WUSTL Top News Stories

Folic acid may reduce some childhood cancers

Jessica Martin — 2012-05-21 00:00:00

Folic acid fortification of foods may reduce the incidence of the most common type of kidney cancer and a type of brain tumors in children, finds a new study by Kimberly J. Johnson, PhD, assistant professor at the Brown School at Washington University in St. Louis, and Amy Linabery, PhD, postdoctoral fellow at the University of Minnesota.

Incidence reductions were found for Wilms’ tumor, a type of kidney cancer, and primitive neuroectodermal tumors (PNET), a type of brain cancer.

Since 1998, the U.S. Food and Drug Administration has mandated fortification of foods with folic acid because earlier studies show that prenatal consumption of folic acid significantly reduces the incidence of neural tube defects in babies.

“Our study is the largest to date to show that folic acid fortification may also lower the incidence of certain types of childhood cancer in the United States,” Johnson says.

The study, published in the current issue of Pediatrics, examined the incidence of childhood cancer pre- and post-mandated folic acid fortification.

“We found that Wilms’ tumor rates increased from 1986 to 1997 and decreased thereafter, which is an interesting finding since the downward change in the trend coincides exactly with folic acid fortification,” Johnson says.

“PNET rates increased from 1986 to 1993 and decreased thereafter. This change in the trend does not coincide exactly with folic acid fortification, but does coincide nicely with the 1992 recommendation for women of childbearing age to consume 400 micrograms of folic acid daily.”

Study authors used the 1986-2008 data from the National Cancer Institute’s Surveillance, Epidemiology, and End Results Program (SEER), which has collected information on cancer cases in various areas of the U.S. since 1973. The study involved 8,829 children, from birth to age four, diagnosed with cancer.

“Declines in Wilms’ tumors and PNETs in children were detected by multiple analyses of the data,” Johnson says.

“Importantly, the reduced rates of Wilms’ tumors also were found in a smaller study conducted in Ontario, Canada, that was published in 2011.

“More research is needed to confirm these results and to rule out any other explanations.”

Julie A. Ross, PhD, professor and director of the Division of Pediatric Epidemiology & Clinical Research in the Department of Pediatrics at the University of Minnesota, was a study co-author.

Johnson notes that one concern countries face as they are deciding whether or not to fortify foods to reduce neural tube defects in newborns is the possibility that fortification may cause unintended harm, such as causing new cancers or pre-cancerous lesions.

“Here, we are showing that folic acid fortification does not appear to be increasing rates of childhood cancers, which is good news,” she says.

For the full study, “Childhood Cancer Incidence Trends in Association With Folic Acid,” visit: http://pediatrics.aappublications.org/content/early/2012/05/15/peds.2011-3418.full.pdf+html

Atrocities Prevention Board could significantly change U.S. foreign policy

2012-05-15 00:00:00

President Barack Obama recently announced the establishment of an Atrocities Prevention Board as part of his comprehensive strategy to prevent genocide and mass atrocities.

“For the first time, the National Intelligence Council will prepare an estimate on the global risk of mass atrocities and genocide,” says Leila Nadya Sadat, JD, international law expert and director of the Whitney R. Harris World Law Institute at Washington University in St. Louis School of Law.

Sadat

“By sensitizing the diplomatic and intelligence communities to atrocities risk and systematizing responses to potential crises, the policies of the Atrocities Prevention Board could significantly change U.S. foreign policy,” she says.

The Atrocities Prevention Board is a key feature of the reforms package initiated following the Presidential Study Directive in August 2011 that made the prevention of atrocities a key thrust of U.S. foreign policy.

The board is made up of senior officials from throughout the federal government, including the U.S. Departments of State and Defense as well as the federal agency USAID, and will convene once a month to create and implement policies to prevent atrocities and respond urgently to situations as they arise.

Sadat, the Henry H. Oberschelp Professor of Law at WUSTL, is director of the Crimes Against Humanity Initiative, which has drafted a Proposed International Convention on the Prevention and Punishment of Crimes Against Humanity (law.wustl.edu/harris/crimesagainsthumanity/).

She noted “the adoption of the Proposed Convention would provide a tool that the Atrocities Prevention Board can use to address developing or ongoing situations of mass atrocities by ensuring that states – including the United States – do not unwittingly or purposefully harbor the perpetrators of crimes against humanity.”

“This bold move by the president sends a clear message that the United States is committed to preventing and responding to atrocities as a moral stance as well,” Sadat says.

IUDs, implants are most effective birth control

Diane Duke Williams — 2012-05-23 00:00:00

Audio available

A study to evaluate birth-control methods has found dramatic differences in their effectiveness. Women who used birth-control pills, the patch or vaginal ring were 20 times more likely to have an unintended pregnancy than those who used longer-acting forms such as an intrauterine device (IUD) or implant.

Results of the study, by researchers at Washington University School of Medicine in St. Louis, are reported May 24 in the New England Journal of Medicine.

Birth-control pills are the most commonly used reversible contraceptive in the United States, but their effectiveness hinges on women remembering to take a pill every day and having easy access to refills.

http://youtu.be/0ci4B7BtXwI

In the study, birth-control pills and other short-term contraceptive methods, such as the contraceptive patch or ring, were especially unreliable among younger women. For those under 21 who used birth-control pills, the patch or ring, the risk of unplanned pregnancy was almost twice as high as the risk among older women. This finding suggests that increased adolescent use of longer acting contraceptive methods could prevent substantially more unplanned pregnancies.

Peipert

“This study is the best evidence we have that long-acting reversible methods are far superior to the birth-control pill, patch and ring,” says senior author Jeffrey Peipert, MD, the Robert J. Terry Professor of Obstetrics and Gynecology. “IUDs and implants are more effective because women can forget about them after clinicians put the devices in place.”

Unintended pregnancy is a major problem in the United States. About 3 million pregnancies per year — 50 percent of all pregnancies — are unplanned. The rate of unintended pregnancy in the United States is much higher than in other developed nations, and past studies have shown that about half of these pregnancies result from contraceptive failure.

IUDs are inserted into the uterus by a health-care provider. The hormonal IUD is approved for five years, and the copper IUD can be used for as long as 10 years. Hormonal implants are inserted under the skin of the upper arm and are effective for three years. Many women, however, cannot afford the upfront costs of these methods, which can be more than $500.

“We know that IUDs and implants have very low failure rates — less than 1 percent,” says Brooke Winner, MD, a fourth-year resident at Barnes-Jewish Hospital and the study’s lead author. “But although IUDs are very effective and have been proven safe in women and adolescents, they only are chosen by 5.5 percent of women in the United States who use contraception.”

