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  1. Article ; Online: Neural correlates of inhibitory control in severe class III compared with class I/II obesity using a sample of endometrial cancer survivors seeking weight loss.

    Nock, Nora L / Jiang, Huangqi / Rao, Stephen M / Dimitropoulos, Anastasia

    Obesity (Silver Spring, Md.)

    2023  Volume 31, Issue 6, Page(s) 1558–1568

    Abstract: Objective: No prior studies have evaluated inhibitory control in people with severe class III compared with class I/II obesity. Thus, the study aim was to evaluate inhibitory control and neural correlates of response inhibition by obesity class using a ... ...

    Abstract Objective: No prior studies have evaluated inhibitory control in people with severe class III compared with class I/II obesity. Thus, the study aim was to evaluate inhibitory control and neural correlates of response inhibition by obesity class using a sample of endometrial cancer (EC) survivors with obesity, who have a higher risk of overall but not cancer-specific mortality.
    Methods: Forty-eight stage I EC survivors with obesity (class I/II: n = 21; class III: n = 27) seeking weight loss in a lifestyle intervention at baseline completed a stop signal task during functional magnetic resonance imaging.
    Results: It was found that participants with class III obesity had a longer stop signal reaction time (mean [SD], 278.8 [51.3] vs. 251.5 [34.0] milliseconds, p < 0.01) compared with those with class I/II obesity, indicating that patients with EC with severe obesity had greater impulsivity and poorer inhibitory control. Results also showed increased activation in the thalamus and superior frontal gyrus for the incorrect versus correct inhibition contrast in class III but not class I/II obesity (whole brain cluster corrected, p < 0.05).
    Conclusions: These results provide novel insights into inhibitory control and corresponding neural correlates in severe versus less severe classes of obesity and highlight the importance of targeting inhibitory control processes in weight-loss interventions, particularly for people with severe obesity and greater impulsivity.
    MeSH term(s) Female ; Humans ; Obesity, Morbid ; Obesity/therapy ; Weight Loss ; Endometrial Neoplasms ; Survivors
    Language English
    Publishing date 2023-05-08
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 2230457-5
    ISSN 1930-739X ; 1071-7323 ; 1930-7381
    ISSN (online) 1930-739X
    ISSN 1071-7323 ; 1930-7381
    DOI 10.1002/oby.23738
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  2. Article ; Online: Exercise as Medicine for People with a Substance Use Disorder: An ACSM Call to Action Statement.

    Nock, Nora L / Stoutenberg, Mark / Cook, Dane B / Whitworth, James W / Janke, E Amy / Gordon, Adam J

    Current sports medicine reports

    2024  Volume 23, Issue 2, Page(s) 53–57

    Abstract: Abstract: Over 20 million Americans are living with a substance use disorder (SUD) and nearly 100,000 die annually from drug overdoses, with a majority involving an opioid. Many people with SUD have co-occurring chronic pain and/or a mental health ... ...

    Abstract Abstract: Over 20 million Americans are living with a substance use disorder (SUD) and nearly 100,000 die annually from drug overdoses, with a majority involving an opioid. Many people with SUD have co-occurring chronic pain and/or a mental health disorder. Exercise is a frontline treatment for chronic pain and is an effective strategy for reducing depression and anxiety and improving overall mental health. Several studies have shown that exercise improves SUD-related outcomes including abstinence; however, there is limited large-scale randomized clinical trial evidence to inform integration of exercise into practice. In this Call to Action, we aim to raise awareness of the specific issues that should be addressed to advance exercise as medicine in people with SUD including the challenges of co-occurring chronic pain, mental illness, and cardiopulmonary health conditions. In addition, specialized training for exercise professionals and other support staff should be provided on these issues, as well as on the multiple dimensions of stigma that can impair engagement in treatment and overall recovery in people with SUD.
    MeSH term(s) Humans ; United States ; Chronic Pain/therapy ; Substance-Related Disorders/therapy ; Substance-Related Disorders/psychology ; Mental Health
    Language English
    Publishing date 2024-02-01
    Publishing country United States
    Document type Randomized Controlled Trial ; Journal Article
    ZDB-ID 2080040-X
    ISSN 1537-8918 ; 1537-890X
    ISSN (online) 1537-8918
    ISSN 1537-890X
    DOI 10.1249/JSR.0000000000001140
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  3. Article ; Online: Food Insecurity and Nutritional Challenges in Adolescent and Young Adult Cancer Survivors in the U.S.A.: A Narrative Review and Call to Action.

