Taking Flight: Spring 2011
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Transcript of Taking Flight: Spring 2011
Crossing Boundaries: Sexual Violence
Taking Flight S P R I N G 2 0 1 1 I S S U E 4
NEWS FROM THE CENTER FOR VIOLENCE AND INJURY PREVENTION AT WASHINGTON UNIVERSITY’S BROWN SCHOOL
I N S I D E T H I S
I S S U E :
Director’s
Note
2
Violence
Prevention
with Adoles-
cent Girls
3
Janet Lauritsen
Sexual Assault
on College
Campuses
4
4
Professional
Development
Trauma
Response
Program
5 5
New PhD
Scholar Paul
Lanier
6
Publications 7
5th Annual
TRCNC
7
You turn on the television and select an episode of Law and Order SVU, just in me to see a stranger approach the vic m in a dark alley or break into her home. Cut to the next scene, and the vic m lies bandaged and bruised in a hospital bed as Detec ve Olivia Benson gen-tly asks if she remembers what happened. Such media portrayals may be s rring, but focus on only a very small part of sexual violence. According to Kathleen Hanrahan, director of the St. Louis Regional Sexual Assault Center, “The most common misconcep on is ‘stranger danger’. The reality is that over 70% of vic ms know who their a acker is… The sad thing about sexual predators is that they can be anyone. They look like your broth-er, your friend or rela ve…, anyone who is willing to force someone to have sex against their will.” This descrip on of perpetrators is a far cry from the a acker in the dark alley we so o en see in television shows and movies.
Sexual violence crosscuts bounda-ries. For example, childhood sexual abuse is a form of sexual violence that is also considered child maltreatment; 15% of sexual assault and rape vic ms are under age 12 (RAINN, 2010). Cases of in mate partner violence o en include sexual violence. Indi-viduals with a history of rape and sexual assault are 6 mes more likely to report having a empted suicide, especially if the assault happened before the vic m was 16 years old (Davidson, Hughes, George, and Blazer, 1996). Finally, sexual vic miza on is also associated with higher levels of substance abuse and mental health problems (World Health Organiza-on Report, 2002).
Sexual violence is what Hanrahan calls “an equal opportunity crime,” not only transcending categories of violence, but affec ng individuals across “boundaries of age, race, culture, and socioeconomic back-ground.” Na onally, 1 in 6 women
are vic ms of sexual violence and 1 in 33 men (Tjaden and Thoennes, 2006), but it is es mated that only 60% of the crimes are even reported. Sexual violence is prevalent and expensive. According to the Na onal Crime Vic miza on Survey, which includes crimes that were not reported to the police, 232,960 women in the U.S. were raped or sexually assaulted in 2006. Post, Mezey, Maxwell, and Wibert (2002) es mate that sexual violence in the United States cost 261.25 billion dollars in 1996 alone. In 2009, there were 1,615 police responses to rape in Missouri. There are almost 12,000 persons listed as ac ve (not incarcerated or out of state) sexual offenders in Missouri. But progress is being made. Sexual assault has fallen by more than 60% in recent years (RAINN, 2010). Policy and program are credited for this trend. Cost-benefit analyses of the Violence Against Women Act of 1994 suggest the legisla on, which provided $1.6 billion for various preven on programs over five years, saved $14.8 billion in net social costs that otherwise would have been incurred (Clark, Biddle, & Mar n, 2002). Boba & Lilley (2009) found similar posi ve results on the incidence of reported violent crime.
(Con nued on page 2)
Financial Tangible and Intangible Costs
Na onal Level
Sexual Assault and Rape (1995) $26 billion
Sex-offense homicide (1996) $205,800,000
Total na onal cost of sexual violence in 1996
$261.25 billion
Director’s Note
T A K I N G F L I G H T — I S S U E F O U R P A G E 2 R E T U R N T O T A B L E O F C O N T E N T S
Melissa Jonson‐Reid
Professor, Brown School
Director, Center for Violence and Injury Preven on
Faculty Scholar, Ins tute for Public Health
Sexual violence is an im-portant, but some mes difficult topic for people to discuss. It’s important that we recognize that the issue crosses boundaries of age, gender, race and sexual orienta on. We must find ways to help spread effec ve approaches to preven on but also be ready and available to sup-port our friends, family, students, coworkers, and clients who may have been vic ms. The evidence base is build-ing in this area, but it is important to consider the ways in which preven on
and response programs may need to be adapted to specific popula ons. Finally, while the focus is o en on vic ms, we need to also a end to how we prevent the ac ons of per-petrators. Like the other forms of violence and injury we focus on at the Center, this response requires mul-ple disciplines and profes-
sions to address this issue. I am happy to be able to profile just a few research-ers and agencies that work in this area, including one of our center projects.