Winner

Earlier contraceptive studies asked women to recall the birth-control method they used and number of pregnancies. For this study, the investigators wanted to determine whether educating women about the effectiveness of various birth-control options and having them choose a method without considering cost would reduce the rate of unintended pregnancy. Birth control was provided to women at no cost.

The study involved more than 7,500 women enrolled in the Contraceptive CHOICE project. Participants were ages 14-45 and at high risk of unintended pregnancy. The women were sexually active or planned to become sexually active in the next six months. They either were not currently using contraception or wanted to switch birth-control methods. The women also said they did not want to become pregnant for the next 12 months.

Participants in this report could choose among the following birth-control methods: IUD, implant, birth-control pills, patch, ring and contraceptive injection. The women were counseled about the contraceptive methods, including their effectiveness, side effects, risks and benefits. Participants were permitted to discontinue or switch methods as many times as desired during the study.

Investigators interviewed participants by telephone at three and six months and every six months thereafter for the remainder of the study. During each interview, participants were asked about missed periods and possible pregnancy. Any participant who thought she might be pregnant was asked to come in for a urine pregnancy test. Those who were pregnant were asked if it was intended and what contraceptive method, if any, they were using at time of conception.

Over the three-year study, 334 women became pregnant. Of these, 156 pregnancies were due to contraceptive failure. Overall, 133 (4.55 percent) of women using pills, the patch or ring had contraceptive failure, compared with 21 (0.27 percent) of women using IUDs and implants.

“This study also is important because it showed that when IUDs and implants are provided at no cost, about 75 percent of women chose these methods for birth control,” Winner says.

Women who chose an IUD or implant were more likely to be older, to have public health insurance and to have more children than women who chose other contraceptive methods. Women who chose pills, the patch or ring were more likely to have private health insurance and to not have had children previously.

“If there were a drug for cancer, heart disease or diabetes that was 20 times more effective, we would recommend it first,” he says. “Unintended pregnancies can have negative effects on women’s health and education and the health of newborns.”

Winner B, Peipert J, Qiuhong Z, Buckel C, Madden T, Allsworth J, Secura G. Effectiveness of long-acting reversible contraception. New England Journal of Medicine. Vol. 366. May 24, 2012.

Washington University School of Medicine’s 2,100 employed and volunteer faculty physicians also are the medical staff of Barnes-Jewish and St. Louis Children’s hospitals. The School of Medicine is one of the leading medical research, teaching and patient care institutions in the nation, currently ranked sixth in the nation by U.S. News & World Report. Through its affiliations with Barnes-Jewish and St. Louis Children’s hospitals, the School of Medicine is linked to BJC HealthCare.

Washington University School of Law goes online with LLM in U.S. Law

2012-05-08 00:00:00

Washington University School of Law announced it will begin offering its Master of Laws in U.S. Law for Foreign Lawyers (LLM) in a new and innovative online format. Called @WashULaw, the program is the first and only top-tier online LLM in U.S. law.

The online LLM builds on the law school’s internationally recognized postgraduate law degree program, which is designed for foreign attorneys interested in increasing their knowledge of U.S. law to more effectively practice in today’s global legal environment.

@WashULaw will allow foreign lawyers to complete an LLM degree in U.S. law without leaving their law practices or relocating to the United States.

Students will receive an excellent grounding in U.S. law, with a focus on business issues, without dramatic disruption to their professional and personal lives, or the relocation costs associated with a prolonged stay overseas. @WashULaw provides foreign lawyers with a flexible option to earn their degree from a world leader in legal education and research.

“We aim to produce extraordinary graduates who benefit from the highest caliber online education available – and to ensure that the quality equals or exceeds the quality of the best LLM programs in the world,” says Kent Syverud, dean of the School of Law and the Ethan A.H. Shepley Distinguished University Professor.

The @WashULaw LLM program offers students an online version of Washington University School of Law’s on-campus LLM curriculum, with:

Courses designed and taught by WUSTL law school faculty, who are renowned legal educators and scholars;
Classes of students who meet the same selective admissions criteria as the on-campus graduate law program;
An LLM degree identical to the one received by on-campus graduates and the option to attend the campus graduation ceremony;
Intimate classes of no more than 15 students; and
An optional summer immersion in U.S. law experience offered in the U.S. and taught by WUSTL faculty.

Delivered through state-of-the-art online technologies, @WashULaw courses will integrate live classroom sessions with streaming video and self-paced content. In live classroom sessions, WUSTL law faculty and @WashULaw students will “meet” at pre-arranged times for coursework discussions, study groups and face-to-face office hour meetings.

The self-paced content offers students high-quality, faculty-designed coursework, highly produced video content and an interactive social technology platform that allows students to chat, study and join communities with classmates and professors 24 hours a day.

During the summer, @WashULaw students will be offered an intensive U.S. immersion program in St. Louis, Washington D.C. and other U.S. cities to experience U.S. law from inside U.S. courtrooms and law firms.

@WashULaw is being directed by Melissa Waters, JD, professor of law, and Tomea Mersmann, JD, associate dean for strategic initiatives and lecturer in law. An advisory council is being formed to engage the WUSTL School of Law community and thought leaders in education in the development of @WashULaw.

One of the initial advisory council members, Andrew Puzder, CEO of CKE Restaurants Inc., is enthusiastic about the opportunities and benefits provided by @WashULaw.

“I have been extremely supportive of this program since day one. I manage our company by the maxim that to survive and prosper, companies must take advantage of current technology and innovate,” says Puzder, also a member of the law school’s National Council.

“I am proud that my law school is embracing technology, without sacrificing quality, to expand its presence in global legal education.”

WUSTL School of Law has partnered with the education technology company 2tor, Inc. to deliver @WashULaw. 2tor partners with leading higher education institutions to deliver rigorous, selective degree programs online by providing the technology platform, instructional design, marketing and infrastructure support.

"We’re honored to add Washington University to the esteemed family of 2tor partners," says Chip Paucek, co-founder and CEO of 2tor. "We’re thrilled to be working with a school that is pioneering a law program for the 21st century and one that is primed for an increasingly globalized world."

Education innovation expert Michael B. Horn also is a member of the program’s initial advisory council. Horn is the co-founder and executive director of the education practice of Innosight Institute, a nonprofit think tank devoted to applying the theories of disruptive innovation to solve problems in the social sector.

“It's exciting that a top-tier law school is taking a leadership role in online learning,” Horn says. “Washington University’s partnership with 2tor is a clear signal that the field of online learning is being invigorated and transformed by top-flight entrants.”

@WashULaw is now accepting applications; classes begin in January 2013. International applicants must first earn a law degree from their home jurisdiction.

For more information, visit onlinelaw.wustl.edu, email admissions@onlinelaw.wustl.edu or call 888-WashULW (888- 927-4859).