    Ogland-Hand, Callie / Ciesielski, Timothy H / Daunov, Katherine / Bean, Melanie K / Nock, Nora L

    Nutrients

    2023  Volume 15, Issue 7

    Abstract: Advancements in cancer treatments over the past several decades have led to improved cancer survival in adolescents and young adults (AYAs, ages 15-39 years). However, AYA cancer survivors are at an increased risk for "late effects", including ... ...

    Abstract Advancements in cancer treatments over the past several decades have led to improved cancer survival in adolescents and young adults (AYAs, ages 15-39 years). However, AYA cancer survivors are at an increased risk for "late effects", including cardiovascular, pulmonary and bone diseases as well as fatigue, infertility and secondary cancers. The treatments for cancer may also alter taste, lead to nutritional deficiencies and increase financial burdens that, when taken together, may increase the risk of food and nutrition security in AYA cancer survivors. Furthermore, although AYAs are often merged together in cancer survivorship studies, adolescents and young adults have distinct developmental, psychosocial and pathophysiological differences that may modify their risk of nutritional challenges. In this narrative review and "Call to Action", rationale is provided for why there is a need to better understand nutritional challenges and food insecurity in AYA cancer survivors as a special population. Then, recommendations for next steps to advance knowledge and policy in this field are provided. In particular, integrating screening for food and nutrition insecurity and enhancing awareness of existing resources (e.g., the Supplemental Nutrition Assistance Program, SNAP) might help AYA cancer survivors combat nutritional deficiencies and reduce late effects while improving their overall survival and quality of life.
    MeSH term(s) Humans ; Adolescent ; Young Adult ; Adult ; Cancer Survivors/psychology ; Quality of Life/psychology ; Neoplasms/epidemiology ; Malnutrition/etiology ; Food Insecurity
    Language English
    Publishing date 2023-04-01
    Publishing country Switzerland
    Document type Review ; Journal Article
    ZDB-ID 2518386-2
    ISSN 2072-6643 ; 2072-6643
    ISSN (online) 2072-6643
    ISSN 2072-6643
    DOI 10.3390/nu15071731
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  4. Article: Barriers, perceived benefits and preferences to exercise in adults with an opioid use disorder in the U.S.

    Nock, Nora L / Hernandez, Estefania / Robinson, Dallas / Hoffer, Lee / Wachholtz, Amy

    Preventive medicine reports

    2023  Volume 36, Page(s) 102393

    Abstract: Introduction: Over 10 million Americans misuse opioids and more than 5 million have been diagnosed with an opioid use disorder (OUD). In 2021, over 100,000 Americans died of a drug overdose and more than 75% of these deaths involved an opioid. Exercise ... ...