Readers are encouraged to check out the many organi-za ons working on this important topic like the Missouri Department of Health, the Missouri Coali-on Against Domes c and
Sexual Violence, the YWCA, the Children’s Advocacy Centers, and many other regional and local organiza-ons.
Director, Center for Violence and Injury Preven on
Missouri is also respond-ing. Hanrahan reports that, “Increased professional training for law enforcement and hospital staff has significantly improved the immediate response to rape vic ms and the inves ga on process. The training and imple-menta on of Sexual Assault Nurse Examiner (SANE) programs in area emergency departments has made a posi ve impact on both the effec veness of response to vic ms and on the quality of evidence collec on. Legisla on in the past ten years have dras cal-ly improved the
response to vic ms and increased the ability of Missouri to hold perpe-trators accountable.” The Missouri Depart-ment of Health and Human Services has a very helpful website for community members/agencies seeking to implement sexual assault preven on pro-grams found here. This website not only highlights promising and evidence-based programs according to target issues but also provides linkage to na onal resources and specific programming based on your goals and
popula on. Sexual violence is listed as a priority area for the recently completed Missouri Violence and Injury Preven on Plan. We hope that as you read this issue of Taking Flight, you gain a greater apprecia on for the need to con nue to find more effec ve ways to prevent sexual violence and support vic ms, advoca ng for the re-sources to support and sustain this work.
Crossing Boundaries (Con nued from page 1)
Cita ons (Crossing Boundaries: Sexual Violence) Boba, R., & Lilley, D. (2009). Violence Against Women Act (VAWA) funding: A na onwide assessment of effects on rape and assault. Violence Against Women, 15(2), 168-185. Clark, K. A., Biddle, A. K, & Mar n, S. L. (2002). A cost-benefit analysis of the Violence Against Women Act of 1994. Violence Against Women, 8, 417-428. doi:10.1177/10778010222183143. Jonathan R. T. Davidson, Dana C. Hughes, Linda K. George, Dan G. Blazer (1996), The Associa on of Sexual Assault and A empt-ed Suicide Within the Community. Arch Gen Psychiatry. 53(6):550-555. Post, L., Mezey, N. J., Maxwell, C., & Wilbert, W. N. (2002). The rape tax: Tangible and intangible costs of sexual violence. Jour‐nal of Interpersonal Violence, 17, 773-782. Sta s cs. Rape, Abuse and Incest Na onal Network. on-line accessed April 3, 2011. h p://www.rainn.org/sta s cs Tjaden, P. & Thoennes, N. (2006). Extent, Nature, and Conse‐quences of Rape Vic miza on: Findings From the Na onal Vio‐lence Against Women Survey. Special Report. Washington, D.C.: Na onal Ins tute of Jus ce and the Centers for Disease Control and Preven on.
World Health Organiza on Report (2002). On-line accessed April 3, 2011. www.who.int/whr/2002.
Violence Prevention for Adolescent Girls With Prior Maltreatment
T A K I N G F L I G H T — I S S U E F O U R P A G E 3 R E T U R N T O T A B L E O F C O N T E N T S
Girls and women face a higher risk of experi-encing childhood sexual abuse, sexual assault, and in mate partner violence in their life-mes than their male counterparts. Wendy
Auslander, Barbara A. Bailey Professor of Social Work, found in previous research that girls are more likely to experience mul ple types of maltreatment than boys; 77% of the girls experienced emo onal, physical, and sexual abuse compared to only 23% of the boys. Auslander reports that girls are more vulnera-ble to re-vic miza on in adolescence and adulthood than boys, which puts them at greater risk for mental health and substance abuse problems, which in turn increases even further their risk of re-vic miza on. Girls and women are also more likely than boys and men to develop Post-Trauma c Stress Syndrome (PTSD), even when exposed to the same level of trauma, and PTSD has also been shown to increase risk for re-vic miza on. In addi on to beginning a cycle of re-vic miza on, child maltreatment o en also begins a cycle of perpetra on of violence by the vic m. “Childhood maltreatment creates for survivors a risk for the perpetua-on of a cycle of violence in the form of
sexual violence, in mate partner violence, and child maltreatment in the next genera-on of children,” says Auslander.