About Washington University School of Law

Washington University School of Law offers students an outstanding legal education in an intellectually challenging and collegial environment.

With faculty members recognized for excellent teaching and scholarship, a student body among the most selective in the country, and an increasingly global and diverse community, the school strives to prepare graduates for the quickly evolving legal and business environment.

@WashULaw is an example of the law school’s efforts to innovate using technology and new teaching methods as it pursues its mission to be the best place in the United States to learn to be a lawyer.

About 2tor, Inc.

2tor, Inc. partners with top-tier universities to deliver rigorous, selective graduate programs online. Founded in 2008 by a unique team of education veterans, the company provides universities with the web technologies, infrastructural support and capital needed to compete in a space previously dominated by mediocre online programs.

2tor is one of the highest-funded education technology startups in the United States. The company has partnered with prestigious research universities, including the University of Southern California, Georgetown University and the University of North Carolina Chapel Hill, to deliver groundbreaking online degree programs.

Washington University receives $3 million to design cancer-killing viruses

Julia Evangelou Strait — 2012-05-22 00:00:00

Igor Dmitriev, PhD

The illustration shows an adenovirus particle carrying metals and antibodies for cancer therapy. In this case, the metal is copper-64, a radioactive metal useful for both imaging and cancer therapy. Antibodies shown in orange and purple can target the virus to specific tissues or tumor types.

Researchers at Washington University School of Medicine in St. Louis have received a $3 million grant from the National Cancer Institute (NCI) to develop a triple threat in the fight against cancer: a single virus equipped to find, image and kill cancer cells, all at once.

Led by David T. Curiel, MD, PhD, Distinguished Professor of Radiation Oncology, the program will build on his group’s expertise with adenovirus, a virus that causes the common cold and has shown promise in cancer therapeutics and imaging.

“This is a virus that we know a lot about,” says Curiel, director of the Biologic Therapeutics Center at Washington University. “Our research seeks ways to use the virus like a nanoparticle and capitalize on all the unique capacities of the virus and our ability to manipulate it.”

Developing a three-pronged attack on cancer cells is in line with the NCI’s pursuit of a new paradigm in cancer research. Known as theragnostics, the concept is to combine therapy and diagnostics into one targeted attack on a specific cancer.

“We would like to understand the patient’s biology and direct therapy on that basis,” Curiel says. “And ideally, such a personalized treatment agent should include everything you would want it to do — it would be targeted specifically to the cancer and avoid healthy cells, it would deliver therapeutic drugs, and it would have a method to image the tumor to monitor the outcome of therapy.”

Curiel

According to Curiel, there is a focus on nanoparticles in this three-part theragnostic tool. Similar in size to viruses, nanoparticles are also heavily studied for their anti-cancer possibilities. But Curiel argues that viruses have some advantages over nanoparticles. Unlike nanoparticles that serve only as passive carriers, viruses have DNA, which offers another layer of cancer fighting or imaging potential.

“With a virus, we can alter its genes so that it expresses a protein that could be used against the cancer, or a protein that might enable us to image the tumor,” Curiel says.

And like a nanoparticle, a virus can be modified to carry different molecules, drugs and metals on its surface. Previous work by Curiel and others has identified certain proteins that would target the virus to specific tissues in the body and even specific tumor types.

In addition to targeting, Curiel and his collaborators at Louisiana State University have developed a novel way to attach heavy metals to the surface of viruses so they are visible to non-invasive X-ray imaging. In a study published in PLoS ONE last year, they demonstrated the ability to use CT scans to track the location of these metal-carrying viruses in mice.

Beyond imaging, the metal-binding viruses could also carry radioactive metals that deliver radiation therapy directly to the cancer cells while sparing healthy ones.

“Within the cancer world, this idea of theragnostics is something of a holy grail,” Curiel says. “It’s an idea that has preceded the technology. With this grant, we hope to make inroads in developing a cancer therapeutic that accomplishes all of these targeting, treating and imaging goals.”

The grant "Targeted- and Image-Based Adenovirus Cancer Therapeutic Vectors" is supported by the National Cancer Institute (NCI), part of the National Institutes of Health (NIH). Grant 1R01CA154697-01A1.

Mathis JM, Bhatia S, Khandelwal A, Kovesdi I, Lokitz SJ, Odaka Y, Takalkar AM, Terry T, Curiel DT. Genetic incorporation of human metallothionein into the adenovirus protein IX for non-invasive SPECT imaging. PLoS ONE. February 2011.

Youth with autism face barriers to employment and education after high school

Jessica Martin — 2012-05-14 00:00:00

Compared with youth with other disabilities, young adults with autism spectrum disorders (ASD) face a disproportionately difficult time navigating work and educational opportunities after high school, finds a new study by Paul Shattuck, PhD, assistant professor at the Brown School at Washington University in St. Louis.

“Thirty-five percent of the youth with ASDs had no engagement with employment or education in the first six years after high school,” Shattuck says.

“Rates of involvement in all employment and education were lower for those with lower income.”

The study, published in the current issue of the journal Pediatrics, examined data from the National Longitudinal Transition Study 2 (NLTS2), a nine-year study of adolescents who were enrolled in special education at the outset. The NLTS2 included groups of adolescents with ASDs, learning disabilities, intellectual disabilities and speech and language impairments.

“Compared with youth in the three other disability categories, those with an ASD had significantly lower rates of employment and the highest overall rates of no participation in any work or education whatsoever,” Shattuck says.

“Those with an ASD had a greater than 50-percent chance of being unemployed and disengaged from higher education for the first two years after high school.”

http://youtu.be/Qyl2ZQRb4dsCompared with youth with other disabilities, young adults with autism spectrum disorders (ASD) face a disproportionately difficult time navigating work and educational opportunities after high school, finds a new study by Paul Shattuck, PhD, assistant professor at the Brown School at Washington University in St. Louis. Shattuck discusses the study results.

Shattuck notes that approximately 50,000 youth with ASDs will turn 18 this year in the United States.

“Many families with children with autism describe turning 18 as falling off a cliff because of the lack of services for adults with ASDs,” he says.

“The years immediately after high school are key. They are the time when people create an important foundation for the rest of their lives.

“There needs to be further research into services for young adults with ASDs to help them make the transition into adulthood and employment or further education.”

Shattuck says that particular attention should be paid to interventions that will help poorer youth overcome barriers to accessing services and achieving fuller participation in society.

This study was funded by the Organization for Autism Research, Autism Speaks and the National Institute of Mental health.

Shattuck’s study co-authors are Sarah Carter Narendorf, Benjamin Cooper and Paul Sterzing of the Brown School; Mary Wagner, PhD, of SRI International; and Julie Lounds Taylor, PhD, of Vanderbilt University.

