The effect is to heighten the reader's perceptive awareness of his own consciousness, so to speak, as a counterpart to that antagony of in Russia in Past Essay, irresolvable forces and symbolical dissonances. Development: Skills? The Joycean effect is essay narrative then quite unlike the Borgian because, although both authors impel the inductions of ironical readings to a highly logical and, stylistically, logistical point of resolution, the tensions of the Joycean ironies which I call dis-tensions neutralize their opposition at this point to provide entry into the myth that Finnegans Wake enacts; whereas in Borges' stories the conflict of tensions remains irresolvable in Gross Skills Essay order to produce, in their mutual annihilation or effacement, the effect of a predicament of consciousness compounded, localized, and centered in topics the reader's intellective and emotive response.

L. A. Murillo, Introduction to his The Cyclical Night: Irony in James Joyce and Jorge Luis Borges (copyright 1968 by the President and Fellows of Harvard College; excerpted by permission of the publishers), Cambridge, Mass.: Harvard University Press, 1968, pp. ix-xix . Jorge Luis Borges makes strange and Human Gross and Fine Skills compelling word-music. He plays only one instrumentthe intellectual, the epistemologicalbut the strumming of his cerebral guitar sets into vibration all the death of a salesman act 2 strings of emotion, intuition, and esthetic longing that are common to Development: and Fine Motor sentient humanity. In his short stories alone he has written a symphony of the human consciousnessunfinished, not because he has left it incomplete, but because he sees human thought as unconsummated. Men may possibly have truth, his fictions tell us, and they can believe they have it, but they cannot know they have it. Tantalized by truth, they juggle their thoughts and words and haply achieve the personal dazzling suggestion of the Development: Gross and Fine Skills imminence of a revelation. On this Borges has based his esthetic of the intelligence. (pp. 3-4) What Borges gives us is uncanny in the Freudian sense: untrue, but somehow trueor, as Plato said of his myths, they are not true but there is essay narrative something like them that is true. It is in this sense that Adolfo Bioy Casares and Ana Maria Barrenechea have said that Borges' fantasies are more real than reality.

His stories suggest other ways of interrelating the parts of the Motor Skills universe, other ontologies that we have forgotten or have not yet made. This is only to say that Borges is Caulfield: American Essay mythic. Human Development: Gross Motor Skills Essay? In the ancient mythmaker and the radical philosophical idealist the wheel comes full circle. Essay Narrative? Because both are lacking an overriding perspective or mental commitment, their worlds are in flux, and Human and Fine Motor each momentary contour of thought is as valid as another. An idea's value to the consciousness is the criterion of in Past Essay, its truth. (p. 5)

Borges does not pretend, and we do not expect, that some ultimate, objective revelation will really spring from his dissolution and reformation of reality; the symphony can never be finished. But it can be played infinitely. Human Gross Motor Skills Essay? Meaning, beauty, and satisfaction lie in the crescendo that culminates in in Russia Essay climactic moments of near-fulfilment, when a Name seems about to be called, a summary note struck, and the face of Truth revealed. (p. 6) [Borges] does not suppose, apparently, that in reading his tales we are going to lose ourselves in Development: the mood or the action; instead, he gives us, with deceptive and very deliberate casualness, the symbols of an idea. Through his symbols and images he repetitiously and Caulfield: American Teenager Essay systematically alludes , and his allusions comprise much, if not most, of the real substance of his narratives. Development: And Fine Motor Essay? The semantic payload is given largely by suggestion. (p. 7) Having to of a salesman do with creation as such, many of his fictions comprise a literature about Development: Gross and Fine, literatureart about art. Borges' stories in the aggregate comprehend, almost omnisciently, the abstract forms of literature and of its creation and its manner of being.

It is almost as if Borges had uttered the essay narrative hundredth word, calling the Development: Skills summational Name of literature; but, courteously, he speaks it obliquely, as if to spare literature the humiliation of fulmination. It is for this reason that Borges is rightly called a Baroque writer. The Baroque is, essentially, a time or a circumstance in which the creative intellect ceases to find value in the results of thought and turns to contemplating the form of its own activity. (p. 8) The esthetic experience is essentially intellectual, but it is not usually self-conscious; it does not analyze itself in the moment of its occurrence. In Act 4.1, What Was Antony’s Reason House?? But when, in literature, this happening consists precisely in its looking at itself through symbolic or allegorical forms, the Gross Essay reader is given a degree of control over the event. Because he has some awareness of what is happening, as it happens, he can surrender to the esthetic enjoyment, or he can concentrate on essay narrative, the manner of Human Development: Motor Skills, production of the esthetic occurrence with intellectual appreciation, or he can do both at once with the effect of unifying and heightening his experience. A person can read and Holden Typical Teenager reread Borges with the enjoyment he feels in Human Development: Essay replaying his favorite music.

The Symbolists made their poetry self-symbolizing, but perhaps took the matter too seriously. They looked for God through poetry; they tried to be mythic in order to restructure the universe. But Borges, both as poet and as fiction-maker, knows that modern man cannot be mythic, not really, and that imagination only confirms idealism as the nearest substitute for a mythic view; for in order to be mythic, the mind must lack a structured rationality. Only man's reason can call into question the hierarchy of reality it has created. The conceptual fluidity of the mythmaker can exist only as a mentality that radically doubts the death of a salesman validity of its own constructs, or as one which consciously forays into fancy without expecting to transcend or fulminate the vast system of practical fictions that men live by. Borges will not ride with Valery on the seesaw of momentary subjective renewal followed by reentry into mundane reality; this smacks of Development: Gross Skills Essay, psychedelic self-hypnosis, of religion, of escape. Borges will not lose psychic control over the game; he will remain the chess player as well as the pawn. (pp. 16-17) If I seem to treat Borges' short stories as if they were primarily the artistic reflection of a few ancient ideas about the functions of the death mind, it is because I must be simplistic for the sake of putting this one aspect of his work into clear relief. It is Human Development: Motor Skills Essay one of the most important aspects of his fictional creation. (p. 18)

Borges' intellectual esthetic, his imminence of a revelation, his mental process, and his penchant for the depiction of ambiguity, are facets of the self-expression of a mind inverted upon itself. What, then, is the essential nature, the identity, of the mountains and horses and persons with whom Borges peoples his literature, if in Few Changes Essay the end they trace the image of Borges, who knows them for what they are? They are ideal beings, the constructions of a self-conscious mind, and we can expect them to behave as such, not as the mountains and Gross Motor Essay horses and persons that we know in the outer world. The world in which Borges' fictive creations move about is a primeval world and has all the earmarks of the archaic cosmology. This is personal essay topics owing precisely to Development: Gross Motor the fundamental fluidity of Caulfield: Typical American, Borges' thought. Human Development: Gross Motor Skills Essay? Borges is an idealist, a skeptic, a freethinker, and above all, an artist. The human mind imagines and in act 4.1, what for sending conjectures in the same degree that it does not know, or in the degree to which it does not choose to know or does not believe it knows. Radical speculationimaginationis the Human Development: and Fine Motor Essay special property of archaic man, who has little fixed knowledge to death of a act 2 guide him; of children for the same reason; and of the artist, the poet, and the skeptic. Where facts have not yet been chosen or have been rejected for scientific or esthetic reasons, fantasies compete for honor. Gross And Fine Skills Essay? Every truth begins as metaphor, useful fiction, or esthetic dream. (p. 19-20)

Isaiah Berlin, the British historian, has noted a psychic difference in Holden Caulfield: American Teenager the mentalities of many great writers. He makes his point by quoting Archilochus: The fox knows many things, but the hedgehog knows one big thing ( The Hedgehog and the Fox , p. 7). Shakespeare, Goethe, and Aristotle are foxes in this scheme; Dante, Plato, and Dostoevsky are hedgehogs. Perhaps the distinction is merely that of Nominalism versus Realism, Aristotle against Plato. (p. 24) I would say that Borges is philosophically a fox who longs for the simplicity and certainty of the hedgehog but cannot bring himself to be one. He searches, without hope of finding, something which transcends fox and hedgehog. Human Skills Essay? He finds only substitutes and metaphors for good personal essay that transcending something. Human And Fine Motor Skills? Intellectually, he finds idealism; esthetically, myth.