Programming and treatment have not caught up with the empirical data showing girls with histories of maltreatment to be more likely to engage in youth violence and adult interper-sonal violence, as there are no reports of violence preven on programs tailored specifi-cally to adolescent females in foster care. Because cogni ve behavioral therapy (CBT) has been shown by the CDC to be effec ve in reducing psychological harm and promo ng healthy rela onships among youth with trau-ma exposure, Auslander has adapted a school-based version of the CBT interven on for children exposed to family or community trauma, called Cogni ve-Behavioral Interven-on for Trauma in School (CBITS), for use with
adolescent girls in foster care. Auslander was interested in this community-based model of
trauma treatment and violence preven on because it was consistent with her values of promo ng health and mental health. “The CBITS program teaches girls how to cope with their past trauma and its a ermath focusing on skills such as relaxa on training and social problem solving that will help them in the future.” Auslander, in collabora on with St. Louis Children’s Division and Children’s Advocacy Services of Greater St. Louis, is currently conduc ng a study to evaluate the effec veness of the adapted version of CBITS for adolescent girls with histories of maltreat-ment. The randomized clinical trial will be evaluated by measuring mental health outcomes such as PTSD and depression, as well as aggressive or violent behaviors, inten ons, and beliefs. The modified version of CBITS, called the GAIN Program (Girls Aspiring toward INde-pendence), consists of ten sessions of group therapy with two sessions of individual thera-py. The interven on includes elements of trauma-focused cogni ve behavioral therapy such as educa on about reac ons to trauma, cogni ve restructuring skills, anxiety reduc on techniques, and real life and
imaginal exposure, which translate into ac vi es that include construc on of a fear hierarchy, guided imagery relaxa on, various art projects, and group discussion.
Auslander and her team hope that by adap ng this evidence based treatment to meet the unique needs of adolescent girls with histories of maltreatment, the cycles of re-vic miza on and perpetra on of violence can be broken. Social workers who work in the child welfare system, in schools, and in community-based agencies can deliver this program across se ngs to promote mental health and healthy rela onships among girls and young women who have experienced varying degrees of trauma.
“Childhood maltreatment creates for survivors a risk for the perpetua-on of a cycle of violence in the
form of sexual violence, in mate partner violence, and child mal-treatment in the next genera on of children.”
Wendy Auslander Barbara A. Bailey Professor of Social Work
Brown School
Girls in the GAIN program created a poster represen ng what they hoped to gain from the program as well as their goals and dreams for their lives.
Behind the Scenes
T A K I N G F L I G H T — I S S U E F O U R P A G E 4 R E T U R N T O T A B L E O F C O N T E N T S
Dr. Janet Lauritsen: Na onal Research Advisory Board Member In order to stay on top of na onal trends in policy and research as well as assess the progress of the center and select seed grants, the Center for Violence and Injury Preven on maintains a Na onal Research Advisory Board, which boasts experts from a range of fields from Clinical Psychology to Organiza onal Decision Science. Among these experts is Janet Lauritsen, Professor in the Department of Criminology and Criminal Jus ce at University of Missouri – St. Louis and Visi ng Research Fellow to the Bureau of Jus ce Sta s cs in the US Department of Jus ce. For more than twenty years, Dr. Lauritsen has studied the causes and consequences of vic miza on, and she has been working to improve the validity, reliability, and usefulness of the indicators for measuring vic miza on. As a college student at the University of Illinois, where she studied sociology, Dr. Lauritsen says that she discovered that she was “most interested in finding ways to develop and use empiri-cal evidence to help solve social
problems and improve societal condi ons.” These days, she finds herself doing just that in her work on several ongoing projects through which she seeks to understand changes in vic miza on risk over me. Many of these projects assess the effects of macro-economic condi ons on the risk for violent vic miza on for various subgroups in the popula on. She and her colleagues are “par cularly interested in com-paring the experience of men and women and race and ethnic groups, to assess how socio-historical condi ons moderate the significance of these factors.” As with most social research, Dr. Lauritsen is mo vated, not by the pursuit of knowledge alone, but by compassion and a desire for social change. “Like most researchers who study vic miza on, I’d like to believe that my work can help us be er understand the ways in which we might reduce a per-son’s likelihood of experiencing vic miza on, and help vic ms rebuild their lives.” Dr. Lauritsen has been on the center’s Na onal Research Advi-sory Board from the beginning, and she con nues to express
enthusiasm for the center’s work and her own involvement in it: “The Center has a very important mission – to develop and assess evidence-based programs for the reduc on of violence through community partnerships. This is very challenging work and I am happy to have been asked to contrib-ute through my par cipa on as a criminologist on the Advisory Board.”