Shattuck will give a keynote presentation on his research at the International Meeting for Autism Research in Toronto Thursday, May 16.

Washington University in St. Louis-Fudan University EMBA program celebrates 10th anniversary

Neil Schoenherr — 2012-05-18 00:00:00

http://youtu.be/oZI8wCWERNIOlin Business School's EMBA Shanghai program, offered in partnership with Fudan University, will celebrate its 10th anniversary on May 25th. The program has attracted executive students from some of the world's largest corporations. They are attracted to the program's diversity, outstanding faculty and global nature.

The Washington University in St. Louis-Fudan University Executive MBA program, ranked second in mainland China by the Financial Times, will celebrate its 10th anniversary May 25. Established in 2002 at Olin Business School, the program was among the first U.S.-China joint MBA degree programs.

The Olin Executive MBA in Shanghai now attracts around 75 percent of its students from China and is designed to prepare Chinese professionals for global executive positions.

The joint venture also provides valuable international experience for Olin’s St. Louis and Kansas City-based Executive MBA students, who spend two weeks in China working and studying with their Chinese counterparts. The Shanghai-based students also travel to St. Louis each December for a final joint session before graduation.

Over the years, the program has become more complex and specialized as the capabilities of the students have evolved says Patrick Moreton, PhD, former associate dean and managing director of the Olin Executive MBA-Shanghai program from 2004-2012.

“If you go back to 2001-02 when we first started recruiting students, this was just at the dawn of China’s ascension to the WTO (World Trade Organization),” Moreton says. “Fast-forward 10 years and China is now the second-largest economy in the world, a major player and major factor in financial markets and a political entity to be reckoned with. So we’ve had as an institution to step up to the plate and really design an experience that matches their level of sophistication.”

Olin is proud to have Executive MBA programs operating on the ground in three cities – St. Louis, Kansas City and Shanghai, says Kay Henry, former associate dean and director of Executive MBA programs at Olin from 2006-2012.

“They mutually enhance each other programmatically because the Chinese students come to the United States for a two-week residency and the United States students go to China for a residency as well,” she says.

“A lot of Executive MBA programs have international experiences for their students, but where we have the advantage is that we have over 500 alumni in Shanghai —and they all have a wealth of business experience and local experience to share with their U.S. counterparts.”

The program’s excellence is attracting top-notch students from all over the world.

“In China there are a lot of executive MBA programs, but academically they are not serious about it,” says Michael Lam, member of the Executive MBA Shanghai Class of 2011. “The reason I chose this program is that the Financial Times ranking is pretty high. That tells everything. Second of all, I talked to a lot of friends. Those people that I regarded as serious wholly recommended this program.

“The comprehensive knowledge that I acquired in the program is very valuable,” Lam says. “At the same time, we are communicating with a class of elite students from different industries, and that in itself is a very great learning experience.”

Henry says the program with Fudan University is a way to add value to the regional business community as well.

“All business is global business,” she says. “We’re in St. Louis. There are companies in our city that are doing business globally. We really feel we are preparing out students to serve those companies and to serve our regional business community through our global program.”

Babies’ susceptibility to colds linked to immune response at birth

Julia Evangelou Strait — 2012-05-17 00:00:00

Innate differences in immunity can be detected at birth, according to new research at Washington University School of Medicine in St. Louis. And babies with a better innate response to viruses have fewer respiratory illnesses in the first year of life.

“Viral respiratory infections are common during childhood,” says first author Kaharu Sumino, MD, assistant professor of medicine. “Usually they are mild, but there’s a wide range of responses — from regular cold symptoms to severe lung infections and even, in rare instances, death. We wanted to look at whether the innate immune response — the response to viruses that you’re born with — has any effect on the risk of getting respiratory infections during the baby’s first year.”

Sumino

Reporting in the May issue of the Journal of Allergy and Clinical Immunology, Sumino and her colleagues found that newborns with a diminished immune response to viruses experienced more respiratory infections in their first year of life than newborns whose immune response was more robust.

Using umbilical cord blood samples taken in the delivery room, the researchers measured a specific immune system response to viral infection known as interferon-gamma (IFN-gamma). IFN-gamma is released by some cells of the immune system when they encounter a virus. An important weapon in the immune system’s arsenal, IFN-gamma helps fight viruses by stopping them from replicating.

The researchers studied cord blood samples from 82 babies in St. Louis enrolled in the Urban Environment and Childhood Asthma (URECA) trial. Eighty-five percent of the infants were African-American, and all lived in an area where at least 20 percent of the residents were below the poverty level. All had at least one parent with allergies, asthma or eczema, putting them at higher risk for these conditions themselves.

As reported by their caregivers, the babies averaged four colds in their first year with 88 percent of them suffering at least one cold. But the range varied widely with some caregivers reporting no colds and a few reporting as many as nine or 10.

To measure the innate immune response, the blood samples were taken at birth, before any exposure to the environment could influence the child’s immunity. The researchers isolated monocytes, a specific type of white blood cell, from the babies’ cord blood, and infected these cells with a common respiratory virus. They then measured the amount of IFN-gamma produced by the monocytes in response to the virus.

In general, babies whose monocytes responded to the virus by producing higher levels of IFN-gamma had fewer reported colds. Likewise, babies whose monocytes produced lower IFN-gamma levels had more reported colds.

The scientists also found that newborns whose monocytes produced less IFN-gamma also experienced more ear infections, sinus infections, pneumonia, and hospitalizations due to respiratory illness during their first year. But low IFN-gamma levels were not associated with croup or "stomach flu," indicating that this system may be closely associated with respiratory viruses and not other types of infections.

In an effort to identify other indicators of viral response, the researchers measured amounts of two other immune molecules: chemokine CCL5 and STAT1. Unlike IFN-gamma, neither showed any correlation with the number of illnesses the babies experienced.

This study in infants, as well as research in mice and human cells, supports the idea that dialing up the body’s IFN-gamma signaling system may help protect against viral infection. The report’s senior author Michael J. Holtzman, MD, the Selma and Herman Seldin Professor of Medicine, is working on drug discovery in this area. Unlike a vaccine, which protects against a specific virus, a drug that improves the body’s innate immunity could help fight a broad range of viruses, including the constantly evolving seasonal flu.

“Ideally, if these results are confirmed, we would like to be able to intervene based on knowledge of the innate IFN-gamma response,” Sumino says. “We’re not there yet — measuring IFN-gamma levels is complex. But in the future, if we can develop a relatively easy way to find out if someone has a deficiency in this system, we would like to be able to give a drug that can boost the innate immune response.”

Sumino K, Tucker J, Shahab M, Jaffee KF, Visness CM, Gern JE, Bloomberg GR, Holtzman MJ. Antiviral interferon-gamma responses of monocytes at birth predict respiratory tract illness in the first year of life. Journal of Allergy and Clinical Immunology. Vol 129. No 5. May 2012. Online March 29, 2012.