    Abstract Introduction: Over 10 million Americans misuse opioids and more than 5 million have been diagnosed with an opioid use disorder (OUD). In 2021, over 100,000 Americans died of a drug overdose and more than 75% of these deaths involved an opioid. Exercise has been shown to increase abstinence and decrease anxiety and depression in people with a substance use disorder. However, only a few small trials have focused on persons with OUD who often experience additional challenges including chronic pain, mental health disorders and cardio-metabolic abnormalities.
    Methods: We aimed to describe the barriers, perceived benefits and preferences to exercise in adults with OUD in residential treatment in the U.S. as part of a larger study. We conducted 33 individually administered, semi-structured interviews and transcribed audiotapes verbatim, conducted coding and thematic analysis using NVivo v12 software (QSR International Inc.).
    Results: Our sample had nearly equal representation of males and females and, was predominantly Caucasian (88%) with a mean of age of 34.5 (s.d. 7.5) years old. Participants stated that exercise helps to reduce drug cravings, anxiety, depression and pain and improve mood, physical health and build "normalcy". Barriers included lack of time, access to resources, fear of poor health and triggering pain. Participants preferred moderate intensity exercise 3 times/week and 30-60 min sessions.
    Conclusions: Our findings indicate that adults with OUD believe exercise is a valuable tool to use in their recovery but they encounter several barriers. Many barriers, however, could be overcome with structured programs offered by residential treatment centers.
    Language English
    Publishing date 2023-08-29
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2785569-7
    ISSN 2211-3355
    ISSN 2211-3355
    DOI 10.1016/j.pmedr.2023.102393
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  5. Article ; Online: Insights to the neural response to food cues in class III compared with class I and II obese adults using a sample of endometrial cancer survivors seeking weight loss.

    Nock, Nora L / Jiang, Huangqi / Borato, Lauren / Alberts, Jay / Dimitropoulos, Anastasia

    Nutrition & diabetes

    2020  Volume 10, Issue 1, Page(s) 21

    Abstract: Background: The rates of severe or Class III obesity (BMI ≥ 40.0 kg/m: Methods: We conducted a functional magnetic resonance imaging visual food cue task in 85 obese Stage I EC survivors who were seeking weight loss in a lifestyle intervention at ... ...

    Abstract Background: The rates of severe or Class III obesity (BMI ≥ 40.0 kg/m
    Methods: We conducted a functional magnetic resonance imaging visual food cue task in 85 obese Stage I EC survivors who were seeking weight loss in a lifestyle intervention at baseline. We evaluated the neural response to high-calorie vs. non-food images after an overnight fast (fasted state) and after eating a standardized meal (fed state), and grouped patients by obesity class (Class I/II: n = 38; Class III: n = 47).
    Results: In the fasted state, we found increased activation in several regions including the dorsolateral prefrontal cortex (DLPFC) in Class III and Class I/II patients (whole brain cluster corrected (WBCC), p < 0.05), which was significantly higher in Class III vs. Class I/II (p < 0.05). We found decreased activation in the insula in the fasted state, which was significantly lower in Class I/II vs. Class III (p = 0.03). In the fed state, we found increased activation in the DLPFC in Class III and Class I/II (WBCC, p < 0.05). The increased activation in cognitive control/inhibition regions (DLPFC) is consistent with the summative literature; however, the decreased activation in taste information processing regions (insula) was unexpected.
    Conclusions: Our results provide novel insights on food cue response between different classes of obesity and highlight the importance of targeting the DLPFC in weight loss interventions, particularly in severely obese patients. Additional studies examining food-related neural circuitry between different classes of obesity are needed.
    MeSH term(s) Aged ; Brain/metabolism ; Cancer Survivors/psychology ; Cues ; Endometrial Neoplasms/epidemiology ; Endometrial Neoplasms/psychology ; Energy Intake ; Feeding Behavior ; Female ; Humans ; Magnetic Resonance Imaging/methods ; Meals ; Middle Aged ; Obesity/classification ; Obesity/epidemiology ; Obesity/psychology ; Obesity, Morbid/epidemiology ; Obesity, Morbid/psychology ; Prefrontal Cortex/metabolism ; Reward ; Weight Loss
    Language English
    Publishing date 2020-06-15
    Publishing country England
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 2609314-5
    ISSN 2044-4052 ; 2044-4052
    ISSN (online) 2044-4052
    ISSN 2044-4052
    DOI 10.1038/s41387-020-0124-7
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  6. Article ; Online: Neurobiology of substance use in adolescents and potential therapeutic effects of exercise for prevention and treatment of substance use disorders.