Conference: Show Me You Care About Suicide Prevention Missouri Department of Mental Health July 28‐29, 2011 Jefferson City, MO
Proposals are now being accepted for presenta ons, workshops or poster sessions at the Sixth Annual Missouri Suicide Preven on Conference. We invite you to share your knowledge and exper se at this conference; a valuable educa onal opportunity for service providers from health, mental health, educa on, criminal jus ce, clergy, survivors of suicide, members of the media and others with an interest in suicide. For more informa on, please email: [email protected]
Federal Government Addresses Sexual Assault on College Campuses:
Sexual violence has long been a major issue on college campuses, but has o en been swept under the rug. Now, both the Department of Educa on and the Jus-ce Department are tak-
ing on the issue . Read or listen to the NPR story here.
T A K I N G F L I G H T — I S S U E F O U R P A G E 5 R E T U R N T O T A B L E O F C O N T E N T S
Resolving Ethical Dilemmas in Suicide Preven on Friday, September 16, 2011 Preferred registra on deadline: September 9th 8:30—11:30 a.m.
Professional Development Opportunities
Project Overview: Trauma Response Program Purpose: To develop a comprehensive, state-of-the-science intervention model to make mental health care available to children who have experienced sexual abuse. To update and refine the approach to caring for these children by determining the status of the existing system in metropolitan St. Louis, integrating an evidenced-based program in the areas with the most prevalent unmet mental health needs, and provid-ing a mechanism to evaluate that service to monitor its impact on outcomes, and to assure continuous quality improve-ment. Process: With the support of the Center for Violence and Injury Prevention, the team completed a review of the scien-tific literature on evidence-based assess-ment and treatment of sexually abused children and adolescents Ini al efforts focused on referrals from the Sexual Abuse Management (SAM) Clinic at St. Louis Children’s Hospital. The SAM Clinic annually serves 200 to 300 children with medical needs or concerns related to sexual development, sexual abuse or sexual assault. An assessment and interven on strategy is integrated with the clinical services from which pa ents are referred. The assess-ment protocol is evidenced based and overlaps with assessments performed in other centers of excellence across the na on. As a result, this approach allows for possible data sharing for monitoring interven on outcomes.
Before a child’s first appointment, the family completes objec ve measures of psychosocial and behavioral status, parental stress, and post-trauma c stress symptoms. In the first appointment, the therapist interviews the family and then consults on every case with the child and adoles-cent psychiatrist. During the second appointment, a defini ve treatment plan is developed with the family. This plan may include: psychiatric evalua on and
treatment; a brief secondary preven on inter-
ven on (Child and Family Trauma c Stress Interven on, CFTSI);
Trauma-Focused Cogni ve Behavior Therapy (TF-CBT);
referral for Trauma-Focused Parent-Child Interac on Therapy;
referral for group therapy; referral for family therapy; referral for case management; or if appropriate, a plan to monitor
the child periodically with no formal treatment.
