Homeobox

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Homeodomain
The Antennapedia homeodomain protein from Drosophila melanogaster bound to a fragment of DNA. The recognition helix and unstructured N-terminus are bound in the major and minor grooves respectively.

A homeobox is a DNA sequence, around 180 base pairs long, that regulates large-scale anatomical features in the early stages of embryonic development. Mutations in a homeobox may change large-scale anatomical features of the full-grown organism.

Homeoboxes are found within genes that are involved in the regulation of patterns of anatomical development (morphogenesis) in animals, fungi, plants, and numerous single cell eukaryotes. Homeobox genes encode homeodomain protein products that are transcription factors sharing a characteristic protein fold structure that binds DNA to regulate expression of target genes.Homeodomain proteins regulate gene expression and cell differentiation during early embryonic development, thus mutations in homeobox genes can cause developmental disorders.

Homeosis is a term coined by William Bateson to describe the outright replacement of a discrete body part with another body part, e.g. antennapedia—replacement of the antenna on the head of a fruit fly with legs. The "homeo-" prefix in the words "homeobox" and "homeodomain" stems from this mutational phenotype, which is observed when some of these genes are mutated in animals. The homeobox domain was first identified in a number of Drosophila homeotic and segmentation proteins, but is now known to be well-conserved in many other animals, including vertebrates.

Discovery

Drosophila with the antennapedia mutant phenotype exhibit homeotic transformation of the antennae into leg-like structures on the head.

The existence of homeobox genes was first discovered in Drosophila by isolating the gene responsible for a homeotic transformation where legs grow from the head instead of the expected antennae. Walter Gehring identified a gene called antennapedia that caused this homeotic phenotype. Analysis of antennapedia revealed that this gene contained a 180 base pair sequence that encoded a DNA binding domain, which William McGinnis termed the "homeobox". The existence of additional Drosophila genes containing the antennapedia homeobox sequence was independently reported by Ernst Hafen, Michael Levine, William McGinnis, and Walter Jakob Gehring of the University of Basel in Switzerland and Matthew P. Scott and Amy Weiner of Indiana University in Bloomington in 1984. Isolation of homologous genes by Edward de Robertis and William McGinnis revealed that numerous genes from a variety of species contained the homeobox. Subsequent phylogenetic studies detailing the evolutionary relationship between homeobox-containing genes showed that these genes are present in all bilaterian animals.

Homeodomain structure

The characteristic homeodomain protein fold consists of a 60-amino acid long domain composed of three alpha helixes. The following shows the consensus homeodomain (~60 amino acid chain):

            Helix 1          Helix 2         Helix 3/4
         ______________    __________    _________________
RRRKRTAYTRYQLLELEKEFHFNRYLTRRRRIELAHSLNLTERHIKIWFQNRRMKWKKEN
....|....|....|....|....|....|....|....|....|....|....|....|
         10        20        30        40        50        60

The vnd/NK-2 homeodomain-DNA complex. Helix 3 of the homeodomain binds in the major groove of the DNA and the N-terminal arm binds in the minor groove, in analogy with other homeodomain-DNA complexes.

Helix 2 and helix 3 form a so-called helix-turn-helix (HTH) structure, where the two alpha helices are connected by a short loop region. The N-terminal two helices of the homeodomain are antiparallel and the longer C-terminal helix is roughly perpendicular to the axes established by the first two. It is this third helix that interacts directly with DNA via a number of hydrogen bonds and hydrophobic interactions, as well as indirect interactions via water molecules, which occur between specific side chains and the exposed bases within the major groove of the DNA.

Homeodomain proteins are found in eukaryotes. Through the HTH motif, they share limited sequence similarity and structural similarity to prokaryotic transcription factors, such as lambda phage proteins that alter the expression of genes in prokaryotes. The HTH motif shows some sequence similarity but a similar structure in a wide range of DNA-binding proteins (e.g., cro and repressor proteins, homeodomain proteins, etc.). One of the principal differences between HTH motifs in these different proteins arises from the stereochemical requirement for glycine in the turn which is needed to avoid steric interference of the beta-carbon with the main chain: for cro and repressor proteins the glycine appears to be mandatory, whereas for many of the homeotic and other DNA-binding proteins the requirement is relaxed.

Sequence specificity

Homeodomains can bind both specifically and nonspecifically to B-DNA with the C-terminal recognition helix aligning in the DNA's major groove and the unstructured peptide "tail" at the N-terminus aligning in the minor groove. The recognition helix and the inter-helix loops are rich in arginine and lysine residues, which form hydrogen bonds to the DNA backbone. Conserved hydrophobic residues in the center of the recognition helix aid in stabilizing the helix packing. Homeodomain proteins show a preference for the DNA sequence 5'-TAAT-3'; sequence-independent binding occurs with significantly lower affinity. The specificity of a single homeodomain protein is usually not enough to recognize specific target gene promoters, making cofactor binding an important mechanism for controlling binding sequence specificity and target gene expression. To achieve higher target specificity, homeodomain proteins form complexes with other transcription factors to recognize the promoter region of a specific target gene.

Biological function

Homeodomain proteins function as transcription factors due to the DNA binding properties of the conserved HTH motif. Homeodomain proteins are considered to be master control genes, meaning that a single protein can regulate expression of many target genes. Homeodomain proteins direct the formation of the body axes and body structures during early embryonic development. Many homeodomain proteins induce cellular differentiation by initiating the cascades of coregulated genes required to produce individual tissues and organs. Other proteins in the family, such as NANOG are involved in maintaining pluripotency and preventing cell differentiation.

Regulation

Hox genes and their associated microRNAs are highly conserved developmental master regulators with tight tissue-specific, spatiotemporal control. These genes are known to be dysregulated in several cancers and are often controlled by DNA methylation. The regulation of Hox genes is highly complex and involves reciprocal interactions, mostly inhibitory. Drosophila is known to use the polycomb and trithorax complexes to maintain the expression of Hox genes after the down-regulation of the pair-rule and gap genes that occurs during larval development. Polycomb-group proteins can silence the Hox genes by modulation of chromatin structure.

Mutations

Mutations to homeobox genes can produce easily visible phenotypic changes in body segment identity, such as the Antennapedia and Bithorax mutant phenotypes in Drosophila. Duplication of homeobox genes can produce new body segments, and such duplications are likely to have been important in the evolution of segmented animals.

Evolution

The homeobox itself may have evolved from a non-DNA-binding transmembrane domain at the C-terminus of the MraY enzyme. This is based on metagenomic data acquired from the transitional archaeon, Lokiarchaeum, that is regarded as the prokaryote closest to the ancestor of all eukaryotes.