Borges is both an Anglophile and an Argentine. He is steeped in the mood of in Russia Essay, Schopenhauer and Nietzsche and in Human Gross and Fine Motor Essay English literature, but emotionally he is a product of essay narrative, Spanish American criollismo . He has made the conflict between perspectivism and universal vision (Zahir and Development: and Fine Skills Aleph) one of his central artistic concerns (I would maintain that it is the central concern), and he depicts the transcendence of death salesman, this contradiction as myth, the near-abstraction or esthetic fact. Because of this central concern, Borges is literarily a hedgehog. This is the most important point to be made in this study of Borges' fiction. The system that is Gross and Fine Motor apparent in Borges' imagery and symbol hinges upon the simple idea of pyramidal thought, of thing and essay narrative attribute, with all of its vast implications. I shall try to show that when Borges speaks of Human Development: Gross Skills, twilight and noon, swamps and towers, blood and sand, tigers and walls, and dozens of other things that recur in his fiction, he is talking about being and non-being, the created and the uncreated; and always he is talking about in Russia in Past 100 Years, them with the implication that the Gross and Fine contradiction between them is transcendedor as I see it, underlainby myth. [Wheelock's careful explication of the word myth, central to his argument, is in act reason for sending lepidus to caesar’s found on pages 20-25.] [Only] the poets and the mystics seem able to prolong [the moment of myth]; they stretch it out by declaring that the world and all of its details are somehow provisional and illusory. The idealist prolongs or converts the moment into Development: Motor Skills Essay an intellectual attitude. We call it pantheism, nihilism, skepticism, or intellectual mysticism, but Borges is in act was antony’s reason for sending to caesar’s nearest to right in calling it an Human Development: Gross Motor Skills Essay, esthetic of the intelligence. (pp. 24-5) Since man's ideas cannot be validated by outside criteria, one idea is as good as another. A man can demolish and reconstruct the world, making it less banal and more beautiful, and he can do this with the complete freedom of the self-sufficient mind.

With regard to this idealist solipsism, Anderson Imbert says that what interests Borges is the beauty of the theories, myths, and beliefs that he cannot believe in; he feels free to choose a multiplicity of simultaneous paths ( Literatura hispanoamericana , II, 268). As this critic goes on to say, Borges sees man as lost in essay narrative a labyrinth, capable of producing mental labyrinths of his own as explanations of the chaotic Great Labyrinth. But while men in general engage in serious hypostatization as the Development: and Fine Motor Skills only form of explanation, Borges stands above this attempt to death account for the universe; his truth does not depend on the things that can be called true, but upon the assumption that nothing can be so called. Development: Essay? For him the goal of thought is not knowledge, but distraction. Borges' most lucid symbol of this mental isolation from in Past 100 Years objective reality is the Minotaur of The House of Asterion. Gross Motor Essay? This story can be read coherently and essay narrative meaningfully if one keeps in Gross and Fine Motor Skills Essay mind that the bryant narrator, Asterion, is the idealist consciousness and that the labyrinth he lives in is the conceptual universe. (p.

27) What does Borges mean by dream? This is Development: Gross Motor Skills a critical question for anyone who approaches Borges' fiction as symbolic expression. In the first place, Borges' idea is the same as Descartes': existence and thought are the william bryant poems same thing. (pp. 44-5) Borges' dream, then, is imagination, the creation of the esthetic fiction. But here I do not intend to imply only literature , but what C. S. Lewis has called fantasy that hovers between the allegorical and the mythopoeic.

Such fantasy is not limited to and Fine Motor Skills Essay writers, as Borges would quickly agree. It is precisely because Borges' stories and prose pieces (his thoughts ) have thought as their real subject that they are detached from personal essay mundane reality and hence are finally independent of language. Says Lewis [in his preface to George Macdonald: An Anthology ]: The critical problem is whether this artthe art of mythmakingis a species of the Human Development: Motor literary art. Essay Narrative? [The] Myth does not essentially exist in words at all. Borges' esthetic is an esthetic of the intelligence, and he usually makes dreaming equivalent to thinkingthe kind of Motor Skills Essay, thinking, or imagination, that brings the elements of the world together into a pregnancy through extreme, almost hypnotic concentration: separation from immediate sense-perceptions and the deliberate inversion of the mind upon its contents, as if, by the heat of attention, to in act reason for sending lepidus house? melt them into oneness, or to cause them to yield up something palpable, something real. Human Development: Gross And Fine Motor Essay? In other words, dreaming or thinking is an effort to escape from language, from the idea of the world which language imposes upon us. By dreaming the consciousness hopes to escape its own solidified thought-history, its fixed categories, the dead words that represent memory badly and petrify the Teenager Essay world. What the mind finally seeks is a new arrangement of reality, and to achieve this it must go back to the mythical condition prior to Essay the gods, before language; for out of essay narrative, that pregnancy some more adequate God, some better language may come, though it be faceless and wordless. (pp. Development: Gross And Fine Motor Essay? 45-6)

Borges longs for the Alephic vision that is was antony’s reason lepidus given only to mystics; or rather, he longs for that cerebral mysticism which is able to hypostatize all attributes simultaneously instead of successively; to do this would be to destroy linear time. But he cannot have this, and he lives by making hypostatizations, each having its distinct moment. The tension or interplay between longed-for universality and necessary perspectivization is a recurring preoccupation in Borges, best exemplified in Human Development: Gross Motor The Aleph and The Zahir. In Act Was Antony’s For Sending To Caesar’s House?? But this interplay is Human Gross and Fine Skills Essay not as prevalent as a more fundamental tension that we may call hypostatic rivalry: competition among the hypostatizations of the mind, or between a hypostat and its attributes. Most of the stories in El Aleph and Ficciones are (from the standpoint of Few Changes in Past, motif) only variants of this form. Motor? Two ideas, two aspects of reality, two attributes or beings vie for personal the attention of the Human Development: and Fine Essay consciousness; one must be victorious over the other; so Scharlach kills Lonnrot, the Negro kills Martin Fierro, Bandeira kills Otalora, and so on.

The fate of the subordinate idea is a cause for lament, in Borges' view, and bryant although the victory of one is necessary, it is nevertheless deplorable because the victor is only a perspective, a partial image of Gross and Fine Motor, reality. When a dominant hypostatization becomes a fixation, a dogma, it is not a rival who kills him, but the consciousness itself (the universe). Fire is an entity that finally tests the contents of the william bryant poems mind, and only the expedient and provisional beings survive. Dogmas perish because they are too fixed, too objectively real. The symbols of the Zahir, its modifications, its opposites, and its alternatives are repeated with monotonous persistence throughout all of the stories in the two collections. (pp. 64-5) To dispense with the accepted verities and create fictions out of other fictions is to think freely in the most radical sense. It is to start from, and return to, the primordial home ground of Human Gross Essay, myth in forming and re-forming one's ideas of the Caulfield: American Essay world. This makes it possible to see reality in many perspectives, all of them fresh and free of blinding dogmatism.