    Nock, Nora L / Minnes, Sonia / Alberts, Jay L

    Birth defects research

    2017  Volume 109, Issue 20, Page(s) 1711–1729

    Abstract: Substance use (e.g., alcohol, marijuana, opioids, cocaine., etc,) use often initiates during adolescence, a critical period of physiological and social development marked by an increase in risk-taking due, in part, to heightened motivation to obtain ... ...

    Abstract Substance use (e.g., alcohol, marijuana, opioids, cocaine., etc,) use often initiates during adolescence, a critical period of physiological and social development marked by an increase in risk-taking due, in part, to heightened motivation to obtain arousal from rewards. Substance use during adolescence has been associated with a greater risk of substance use disorders (SUD) in adulthood. Although use rates for most substances have remained relatively stable, the frequency of marijuana use and the perception that regular marijuana use is not harmful has increased in adolescents. Furthermore, the nonmedical use of opioids has increased, particularly in the South, Midwest, and rural low-income communities. Substance use in adolescence has been associated with adverse structural and functional brain changes and, may exacerbate the natural "imbalance" between frontal/regulatory and cortical-subcortical circuits, leading to further heightened impulsive and reward-driven behaviors. Exercise increases growth and brain-derived neurotrophic factors that stimulate endogenous dopaminergic systems that, in turn, enhance general plasticity, learning, and memory. Exercise may help to reinforce the "naïve" or underdeveloped connections between neurological reward and regulatory processes in adolescence from the "bottom up" and "offset" reward seeking from substances, while concomitantly improving cardiovascular health, as well as academic and social achievement. In this review, we provide an overview of the current state of substance use in adolescents and rationale for the utilization of exercise, particularly "assisted" exercise, which we have shown increases neural activity in cortical-subcortical regions and may modulate brain dopamine levels during adolescence, a unique window of heightened reward sensitivity and neural plasticity, for the prevention and adjunctive treatment of SUD.
    MeSH term(s) Adolescent ; Exercise Therapy ; Humans ; Neurobiology ; Substance-Related Disorders/physiopathology ; Substance-Related Disorders/prevention & control
    Language English
    Publishing date 2017-12-01
    Publishing country United States
    Document type Journal Article ; Review
    ISSN 2472-1727
    ISSN (online) 2472-1727
    DOI 10.1002/bdr2.1182
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  7. Article ; Online: Customer discovery as a tool for moving behavioral interventions into the marketplace: insights from the NCI SPRINT program.

    Oh, April / Gaysynsky, Anna / Knott, Cheryl L / Nock, Nora L / Erwin, Deborah O / Vinson, Cynthia A

    Translational behavioral medicine

    2019  Volume 9, Issue 6, Page(s) 1139–1150

    Abstract: The National Cancer Institute established a dissemination and implementation accelerator program called Speeding Research-tested INTerventions (SPRINT) in order to expedite the translation of behavioral research into practice. The goal of SPRINT is to ... ...

    Abstract The National Cancer Institute established a dissemination and implementation accelerator program called Speeding Research-tested INTerventions (SPRINT) in order to expedite the translation of behavioral research into practice. The goal of SPRINT is to introduce researchers to a new method for moving their research into practice in order to increase the real-world impact of their evidence-based interventions. The goal of this article is to present case studies on three teams that have completed the SPRINT program to date. Each case study provides a description of the intervention the team came into the program with, the team's motivation for participating in the SPRINT program, the team's experience in the program, lessons learned from "customer discovery" interviews conducted by the team during the course, and the team's future plans for their intervention. The case studies suggest that by focusing on behavioral researchers, SPRINT addresses an unmet need in the commercialization training space; that the definition of "success" can vary across SPRINT projects; that identifying and engaging "payors" for behavioral interventions is an ongoing challenge; and that there are potential "misalignments" between the research process and market demands. Overall, these examples show that customer discovery is a potentially useful method for making interventions more responsive to the needs of stakeholders, and that researchers can benefit from learning the "language" of business and working with individuals who have business experience before trying to move their research from the lab to the real world.
    MeSH term(s) Behavioral Medicine/methods ; Behavioral Research/methods ; Humans ; Intersectoral Collaboration ; Marketing ; National Cancer Institute (U.S.) ; Technology Transfer ; United States
    Language English
    Publishing date 2019-07-16
    Publishing country England
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 2586893-7
    ISSN 1613-9860 ; 1869-6716
    ISSN (online) 1613-9860
    ISSN 1869-6716
    DOI 10.1093/tbm/ibz103
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  8. Article ; Online: Structural Equation Modeling.