Phylogenetic analysis of homeobox gene sequences and homeodomain protein structures suggests that the last common ancestor of plants, fungi, and animals had at least two homeobox genes. Molecular evidence shows that some limited number of Hox genes have existed in the Cnidaria since before the earliest true Bilatera, making these genes pre-Paleozoic. It is accepted that the three major animal ANTP-class clusters, Hox, ParaHox, and NK (MetaHox), are the result of segmental duplications. A first duplication created MetaHox and ProtoHox, the latter of which later duplicated into Hox and ParaHox. The clusters themselves were created by tandem duplications of a single ANTP-class homeobox gene. Gene duplication followed by neofunctionalization is responsible for the many homeobox genes found in eukaryotes. Comparison of homeobox genes and gene clusters has been used to understand the evolution of genome structure and body morphology throughout metazoans.

Types of homeobox genes

Hox genes

Hox gene expression in Drosophila melanogaster.

Main article: Hox gene

Hox genes are the most commonly known subset of homeobox genes. They are essential metazoan genes that determine the identity of embryonic regions along the anterior-posterior axis. The first vertebrate Hox gene was isolated in Xenopus by Edward De Robertis and colleagues in 1984. The main interest in this set of genes stems from their unique behavior and arrangement in the genome. Hox genes are typically found in an organized cluster. The linear order of Hox genes within a cluster is directly correlated to the order they are expressed in both time and space during development. This phenomenon is called colinearity.

Mutations in these homeotic genes cause displacement of body segments during embryonic development. This is called ectopia. For example, when one gene is lost the segment develops into a more anterior one, while a mutation that leads to a gain of function causes a segment to develop into a more posterior one. Famous examples are Antennapedia and bithorax in Drosophila, which can cause the development of legs instead of antennae and the development of a duplicated thorax, respectively.

In vertebrates, the four paralog clusters are partially redundant in function, but have also acquired several derived functions. For example, HoxA and HoxD specify segment identity along the limb axis. Specific members of the Hox family have been implicated in vascular remodeling, angiogenesis, and disease by orchestrating changes in matrix degradation, integrins, and components of the ECM. HoxA5 is implicated in atherosclerosis. HoxD3 and HoxB3 are proinvasive, angiogenic genes that upregulate b3 and a5 integrins and Efna1 in ECs, respectively. HoxA3 induces endothelial cell (EC) migration by upregulating MMP14 and uPAR. Conversely, HoxD10 and HoxA5 have the opposite effect of suppressing EC migration and angiogenesis, and stabilizing adherens junctions by upregulating TIMP1/downregulating uPAR and MMP14, and by upregulating Tsp2/downregulating VEGFR2, Efna1, Hif1alpha and COX-2, respectively. HoxA5 also upregulates the tumor suppressor p53 and Akt1 by downregulation of PTEN. Suppression of HoxA5 has been shown to attenuate hemangioma growth. HoxA5 has far-reaching effects on gene expression, causing ~300 genes to become upregulated upon its induction in breast cancer cell lines. HoxA5 protein transduction domain overexpression prevents inflammation shown by inhibition of TNFalpha-inducible monocyte binding to HUVECs.

LIM genes

Main article: LIM domain

LIM genes (named after the initial letters of the names of three proteins where the characteristic domain was first identified) encode two 60 amino acid cysteine and histidine-rich LIM domains and a homeodomain. The LIM domains function in protein-protein interactions and can bind zinc molecules. LIM domain proteins are found in both the cytosol and the nucleus. They function in cytoskeletal remodeling, at focal adhesion sites, as scaffolds for protein complexes, and as transcription factors.

Pax genes

Main article: Pax genes

Most Pax genes contain a homeobox and a paired domain that also binds DNA to increase binding specificity, though some Pax genes have lost all or part of the homeobox sequence. Pax genes function in embryo segmentation, nervous system development, generation of the frontal eye fields, skeletal development, and formation of face structures. Pax 6 is a master regulator of eye development, such that the gene is necessary for development of the optic vesicle and subsequent eye structures.

POU genes

Main article: POU family

Proteins containing a POU region consist of a homeodomain and a separate, structurally homologous POU domain that contains two helix-turn-helix motifs and also binds DNA. The two domains are linked by a flexible loop that is long enough to stretch around the DNA helix, allowing the two domains to bind on opposite sides of the target DNA, collectively covering an eight-base segment with consensus sequence 5'-ATGCAAAT-3'. The individual domains of POU proteins bind DNA only weakly, but have strong sequence-specific affinity when linked. The POU domain itself has significant structural similarity with repressors expressed in bacteriophages, particularly lambda phage.

Plant homeobox genes

As in animals, the plant homeobox genes code for the typical 60 amino acid long DNA-binding homeodomain or in case of the TALE (three amino acid loop extension) homeobox genes for an atypical homeodomain consisting of 63 amino acids. According to their conserved intron–exon structure and to unique codomain architectures they have been grouped into 14 distinct classes: HD-ZIP I to IV, BEL, KNOX, PLINC, WOX, PHD, DDT, NDX, LD, SAWADEE and PINTOX. Conservation of codomains suggests a common eukaryotic ancestry for TALE and non-TALE homeodomain proteins.

Body plan

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https://en.wikipedia.org/wiki/Body_plan

Modern groups of animals can be grouped by the arrangement of their body structures, so are said to possess different body plans.

A body plan, Bauplan (pl. German: Baupläne), or ground plan is a set of morphological features common to many members of a phylum of animals. The vertebrates share one body plan, while invertebrates have many.

This term, usually applied to animals, envisages a "blueprint" encompassing aspects such as symmetry, layers, segmentation, nerve, limb, and gut disposition. Evolutionary developmental biology seeks to explain the origins of diverse body plans.

Body plans have historically been considered to have evolved in a flash in the Ediacaran biota; filling the Cambrian explosion with the results, and a more nuanced understanding of animal evolution suggests gradual development of body plans throughout the early Palaeozoic. Recent studies in animals and plants started to investigate whether evolutionary constraints on body plan structures can explain the presence of developmental constraints during embryogenesis such as the phenomenon referred to as phylotypic stage.

History

Among the pioneering zoologists, Linnaeus identified two body plans outside the vertebrates; Cuvier identified three; and Haeckel had four, as well as the Protista with eight more, for a total of twelve. For comparison, the number of phyla recognised by modern zoologists has risen to 36.

Linnaeus, 1735

In his 1735 book Systema Naturæ, Swedish botanist Linnaeus grouped the animals into quadrupeds, birds, "amphibians" (including tortoises, lizards and snakes), fish, "insects" (Insecta, in which he included arachnids, crustaceans and centipedes) and "worms" (Vermes). Linnaeus's Vermes included effectively all other groups of animals, not only tapeworms, earthworms and leeches but molluscs, sea urchins and starfish, jellyfish, squid and cuttlefish.