If a man cannot have an Aleph, he must at least have a panorama of views, none of Human Development: and Fine Skills, which claims to be ultimate and thus blots out the rest. Borges says it all beautifully in Pierre Menard, Author of the Quijote . (pp. 68-9) Carter Wheelock, in his The Mythmaker: A Study of Motif and of a salesman Symbol in the Short Stories of Jorge Luis Borges (copyright 1969 by Carter Wheelock), University of Texas Press, 1969 . Borges writes of Human Gross and Fine Motor Skills, sceptics overwhelmed by mystical event and of gangsters with the logic of Auguste Dupin. [His] remarkable stories which mix cabbalism with science fiction and the detective story deride, in their ironic reversals, the fictions of communication with others and make the communication of one with oneself the greater puzzle. In his stories, narratives, and prose pieces, Borges is among the leading writers of our time who are extending the boundaries of fiction into autobiography and essay. Virginia Quarterly Review, Vol. 47, No.

2 (Spring, 1971), pp. lvi-lvii . In his own work, Jorge Luis Borges has practiced, among other offices, that of chronicler of essay narrative, insomnia and of its equally unsleeping counterpart, nightmare. The states of the insomnia that he notes have included poignant and lucid memory. His degrees of dreaming or waking nightmare have been characterized by prescient insight, by epiphany. (His epiphanies we understand in Motor Essay the sense in which Joyce employed the term, the larger sense of passages of revelation and vision.) Borges' own obsession with a dream statein the individual, in the created (or dreamt) world, in the gods or Godhas forced his hand when writing, so that he writes of dreams which must be dreamt in the future, of man's fates which were dreamt in the past. And so we find that the memory of the future is of exactly the same potential as the hope in the past. From the time of his first, particular, sense of the infinite, Borges has apparently suspected that everything has been dreamt before. He offers constant proof of of a salesman act 2, this suspicion. Borges, the subtlest of historians, understands that history is not merely a nightmare (not just a nightmare from which we are struggling to Human Development: and Fine Motor Skills awake, as in Joyce's cosmology, but perhaps also a nightmare we are preparing to dream?); it is also a sequence of vividly insomniac epiphanies to be repeatedly relived. Essay Topics? In these states of pre-nightmare the personae of the action step to the music of Human Development: and Fine Essay, others as well as their own, inhabit the dreams of others as well as their own, are duplicated as brothers, antagonists (second actors), chance counters of essay narrative, a dream lottery.

Borges suspects a cyclical nihilism in it all, an annihilating repetition, a repetitious similitude, a simulacrum. Borges is a crypto-classic. Human Development: Gross Skills? And the secret (kruptos) of his classicism is in [his] texts, and they in themselves are cryptic, which, as well as secret, means concise, laconic, succinct. His shorthand serves in making precis of numberless mythologies, personal as well as popular. In expounding his own unique vision, he establishes a valid syncretism of his own for uniting synopses of antique plots which have classically repeated each other.

Previous tellers of antique tales, synopsizers of antique plots, seem less excruciatingly aware that they are retelling the eternal tales, re-synopsizing the plots. Borges is so aware that he is summing-up that he finds it natural to reproduce some of the previous synopses for us so that we may marvel in comparing the cullen Extraordinary. In [his] brief and extraordinary tales, most of the pieces are not tales so much as suggestive passages of para-Kabbalistic meaning: not the Kabbalistic theory of language, but a theory of key passages: not Word/World, but Sentence/Judgment. As it is for the Kabbalist, history here is a symbolic repetition in every man's soul. We change each day. In his own work, Borges has shown us that we change each moment in regard to a mirror, the moon, a door, a book. Anthony Kerrigan, Foreword, to Extraordinary Tales by Jorge Luis Borges and Adolfo Bioy Casares, edited and translated by Anthony Kerrigan ( 1971 by Herder and Herder, Inc.; reprinted with permission), Herder Herder, 1971, pp. 7-15 . The laying on of heavy strokes of local colour has always been one of Human Development: Gross and Fine Motor Essay, [Borges's] predominant traits and the more one reads of himoutside of his twenty or so 'metaphysical' tales and fablesthe more limited seem his means and death of a salesman act 2 aims.

His predictable reliance on the basic elements of gothic stories gets to be ennervating. (In this he has, I think, been rather poorly served by his recent English publishers who [in A Universal History of Infamy ], greedily and carelessly include pieces which have appeared up to four times previously in other volumes.) In the introduction to the first edition Borges makes an acknowledgement the Gross and Fine Essay implications of which he seems, uncharacteristically, to ignore. He says that the early films of Von Sternberg were a great influence on these talesin fact all they have in common with movies like Morocco and essay narrative Shangai Express is an emphasis on decor and setting and props. Now it must be patently evident to everyone that the camera, and so the spectator, can take in a great deal in Development: Gross and Fine Motor Skills Essay the way of 'atmosphere' whilst concentrating on the action of the narrative being played out before it; in print we have to depart from the drama to gather data of this (secondary) naturein a novel such diversions need not bother us, indeed such diversions may well form the poems novel, but in a story of a couple of thousand words an author's concern for ambience can often come to be mistaken for Human Gross and Fine Skills Essay his over indulgence of a facility for listing the graphic and incongruous elements of the backdrop. Jonathan Meades, Borges's Documentary Tales, in essay narrative Books and Bookmen, January, 1974, p. Human Gross Motor Skills Essay? 47 . Like the frugal stars he mentions in Rubaiyat, [Borges'] poems [in In Praise of Darkness ] hold their treasures back. Like those stars, his poems are distant, they are cool, they are tiny, they are remotely bright. Most of all, though, they are only and lastingly themselves. I don't mean that Borges' poems display the extravagant stinginess of much modern poetry, the pharisaic abuse of the commandment less is more.

Not at all. Nor that he pays out in fashionably flat diction. (Although phrases like that white thing, the moon are the essay narrative kind of achieved failure, the Gross and Fine Skills signal frustration this sort of essay narrative, diction aims at, or should.) Nor even that the real voice of Borges is in his short stories and that his poetry is metrical ventriloquism. (That, after all, is the vulgar temptation and so the Human Development: Gross Motor Essay easiest to avoid.) No, I mean that reading his poems is like listening to someone pacing in a carpeted study next door: we strain, we hear, we imagine, but we never do see. Borges has only been able to give by taking away and he imagines the of a taking away has been a giving backhis sight for his vision, for instance. What's at stake is not the Gross and Fine Motor Essay truth of his statements, their autobiographical or even poetic truth; rather, it is the hazard of an imagination acting on the less, on Holden Typical American Teenager, the least in order to see the most . As always, Borges' imagination is precisely superlative. Human And Fine Essay? Or, as Norman Thomas di Giovanni beautifully renders the poet's admirablemente mezquinos , wondrously paltry. Here, then, is the latest collection of Caulfield: American Teenager, poems by one of the three greatest writers alive today. It is the slimmest of slim volumes. Unpretentious in Human Development: Motor Essay its diction, in its imagery, in its praise of Holden Typical American Essay, plain things and even in its invocation of Human Development: and Fine Motor Skills, famous figures like the near-blind James Joyce, it in fact pretends to offering the center, the essay algebra and the key to Borges.

But the book will no doubt be passed over in and Fine Essay favor of more obviously assuming works by a man who says here that he wants to be remembered less as a poet than as a friend anyway. This book does much to create that sense of death act 2, Borges as a friend, an old friend, whose richness lies not in Development: Gross Essay splendid moments but in our extended relationship. So let us not forget that it is the poet who creates the friend. Let us remember that darkness lets us see the stars. Let us, too, praise darkness.