This work was supported by grants from the National Institute of Allergy and Infectious Disease (NIAID) and the National Heart, Lung, and Blood Institute (NHLBI), both part of the National Institutes of Health (NIH).

Finance student, rising DJ star, to raise money for schools for underprivileged children

Neil Schoenherr — 2012-05-17 00:00:00

Rising senior Justin Blau is on a mission.

Blau, a finance major at Olin Business School at Washington University in St. Louis, is more widely known by his stage name, 3LAU. He plans to use his status as a rising star in the electronic music world to raise money for schools for underprivileged children in developing nations.

Justin "3LAU" Blau performs for a packed crowd.

Blau, who was recently named resident DJ at Hard Rock Café Las Vegas and ranks No. 3 on BeatPort’s Top 10 music chart, hopes to take electronic dance music to another level by teaming with his fans to support Pencils of Promise.

The nonprofit organization builds schools for underprivileged children in developing nations like Guatemala, Laos and Nicaragua.

“Every dollar that I make by selling my ‘Back to New’ remix on BeatPort.com will be donated to Pencils of Promise,” Blau says. “My goal is $25,000, and I will personally match all money donated via BeatPort.com sales until we reach that goal.

“I want to harness the power of the dance music movement to give something real, to give back.”

Blau is an accomplished performer, with 45 nationwide shows under his belt in this year alone. When he’s not behind the turntables or studying for exams, Blau says he is adamant about giving back by working with the community that has catapulted his career.

“I have more than 40,000 fans on Facebook,” he says. “If each of them donates just 50 cents, we can raise enough money to build another school and bring awareness to global education.

“Education is a right that all human beings should have,” he says, “yet there are 75 million children just like us without access to it. I’m ready to help that change.”

“Justin is a top-notch student, a talented and original musician, and a terrifically nice guy who makes everyone near him better,” says Glenn MacDonald, PhD, the John M. Olin Distinguished Professor of Economics and Strategy and professor of the popular “Economics of Entertainment” class at Olin.

“It is such a great thing for our community to enjoy his music and his success story up close. Download ‘Back to New’!”

To learn more about Pencils of Promise and to donate, visit 3lau.com.

Surgeons restore some hand function to quadriplegic patient

Julia Evangelou Strait — 2012-05-15 00:00:00

Audio available

Eric Young

To detour around the block in this patient’s C7 spinal cord injury and return hand function, Mackinnon operated in the upper arms. There, the working nerves that connect above the injury (green) and the non-working nerves that connect below the injury (red) run parallel to each other, making it possible to tap into a functional nerve and direct those signals to a non-functional neighbor (yellow arrow).

Surgeons at Washington University School of Medicine in St. Louis have restored some hand function in a quadriplegic patient with a spinal cord injury at the C7 vertebra, the lowest bone in the neck. Instead of operating on the spine itself, the surgeons rerouted working nerves in the upper arms. These nerves still “talk” to the brain because they attach to the spine above the injury.

Following the surgery, performed at Barnes-Jewish Hospital, and one year of intensive physical therapy, the patient regained some hand function, specifically the ability to bend the thumb and index finger. He can now feed himself bite-size pieces of food and write with assistance.

The case study, published online May 15 in the Journal of Neurosurgery, is, to the authors’ knowledge, the first reported case of using nerve transfer to restore the ability to flex the thumb and index finger after a spinal cord injury.

“This procedure is unusual for treating quadriplegia because we do not attempt to go back into the spinal cord where the injury is,” says surgeon Ida K. Fox, MD, assistant professor of plastic and reconstructive surgery at Washington University, who treats patients at Barnes-Jewish Hospital. “Instead, we go out to where we know things work — in this case the elbow — so that we can borrow nerves there and reroute them to give hand function.”

Fox

Although patients with spinal cord injuries at the C6 and C7 vertebra have no hand function, they do have shoulder, elbow and some wrist function because the associated nerves attach to the spinal cord above the injury and connect to the brain. Since the surgeon must tap into these working nerves, the technique will not benefit patients who have lost all arm function due to higher injuries — in vertebrae C1 through C5.

The surgery was developed and performed by the study’s senior author Susan E. Mackinnon, MD, chief of the Division of Plastic and Reconstructive Surgery at Washington University School of Medicine. Specializing in injuries to peripheral nerves, she has pioneered similar surgeries to return function to injured arms and legs.

Mackinnon originally developed this procedure for patients with arm injuries specifically damaging the nerves that provide the ability to flex the thumb and index finger. This is the first time she has applied this peripheral nerve technique to return limb function after a spinal cord injury.

http://youtu.be/zccK4An10kA

“Many times these patients say they would like to be able to do very simple things,” Fox says. “They say they would like to be able to feed themselves or write without assistance. If we can restore the ability to pinch, between thumb and index finger, it can return some very basic independence.”

Mackinnon cautions that the hand function restored to the patient was not instantaneous and required intensive physical therapy. It takes time to retrain the brain to understand that nerves that used to bend the elbow now provide pinch, she says.

Though this study reports only one case, Mackinnon and her colleagues do not anticipate a limited window of time during which a patient with a similar spinal cord injury must be treated with this nerve transfer technique. This patient underwent the surgery almost two years after his injury. As long as the nerve remains connected to the support and nourishment of the spinal cord, even though it no longer “talks” to the brain, the nerve and its associated muscle remain healthy, even years after the injury.

Mackinnon

“The spinal cord is the control center for the nerves, which run like spaghetti all the way out to the tips of the fingers and the tips of the toes,” says Mackinnon, the Sydney M. Shoenberg Jr. and Robert H. Shoenberg Professor and director of the School of Medicine’s Center for Nerve Injury and Paralysis. “Even nerves below the injury remain healthy because they are still connected to the spinal cord. The problem is that these nerves no longer ‘talk’ to the brain because the spinal cord injury blocks the signals.”

To detour around the block in this patient’s C7 spinal cord injury and return hand function below the level of the injury, Mackinnon operated in the upper arms. There, the working nerves that connect above the injury and the non-working nerves that connect below the injury run parallel to each other, making it possible to tap into a functional nerve and direct those signals to a non-functional neighbor.

In this case, Mackinnon took a non-working nerve that controls the ability to pinch and plugged it into a working nerve that drives one of two muscles that flex the elbow. After the surgery, the bicep still flexes the elbow, but a second muscle, called the brachialis, that used to also provide elbow flexion, now bends the thumb and index finger.

“This is not a particularly expensive or overly complex surgery,” Mackinnon says. “It’s not a hand or a face transplant, for example. It’s something we would like other surgeons around the country to do.”