Cuvier, 1817

Haeckel's 'Monophyletischer Stambaum der Organismen' from Generelle Morphologie der Organismen (1866) with the three branches Plantae, Protista, Animalia

In his 1817 work, Le Règne Animal, French zoologist Georges Cuvier combined evidence from comparative anatomy and palaeontology to divide the animal kingdom into four body plans. Taking the central nervous system as the main organ system which controlled all the others, such as the circulatory and digestive systems, Cuvier distinguished four body plans or embranchements:

1. with a brain and a spinal cord (surrounded by skeletal elements)
2. with organs linked by nerve fibres
3. with two longitudinal, ventral nerve cords linked by a band with two ganglia below the oesophagus
4. with a diffuse nervous system, not clearly discernible

Grouping animals with these body plans resulted in four branches: vertebrates, molluscs, articulata (including insects and annelids) and zoophytes or radiata.

Haeckel, 1866

Ernst Haeckel, in his 1866 Generelle Morphologie der Organismen, asserted that all living things were monophyletic (had a single evolutionary origin), being divided into plants, protista, and animals. His protista were divided into moneres, protoplasts, flagellates, diatoms, myxomycetes, myxocystodes, rhizopods, and sponges. His animals were divided into groups with distinct body plans: he named these phyla. Haeckel's animal phyla were coelenterates, echinoderms, and (following Cuvier) articulates, molluscs, and vertebrates.

Gould, 1979

Stephen J. Gould explored the idea that the different phyla could be perceived in terms of a Bauplan, illustrating their fixity. However, he later abandoned this idea in favor of punctuated equilibrium.

Origin

20 out of the 36 body plans originated in the Cambrian period, in the "Cambrian explosion". However, complete body plans of many phyla emerged much later, in the Palaeozoic or beyond.

The current range of body plans is far from exhaustive of the possible patterns for life: the Precambrian Ediacaran biota includes body plans that differ from any found in currently living organisms, even though the overall arrangement of unrelated modern taxa is quite similar. Thus the Cambrian explosion appears to have more or less completely replaced the earlier range of body plans.

Genetic basis

Further information: evolutionary developmental biology and morphogenesis

Genes, embryos and development together determine the form of an adult organism's body, through the complex switching processes involved in morphogenesis.

Developmental biologists seek to understand how genes control the development of structural features through a cascade of processes in which key genes produce morphogens, chemicals that diffuse through the body to produce a gradient that acts as a position indicator for cells, turning on other genes, some of which in turn produce other morphogens. A key discovery was the existence of groups of homeobox genes, which function as switches responsible for laying down the basic body plan in animals. The homeobox genes are remarkably conserved between species as diverse as the fruit fly and humans, the basic segmented pattern of the worm or fruit fly being the origin of the segmented spine in humans. The field of animal evolutionary developmental biology ('Evo Devo'), which studies the genetics of morphology in detail, is rapidly expanding with many of the developmental genetic cascades, particularly in the fruit fly Drosophila, catalogued in considerable detail.

Slave health on plantations in the United States

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The health of slaves on American plantations was a matter of concern to both slaves and their owners. Slavery had associated with it the health problems commonly associated with poverty. It was to the economic advantage of owners to keep their working slaves healthy, and those of reproductive age reproducing. Those who could not work or reproduce because of illness or age were sometimes abandoned by their owners, expelled from plantations, and left to fend for themselves.

Life expectancy

A broad and common measure of the health of a population is its life expectancy. The life expectancy in 1850 of a White person in the United States was forty; for a slave, it was twenty-two. Mortality statistics for Whites were calculated from census data; statistics for slaves were based on small sample-sizes.

Diseases among slaves

European physicians in the West Indies frequently shared their knowledge of black-related diseases with North American colleagues. Diseases that were thought to be "negro diseases" included, but were not limited to:

• tetanus
• nascentium, or "nine day fits"
• high infant mortality
• worms
• diphtheria
• whooping cough
• cholera
• typhoid
• tuberculosis
• influenza
• hepatitis
• rheumatism
• "scabies"
• "frambesia" (yaws)
• lepra vulgaris and psoriasis
• leprosy
• syphilis

While working on plantations in the Southern United States, many slaves faced serious health problems. Improper nutrition, the unsanitary living conditions, and excessive labor made them more susceptible to diseases than their owners; the death rates among the slaves were significantly higher due to diseases.

Considered today to be abuse based on pseudo-science, two alleged mental illnesses of negros were described in scientific literature: drapetomania, the mental illness that made slaves desire to run away, and dysaesthesia aethiopica, laziness or "rascality". Both were treated with whippings.

Slave diet

There are contrasting views on slave's diets and access to food. Some portray slaves as having plenty to eat, while others portray "the fare of the plantation [as] coarse and scanty". For the most part, slaves' diet consisted of a form of fatty pork and corn or rice. Historian Ulrich Bonnell Phillips found that slaves received the following standard, with little or no deviation: "a quart (1 liter) of cornmeal and half-pound (300 gm) of salt pork per day for each adult and proportionally for children, commuted or supplemented with sweet potatoes, field peas, syrup, rice, fruit, and 'garden sass' [vegetables]". Scholars came to realize that the slave's diets were quantitatively satisfactory, but not qualitatively sufficient. The poor quality of food led to slaves that were either "physically impaired or chronically ill".

Antebellum plantations had a larger population of hogs than cows, therefore producing more pork than beef. There are a few reasons behind having more pigs than cows: a stereotype that slaves preferred pork over beef, pigs were easier to feed, beef was harder to preserve so it was typically only served fresh (which happened more often in the winter because the cold slowed spoiling), a fear of fresh meat because it was believed that it caused disease among blacks (which it was probably not that fresh), and the planters' conviction that "hog was the only proper meat for laborers".

Due to the shortage of cows, slave diets lacked milk. There was often a stereotype in the Antebellum South that slaves were lactose intolerant. However, many slaves had trouble digesting lactose (in dairy products) because it was not a staple in African diets. Due to the summer heat and the poor quality of the animals themselves, milk became a scarce product only available seasonally. When it did become available, it was first given to Whites and if any remained, then to slave children. Additionally, there is some scientific hypotheses behind blacks more often being lactose intolerant than Whites today. In West Africa, the presence of the tsetse fly made raising cattle practically impossible, creating a historical situation in which there was no need for humans to develop higher levels of the lactate enzyme (which allows the body to digest lactate).

Due to slaves' diets lacking quality, there were many vitamin and nutrient insufficiencies that lead to sicknesses. These were not recognized at the time as caused by poor diet.

• Vitamin A deficiency led to weakened eyesight. (Vitamin A was not identified until the 20th century.)
• Lack of milk contributed to diseases such as rickets and calcium deficiency, causing weakened bones.
• Inadequate iron led to anemia.

Clothing

The masters only gave slaves pairs of "gator shoes" or "brogans" for footwear, and sometimes children and adults who were not working had to walk around barefoot. These clothes and shoes were insufficient for field work; they did not last very long for field slaves. It is judged that the health of male workers broke down rapidly after they joined the field gangs.

Medical attentions

Page from Francis T. Tennille Slave Medical Care Accounts, 1859-1860

"Evidence exists that many...masters provided some health care for their slave investments.... Some planters employed doctors to come every two weeks to check on slaves' health and give them any needed medicine." This was quite lucrative for the physicians.

