A Mental Health Self-Screening Tool for Graduate Students

Background: Excessive perceived stress and mental health crises are escalating among college students. About 50% meet mental health disorder criteria, and half of them receive inadequate treatment. Aim: This study aimed to evaluate the feasibility and outcomes of a 15-20 minute online, anonymous, mental health self-screening survey and resource tool for graduate students across a large midwestern university campus. Methods: A descriptive, correlational design addressed the study's aims. Recruitment occurred through multiple campus communication mechanisms and included a brief study description, quick reference (QR) code, and weblink to access the tool and survey. Data collected with the tool included demographic items and scores from standardized screening instruments measuring burnout, perceived stress, depression, anxiety, post-traumatic stress disorder (PTSD), alcohol misuse, and health behavior practices. Descriptive and correlational statistics were computed. Results: Among 778 graduate students who accessed and completed the survey, nearly 60% met the burnout threshold, 58% scored 8 (of 16) on the stress scale, 32% met the depression threshold, 47% met the anxiety threshold, 54% reported one or more symptoms of PTSD, and 38% reported poor health behaviors. Significant positive correlations (r = 0.184 to 0.615) were found between burnout, perceived stress, depression, and anxiety. Health behavior scores were significantly negatively correlated (r = -0.151 to -0.283) with burnout, perceived stress, depression, and anxiety. Scores differed by gender, race, and graduate student status (part-time vs. full-time). Female identifying students, age, and hours worked per week were associated with various outcome scores. Students commented that the tool needed more specific resources tailored to their scores. Conclusions: The data support the need for tailored coping resources based on student self-reported data. Video-based micromodules guiding individuals through coping skills (breathing, mindfulness, identifying negative thoughts, gratitude exercises) have since been developed and will be studied as a tailored resource for students

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