Detailed information for potential patients interested in nerve transfer surgery for C6 and C7 spinal cord injury will be available after 10 a.m. EDT Tuesday, May 15, 2012 at nerve.wustl.edu.

Mackinnon SE, Yee A, Ray WZ. Spinal cord injury bypass technique with nerve transfers for the restoration of hand function after spinal cord injury – case report and review of the literature. The Journal of Neurosurgery. Online May 15, 2012.

Inaugural Ferencz essay contest at Washington University School of Law focuses on crimes against humanity

2012-05-09 00:00:00

Individuals interested in addressing the relationship between crimes against humanity and the crime of aggression are invited to participate in the inaugural Benjamin B. Ferencz Essay Competition, hosted by the Whitney R. Harris World Law Institute at Washington University School of Law.

“Given that the crime of aggression is not currently enforceable at the International Criminal Court (ICC), the competition aims to address whether illegal uses of force, interstate or otherwise, resulting in significant loss of life may currently be prosecutable before the ICC as crimes against humanity,” says Leila N. Sadat, JD, director of the Harris Institute and the Henry H. Oberschlep Professor of Law at WUSTL.

The contest, named in honor of former Nuremberg prosecutor Benjamin B. Ferencz, calls for scholars and students from around the world to answer the question: Under what conditions may acts that constitute illegal use of armed force and that result in the widespread or systematic attack upon a civilian population be prosecuted as crimes against humanity by the ICC, pursuant to the Rome Statute?

Contestants are encouraged to register for the competition at the competition’s website (http://law.wustl.edu/harris/pages.aspx?id=9126) as soon as possible. The deadline for submission of entries is 5 p.m. (Central Daylight Time) Friday, Aug. 31, 2012.

The first-place winner will receive an award of $10,000. Second- and third-place runners-up each will receive an honorable mention and a plaque as well as runner-up awards in the amount of $2,500.

The first-place winner will be invited to St. Louis, Mo., for an award ceremony that will take place during the International Criminal Court at Ten conference Nov. 11 and 12, 2012.

The essay will be included in the symposium issue published by the Washington University Global Studies Law Review resulting from the conference.

Visit the Harris Institute’s website for additional information on eligibility, requirements and guidelines for the competition. For more information, contact Bethel Mandefro at bmandefro@wulaw.wustl.edu.

Genetic test identifies eye cancer tumors likely to spread

Jim Dryden — 2012-05-14 00:00:00

Audio

Harbour laboratory

Using very small amounts of tumor tissue collected by a needle biopsy, doctors can conduct gene expression profile testing to determine the likelihood that an ocular melanoma tumor will spread beyond the eye.

Researchers at Washington University School of Medicine in St. Louis have developed a genetic test that can accurately predict whether the most common form of eye cancer will spread to other parts of the body, particularly the liver.

In 459 patients with ocular melanoma at 12 centers in the United States and Canada, the researchers found the test could successfully classify tumors more than 97 percent of the time.

The study will appear in an upcoming issue of the journal Ophthalmology, but is now online.

“When the cancer spreads beyond the eye, it’s unlikely any therapy is going to be effective,” says principal investigator J. William Harbour, MD. “But it’s very possible that we can develop treatments to slow the growth of metastatic tumors. The real importance of this test is that by identifying the type of tumor a patient has, we can first remove the tumor from the eye with surgery or radiation and then get those individuals at high risk into clinical trials that might be able to help them live longer.”

Harbour believes the test should allow ocular oncologists to quickly evaluate the risks associated with particular tumors and to begin treatment the moment they can detect any spread of the cancer.

Melanoma of the eye is relatively rare, diagnosed in about 2,000 people in the United States each year. Advances in treatment have allowed surgeons to preserve patients’ vision, but when cancer spreads beyond the eye, it often is deadly.

About a decade ago, Harbour, the Paul A. Cibis Distinguished Professor of Ophthalmology and Visual Sciences, began using gene expression profiling to monitor the activity of thousands of genes in and around ocular melanoma tumors.

“At the time, we were surprised to see that based on these gene expression profiles, the tumors clustered into two groups that corresponded, almost perfectly, to patients whose cancer spread and those whose cancer was confined within the eye,” says Harbour, who directs Washington University’s Center for Ocular Oncology. “Tumors with a class 1 gene expression profile, or ‘signature,’ very rarely spread, but those with a class 2 profile frequently develop into metastatic cancer.”

Harbour

Initially, Harbour’s group identified differences in approximately 1,000 genes between class 1 and class 2 tumors, but they whittled down that number, hoping to develop a simple test that could be used easily by ophthalmologists. Eventually, they settled on about a dozen genes that could be evaluated in tumor samples collected with a needle biopsy.

“We went through a number of sophisticated algorithms and validations, and we came up with a group of 12 genes,” he says. “We also included three more genes that don’t change whether they are in tumor tissue or healthy tissue. Those genes act as our ‘controls’ in this prognostic test.”

Testing tumor tissue from his own ocular melanoma patients at the Alvin J. Siteman Cancer Center at Barnes-Jewish Hospital and Washington University in St. Louis, Harbour found that the gene expression profile test was very good at identifying the two classes of tumors. Then he started recruiting other centers to test the method, too.

“It doesn’t make for a good test if it works really well for us, but it doesn’t really work for anybody else,” Harbour says.

Doctors at the other centers collected tumor samples and shipped them to Harbour’s lab. Not knowing anything about which tumor samples came from which patients, the lab then analyzed the samples and made predictions about which tumors were likely to spread. Although it can take up to five years before there is any evidence that cancer has spread beyond the eye, this study went back less than two years later and tested predictions against what actually had happened.

Almost 62 percent of those tested (276 patients) had class 1 tumors, which were unlikely to spread. About a year and a half after the samples were tested, only three of those tumors had metastasized. Meanwhile, 38 percent of those tested (170 patients) had class 2 tumors, indicating that spread of the cancer was more likely. In that group, 44 (26 percent) developed metastatic disease during the study period. Had patients been followed longer, more likely would have experienced spread of their cancer. Statistical predictions estimate that among class 2 patients, about 60 percent would have metastatic disease within three years, and approximately 80 percent in five years.

“In this relatively short study period, the test worked as well as in the larger group of patients as it had in our patients,” Harbour says. “That was important because it validated not only that our test was an accurate predictor of which patients will develop metastasis, but it also proved that the test can be performed successfully in most other clinics. At the moment, more than 70 centers around the world are using a commercially available version of the same test.”

In the past, some centers relied on a chromosome test to identify eye tumors that were likely to spread. That test looked at chromosome 3 because many ocular melanoma tumors have only one copy of that chromosome.