However, slave masters often tried to cure their ill slaves before they called for a doctor. Planters wishing to save money relied on their own self-taught skills and the help of their wives to address the health care needs of slaves. Some Black people developed or retained from African heritage their own brand of care, complete with special remedies, medical practitioners, and rituals. If the home treatment did not help to improve the slave's condition, they would then send them to the physician or ask the doctor to come to the plantation. A slave who became ill meant loss of working time; death an even greater loss. Given the cost of slaves and their importance to plantation economies, planters organized slave hospitals to treat their serious health problems. There were also separate physicians for slaves and whites because it was believed that slaves' bodies were fundamentally different from whites'. Due to this thinking, many slaves became the subjects of physician's experimental interests to help expand both the physician's knowledge and reputation, often resulting in slave's mutilation and death.

Slave hospitals

Slave hospitals were thought to be an essential part of plantation life by Dr. A. P. Merrill and Dr. Samuel A. Cartwright. The physicians believed that the slaves' bodies were biologically and physiologically different than those of Whites; therefore, they should have their own resource for medical attention and treatment. In some histories of the Antebellum South, like William Scarborough's Masters of the Big House (2006), slaveholders are depicted as going to great lengths to protect the health of their slaves. Examples of this include vaccinating slave infants against smallpox, paying hundreds of thousands of dollars in medical expenses, and dispensing sherry or madeira wine to sick slaves. Dr. Merrill provides a detailed description of what he thought slave hospitals should be like in an 1853 article about plantation hygiene. However, in reality, the hospitals were representations of the way slaves were viewed: as chattel. They were often a slave cabin used to isolate those with a fever or illness to make sure that the slave was not faking an illness in an attempt to run away. Frances Kemble's recollection of the slave infirmary at Butler Island, Georgia, paints a stark reality of slave women lying on the floor in "tattered and filthy blankets". Dr. J. Marion Sims set up, in his back yard in Montgomery, Alabama,the first hospital in the United States for black females, on whom he developed techniques and materials (silver suture) for gynecological surgery. In the later 20th century, Sims' surgical experimentation on enslaved women, who could not consent because they could not refuse, was criticized as unethical.

Experimentation

Southern medical education's predisposition for use of black bodies to teach anatomy and be subjects of clinical experiments led to a major distrust of White physicians among slaves. The exploitation of slave's bodies for medical knowledge created a horrific doctor-patient relationship that involved a third party: the slave owner. This relationship often left the slave voiceless and deemed "medically incompetent", therefore taking control of their own bodies away from them.

Gynecology

A major field of experimentation that involved slaves was gynecology under Dr. J. Marion Sims in Montgomery, Alabama between 1845 and 1849. Dr. Sims is known for being a pioneer in the treatment of clubfoot, advances in "women's medicine", his role in the founding of the Women's Hospital in New York, and as the "father of American gynecology". Sims routinely operated on nine slave women, of which only three are known: Anarcha, Betsy, and Lucy. The purpose of the operations was to try and fix conditions called vesico-vaginal fistula and recto-vaginal fistula, i.e. a tear in the vaginal wall resulting in chronic leakage from the bladder or colon. These conditions were common results of childbirth during Sims' time. However, these conditions do not include symptoms of chronic pain, just discomfort and most likely embarrassment, suggesting that Sims was exaggerating their conditions to gain a competitive edge over his colleagues.

Betsy, Anarcha, and Lucy survived multiple attempts to fix their condition, and although Sims was able to close the fistula, small perforations remained after healing, leakage continued, and often the sutures became infected. It was not until after the thirtieth surgery that Sims was successful on Anarcha. During these surgeries, the women were not under anesthesia, only an ineffective opium that resulted in constipation and nausea instead of anesthetic. After the success of Anarcha, many White women came to Sims to have the procedure, yet none of them endured a single operation, noting the intense pain associated with the surgery.

Other

Dr. Sims also performed other surgical experimentations on slaves, including facial operations. Slave owners came to Sims in last attempt efforts to save their investments. One particular case that was published in The American Journal of the Medical Sciences involved a slave named Sam whose owner thought he had a gumboil on his face that was a result of syphilis medication. Surgery was attempted on Sam before by another physician, but was unsuccessful because "at the first incision…Sam had leaped from is chair and absolutely refused to submit to further cutting". Sims knew of the attempted surgery and was "determined not to be foiled in the attempt" of his own. Sims attempted to dissect the patient's jaw-bone over the course of a forty-minute operation. In this time, Sims removed a tooth to make room and after unsuccessful attempts with a "small, long, narrow saw" and "Liston's bone forceps", Sims resorted to the chain-saw to remove the diseased bone. Infirmaries, like Sims', allowed physicians to be successful businessmen in the slavery-based Southern economy, but also to create professional reputations as clinical medical researchers.

Weathering hypothesis

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https://en.wikipedia.org/wiki/Weathering_hypothesis 

The weathering hypothesis was proposed to account for early health deterioration as a result of cumulative exposure to experiences of social, economic and political adversity. It is well documented that minority groups and marginalized communities suffer from poorer health outcomes. This may be due to a multitude of stressors including prejudice, social alienation, institutional bias, political oppression, economic exclusion and racial discrimination. The weathering hypothesis proposes that the cumulative burden of these stressors as individuals age is "weathering," and the increased weathering experienced by minority groups compared to others can account for differences in health outcomes. In recent years, the biological plausibility of the weathering hypothesis has been investigated in studies evaluating the physiological effects of social, environmental and political stressors among marginalized communities. This has led to more widespread use of the weathering hypothesis as a framework for explaining health disparities on the basis of differential exposure to racially based stressors. Researchers have also identified patterns connecting weathering to biological phenomena associated with stress and aging, such as allostatic load, epigenetics, telomere shortening, and accelerated brain aging.

Origins

The weathering hypothesis was initially formulated by Dr. Arline T. Geronimus to explain the poor maternal health and birth outcomes of African American women that she observed in correspondence with increased age. While working part-time at a school for pregnant teenagers in Trenton, New Jersey, Geronimus first noticed that the teens who came to the school tended to have far more health problems than her classmates at Princeton University. She thus began to wonder whether the health conditions of the teens at that clinic may have been caused by their environment. Subsequent research on the disparity in maternal health between African American and white women led Geronimus to propose the weathering hypothesis. She proposed that the accumulation of cultural, social and economic disadvantages may lead to earlier deterioration of health among African American women compared to their non-Hispanic, white counterparts. Geronimus specifically chose the term weathering as a metaphor for the effects she perceived that exposure to stress was having on the health of marginalized people. While the weathering hypothesis was initially proposed based on observations of patterns in maternal health, academics have expanded its application as a framework to examine other health disparities as well.