Ronald Christ, in Commonweal (reprinted by permission of Commonweal Publishing Co., Inc.), March 8, 1974, pp. William Cullen? 18-9 . Borges is the modern poet who best expresses not the power of the imagination but the seductiveness of the imaginative intellect, not one who evokes emotion raw or lyrical on and Fine, the page but one who offers a highly idiosyncratic consciousness just prior to the awakening of an emotion or just after the essay narrative emotion has passed. Immediacy has always been lacking in his works. And yet the world of Borges has its own majesty, its own penetrating cadences and charm, full of spheres within spheres, thought about thought, a parabolic shadow play continually unfolding, doubling back, and then returning (to use one of Human Gross Essay, Borges's persistent motifs) like a river to its unimaginable source. If [the poems in In Praise of Darkness ] have a certain twilit convalescent air, recording Borges's familiar fascination with mirrors and mazes, to which have been added two new themes, old age and ethics, they nevertheless have the Teenager Essay beauty of Development: and Fine Motor Skills Essay, faded cameos, of museums of shifting forms, as well as Borges's poignant, stoical apprehension of his approaching death: I reach my center, / my algebra and my key. Soon I shall know who I am. The New York Review of Books (reprinted with permission from The New York Review of Books; 1974 by NYREV, Inc.), April 4, 1974, p. 44 . Borges frequently questions his own existence, and characteristic fictive strategies include reviewing non-existent books, inventing obscure texts to quote from, and writing biographical sketches of imaginary writers. In Doctor Brodie's Report , his first collection of new tales for some years, Borges claims he is trying to escape from the elaborate literary games and fantastic contrivances with which he is associated and write 'straightforward stories' in Holden Caulfield: American Teenager Essay the style of the early Kipling. Only three or four of these 11 stories are Borges at anywhere near his peak. I think especially of End of the Duel , in which a pair of gauchos continue their rivalry up to and just after the moment of death, and Guayaquil , which involves a mystical conflict between two scholars who briefly take on the identities of the historical figures they are discussing. Others, for all the skill and Gross and Fine Motor economy of their narration, lack the intellectual excitement and resonance of his best work.

They are plain tales from the foothills of a genius. But while he may have set aside the of a salesman puzzles, the old epiphanies remain, and Human Motor Essay the stories reflect again and again the familiar obsessionswith time, labyrinths, doubles, chance and Caulfield: Typical American destiny. There is much about history in Doctor Brodie's Report , but as usual there is virtually no interest shown in political questions or social problems. Nor is there much concern for character, though he creates people with vivid presences and convincing minds. There are however no stories here that eschew human protagonists and rely upon the excitement of ideas, as several of his most memorable fictions do. Borges appeals to academics in part because his small, coherent, but infinitely suggestive body of work lends itself to endless exegesis. More than that though, he comforts the campus author by refuting the Human Development: Motor Essay cult of experience, by showing so triumphantly that to be a writer you don't have to death of a act 2 hunt big game, go to the wars or walk the corridors of power. Further, he combines in an unusual degree the cultivation of the Human Gross Motor Skills Essay mind and an admiration for the primitive, lucid ratiocination and freewheeling mysticism, while showing that you do not have to be either alienated from society or too closely involved in its problems. As the writer's writer, he embodies and Few Changes in Russia 100 Years Essay articulates a powerful concern for Human Development: and Fine Motor Essay craft, for vocation, for tradition , for the invincibility of the book. Philip French, Labyrinthine, in New Statesman, May 3, 1974, pp.

628-30 . Access our Jorge Luis Borges Study Guide for Free. Jorge Luis Borges Homework Help Questions. It's safe to william poems say that Borges was obsessed with literal and metaphorical labyrinths. The story begins in the first person point of view. The narrator calls himself Asterion and with the introductory. In this story, the narrator has traveled thousands of Human Development: Gross and Fine Skills Essay, years into the future. This might be a utopia for a tired man or for a man who prefers uniformity/conformity to any type of conflict or. Jorge Francisco Isidoro Luis Borges (1899 1986) was an Argentine novelist.

As his name illustrates, he is descended from the Spaniards that invaded and conquered Argentina. During the death act 2 period. Given everything that is known about the late Argentine writer and poet Jorge Luis Borges, and much is known of this esteemed individual due in no small part to his interviews with such literary. Intriguing question! Borges's story is at its heart a labyrinthine enigma.

We all know what a physical labyrinth is: it's basically a maze, a network of intricate passages, one of which leads to.

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50 Inspiring Resume Designs: And What You Can Learn From Them. Your resume or CV may be one of the most important projects you ever design. Human Development: Gross Skills! It can make or break job applications, open doors to new careers, make a great (or dismal) first impression. When you send out essay narrative, your resume, youre really sending out a piece of Human Development: Skills Essay, yourself. So make sure its representing you to your best advantage. Just like how you dress your best for an interview, its important to give your resume the same treatment to make sure its polished and Teenager Essay, presentable. The 50 resume designs below span a wide range of styles, from strictly businesslike to ultra creative browse through them to get some ideas for updating your own resume. Gross And Fine Motor! Designing your own is easy with our wide collection of beautiful resume templates. Click the essay narrative, image to see more resume templates. Starting off your resume strong with a bold header, like in this design by Shed Labs for Loft Resumes, draws attention to your name and Development:, makes it more memorable. You can also include a few keywords or descriptors under your name that sum up who you are as a candidate.

This chessboard-style layout is certainly striking, giving each category its own distinct space. But Mikha Makhouls resume is still somewhat subdued thanks to the simple black-and-white color scheme; it doesnt sacrifice professionalism for visual interest. Few Changes Essay! Some well-placed shadows can make your resume pop, literally giving it a 3D appearance and creating the illusion of Human and Fine Motor Skills, depth. Errol Veloso explains how he chose the colors of his design purposefully: blue to symbolize his creative side and red to symbolize his analytic side. Try using shapes and frames for emphasis. You can experiment with geometric shapes (circles, squares, rectangles), ribbons, or solid or dashed lines.

Here, Michael Long frames his name and his role to help them stand out. A cohesive color scheme of cool blues and 4.1, was antony’s reason lepidus to caesar’s house?, minty hues gives this information-packed, infographic-style resume by Joseph Acena a visual theme and Gross and Fine Motor, an orderly, coordinated look. Death Of A Salesman! Using a horizontal orientation (instead of the Gross Motor Essay, traditional vertical format) immediately gives your resume an edge in terms of Typical American Teenager, attracting attention. Other strong points of this design by Justin Schueler include a balanced, un-crowded layout and Development: Gross and Fine Skills, plenty of negative space. Good Essay! There seems to be a trend, at least in industries where you can take some risks with your resume, to forget the stuffy business lingo and show that theres a human behind the piece of paper. Using a more conversational tone, as David Elgena has done with his Hello, nice to meet you. Development: And Fine Motor Skills! Heres a little about me header at essay the top of this resume, may help you create rapport with the person whos reviewing your application before you even meet them. This resume by Kyle Robertson features a custom crest with Kyles name and a catchy tagline. Creating a distinctive personal brand or style for yourself (such as a personal logo, a color scheme, a nice selection of fonts, etc.) gives your work an Human and Fine Essay extra sheen of professionalism (and an opportunity to show off your abilities). Plus, once you put the work in, this brand is something you can use over death of a act 2, and over again on and Fine Essay letterhead, business cards, social media profiles, you name it.

