Policy Options for Addressing Childhood Obesity in Missouri

The prevalence of overweight children has increased threefold nationwide, from 5.7% to 18% between 1980 and 2004.1 The current percentage of overweight children in Missouri is greater than the national average. These trends are alarming because they have implications for children's quality of life today as well as for when these children become adults. There are, however, policy options to improve children's quality of life.Includes bibliographical reference

Public Approval for State Government Institutions

There are a number of state level institutions designed to limit the impact of special interests on government or to facilitate citizen participation in government. These include legislative term limits, ballot initiatives, governors' line item veto power and public funding for legislative and gubernatorial candidates. While most of these state government institutions are fairly common around the United States, relatively little is known about Americans' opinion of them. This policy note explores Americans' views on these features as well as the relationship between survey respondents' partisanship and their approval of these state government institutions. To assess the public's attitudes on these political institutions, researchers at the Harry S Truman School of Public Affairs at the University of Missouri conducted a national survey of 1,000 adults. The survey was administered as part of the 2007 Cooperative Congressional Election Study (CCES), a 10,000 person survey conducted through the collaborative efforts of a consortium of universities. The 2007 CCES was administered in November 2007 by Polimetrix, an Internet survey firm located in Palo Alto, California.Includes bibliographical reference

Seat Belt Use by Missouri Teens*

In 2006, the Institute of Public Policy conducted 12 focus groups with Missouri teens on behalf of the Missouri Department of Transportation to:1) understand how teenagers make decisions on seatbelt use; and 2) determine what outreach methods could influence teens' decisions regarding seatbelt use and traffic safety. The study found that teens' seatbelt use is set well before they begin driving, that the lack of use of seatbelts among parents is especially influential, and that teens are not well informed about the consequences of accidents when drivers or passengers are not wearing seatbelts. This report summarizes studies of seatbelt use in Missouri as compared to other states and describes teens' attitudes about seatbelt usage. Finally, it recommends that the Department continue its teen- focused informational campaign and that the state enact primary enforcement of the seatbelt law.Includes bibliographical reference

Findings from Year Two of the External Evaluation of the Healthy & Active Communities Initiative

The Missouri Foundation for Health has funded 33 projects under its Healthy & Active Communities (H&AC) Initiative in two-year funding cycles. A set of 15 projects was funded beginning in 2005 while a set of 18 was funded starting in 2006. This report is the second of three annual reports that assess the extent to which the H&AC Initiative is achieving its objectives. The report builds upon the findings described in “Findings from Year One of the External Evaluation of the Healthy & Active Communities Initiative.” The Missouri Foundation for Health contracted with the Institute of Public Policy, Truman School of Public Affairs at the University of Missouri to provide an evaluation of the success of the Initiative as a whole. This focus differs from the typical evaluation where evaluators are assessing and reporting on the success of individual funded projects. Instead, the evaluation looked across the funded projects to identify common factors of success. Continuing from the framework established in 2006, the evaluation team worked from a socio-ecological model. This model assumes that complex prevention programs such as the H&AC projects must use a multi-faceted approach in order to change behavior on individual, organizational and community levels simultaneously. To evaluate programs with multiple approaches such as these, the evaluators determined that cluster evaluation, a strategy developed by the Kellogg Foundation, could be used to identify successful features of the Initiative as a whole. This method enables the evaluators to identify successful program and community conditions that transcend the individual projects

31st Annual Meeting and Associated Programs of the Society for Immunotherapy of Cancer (SITC 2016) : part two

Background The immunological escape of tumors represents one of the main ob- stacles to the treatment of malignancies. The blockade of PD-1 or CTLA-4 receptors represented a milestone in the history of immunotherapy. However, immune checkpoint inhibitors seem to be effective in specific cohorts of patients. It has been proposed that their efficacy relies on the presence of an immunological response. Thus, we hypothesized that disruption of the PD-L1/PD-1 axis would synergize with our oncolytic vaccine platform PeptiCRAd. Methods We used murine B16OVA in vivo tumor models and flow cytometry analysis to investigate the immunological background. Results First, we found that high-burden B16OVA tumors were refractory to combination immunotherapy. However, with a more aggressive schedule, tumors with a lower burden were more susceptible to the combination of PeptiCRAd and PD-L1 blockade. The therapy signifi- cantly increased the median survival of mice (Fig. 7). Interestingly, the reduced growth of contralaterally injected B16F10 cells sug- gested the presence of a long lasting immunological memory also against non-targeted antigens. Concerning the functional state of tumor infiltrating lymphocytes (TILs), we found that all the immune therapies would enhance the percentage of activated (PD-1pos TIM- 3neg) T lymphocytes and reduce the amount of exhausted (PD-1pos TIM-3pos) cells compared to placebo. As expected, we found that PeptiCRAd monotherapy could increase the number of antigen spe- cific CD8+ T cells compared to other treatments. However, only the combination with PD-L1 blockade could significantly increase the ra- tio between activated and exhausted pentamer positive cells (p= 0.0058), suggesting that by disrupting the PD-1/PD-L1 axis we could decrease the amount of dysfunctional antigen specific T cells. We ob- served that the anatomical location deeply influenced the state of CD4+ and CD8+ T lymphocytes. In fact, TIM-3 expression was in- creased by 2 fold on TILs compared to splenic and lymphoid T cells. In the CD8+ compartment, the expression of PD-1 on the surface seemed to be restricted to the tumor micro-environment, while CD4 + T cells had a high expression of PD-1 also in lymphoid organs. Interestingly, we found that the levels of PD-1 were significantly higher on CD8+ T cells than on CD4+ T cells into the tumor micro- environment (p < 0.0001). Conclusions In conclusion, we demonstrated that the efficacy of immune check- point inhibitors might be strongly enhanced by their combination with cancer vaccines. PeptiCRAd was able to increase the number of antigen-specific T cells and PD-L1 blockade prevented their exhaus- tion, resulting in long-lasting immunological memory and increased median survival