Geronimus' research

While conducting research in the Department of Public Health Policy and Administration as a graduate student at the University of Michigan in 1992, Geronimus noticed a trend in disparities between the fertility of African American women versus their white counterparts. She noted that while the average white woman experiences her point of highest fertility and lowest risk of pregnancy complications or neonatal mortality in her 20's and 30's, this generalization did not apply to African American women. Instead, among African American women, teen mothers are most likely to have healthy pregnancies and offspring. The data indicated a widening disparity in black-white infant mortality as maternal ages increase. Subsequently, Geronimus proposed the "weathering hypothesis," which she initially conceived as a potential explanation for the patterns of racial variation in infant mortality with increasing maternal age.

Health disparities

In the context of the weathering hypothesis, individual health is dynamic and shaped over time by social, economic, and environmental influences. These social determinants dictate what different demographics are exposed to as they develop and age. Racism and discrimination are two specific social determinants that lay the foundation for systemic inequality in access and upward mobility. This entrenchment of social inequities disproportionately impacts minorities and communities of color, who remain in environments of poverty that have significantly more stressors than those of wealthier, predominantly white communities. These stressors—and the associated burden of coping with them—manifest as physiological responses that have detrimental effects on individual health, often leading to a disproportionately high occurrence of chronic illness and shorter life expectancy in minority communities. Multiethnic studies have yielded significant data demonstrating that weathering—accumulated health risk due to social, economic and environmental stressors—is a manifestation of social stratification that systemically influences disparities in health and mortality between dominant and minority communities.

Maternal health

Further information: Black maternal mortality in the United States

Maternal mortality is three to four times higher for Black mothers than white mothers in the United States. Infant mortality is also twice as high for infants born to non-Hispanic Black mothers compared to infants born to non-Hispanic white mothers. Additionally, there are racial disparities for negative birth outcomes like low birth weight, which has been found to influence risk of infant mortality and developmental outcomes after birth, and preterm birth. Across all women, older maternal age is associated with higher rates of these negative outcomes during pregnancy, but studies have consistently found that rates rise more rapidly for Black women than white women. The weathering hypothesis proposes that the accumulation of racial stress over Black women's lives contributes to this observed pattern of racial disparities in maternal health and birth outcomes that increase with maternal age. Research has consistently identified an association between preterm birth and low birth weight in Black women and maternal stress caused by experiences of racism, systemic bias, socioeconomic disadvantage, segregated neighborhoods, and high rates of violent crime. There is biological evidence of weathering, including the finding that Black women have shorter telomeres, a biological indicator of age, when compared with white women of the same chronological age. Though increased socioeconomic status serves as a protective factor against negative birth outcomes for non-Hispanic white mothers, disproportionate rates of preterm birth and low birth weight for non-Hispanic Black mothers have been found at every education and income level. The weathering hypothesis has also been used to explain this trend because upward socioeconomic mobility is associated with increased exposure to discrimination for women of color.

There is modest evidence supporting the effects of weathering on mothers from other minority groups, including for high birth weight outcomes among American Indian/Alaska Native women. Research has started to explore whether the weathering hypothesis could also explain racial disparities in the outcomes of assisted reproductive technologies, but so far the findings are inconsistent.

Mental health

Research shows that mental health disparities among marginalized communities exist. Daily discrimination faced by marginalized groups have been found to be associated with increased depressive symptoms and feelings of loneliness. Low-income communities are more likely to have severe mental illnesses, which is frequently heightened by the inaccessibility to quality healthcare. Researchers found that persisting epigenetic changes lead to increased risk of postpartum depression as a result of adverse life events and cumulative life stress among Black, Latinx, and low-income women. In a study assessing African American men, experiences of racism were linked to a poorer mental health state.

Cognition

Black Americans often show mean level differences in cognition across multiple cognitive domains compared to non-Hispanic Whites. These cognitive disparities often are reduced or eliminated when factoring various social determinants of health such as stress, education quality, economic stability, or quality of healthcare. Black Americans also have higher rates of Alzheimer's disease and related dementias than non-Hispanic Whites. These higher rates of Alzheimer's disease might be due to the impact of more negative and pronounced social determinants of health, including racial discrimination, that might accelerate brain aging disproportionately in Black Americans.

Intersectionality of systems of oppression

Intersectionality is a term coined by Kimberlé Crenshaw to describe the interconnected nature of different systems of oppression, the layered effects of which can be seen in the healthcare system. Research indicates that lower class status and increased depressive symptoms are associated with higher levels of biological weathering among Black individuals in comparison to white individuals. In a study exploring disparities in mental health, researchers found that Black sexual minority women reported higher frequencies of discrimination and decreased levels of social and psychological well-being than their white sexual minority women counterparts. Black sexual minority women had decreased levels of social well-being and increased levels of depressive symptoms in comparison to Black sexual minority men. African American women are also more likely to contract COVID-19 than African American men and white women. The prevalence of medical racism and sexism (lack of quality healthcare, harmful experimentation, etc.) has led to negative relationships with healthcare systems and increased risk of negative sexual and reproductive health outcomes among African American women. Existing research show how systems of oppression work together to oppress marginalized groups within the healthcare system and, as a result, these groups disproportionately experience negative health effects. Aging adults experience further intersections with health, health care, and structural inequalities that exacerbates health in marginalized groups.

Criticism and related theories

Arline Geronimus faced significant pushback for the weathering hypothesis, including from members of the medical community who believed there was a genetic or evolutionary explanation for racial differences in health outcomes. There was some early criticism regarding the quality of her data, though the evidence of weathering and health disparities has grown since. Others pushed back against the weathering hypothesis because its application to racial disparities in maternal health seemed to contradict what advocacy groups had been saying about the negative consequences of teen pregnancy on young mothers. A further criticism of this theory believes that Geronimus and others have not sufficiently demonstrated a link between weathering and racial and gender disparities in life expectancy.

The weathering hypothesis was initially proposed as a sociological explanation for health disparities, but it is closely related to biological theories like the allostatic load model, which proposes that an individual's exposure to repeated or chronic stress over their lifetime has physiological consequences which can be measured through various biomarkers. Research has tended to discuss allostasis and allostatic load as the molecular mechanism behind the weathering hypothesis, and Geronimus herself went on to study racial differences in allostatic load. Another related theory is the life course approach, which emphasizes focus on cumulative life experiences rather than maternal risk factors as an explanation for birth outcome disparities. Researchers have also been interested in studying the possibility of children inheriting the epigenetic changes which result from their mother's cumulative life stress, which could relate the weathering hypothesis with transgenerational trauma.

Writer's block

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From Wikipedia, the free encyclopedia

https://en.wikipedia.org/wiki/Writer%27s_block

A representation of writer's block by Leonid Pasternak (1862–1945)

Writer's block is a non-medical condition, primarily associated with writing, in which an author is either unable to produce new work or experiences a creative slowdown.