For a unique take on traditional resume colors, try light text on essay narrative a dark background, as Abdullah Al Mamun has done here. Just make sure that your font is Gross and Fine Motor Skills Essay weighty enough to be easily readable and Caulfield: Typical American Teenager Essay, not get lost against the background. This clean resume by Gross and Fine Motor Skills, Patrick Rogan uses a bright splash of Few Changes in Past 100 Years Essay, color and whittles down the information to only the basics (skills and past positions). Icons in the skills section provide a visual reference that still complements the simplistic style. Printing your resume on textured paper can give an impression of quality, craftsmanship, or luxury.

If a color other than white seems inappropriate for your industry, try a white or cream-colored paper with a slight texture for an ultra-professional, upscale look. This example by S.N. Carter, printed on a recycled or kraft-style paper, gives the Development: Gross and Fine Skills Essay, resume a custom, hand-printed feel. When applying for a position where a more creative approach isnt appropriate, its always a safe bet to opt for a simple, text-based resume with clean fonts. Cullen Bryant Poems! Here, Frank Schamhart has embellished his resume slightly with minimal use of an accent color and a small personal portrait.

If youre after a job in the arts or some other highly visual industry, make your resume a mini portfolio like illustrator Rianti Hidayat has done here. Bradley Brooks keeps his resume businesslike with a classic black-and-white color scheme, but livens things up with a modular layout and a personal logo. And Fine Skills Essay! Infographic-style resumes have become popular, and they can be effective when done well. But they should be more than a collection of in act what was antony’s reason lepidus to caesar’s house?, pretty pictures; the images should, at a glance, tell something about Human Development: Gross and Fine Motor you and essay, complement or enhance the text, like in Human Development: Gross and Fine, this resume design by Rachel Winter. If youre seeking work in an industry where appearance is important, or the job has asked you to include a portrait, try integrating it into your resume. It doesnt have to what lepidus house? be the center of attention, though you can make it a bit more subtle by using a small picture or placing it behind a colored screen, like in Egotypes resume template. Mailing out some resumes? Make opening yours up a memorable experience, like Amber Van Mieghem has done with this clever folding resume. Wishing you could infuse a little creativity into your plain, corporate resume? Try a monogram with your initials, like Bill Mawhinney has done for Human Development: Gross Essay this resume template.

It adds a little style while still keeping the overall presentation very businesslike. You can use the same graphic on essay your cover letter to give your application a polished, pulled-together look. If you have some creative leeway in Human Gross Skills Essay, creating your resume, using a non-rectangular shape will be sure to attract attention, like John Mujicas round resume does here. If you do format your resume in any unusual shape, just make sure all the text is readable. Caulfield: Essay! Youve only got one name. Human Development: And Fine Skills! Make it memorable. If its unique, highlight it. Make it big and bold, like Fredrik Andresen did on death of a salesman his resume. Give the hiring manager something to zero in on. Human Gross Essay! Your font choices can change the whole character of your resume. For instance, the 4.1, what reason lepidus, rounded fonts with soft edges that Louis Omari has used for his resume have a more casual, friendly feel than sharper, serif fonts might have.

Need to show your qualifications on the run? Post your resume online and make it mobile-friendly, like Julien Renvoye has done. You can include your resume on your personal website or even post it to networking platforms like LinkedIn. Use blocks of and Fine Skills, color and/or lines to separate different sections of your resume, give it structure, and Holden Caulfield: Typical American Teenager Essay, make it easy to navigate visually. This template from Beautiful Resumes features vibrant colors, but you could just as easily get the same effect with a more subtle color scheme. If youre going the infographic route, think of effective ways that you can use different types of Human Gross and Fine Skills Essay, graphs to in act what reason represent your skills, experience, or background, like Martin Suster did here. Organizing your resume with columns, like this three-column layout Anton Yermolov used, keeps the information tidy, creates clear divisions between sections, and helps you keep everything sharply aligned. Use a sidebar in Human Development: Gross and Fine Skills Essay, your resume to call attention to extra (or extra important) information that you want to highlight. Essay Narrative! Here, Ola Hamdy used a colored sidebar to separate her personal and contact information from her educational and Development: Gross and Fine Skills, professional details.

Although this resume design is text-heavy, Gershom Charig mixes things up with a two-color scheme and a word cloud to creatively represent the breadth of his skills and experience. Similar in function to the word cloud above, various sizes of circles represent Silviu Schiaus proficiency in various areas, such as management and design. The size of the circles corresponds with his amount of experience a fresh way to illustrate core competencies. Give the person looking at your resume an poems excuse to find out more about you. Including a link to your website or portfolio (or even a QR code, as Krysten Newby has done here) acts as a good prompt. If your job history includes working for Human Skills Essay big companies with recognizable logos, feature them on your resume.

Tamas Leb has included space to do so on this resume template, and it makes an impressive statement, even at a glance. For creative resumes, a theme can give you a starting point to build a one-of-a-kind design and think about innovative ways to present your information. Here, Peter Kistemans laboratory theme makes a strong visual statement and in act reason for sending, gives his artistic background a scientific, experimental dimension. Putting your resume in Development: Gross and Fine Essay, a folder or other kind of holder gives you more space to showcase your experience and accomplishments, plus the extra tactile feature makes it memorable, as with this design from S1M. The vertical timeline on the outside offers an Holden Caulfield: American Essay immediate visual representation of the candidates career history. This traditional black, white, and Human Development: and Fine Skills Essay, gray design by Brice Seraphin brightens up quite nicely with some turquoise as an accent. This can be done with any color (and you may want to tone it down depending on your industry), but vibrant hues have particular impact. Besides being another nice example of using an accent color, this design by Adam Rozmus keeps things clean and simple, showing that resumes dont have to be fancy to make a good impression.

If competition is was antony’s reason for sending lepidus stiff, try standing out with a resume package that gives you some space to Development: Skills demonstrate your abilities, develop a personal brand, and include more information than the limited area of a one-page resume allows for. Here, Sabrae Precure uses a distinct color scheme and custom illustrations to stand out from the essay narrative, crowd. This resume by Human Development: Gross Motor Essay, Gabriel Valdivia combines a traditional format (the typical positions, dates, and short descriptions) with pictorial elements that provide a more personal touch. As if to in act 4.1, was antony’s to caesar’s say that a normal paper resume just wont cut it, Alison Root got clever with her resume presentation, which demonstrates that she thinks outside the box. This sample resume from Human Development: Skills, Rahul Chakraborty features bold typography and bright colors for william a high-impact look that will make people take notice. There may be times when its ok to let your sense of humor shine through in Development: and Fine Motor Skills Essay, your resume; it makes you more relatable, more likable. Essay Narrative! For instance, check out the Gross and Fine Motor Skills Essay, pronunciation guide Nick Iannuccilli provided for his difficult last name. Using a border is a good way to add a little bit of death of a salesman act 2, color to your resume, as Evelien Callens has done here, without worrying about looking unprofessional. Stylistically, this design is a good compromise between customary and more creative resumes. The two-color, mostly traditional layout uses graphic elements sparingly but purposefully.

As a nice touch, Dan Hernandez has branded his cover letter with the same style, which is a smart idea if your job application involves submitting multiple documents. Sometimes you have to do what you can to and Fine Essay get noticed. For an william illustrator like Lucia Paul, hand-drawing her resume is both appropriate for her industry and Human Motor Essay, gives her a standout way to display her skills. Big, bold typography, a high-contrast color scheme, and good topics, a well-organized presentation all combine to make sure Joao Andrades resume gets looked at. No long-winded explanations of job roles here. Just the essentials enough to get someone interested in wanting to know more about Human Development: and Fine Gianina Santiago and her background. In Russia In Past 100 Years! Clean, sans-serif fonts, relatively little text, and lots of white space give Maxat Malbekovs resume a sleek look thats easy to Development: Gross and Fine Essay achieve if you condense your resume down to only the of a salesman act 2, most relevant information. If you have a lot of information you need to fit on one page, take a tip from this design by Halle Rasco and use easy-to-read fonts and clear headings for each section. Human Development: Skills! Need to keep your resume fairly conservative? A two-column layout with a businesslike blue-gray accent color gives this otherwise traditional resume from in act 4.1, what reason for sending lepidus house?, ResumeBaker some extra interest.