    Stein, Catherine M / Morris, Nathan J / Hall, Noémi B / Nock, Nora L

    Methods in molecular biology (Clifton, N.J.)

    2017  Volume 1666, Page(s) 557–580

    Abstract: Structural equation modeling (SEM) is a multivariate statistical framework that is used to model complex relationships between directly observed and indirectly observed (latent) variables. SEM is a general framework that involves simultaneously solving ... ...

    Abstract Structural equation modeling (SEM) is a multivariate statistical framework that is used to model complex relationships between directly observed and indirectly observed (latent) variables. SEM is a general framework that involves simultaneously solving systems of linear equations and encompasses other techniques such as regression, factor analysis, path analysis, and latent growth curve modeling. Recently, SEM has gained popularity in the analysis of complex genetic traits because it can be used to better analyze the relationships between correlated variables (traits), to model genes as latent variables as a function of multiple observed genetic variants, and to assess the association between multiple genetic variants and multiple correlated phenotypes of interest. Though the general SEM framework only allows for the analysis of independent observations, recent work has extended SEM for the analysis of data on general pedigrees. Here, we review the theory of SEM for both unrelated and family data, describe the available software for SEM, and provide examples of SEM analysis.
    MeSH term(s) Algorithms ; Genetic Variation ; Humans ; Models, Genetic ; Models, Statistical ; Multivariate Analysis ; Pedigree ; Phenotype ; Software
    Language English
    Publishing date 2017-10-04
    Publishing country United States
    Document type Journal Article
    ISSN 1940-6029
    ISSN (online) 1940-6029
    DOI 10.1007/978-1-4939-7274-6_28
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  9. Article ; Online: Improving Surveillance and Epidemic Response in Ohio Childcare Settings.

    Freedman, Darcy A / Ciesielski, Timothy H / Yamoah, Owusua / Borawski, Elaine A / Ross, Kristie R / Nock, Nora L / Lee, Eun Kyung / Dimitropoulos, Anastasia / Minnes, Sonia / Burkhart, Kimberly / Ogland-Hand, Callie / Tisch, Daniel J

    International journal of environmental research and public health

    2022  Volume 19, Issue 24

    Abstract: At the start of the Coronavirus Disease of 2019 (COVID-19) pandemic, the risk of cases in childcare programs was unknown. Thus, a rapid-response research approach was launched in Ohio childcare settings. Passive surveillance data from a state-operated ... ...

    Abstract At the start of the Coronavirus Disease of 2019 (COVID-19) pandemic, the risk of cases in childcare programs was unknown. Thus, a rapid-response research approach was launched in Ohio childcare settings. Passive surveillance data from a state-operated incident reporting system were evaluated to estimate the number of COVID-19 cases from 15 August 2020 to 1 January 2021. Additionally, active surveillance with self-administered reverse transcriptase-polymerase chain reaction (RT-PCR) tests were conducted among staff at 46 childcare programs. Finally, six zoom-based focus groups with program administrators were used to gain feedback. Staff and children in childcare settings contributed 0.38% and 0.15% of the COVID-19 cases in Ohio during this timeframe, respectively. RT-PCR testing identified 3 unrecognized cases (0.88% of tests), and all occurred when the statewide positivity rate was >5%. Focus groups revealed that access to affordable cleaning supplies, masks, and reliable staffing were critical. Perhaps most importantly, we conclude that expanding the incident reporting system to include a childcare census would allow for the tracking of future health problems with highly valuable incidence rate estimations.
    MeSH term(s) Child ; Humans ; COVID-19/epidemiology ; Child Care ; Ohio/epidemiology ; COVID-19 Testing ; Pandemics
    Language English
    Publishing date 2022-12-16
    Publishing country Switzerland
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2175195-X
    ISSN 1660-4601 ; 1661-7827
    ISSN (online) 1660-4601
    ISSN 1661-7827
    DOI 10.3390/ijerph192416927
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  10. Article ; Online: A randomized controlled trial of the effect of supervised exercise on functional outcomes in older African American and non-Hispanic White breast cancer survivors: Are there racial differences in the effects of exercise on functional outcomes?