Writer's block has various degrees of severity, from difficulty in coming up with original ideas to being unable to produce work for years. This condition is not solely measured by time passing without writing, it is measured by time passing without productivity in the task at hand. Writer's block has been an acknowledged problem throughout recorded history.

However, not until 1947 was the term writer's block coined by the Austrian psychiatrist Edmund Bergler. All types of writers, including full-time professionals, academics, workers of creative projects, and those trying to finish written assignments, can experience writer's block. The condition has many causes, some that are even unrelated to writing. The majority of writer's block researchers agree that most causes of writer's block have an affective/physiological, motivational, and cognitive component.

Studies have found effective coping strategies to deal with writer's block. These strategies to remove the anxiety about writing range from ideas such as free writing and brainstorming to talking to a professional.

History

Throughout history, writer's block has been a documented problem. Professionals who have struggled with the affliction include authors such as F. Scott Fitzgerald and Joseph Mitchell, composer Sergei Rachmaninoff, and songwriter Adele. Early Romantic writers did not understand much about the topic; they assumed writer's block was due to a power that did not want them to write any more. It became slightly more recognised during the time of French Symbolists (late 19th-century art movement) who had famously recognised poets that gave up writing early into their career because they were unable to find the language to convey their message. During the Great American Novel period (mid-18th to mid-19th century), it was widely recognised as something that would block a writer and cause them emotional instability. Research concerning this topic was done in the late 1970s and 1980s. During this time, researchers were influenced by the Process and Post-Process movements and therefore focused specifically on the writer's processes. The condition was first described in 1947 by Austrian psychoanalyst Edmund Bergler, who described it as being caused by oral masochism, mothers that bottle fed, and an unstable private love life. The growing reputation of psychiatry in the United States made the term gain more recognition. However, some great writers may have already suffered from writer's block years before Bergler described it, such as Herman Melville, who stopped writing novels a few years after writing Moby-Dick.

Causes

Writer's block may have several causes. Some are creative problems that originate within an author's work itself. A writer may run out of inspiration, or be distracted by other events. The writer Elizabeth Gilbert, reflecting on her post-bestseller prospects, proposed that such a pressure might be released by interpreting creative writers as "having" genius rather than "being" a genius.

A fictional example can be found in George Orwell's novel Keep the Aspidistra Flying, in which the protagonist Gordon Comstock struggles in vain to complete an epic poem describing a day in London: "It was too big for him, that was the truth. It had never really progressed, it had simply fallen apart into a series of fragments."

Psychological disorder

It has been suggested that writer's block is more than just a mentality. Under stress, a human brain will "shift control from the cerebral cortex to the limbic system". The limbic system is associated with the instinctual processes, such as "fight or flight" response; and behaviour that is based on "deeply engrained training". The limited input from the cerebral cortex hinders a person's creative processes, which is replaced by the behaviours associated with the limbic system. The person is often unaware of the change, which may lead them to believe they are creatively "blocked". In her 2004 book The Midnight Disease: The Drive to Write, Writer's Block, and the Creative Brain, the writer and neurologist Alice W. Flaherty has argued that literary creativity is a function of specific areas of the brain, and that block may be the result of brain activity being disrupted in those areas. Dr. Flaherty suggested in her writing that there are many diseases that may impact one's ability to write. One of which she refers to is hypergraphia, or the intensive desire to write. She points out that in this condition, the patient's temporal lobe is afflicted, usually by damage, and it may be the same changes in this area of the brain that can contribute to writer's-blocking behaviours. Not to be confused with writer's block, agraphia is a neurological disorder caused by trauma or stroke causing difficulty in communicating through writing. Agraphia cannot be treated directly, but it is possible to relearn certain writing abilities.

Brain trauma

Other research identifies neurological malfunctions as a cause. Malcolm T. Cunningham showed how these malfunctions can be linked to trauma both mental and physical.

Physical damage can produce writer's block. If a person experiences tissue damage in the brain, i.e. a stroke, it is likely to lead to other complications apart from the lesion itself. This damage causes an extreme form of writer's block known as agraphia. With agraphia, the inability to write is due to issues with the cerebral cortex; this disables the brain's process of translating thoughts into writing. Brain injuries are an example of a physical illness that can cause a writer to be blocked. Other brain related disorders and neurological disorders such as epilepsy have been known to cause the problem of writer's block and hypergraphia, the strong urge to write.

Writer anxiety and inhibition

Some other causes of writer's block has been due to writer's anxiety. Writer's anxiety is defined as being worried with one's words or thought, thus experiencing writer's block.

For a composition perspective, Lawrence Oliver said in his article "Helping Students Overcome Writer's Block": "Students receive little or no advice on how to generate ideas or explore their thoughts, and they usually must proceed through the writing process without guidance or corrective feedback from the teacher, who withholds comments and criticism until grading the final product." He said that students "learn to write by writing", and often they are insecure or paralyzed by rules.

Phyllis Koestenbaum wrote in her article "The Secret Climate the Year I Stopped Writing" about her trepidation toward writing, claiming it was tied directly to her instructor's response. She said, "I needed to write to feel, but without feeling I couldn't write." In contrast to Koestenbaum's experience, Nancy Sommers stated that papers do not end when students finish writing and that neither should instructors' comments. She urges a "partnership" between writers and instructors so that responses become a conversation.

Student motivation

Herman A. Estrin in his article "Motivation in Composition Writing" writes, "When freshmen are assigned such topics for a research paper as...they have no real background of the subject for an in-depth paper...they prepare a mechanical, lifeless paper with no creativity, imagination, or originality". According to him, freshman students write well about topics they are passionate about.

Aline Alves-Wold, in her article, "Assessing Writing Motivation: a Systematic Review of K-5 Students' Self-Reports" states that there is a general lack of research on the motivation of students to write in the first few years of education, which is problematic when one considers how important initial experiences are in motivating students to write. Success generally enhances one's belief in their efficacy, whereas failure weakens them. "These mechanisms are particularly evident in early phases of skill development where failure typically occurs before a sense of efficacy has been firmly established. This implies that children in their first years in school have writer self-beliefs that are particularly malleable and dynamic". Writing development is therefore both enhanced and endangered during the first years in school.

Negative self-beliefs and feeling of incompetence

Mike Rose stated that writer's block can be caused by a writer's history in writing, rules and restrictions from the past. Writers can be hesitant of what they write based on how it will be perceived by the audience. Guangming Ling states that there is a negative correlation between self-efficacy and avoidance goals in studies on writing apprehension and writer's block, which suggests that having hesitations about writing may lead to less effort and thus less success.

James Adams noted in his book Conceptual Blockbusting that various reasons blocks occur include fear of taking a risk, "chaos" in the pre-writing stage, judging versus generating ideas, an inability to incubate ideas, or a lack of motivation.

In "Motivation in the Writing Centre: A Peer Tutor's Experience," Leonie Kirchoff states "The concept of 'amotivation' describes a lack of motivation due to an individual's feeling of incompetence and helplessness." Demotivation is the process of reducing or diminishing motivational basis for behavior or ongoing actions through external influences. An external factor such as feedback may affect demotivation, whereas an internal factor, such as pessimistic expectations, may cause amotivation. Even so, both concepts have similar effects on writers.