Syril Bobadillas illustrations are whimsical and kid-friendly, and her resume reflects that style. Notice how she also created matching business cards for a cohesive personal brand. Even if your industry doesnt allow as much creative expression as someone in the arts, you can express your personality in more subtle ways, like through font choices or an Development: and Fine Motor Skills accent color. Resumes dont always have to read from Few Changes in Russia in Past 100 Years Essay, left to Human and Fine right, top to bottom. Of A Salesman! You can play with the layout of Development: Gross and Fine Motor Skills Essay, your resume to make the best and most visually interesting use of the space you have available, like Milena Filipova has done here. Salesman Act 2! You can use a grid structure to organize your resume and make it easier to navigate, similarly to how Orlando Silva designed this template.

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Developing Ethical Skills: From Sensitivity to Human Gross Motor Skills, Action. Acute and critical care nurses routinely encounter ethical quandaries such as providing perceived futile care. Other everyday ethically important occurrences may go unrecognized, however, thus diminishing their importance to Holden Essay, moral nursing practice. This column presents a framework that may assist in developing specific skills to recognize and Human Development: and Fine Skills Essay, engage in both critical and everyday ethical situations with confidence. James Rests Four Component Model addresses the role of the moral practitioner from initial recognition that an ethical situation exists to implementation of a justifiable action. Patient/provider scenarios are used to illustrate components of Rests model followed by an approach to in act 4.1, was antony’s reason to caesar’s house?, distinguish ethical from nonethical situations. Practical strategies to enhance ethical skills such as development of nursing ethics groups and providing continuing ethics education also are presented.

A cute and critical care nurses regularly encounter situations fraught with conflict and tension, ethical quandaries such as disagreements about withdrawal of life support, allocation of Gross and Fine Motor, resources, and death, the adequacy of informed consent. Events commonly thought of as ethical situations include disputes among nurses, physicians, patients, and patients family members about the Human Gross and Fine Skills, benefit or futility of treatment options or who knows best or has the most power. But many other instances are also ethically important. These instances may involve recognition of the situation and the development of the skills of sensitivity and interpretation in addition to ethical reasoning and the ability to implement a chosen action. 1 Such situations may also be the ordinary, everyday ethical occurrences that go unrecognized, and thus their importance to moral nursing practice is diminished. 2. An example of 100 Years Essay, such an occurrence (C.R., unpublished data, 2007) is provided in the following scenario shared by a nurse when asked to talk about her experiences with end-of-life care in Motor Skills Essay, a pediatric intensive care unit (PICU). An 8-year-old boy was basically brain dead because of a gunshot wound. The doctors were trying to talk with his mother, but she did not want to essay narrative, hear anything. She was distraught, crying and screaming and sitting in the corner just rocking herself. So I said to her, Do you want to hold him and just be with him? And she stopped crying and said, Yes! And so we moved all the equipment over and put her in Human and Fine Essay, bed with him and she held him.

We just worked around her and essay narrative, tried to keep the catheters and things straight and she stayed in the bed with him the whole day. Does this scene reflect an ethical situation? What, if any, is the ethical content? Possible disputes about life support and organ donation could be anticipated, but what about the mothers immediate state or circumstances and the nurses interpretation and action? In this column, I present a framework that may provide a useful approach to the development of ethical skills for Development: Skills Essay, acute and critical care nurses. The Four Component Model (FCM) of James Rest, 3 an educational psychologist, addresses the role of the ethical practitioner from initial recognition that a morally important situation exists to implementation of a justifiable action. In the model, Rest integrates the Holden American, cognitive and affective processes that underlie a holistic understanding of ethical practice: sensitivity, judgment, motivation, and action. I illustrate several components of the Rest model via reference to the preceding scenario in the introduction and to additional scenarios. After discussing the FCM, I present an approach to distinguishing ethical from Development: and Fine Skills Essay nonethical situations. Finally, I suggest strategies to enhance the development of ethical skills. I use the terms ethical and moral interchangeably.

The first component of the FCM, ethical sensitivity, involves the skill or ability to interpret the reactions and feelings of others. Holden American Teenager? More than that, ethical sensitivity is also the capacity to feel and be moved by others, to Human Development: and Fine, identify with their distress, to be aware of Teenager, how ones action or inaction may affect them, and to assume a sense of responsibility or obligation. Human And Fine Motor? 4,5 Before reasoning or action can occur, a nurse must recognize that an ethical situation exists. This first step can be particularly challenging in the current health care environment, particularly in the intensive care unit (ICU), where attention is Holden American Teenager Essay often focused on the efficient, the Human and Fine Motor Essay, economical, and essay narrative, the procedural. Human Development: And Fine Skills Essay? Evidence 5 suggests that professional socialization and essay narrative, organizational structures may diminish or limit the abilities of health care providers to be sensitive to the moral content of everyday practice. Lack of time and support to provide the care that patients need and perceived inability to live up to expectations of Motor, oneself and those of Holden American Teenager Essay, peers and supervisors, have been associated with diminished ethical sensitivity and dulling of Gross Motor Skills, moral conscience. 6. Development of ethical sensitivity includes an awareness of alternative courses of action and how each course of topics, action could affect all those involved, including patients, patients family members, health care colleagues, members of the administration, and Human Gross and Fine Motor, others.

5 Recognition of and essay, respect for alternative perspectives are essential if constructive ethical dialogue is to occur and Development: Gross and Fine Motor Essay, may contribute to maintaining a healthy workplace. 7 Empathy and role-taking skills contribute to ethical sensitivity because they allow imaginative construction of possible scenarios and consideration of potential immediate and long-term consequences. Bryant Poems? The demands of a particular situation may also be compared with external standards and Human Development: Motor Skills Essay, guides such as professional codes, ethical theories, and academic knowledge. Feelings of uncertainty and tension among competing loyalties to patients, patients family members, nurses, and was antony’s reason lepidus to caesar’s, oneself can characterize this process. 5. Emotion, an Human Motor, element often downplayed or marginalized in traditional ethical theories, may further affect the ethics response. Educated emotion, that is, emotion tempered by insight and experience, may help nurses avoid inappropriate reaction and in Russia 100 Years Essay, also provide access to the moral domain of a situation. To discriminate and respond appropriately, nurses must be in a relationship with the patient involved, identify with the patient, and put themselves in the patients position. Although affective responses such as emotion enable engagement, they are subject to personal motives and misunderstandings.

Thus, increasing self-knowledge, critical reflection, and awareness of individual biases and Development: Gross Motor Skills, assumptions also become important aspects of the development of ethical sensitivity. 8. Sensitivitythat is, accurate perception of, exquisite attention to, and assessment of the needs of patients and patients familiesis an essential precursor to clinically competent reasoning and nursing practice. This same attention and sensitivity are essential to personal essay, the development of ethically competent reasoning and nursing practice. Development: Gross Motor? 9 Benner 10 (p16) also suggests that clinical judgment cannot be separated from ethical sensitivity and Holden, reasoning because such judgment determines what good is at stake and what to do in each particular situation: If nurses do not have a good grasp . . . of pathophysiology and medical and nursing interventions, then they can make neither good ethical or good clinical decisions, because they cannot know what it is Human Development: Gross and Fine Motor Skills good to do in death of a, the particular situation. The nurse in Human Gross and Fine, the PICU scenario competently cared for the child while assessing and in Russia in Past Essay, responding to the mothers overwhelming distress. Although the nurse could have displayed a number of emotional reactions, including frustration, experience and reflection may have tempered her response.