But the 15-gene expression profile test is more accurate. It takes a more complete “snapshot” of the entire tumor. Harbour says the results of the chromosome test can change, depending on which part of a tumor gets sampled.

“I compare it to how our brains recognize faces,” he says. “We don’t just focus on somebody’s nose. We take in all of the information from the entire face. This test takes information from the entire tumor, so if the ‘nose’ in the ‘picture’ is out of focus for some reason, it still can analyze other things.”

Another strength of the test, he says, is that it can identify which patients will need the closest monitoring.

“Here at Washington University, for example, we monitor patients with class 2 tumors every three months and can begin treatment right away if we find evidence that a tumor has spread,” he says.

On the other hand, the current study found that more than 60 percent of patients with ocular melanoma have class 1 tumors. Those patients don’t need to be followed with the same frequency.

“We won’t have to use high-intensity surveillance on everyone, only on those patients with a class 2 molecular signature, because they’re the ones at risk for metastatic cancer,” Harbour says.

Onken MD, et al. Collaborative Ocular Oncology Group report number 1: prospective validation of a multi-gene prognostic assay in uveal melanoma. Ophthalmology, vol. 119, Advance online publication. http://dx.doi.org/10.1016/j.ophtha.2012.02.017

J. William Harbour, MD, and Washington University may receive royalties based on a license of related technology by the university to Castle Biosciences Inc. This research was not funded by Castle Biosciences, Inc.

Funding for this research comes from the National Cancer Institute and the National Eye Institute of the National Institutes of Health (NIH), the Barnes-Jewish Hospital Foundation, Kling Family Foundation, Tumori Foundation, Horncreast Foundation, a Research to Prevent Blindness David F. Weeks Professorship and a Research to Prevent Blindness Inc. unrestricted grant.

Washington University receives $8 million to lead international childhood malnutrition effort

Caroline Arbanas — 2012-05-14 00:00:00

Jeffrey I. Gordon, MD, at Washington University School of Medicine in St. Louis, will lead an international team of scientists to find new ways to diagnose, treat and prevent a critical global health problem: malnutrition in infants and children. The work is funded by an $8.3 million grant from the Bill & Melinda Gates Foundation.

Gordon’s research first established a link between obesity and the trillions of friendly microbes that live in the intestine, where they extract nutrients and calories from food. His studies have shown that diet helps shape the mix of microbes in the intestine and that these microbes, in turn, influence how efficiently nutrients and calories are harvested from foods. This dynamic interplay has led Gordon to suspect that an imbalance of certain types of gut microbes conspires with an inadequate diet to trigger malnutrition.

Gordon

“A complex relationship exists between diet, gut microbial communities and the immune system in severely malnourished children,” says Gordon, the Dr. Robert J. Glaser Distinguished University Professor and director of Washington University’s Center for Genome Sciences and Systems Biology. “We now have a way to tease apart these influences. This project seeks to discover novel dietary and microbial therapeutics that can be targeted to infants and children living in countries with rampant malnutrition.”

Severe malnutrition has long been thought to stem simply from a lack of adequate food. But now scientists understand the condition is far more complex and may involve a breakdown in the way gut microbes process various components of the diet.

The community of intestinal microbes and their vast collection of genes, known as the gut microbiome, are assembled right from birth and influenced by babies’ early environments and the first foods they consume, such as breast milk. As part of the Breast Milk, Gut Microbiome and Immunity Project, Gordon will work with other scientists to evaluate the relationship among first foods, the developing community of microbes in the intestine and the developing immune system.

The new research builds on ongoing clinical studies in Africa, South Asia and South America of malnourished and healthy infants and children and their mothers. Gordon has played a key role in that research, which also is funded by the Gates Foundation.

As part of the new project, scientists will evaluate the function of gut microbial communities in malnourished and healthy infants and children living in countries where malnutrition is prevalent. They also will characterize the nutritional content and immune activity present in breast milk samples obtained from the children’s mothers during periods of exclusive and supplemental breastfeeding. In parallel, the scientists will use a preclinical discovery pipeline recently developed in Gordon’s laboratory to identify next-generation probiotics and nutrient supplements or combinations of the two (synbiotics) that may promote healthy growth in infants and children.

The investigators also will transplant communities of intestinal microbes, obtained from stool samples, from both malnourished and healthy children into germ-free mice raised under sterile conditions. These mice will harbor collections of human gut microbes that mimic those found in the children, and they will be fed the same diets as the children.

Then, using the mice, Gordon and his colleagues can carefully evaluate how various nutritional interventions influence gut microbiomes obtained from these children. They will be able to determine which microbes respond, how they respond and how they affect the overall function of the gut microbial communities. The researchers also will evaluate certain aspects of childhood development.

“It’s extremely difficult to study individual triggers for malnutrition because there are so many variables to consider,” Gordon says. “Recreating the human gut ecosystem in mice gives us a way to control these variables. The lead compounds derived from these well-controlled, pre-clinical studies then can be considered for future clinical trials in malnourished infants and children.”

Gordon’s research underscores the need understand the workings of gut microbiomes among people of different ages living in different parts of the world, especially as scientists consider manipulating intestinal microbes to improve health and nutrition. In a study published online May 9 in Nature, he and his colleagues surveyed the gut microbiomes of more than 500 healthy individuals, ranging in age from one month to more than 80 years, who lived in villages in Malawi, the Amazon region of Venezuela and in three U.S. cities.

The researchers found a similarity across cultures in the way the gut microbiome matures, especially in the first three years of life. But they also noted distinct differences in the microbiomes of babies, children and adults depending on where they lived.

The differences were most notable between individuals living in the U.S. compared to those in Malawi or Venezuela, and seemed to be linked to diet. Malawian and Venezuelan gut communities were rich in genes that break down complex sugars and starches, like those found in cassava and corn, while gut communities in individuals in the U.S., who typically eat high-protein diets, were more heavily loaded with genes for breaking down amino acids.

Other scientists involved in the Gates Foundation project include: Per Ashorn, MD, PhD, at the University of Tampere School of Medicine in Finland; Kathryn Dewey, PhD, University of California, Davis; Michael Gottlieb, PhD, Foundation for the National Institutes of Health (NIH); Rob Knight, PhD, University of Colorado, Boulder; Kenneth Maleta, PhD, University of Malawi College of Medicine; David Mills, University of California, Davis; Jeremy Nicholson, PhD, Imperial College, London; Linda Saif, PhD, The Ohio State University.

Washington University School of Medicine’s 2,100 employed and volunteer faculty physicians also are the medical staff of Barnes-Jewish and St. Louis Children's hospitals. The School of Medicine is one of the leading medical research, teaching and patient care institutions in the nation, currently ranked sixth in the nation by U.S. News & World Report. Through its affiliations with Barnes-Jewish and St. Louis Children's hospitals, the School of Medicine is linked to BJC HealthCare.