Coping strategies

Irene Clark describes the following strategies for coping with writer's block: class and group discussion, journaling, free writing and brainstorming, clustering, list making, and engaging with the text. To overcome writing blocks, Oliver suggests asking writers questions to uncover their writing process. He then recommends solutions such as systematic questioning, free writing, and encouragement. A recent study of 2,500 writers aimed to find techniques that writers themselves use to overcome writer's block.  The research discovered a range of solutions from altering the time of day to write and setting deadlines to lowering expectations and using mindfulness meditation.

Right-brain involvement

Main article: Lateralization of brain function

Garbriele Lusser Rico's concern with the mind links to brain lateralisation, also explored by Rose and Linda Flowers and John R. Hayes, among others. Rico's book, Writing the Natural Way looks into invention strategies, such as clustering, which has been noted to be an invention strategy used to help writers overcome their blocks, and further emphasizes the solutions presented in works by Rose, Oliver, and Clark. Similar to Rico, James Adams discusses "right-brain" involvement in writing. While Bill Downey proposes that he is basing his approach in practical concerns, his concentration on "right-brain" techniques speaks to cognitive theory approach similar to Rico's and a more practical advice for writers to approach their writer's block. Mike Rose mentions that peer tutors provide supportive feedback so that blocked writers can feel secure in sharing their problems and experimenting with new ideas about writing.

Writing environment

It is also important to evaluate the environment in which the writing is being produced to determine if it is the best condition to work in. One must look into these different factors to determine if it is a good or bad environment to work in. Psychologists who have studied writer's block have concluded that it is a treatable condition once the writer finds a way to remove anxiety and build confidence in themselves. Sarah Ahmed and Dominik Güss state that solutions for coping with writer's block include using more efficient writing strategies during the composing process, more effective goal-setting strategies, and even brainstorming ideas with others.

Splitting the writing into smaller pieces

Research has also shown that it is highly effective if one breaks their work into pieces rather than doing all of their writing in one sitting, in order to produce good quality work. While it can be helpful to split up the writing process into pieces, Patricia Huston suggests that starting with different sections of a paper, rather than trying to start with an introduction, can be a useful strategy to cope with writer's block. She points out that if a person is stuck on the introduction, they can try moving onto a different section like a body paragraph. Huston states, "There is no need to begin at the beginning and write an article in sequence".

Free writing and brainstorming

Main article: Brainstorming

Free writing is a widely accepted technique for overcoming writer's block. Taught by Peter Elbow, free writing is similar to brainstorming but is written in prose form without stopping. To free-write one writes without pausing to think or edit, and one pours raw ideas onto paper. Author Benjamin Solomon described the rationale for the technique: "Writer's block is a rut, a ditch, a trap, a swampy mire, and in order to lift yourself out, you need to DO something—anything!—to jog yourself into motion." Cherryl Armstrong, who worked with the South Coast Writing Project, stated that one can free-write about anything, even a completely different subject than one was going to write about: "any writing will do". Oliver claims that after free writing the writer is able to analyze many ideas that might not have been generated before and develop a clearer sense of what theme is trying to be communicated throughout the writing. Lawrence J. Oliver suggests that freewriting is another effective method that has helped people deal with writer's block. This method consists of writing down ideas or thoughts about a certain topic. Freewriting doesn't focus on grammar or style. There is only one rule for this method, and that is to keep on writing. Educators should also never read students' freewriting unless asked to do so.

Mind mapping

Main article: Mind mapping

Mind mapping is suggested as another potential solution to writer's block. The technique involves writing a stream of consciousness on a horizontal piece of paper and connecting any similar or linked thoughts. This exercise is intended to help a writer suffering from writer's block to bypass the analytical or critical functioning of their brain and access the creative functioning more directly, stimulating the flow of ideas. Other techniques similar to clustering and mind mapping are the writing of notes on cards in a card file, and nonlinear electronic writing using hypertext.

Positive self-beliefs and encouragement

Camacho, Alves and Boscolo wrote about enhancing students' writing motivation in the classroom. She says that to foster students' positive self-beliefs and beliefs about writing, teachers must nurture their self-beliefs as well as their beliefs about the writing task.

Other techniques

Other ways to cope come from ideas such as The Brand Emotions Scale for Writers (BESW). Using the framework of the Differential Emotions Scale, the BESW works with grouping emotions into either states or traits and then classifying them as positive, negative passive, or negative active. Researchers can assess subjects, giving writers a chance to get more work done if left in the right emotional state since data suggests that writers with positive emotions tended to express more than writers with negative passive or negative active.

Anne Johnstone suggests a couple of strategies to help with writer's block. When one finds oneself unable to generate content, Johnstone suggests "recopying a well-liked piece" of one's own to help generate ideas. Johnstone states that individuals who are articulate orally but struggle with writing and forming their ideas into sentences on paper should try tape-recording themselves and later transcribing it onto paper.

Relation to procrastination

Main article: Procrastination

Writer's block and procrastination are two similar issues that people struggle with when it comes to writing. Writer's block is an issue that can cause people to delay their goals and may prevent them from finishing writing projects. Although writer's block and procrastination are not the exact same issue, they can end up leading up to one another. Writer's block is not continuing to do a task, and procrastination is delaying to start the task. In her 1987 Ph.D. thesis (published in 2012), Karen E. Peterson posited two different scenarios on how procrastination and writer's block can lead up to each other. One scenario is that a person will procrastinate due to having the fear of past experiences of getting writer's block when doing a task. The other scenario is that a person will have writer's block because of the feeling of being overwhelmed about needing to do a task at the last minute after procrastinating for a long period of time.

Creative writing

From Wikipedia, the free encyclopedia

https://en.wikipedia.org/wiki/Creative_writing

Creative writing is any writing that goes outside the bounds of normal professional, journalistic, academic, or technical forms of literature, typically identified by an emphasis on narrative craft, character development, and the use of literary tropes or with various traditions of poetry and poetics. Due to the looseness of the definition, it is possible for writing such as feature stories to be considered creative writing, even though it falls under journalism, because the content of features is specifically focused on narrative and character development. Both fictional and non-fictional works fall into this category, including such forms as novels, biographies, short stories, and poems. In the academic setting, creative writing is typically separated into fiction and poetry classes, with a focus on writing in an original style, as opposed to imitating pre-existing genres such as crime or horror. Writing for the screen and stage—screenwriting and playwriting—are often taught separately, but fit under the creative writing category as well.