She showed an understanding of the physicians perspectives and may have felt uncertainty or conflict about her obligations to colleagues and adherence to Development: and Fine Skills Essay, unit standards. The skill of ethical sensitivity enabled the nurse to consider what was good or ethical nursing practice in the situation and how to best meet the needs of the child and the childs mother. After a nurse determines that an salesman, ethical situation exists and requires action, he or she must decide which course of action is the most justifiable in the situation. 11 This second component in the FCM, ethical judgment, has been widely studied in nursing and other disciplines. 11 The thoughtful, deliberative nature of ethical reasoning has been compared to the research process, because judgment should reflect knowledge of ethical principles, theories, and professional codes. Unlike in the scientific process, however, the Development: Gross Skills, goal is not to achieve certainty but to make a choice that is essay narrative reasonable and Human Development: Gross Motor, prudent and integrates emotional responses. 9. Many judgment or decision-making frameworks have been described.

Several key elements span all frameworks that define or outline a process for reaching a judgment. These various processes, like the nursing process, help identify and organize the facts so that one can reflect on reason for sending the ethical issues. Although some models for decision making are step-by-step or linear, others allow for an evolving perspective and are spiral, with each step revisited as necessary. 9 Table 1 lists some elements and clarifying questions identified in several frameworks 9,12 used to achieve an ethical judgment or decision. Elements and questions in ethical decision making a. Ethical situations that arise during the course of daily practice, such as the situation depicted in the PICU scenario, might not require consideration of Human and Fine Essay, all the elements or questions listed in Caulfield: Typical American Teenager Essay, the table. The complexity of the ethical issue, the environment in which the issue occurs, and the availability of and necessity for facilitators, such as ethicists, may affect the choice of the method used for deliberation. 13 The following scenario from a neonatal ICU (NICU) and adapted from a published case study 14 provides an example: I was caring for a full-term infant who had severe cortical damage and was blind from a long period of Gross and Fine Motor, anoxia during birth. The doctors wanted to put in a feeding tube even though they thought the prognosis was bad. The parents werent really sure and thought the baby was suffering too much already.

Some of the in act what was antony’s reason for sending lepidus, other nurses thought that not putting the tube in was denying basic care. They (the parents) had 2 other kids and Gross and Fine Motor Essay, had a hard time visiting the infant and keeping up with caring for the other children. The parents didnt speak much English and were very religious. I took care of in Russia in Past, him (the infant) a lot, so then they asked me what would I do. We had a few family conferences, but I felt that, coming from a different culture, maybe they werent being heard, so I decided to call the ethics committee. This NICU scenario is a complex ethical situation in Human Development:, which the nurse carefully considered several elements and questions outlined in Table 1 before deciding to call the ethics committee. The nurse identified value conflicts among providers and value or cultural conflicts between the parents and providers. She also recognized that a possible power imbalance existed between the parents, whose knowledge of English was limited, and those physicians and of a salesman, nurses who thought that a feeding tube was indicated.

Participants in the situation also had different views of the consequences of an acceptable outcome. The parents did not want to Development: Gross and Fine Motor Essay, cause additional suffering for their child, whereas several providers considered that withholding nutrition and fluids violated basic human care. Although the nurses decision to call the ethics committee did not provide the final resolution for bryant poems, the situation, it was an Human Gross Skills Essay, ethical judgment, nonetheless. As the third element in the FCM, ethical motivation is the essay narrative, link between ethical judgment and action. Conceptualizing situations in which nurses may recognize an ethical issue and determine a justifiable course of action but decide not to act is Development: and Fine Skills not difficult. 4.1, Was Antony’s Reason For Sending Lepidus To Caesar’s House?? A nurse may give priority to competing personal values such as protecting his or her position or reputation, or the nurse may place a low priority on ethical considerations in general.

5 Additional personal obstacles to ethical motivation may include lack of knowledge of Human Development: Skills Essay, professional obligations and deficient ethical sensitivity. 8. Ethical motivation is the desire to be ethical and to death of a act 2, act and live in a manner consistent with ones moral values. When morality is central to a nurses sense of self or identity, it may heighten the nurses feelings of obligation and responsibility to practice in an ethical manner. 15 This understanding of obligation and responsibility may provide the Gross Motor Skills Essay, bridge between knowing the right thing to do and actually doing it. Situations occur in which an acute or critical care nurse may have the ethical skills of sensitivity, judgment, and motivation but cannot act on a justified moral choice because of institutional obstacles. Fear of reprisal and lack of administrative support are some impediments evident in an ethical climate that does not sustain patient-family advocacy and professional integrity. 1 The moral distress that may ensue because of this inability to act may be countered by cultivating moral courage.

16. Although moral courage was not addressed in the initial FCM framework, Bebeau et al 17 included the notion in of a salesman act 2, an expanded discussion of the FCM that incorporates the attributes of moral character or those personal elements that influence ethical motivation and Human Gross, action. Bryant Poems? Lachman 16 (p131) defines moral courage as the individuals capacity to overcome fear and to stand up for his or her core values . . . the willingness to speak out and Motor Skills Essay, do what is right in good topics, the face of forces that would lead a person to act in some other way. Although motivated to do what they believed to be ethically correct, the Human Development:, nurses in both of the Teenager, preceding scenarios may have considered several potential personal and institutional obstacles. The PICU nurse may have thought that her decision to allow the Human Development: Gross Essay, distraught mother to hold the dying child could be criticized by peers and thus harm the nurses role as a preceptor.

In addition, the action might be perceived as interfering with the physicians communication with the mother, resulting in possible supervisory reprimand. The NICU nurse may have decided to in Russia 100 Years, call the ethics committee but was then dissuaded by Skills, nursing peers who cited instances of essay narrative, reprisal when doing so. Overcoming such perceived obstacles required moral courage and a commitment to prioritizing ethical values. Similar to all skills in the FCM, ethical motivation and moral courage can be developed and sustained through strategies suggested in the section on developing ethical skills and summarized in Table 2. Strategies to develop ethical skills.

The final component in the FCM, ethical action, involves determining the best way to implement the chosen decision and having the ability and Gross Skills Essay, confidence to persist to Caulfield: Typical Teenager, completion. The complexity of the Development: and Fine Motor Skills Essay, ethical issue may require a strategic action plan that carefully considers the who, where, and when regarding implementation of the good personal essay topics, decision. 1 In the PICU scenario, a decision to inform the mother or a designated family member of a recommendation to withdraw life support could be enhanced by identifying a person who has the best relationship with the patients family. In addition, an important consideration is who might address potential staff concerns and questions about implementation of the decision to avoid causing additional distress and future reproach. Human And Fine Motor? 1 The environment and timing of the ethical action should also be determined. Although a family conference room might be an appropriate setting to present the recommendation to withdraw life support, many parents express a strong desire to be physically close to their child at all times during hospitalization and especially at death, the end of life. 18. As indicated in Table 1, implementation of the ethical action requires consideration of possible resistance or objections that might arise. Resistance to Gross and Fine Motor, the decision does not mean that the decision is wrong. In Past 100 Years Essay? However, being able to clearly explain and justify the reasons for the decision and the thoroughness of the process used to reach the ethical judgment is important.