All children are monitored, regardless of their treatment plan, at three months and 12 months; and re-assessed, through interviews and objective measures, to determine how the children are doing over time. This assures that any child that enters for sexual abuse medical treatment at the SAM Clinic will have access to quality mental health
assessment, education on the possible effects of SA, supportive psychotherapy, psychiatric care, brief evidence-based first response program (CFTSI), long-term evidence-based mental health treat-ments, follow-up, and comprehensive connections to existing community resources. Outcome: The Trauma Response Program is well-positioned to deliver needed mental health services to hundreds of child victims of sexual trau-ma in years to come. Referrals started coming in for the two-part assessment from the SAM clinic in late September 2010. Soon the program will be accepting referrals from the Emergen-cy Department at St. Louis Children’s Hospital, which will add up to another 300 child and adolescent victims of sexual trauma per year; and SPOT (Suppor ng Posi ve Opportuni es with Teens), adding up to 75 adolescent victims annually. The program will also begin receiving referrals from collaborators at the Chil-dren’s Advocacy Center (CAC) at Univer-sity of Missouri St. Louis. People: John Constantino, MD; Director Jaime Hook, MD; Attending Child
and Adolescent Psychiatrist Jennifer Holzhauer, LCSW
Features: Monica Ma hieu, PhD, Research Assistant Professor, Brown School;
Brad Overmeyer, LMSW, Suicide Preven on Consultant, St. Louis VA Medical Center
Focus: This workshop will examine ethical considera ons which may arise in a social
worker’s complex responsibili es regarding suicide preven on. Par cipants will be guided in a series of exercises and small group ac vi es. Tools will be presented to guide ethical decision-making. A review of the NASW Code of Ethics and the legal responsibili es of social workers will be included.
CEUs: 3 Limited sea ng, register here
Welcome to PhD Scholar, Paul Lanier
T A K I N G F L I G H T — I S S U E F O U R P A G E 6 R E T U R N T O T A B L E O F C O N T E N T S
CVIP has selected Paul Lanier as its new PhD Scholar, Paul Lanier. In addi on to his work at the Center, Paul also is NIMH fellow with the Brown School’s Center for Mental Health Services Research and was recently selected as a recipient of the Doris Duke Founda on’s Fellowship for the Preven on of Child Abuse and Neglect managed by Chapin Hall at the University of Chicago. Paul brings to his research a great deal of experience in the field. Before pursuing a career in social work research, Paul devel-oped and coordinated an a ercare program for youth transi oning out of a residen al treatment facility. The purpose of the program was to help achieve success at home by linking families with resources in the community and providing con nued support through individual, group, and family therapy. Paul then gained experience in policy devel-opment with the North Carolina Child Fatality Taskforce while working towards his MSW at UNC-Chapel Hill. Currently, Paul is involved with two Center-affiliated studies led by Dr. Patricia Kohl: Preven ng Conduct Disorder Among Children in the Child Welfare System and Preven ng Violence by Moving Parent Training Content into Child Welfare Systems. His own disserta-on will examine child maltreatment preven-on and child health outcomes of Nurses for
Newborns services, a nurse home-visi ng program serving very high-risk families, while also assessing the cost-effec veness of the program. CVIP Director Dr. Melissa Jonson-Reid chairs is disserta on commi ee.
Paul is commi ed to the policy and prac ce applica on of his work, and credits his strong field work background for this perspec ve. “In my previous work as a mental health pro-fessional, I o en had a difficult me iden fy-ing effec ve programs that matched the com-plex needs of families o en desperate for help. If the field is going to fully embrace an evidence-based approach, which may truly raise the bar for quality and availability of
services, the link between research and prac-ce must be improved,” said Paul.
Paul’s research interests include child mal-treatment preven on and health promo on through evidence-based prac ce and policy, both of which are integral to his disserta on project.
“Iden fying the best strategies to prevent child abuse and neglect, especially in early childhood, is a necessity in promo ng the healthy development of children. We know that the detrimental effects of maltreatment on well-being begin in childhood and can be poten ally irreversible. Policymakers are realizing that wai ng to intervene is no longer acceptable and inves ng early on in strong and safe families can have major long-term benefits. I believe that our role in this invest-ment is to deliver research that develops, evaluates, and disseminates programs like Nurses for Newborns to move evidence-based preven on to a larger scale.”
About the PhD Scholar Program
Reminder: September is Suicide Preven on Awareness Month
Certificate Program Grows
Our PhD Scholar program is open to doctoral students from Washington University in St. Louis, Saint Louis University, or University of Missouri-St. Louis who have research agendas that align with the Center’s foci and affiliated faculty. This one-year, compe vely awarded, paid, transdisciplinary, predoctoral training program seeks to prepare promising new scholars to con nue to pursue cu ng edge, real-world research in the area of violence preven on and harm reduc on associated with exposure to violence.