Creative writing can technically be considered any writing of original composition. In this sense, creative writing is a more contemporary and process-oriented name for what has been traditionally called literature, including the variety of its genres. In her work, Foundations of Creativity, Mary Lee Marksberry references Paul Witty and Lou LaBrant's Teaching the People's Language to define creative writing. Marksberry notes:

Witty and LaBrant...[say creative writing] is a composition of any type of writing at any time primarily in the service of such needs as

1. the need for keeping records of significant experience,
2. the need for sharing experience with an interested group, and
3. the need for free individual expression which contributes to mental and physical health.

In academia

Unlike its academic counterpart of writing classes that teach students to compose work based on the rules of the language, creative writing is believed to focus on students' self-expression. While creative writing as an educational subject is often available at some stages, if not throughout, K–12 education, perhaps the most refined form of creative writing as an educational focus is in universities. Following a reworking of university education in the post-war era, creative writing has progressively gained prominence in the university setting. In the UK, the first formal creative writing program was established as a Master of Arts degree at the University of East Anglia in 1970 by the novelists Malcolm Bradbury and Angus Wilson. With the beginning of formal creative writing programs:

For the first time in the sad and enchanting history of literature, for the first time in the glorious and dreadful history of the world, the writer was welcome in the academic place. If the mind could be honored there, why not the imagination?

Programs of study

Creative Writing programs are typically available to writers from the high school level all the way through graduate school/university and adult education. Traditionally these programs are associated with the English departments in the respective schools, but this notion has been challenged in recent times as more creative writing programs have spun off into their own department. Most Creative Writing degrees for undergraduates in college are Bachelor of Fine Arts degrees (BFA). Some continue to pursue a Master of Fine Arts in Creative Writing, the terminal degree in the field. Once rare, Ph.D. programs are becoming more prevalent in the field, as more writers attempt to bridge the gap between academic study and artistic pursuit.

Creative writers often place an emphasis in either fiction or poetry, and it is normal to start with short stories or simple poems. They then make a schedule based on this emphasis including literature classes, education classes and workshop classes to strengthen their skills and techniques. Though they have their own programs of study in the fields of film and theatre, screenwriting and playwriting have become more popular in creative writing programs since creative writing programs attempt to work more closely with film and theatre programs as well as English programs. Creative writing students are encouraged to get involved in extracurricular writing-based activities, such as publishing clubs, school-based literary magazines or newspapers, writing contests, writing colonies or conventions, and extended education classes.

In the classroom

Creative writing is usually taught in a workshop format rather than seminar style. In workshops, students usually submit original work for peer critique. Students also format a writing method through the process of writing and re-writing. Some courses teach the means to exploit or access latent creativity or more technical issues such as editing, structural techniques, genres, random idea generating, or unblocking writer's block. Some noted authors, such as Michael Chabon, Sir Kazuo Ishiguro, Kevin Brockmeier, Ian McEwan, Karl Kirchwey, Dame Rose Tremain and reputed screenwriters, such as David Benioff, Darren Star and Peter Farrelly, have graduated from university creative writing programs.

Many educators find that using creative writing can increase students' academic performance and resilience. The activity of completing small goals consistently rather than unfinished big goals creates pride in one's brain, which exudes dopamine throughout the brain and increases motivation. It has been shown to build resilience in students by documenting and analyzing their experiences, which gives the students a new perspective on an old situation and allows sorting of emotions. It also has been proven to increase a student's level of compassion and create a sense of community among students in what could otherwise be deemed an isolating classroom.

Controversy in academia

Creative writing is considered by some academics (mostly in the US) to be an extension of the English discipline, even though it is taught around the world in many languages. The English discipline is traditionally seen as the critical study of literary forms, not the creation of literary forms. Some academics see creative writing as a challenge to this tradition. In the UK and Australia, as well as increasingly in the US and the rest of the world, creative writing is considered a discipline in its own right, not an offshoot of any other discipline.

To say that the creative has no part in education is to argue that a university is not universal.

Those who support creative writing programs either as part or separate from the English discipline, argue for the academic worth of the creative writing experience. They argue that creative writing hones the students' abilities to clearly express their thoughts and that creative writing entails an in-depth study of literary terms and mechanisms so they can be applied to the writer's work to foster improvement. These critical analysis skills are further used in other literary studies outside the creative writing sphere. Indeed, the process of creative writing, the crafting of a thought-out and original piece, is considered by some to constitute experience in creative problem-solving.

Despite a large number of academic creative writing programs throughout the world, many people argue that creative writing cannot be taught. Essayist Louis Menand explores the issue in an article for the New Yorker in which he quotes Kay Boyle, the director of the creative writing program at San Francisco State University for sixteen years, who said, "all creative-writing programs ought to be abolished by law." Contemporary discussions of creative writing at the university level vary widely; some people value MFA programs and regard them with great respect, whereas many MFA candidates and hopefuls lament their chosen programs' lack of both diversity and genre awareness.

In prisons

In the late 1960s, American prisons began implementing creative writing programs due to the prisoner rights movement that stemmed from events such as the Attica Prison riot. The creative writing programs are among many art programs that aim to benefit prisoners during and after their time in prison. Programs such as these provide education, structure, and a creative outlet to encourage rehabilitation. These programs' continuation relies heavily on volunteers and outside financial support from sources such as authors and activist groups.

The Poets Playwrights Essayists Editors and Novelists, known as PEN, were among the most significant contributors to creative writing programs in America. In 1971, PEN established the Prison Writing Committee to implement and advocate for creative writing programs in prisons throughout the U.S. The PEN Writing Committee improved prison libraries, inspired volunteer writers to teach prisoners, persuaded authors to host workshops, and founded an annual literary competition for prisoners. Workshops and classes help prisoners build self-esteem, make healthy social connections, and learn new skills, which can ease prisoner reentry.

Creative writing programs offered in juvenile correction facilities have also proved beneficial. In Alabama, Writing Our Stories began in 1997 as an anti-violence initiative to encourage positive self-expression among incarcerated youths. The program found that the participants gained confidence, the ability to empathize and see their peers in a more positive light, and motivation to want to return to society and live a more productive life.

One California study of prison fine arts programs found art education increased emotional control and decreased disciplinary reports. Participation in creative writing and other art programs result in significant positive outcomes for the inmates' mental health, relationship with their families, and the facility's environment. The study evidenced improved writing skills enhanced one's ability in other academic areas of study, portraying writing as a fundamental tool for building one's intellect. Teaching prisoners creative writing can encourage literacy, teach necessary life skills, and provide prisoners with an outlet to express regret, accountability, responsibility, and a kind of restorative justice.

Elements

• Action
• Character
• Conflict
• Dialogue
• Genre
• Narration
• Pace
• Plot
• Point of view
• Scene
• Setting
• Style
• Suspense
• Theme and motif
• Tone
• Voice

Forms and genres of literature

• Autobiography/Memoir
• Creative non-fiction (Personal & Journalistic Essays)
• Children's books
• Drama
• Epic
• Flash fiction
• Graphic novels/Comics
• Novel
• Novella
• Play
• Poetry
• Screenplay
• Short story
• Dialogues
• Blogs