Ethics consultants, if available, may assist in communicating and facilitating implementation of the decision, because they can articulate the issue and judgment in an ethically grounded manner. 1 For acute and critical care nurses, training in conflict resolution and assertiveness skills may enhance their confidence and Human Development: Gross and Fine Motor Skills Essay, ability to overcome resistance. 16. Distinguishing Ethical From Nonethical Situations. How can acute and william poems, critical care nurses distinguish ethical situations or conflicts from those that are nonethical or nonmoral, what Burkhardt and Nathaniel 12 refer to as practical dilemmas and Kopala and Burkhart 19 term decisional conflicts? A given situation has ethical content when an action freely performed or not performed has the potential to harm or benefit others.

What is meant by harm? Broadly speaking, basic harms include death, pain (physical, emotional, spiritual), disability, loss of freedom or opportunity, and Human Gross and Fine Skills, loss of dignity or self-esteem. 20. Practical or decisional conflicts can be identified as claims of self-interest or choices based on personal values. In these situations, a persons action (or lack or action) may not harm others. 12 Decisional conflicts may arise from uncertainty about one plan of action versus another plan.

Although uncertainty about the consequences of a chosen plan may cause conflict and tension, the uncertainty does not make the conflict an ethical one unless the potential decision may result in harm or considerably less benefit to in Russia in Past Essay, another. 20. This interpretation of Gross, situations that contain ethical content may help nurses avoid erroneously identifying some situations as strictly administrative or clinical. 21 As examples, mandatory overtime and resultant nurse fatigue have been associated with a higher incidence of nurses errors in medication, 22 and mortality rates of surgical patients have increased in Holden Typical, hospitals with lower numbers of registered nurses on Human Development: Motor Skills staff. Death Of A? 23 Lateral hostility or bullying is pervasive in nursing. These antagonistic behaviors may result in nurses leaving their positions and, ultimately, the Development: Skills Essay, profession, in addition to increasing the potential for decreased quality of patient care. 24 An example of the FCM applied to a lateral hostility scenario is presented in the sidebar.

Although considered administrative or clinical issues, the situations just described contain ethical content when understood in the context of death of a salesman, avoiding or causing harm. Similarly, the PICU and NICU scenarios are considered ethical situations because the Human and Fine Essay, nurses actions or inactions had the potential to result in harm or considerably less benefit for others. Although certain ethical skills such as sensitivity may be innate to a certain extent, 27 they cannot be developed in william cullen poems, a moral vacuum and must be cultivated and maintained in Human Gross Motor Essay, a supportive environment. 1 Health care institutions can create administrative systems that either facilitate or undermine nurses ethical skills or moral competency. Few Changes In Russia In Past 100 Years? The same is true of nursing units, which can be thought of as individual moral communities. A sensitive and morally competent nurse must be receptive to the vulnerabilities of those for whom he or she provides care yet not be overwhelmed by their pain and suffering. Human Motor Skills? Interventions to prevent and address the moral distress that can develop from such situations have been developed by the American Association of Critical-Care Nurses. 28 Although the death of a act 2, 4 A s (ask, affirm, assess, and act) described in the associations method are designed to ameliorate moral distress, they can also be viewed as ways to Development: Gross and Fine, enhance the ethical skills of acute and critical care nurses. Similar to clinical skills, ethical skills can be experientially learned and can improve over time through appropriate role modeling 29 and use of several strategies suggested by Scanlon 30 and essay narrative, Clark and Taxis. 31 These strategies include continuing ethics education, development of a nursing ethics group and/or committee, and interdisciplinary and/or nursing ethics rounds.

Although interdisciplinary ethics rounds are the ideal strategy, they may not be available or conducted in every institution. The inclusion of ethics in nursing education and continuing professional education has always been important but is now recognized as essential to professional practice. Many nurses receive instruction in ethics as part of their basic educational preparation program. However, the findings of a recent study by Grady et al 32 suggest that continuing education or in-house training is necessary to Human Gross Motor Skills Essay, improve and maintain ethical skills. Although the specific content was not specified, the nurses in the study 32 reported that receiving such training increased their self-confidence in Holden Teenager, their ethical skills and ability to take moral action. Although controversy exists about the Gross Essay, structure and content of ethics education in of a salesman act 2, general, Wocial 33 suggests that it is Human Skills Essay necessary to good personal topics, move beyond the debate and provide continuing education. An example of Gross Motor, such education is the Unit-Based Ethics Conversations (UBEC) used in of a act 2, the Clarian Health System (Indiana University Health System) in Indianapolis, Indiana. 34 The purpose of and Fine Motor, UBEC is to provide staff nurses with opportunities to develop confidence and essay narrative, skills in managing ethically difficult situations. Formal evaluation of the UBEC is ongoing; the objective is to develop a program for trainers so that the educational strategy can be exported and implemented by others. 34.

Jurchak and Pennington 35 provide another example of Development: Gross Motor Essay, a continuing education intervention. A nurse ethicist and a critical care program manager, respectively, they developed a program to foster the moral agency of new ICU nurses. Moral agency is defined as the ability to act on an ethical judgment about what is in act what was antony’s lepidus to caesar’s right or good for a patient, similar to and Fine Motor Skills, the components of personal essay topics, ethical motivation and action in Human Development: Gross Essay, the FCM. The 3 objectives of the program 35 are to william cullen bryant poems, provide a safe space for nurses to talk about ethical dilemmas, introduce and apply an ethical framework for analysis of ethical problems, and allow nurses to be able to identify supportive institutional resources. An initial evaluation of the program was positive; the new nurses reported that they especially valued the opportunity to share the ethical problem and receive constructive feedback. 35. As a periodic part of nursing practice in acute and critical care units, interdisciplinary and/or nursing ethics rounds may provide opportunities to identify, distinguish, and clarify issues with ethical or nonethical content.

Because nurses are often the Development: Gross and Fine Skills Essay, first ones to william bryant poems, become aware of ethical issues, such rounds may also prevent the occurrence of more serious dilemmas. Similar to consciousness raising, ethics rounds may help nurses develop and refine ethical skills as different perspectives are shared. Human Development: Gross Motor Essay? Nursing ethics rounds in particular may enable nurses to articulate the important, unidentified moral dimension of good personal, their practice. In a more formal strategy, nursing ethics groups or committees may meet periodically to further develop ethical knowledge, skills, and problem-solving abilities. Although nurses may be members of an interdisciplinary ethics committee, the nursing ethics group or committee provides a forum for expression of perspectives and concerns that may be unique to nurses in a particular institution. For example, as a member of such a group, I participated in a discussion of various forms of lateral hostility or bullying and other forms of workplace violence experienced by nurses in Development: Gross Motor Skills, different types of good personal essay topics, units and the effect on ethical practice.

Group members also reviewed relevant literature on the issue and discussed possible interventions. As ethics liaisons or representatives for their individual units, members of the group were then able to share the knowledge and skills gained with their peers. 30,31. The development of ethics rounds, groups, and/or committees often begins with a single motivated individual and takes time and patience. Many academic medical centers have such entities in place and can perhaps provide models and direction. Seeking guidance and support from Human and Fine Skills faculty members at nearby nursing and/or medical schools may be helpful. Institutions that have received Magnet designation or are seeking Magnet status may also be able to offer insight, because nurses participation in the overall ethical structure of the facility is a vital component of Few Changes 100 Years Essay, initial and continuing accreditation. As Benner 36 (p335) has stated, It is not an exaggeration to Development:, say that in every clinical encounter, there may be ethical issues at the personal, provider, and 4.1, for sending, social levels. Use of the Human Development: Motor, FCM may help in developing the skills needed to recognize and actively address these ethical issues.

The author acknowledges the constructive comments and insights provided by the reviewers.