    Owusu, Cynthia / Margevicius, Seunghee / Nock, Nora L / Austin, Kristina / Bennet, Elizabeth / Cerne, Stephen / Hergenroeder, Paul / Moore, Halle C F / Petkac, Jean / Schluchter, Mark / Schmitz, Kathryn H / Webb Hooper, Monica / Wimbley, Leonard / Berger, Nathan A

    Cancer

    2022  Volume 128, Issue 12, Page(s) 2320–2338

    Abstract: Background: The objective of this study was to test the hypothesis that exercise would be more effective than a support group plus Fitbit (SG+Fitbit) program in improving functional outcomes in older breast cancer survivors (BCSs) and that race would ... ...

    Abstract Background: The objective of this study was to test the hypothesis that exercise would be more effective than a support group plus Fitbit (SG+Fitbit) program in improving functional outcomes in older breast cancer survivors (BCSs) and that race would moderate the exercise effect on outcomes.
    Methods: Older African American (AA) and non-Hispanic White (NHW) BCSs were purposively recruited and enrolled into the 52-week randomized controlled trial. The interventions included 20 weeks of supervised moderate-intensity aerobic and resistance training followed by 32 weeks of unsupervised exercise called IMPROVE (n = 108) and a 20-week SG+Fitbit program followed by 32 weeks of unsupervised activity (n = 105). Study outcomes were assessed at 20 and 52 weeks. The primary outcome was the change in Short Physical Performance Battery (SPPB) scores 20 weeks from the baseline between arms. Secondary outcomes included change in the 6-Minute Walk Test (6MWT) in meters 20 weeks from the baseline between arms. General linear regression and multivariable logistic regression analyses were used.
    Results: The mean age was 71.9 years (SD, 5.9 years), and 44% were AA. SPPB scores did not differ between arms (adjusted difference in mean change, 0.13; 95% CI, -0.28 to 0.55; P = .53). However, the exercise arm (vs the SG+Fitbit arm) improved on the 6MWT (21.6 m; 95% CI, 2.5-40.6 m; P = .03). Race moderated the exercise effect on the 6MWT (adjusted interaction effect, 43.3 m; 95% CI, 6.3-80.2 m; P = .02); this implied that the change in the adjusted mean for the 6MWT at 20 weeks from the baseline was 43.3 m higher in AA exercise participants versus NHW exercise participants.
    Conclusions: Combined aerobic and resistance exercise appears to improve physical performance in older BCSs, and the exercise effect might be moderated by race, with AAs appearing to derive larger benefits in comparison with NHWs. Larger studies are warranted to confirm the study findings.
    MeSH term(s) Black or African American ; Aged ; Breast Neoplasms/therapy ; Cancer Survivors ; Exercise ; Exercise Therapy ; Female ; Humans ; Race Factors
    Language English
    Publishing date 2022-03-15
    Publishing country United States
    Document type Journal Article ; Randomized Controlled Trial ; Research Support, N.I.H., Extramural
    ZDB-ID 1429-1
    ISSN 1097-0142 ; 0008-543X ; 1934-662X
    ISSN (online) 1097-0142
    ISSN 0008-543X ; 1934-662X
    DOI 10.1002/cncr.34184
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