Study finds chronic child abuse strong indicator of negative adult experiences

2012-05-07 00:00:00

Child abuse or neglect are strong predictors of major health and emotional problems, but little is known about how the chronicity of the maltreatment may increase future harm apart from other risk factors in a child’s life.

In a new study published in the current issue of the journal Pediatrics, Melissa Jonson-Reid, PhD, child welfare expert and a professor at the Brown School at Washington University in St. Louis, looked at how chronic maltreatment impacted the future health and behavior of children and adults.

Jonson-Reid

The study tracked children by number of child maltreatment reports (zero to four or more) and followed the children into early adulthood, by which time some of the children had become parents.

The study sought to determine how well the number of child maltreatment reports predicted poor outcomes in adolescence, such as delinquency, substance abuse in the teen years or getting a sexually transmitted disease.

“For every measure studied, a more chronic history of child maltreatment reports was powerfully predictive of worse outcomes,” Jonson-Reid says.

“For most outcomes, having a single maltreatment report put children at a 20 percent to 50 percent higher risk than non-maltreated comparison children.

In addition, a series of adult outcomes were tracked to see if the chronicity of maltreatment still mattered after controlling for the poor outcomes in adolescence. Adult outcomes included adult substance abuse or growing up and having children whom they then maltreated.

“In models of adult outcomes, children with four or more reports were about least twice as likely to later abuse their own children and have contact with the mental health system, even when controlling for the negative outcomes during adolescence.”

Jonson-Reid says that there appears to be good reason to put resources into preventing ongoing maltreatment.

“Successfully interrupting chronic child maltreatment may well reduce risk of a wide range of other costly child and adolescent health and behavioral problems,” she says.

Jonson-Reid cites a recently published Centers for Disease Control and Prevention study estimating lifetime costs for a single year’s worth of children reported for maltreatment at $242 billion. (http://www.sciencedirect.com/science/article/pii/S0145213411003140)

“What our study illustrates is that these costs are even more likely to accrue for children who continue to be re-reported,” she says.

The study also found that maltreatment predicts a range of negative adolescent outcomes, and those adolescent outcomes then predict poor adult outcomes.

“If the poor outcomes in adolescence can be dealt with effectively, then later adult outcomes may also be forestalled,” Jonson-Reid says.

“Our findings could therefore be interpreted as supporting many current evidence-based interventions that seek to improve behavioral and social functioning among children and adolescents who have experienced trauma like abuse or neglect.”

Jonson-Reid co-authored the study, “Child and Adult Outcomes of Chronic Child Maltreatment,” with fellow Brown School faculty members Patricia L. Kohl, PhD, associate professor, and F. Brett Drake, PhD, professor.

To view the full study visit: http://pediatrics.aappublications.org/content/early/2012/04/17/peds.2011-2529.abstract.

This chart illustrates the individual childhood and adult outcomes according to the number of reports that occurred before the event of interest. Because it was possible for some children to enter the study period with a pre-existing condition, these are indicated as gray or black bars with the legend indicating the outcome occurred “before the study.” Chronicity is associated with increasing risk for all but child maltreatment perpetration, violent delinquency, and head or brain injury. In these cases, there is a slight decline in prevalence for the highest category compared with middle categories, but in all cases having reports was associated with higher rates of outcomes.

The American dream still possible, but more difficult to achieve, students discover

Neil Schoenherr — 2012-05-10 00:00:00

http://youtu.be/Q1bJSiLDcMkWUSTL students in an interdisciplinary course this semester called "Economic Realities of the American Dream" were urged to consider the meaning of the American Dream and explored pathways to achieving it, including overall economic growth and rising standards of living, equality of opportunity, economic mobility and the availability and creation of jobs that will adequately provide for individuals and families.

In 1931, James Truslow Adams first defined the “American Dream” by writing that “life should be better and richer and fuller for everyone, with opportunity for each according to ability or achievement” regardless of social status or birth circumstance.

In a modern society struggling to loose the grip of a lengthy economic recession, is this dream really attainable?

The dream may still be possible, though much more difficult to achieve, say a renowned macroeconomist and one of America’s foremost experts on poverty, co-teachers of a course on the American Dream this semester at Washington University in St. Louis.

“The American Dream is really at the heart and soul of this country,” says Mark R. Rank, PhD, the Herbert S. Hadley Professor of Social Welfare at the Brown School and author of One Nation, Underprivileged: Why American Poverty Affects Us All.

“It’s the idea of what we stand for and what we represent — the idea of being able to pursue what you are really passionate about and to have a good life,” he says.

The interdisciplinary course, “Economic Realities of the American Dream,” came out of a long friendship between Rank and his co-teacher Steven Fazzari.

“I’ve read Mark’s books and being an economist they really got me thinking about perspectives on the realities of economic life in this country and how we formulate those ideas into this concept of an American Dream,” says Fazzari, PhD, professor of economics in Arts & Sciences.

He says the class has focused on three main components — the freedom to pursue what people want to do to reach their potential, the ability to have a secure and comfortable life and a sense of hope and optimism about the future.

“Many people think the American Dream is owning a home,” Fazzari says. “That may be one way to reach economic security and a sense of hope for the future but maybe it’s more of a pathway to the dream than a component of the dream itself.”

Students in the course examined the meaning of the American Dream and explored pathways to achieving it, including overall economic growth and rising standards of living, equality of opportunity, economic mobility and the availability and creation of jobs that will adequately provide for individuals and families.

“I decided to take this course because I wanted to experience the interdisciplinary approach that both professors provide,” says Doug Griesenauer, second-year master’s of social work student. “My view of the American Dream changed dramatically throughout the course. When it began, I understood it as more of an ephemeral idea, a concept that everyone really knew but you couldn’t pin down.

"Through discussions with both professors, we have been able to give substance to that idea and really understand what made the American Dream such an aspiring thing.”

Students participated in group projects and discussions from a variety of perspectives, including economics, sociology, social work and others.

“I’ve worked a lot with Professor Fazarri on Keynesian macroeconomics but living in St. Louis has gotten me really interested in issues of poverty and social justice,” says Madeleine Dapp, a junior mathematics and economics major in Arts & Sciences.

“I saw this course as a good opportunity to combine those two perspectives,” she says. “After I graduate, I’m hoping to work in agricultural policy. I think this class has really allowed me to more closely examine the problems that prevent people from accessing the American Dream, whether it’s problems with nutrition or something more economic.”

The interdisciplinary nature of the course has been its strong suit, Rank says.

“We have students from economics, social work and several other social sciences,” he says. “Having that mix in the classroom is really dynamic and provides a lot of interesting feedback, questions and discussions that help advance all of our thinking.”