Last year we launched our CVIP cer ficate program with an ini al track on violence preven on in young families. This coming year, the program will grow to about 15 students from Washington University, University of Missouri, St Louis and St. Louis University in either the first track or a new track focused on a violence free transi on to young adulthood. Par cipa on in our cer ficate program is limited to MPH and MSW students so far, but our track course offerings have a racted students from many disciplines. Track descrip ons can be found at h p://cvip.wustl.edu.
Publications Here is a par al list of publica ons by our Center affiliates (bolded) from the past 12 months. The featured publica ons relate to this issue’s theme of sexual violence. Biswas, B., Olate, R., & Vaughn, M. G. (2011). Comparison of risky sexual behavior among gang-
involved youth in metropolitan Boston and San Salvador, El Salvador, Journal of Adolescent Health, under review
Bright, C. L., Raghavan, R., Kliethermes, M. D., Juedemann, D., & Dunn, J. (2010). Collabora ve
implementa on of a sequenced trauma-focused interven on for youth in residen al care. Residen al Treatment for Children & Youth, 27, 69-79. doi:10.1080/08865711003712485
Bright, C. L., Ward, S. K., & Negi, N. J. (2011). “The chain has to be broken”: A qualita ve inves ga on
of the experiences of young women following juvenile court involvement. Feminist Criminology, 6(1), 32-53.
Duncan, A.E., Lessov-Schlaggar, H., Pergadia, M.L., Nelson, E.C., Madden, P.A.F., Heath, A.C.
(2010). The rela onship between Body Mass Index and smoking in young women: modera on by childhood sexual abuse. Addic ve Behaviors, 35(11):983-8.
Johnson, S. D., Co ler, L. B., Ben Abdallah, A., & O'Leary, C. (2010). History of sexual trauma and
sexual adult behaviors reported by community-recruited substance using women. AIDS and Behavior.
Lauritsen, J. L., & Carbone‐Lopez, K. (2011). Gender differences in risk factors for violent vic miza on: An examina on of individual-, family-, and community-level predictors. Journal of Research in Crime and Delinquency, , 1-28.
T A K I N G F L I G H T — I S S U E F O U R P A G E 7 R E T U R N T O T A B L E O F C O N T E N T S
Translational Research on Child Neglect
Consortium Fifth Annual Meeting September 8‐9, 2011 University of Iowa, Iowa Memorial Union Iowa City, Iowa
Focus: Interven on and treatment related to child neglect Keep an eye on the website for registra on informa on: h p://trcnconsor um.com/ (embed the link)
One Brookings Drive | Campus Box 1196 | St. Louis, MO 63130 | Ph: 314‐935‐8129 | Fax: 314‐935‐7508 | E‐mail: [email protected]
T A K I N G F L I G H T — I S S U E F O U R P A G E 8 R E T U R N T O T A B L E O F C O N T E N T S
Next Issue Our October issue will focus on: Child abuse and neglect preven on.
The Brown School’s Center for Violence and Injury Preven on was
founded in 2009 with a grant from the Centers for Disease Control
and Preven on. The Center conducts research, training, and
outreach to prevent and ameliorate harm related to:
child maltreatment (CM)
in mate partner violence (IPV)
sexual violence (SV)
suicide a empts (SA)
Our bu erfly icon represents transforma on and symbolizes the
developmental aspect of our mission to advance evidence-based
primary preven on of violence and injury among young families,
and interven on for childhood vic ms of violence to prevent
poten al later perpetra on of violence toward themselves or
others as they transi on to adulthood. Our colors represent
those typically used by community organiza ons working in
these four areas.
Director Melissa Jonson-Reid, PhD
Co-Director John N. Constan no, MD
Administra ve Assistant Diane Wi ling
Research Assistant Britani Hollis
Special thanks to Taking Flight contributors.
The Center is an open and dynamic collabora on with
researchers from mul ple disciplines and mul ple universi es.
While it is not possible to acknowledge all our individual
colleagues, we want to recognize our other university partners
outside of Washington University who have had a par cularly
instrumental role in the CVIP. These include the Saint Louis
University Schools of Social Work and Public Health; the
University of Missouri at St. Louis Schools of Criminology and
Criminal Jus ce and Social Work; and the University of Missouri
at Columbia Schools of Nursing and Social Work.
Visit us online at h p://cvip.wustl.edu
Opinions or views expressed in this newsle er do not necessarily reflect those of the funding agency.