James W. Whitworth

Randomised trials of STD treatment for HIV prevention: report of an international workshop. HIV/STD Trials Workshop Group.

Three community trials of the impact of STD treatment interventions on HIV incidence in rural populations have been completed or are in progress in Uganda and Tanzania. Investigators from these trials met for a joint technical workshop in Baltimore in May 1996. This report summarises the consensus of the workshop, with the aim of providing useful input to research on HIV intervention strategies. Issues discussed include: (i) the role of community randomised trials; (ii) strategies for STD management; (iii) epidemiological and statistical issues in the design and analysis of community randomised trials; (iv) diagnostic methods for STDs in population surveys; (v) treatment regimens for STDs in rural Africa; and (vi) ethical issues in community trials.

Exercise and post-traumatic stress disorder in military veterans: a systematic review

Post-traumatic stress disorder (PTSD) is a prominent mental health issue for many military veterans. Recent evidence from nonveteran populations with PTSD suggests that exercise may be a potential treatment option. As such, the purpose of this review was to (1) provide the rationale for the use of exercise in the treatment of veterans with PTSD and (2) systematically review studies examining the relationship between exercise and PTSD in military veterans. A search of electronic databases (PubMed, PsycINFO, and Web of Science) for relevant studies published in print or online from January 1980 to September 2015 produced 204 unique articles and 13 relevant studies (9 observational studies, 2 experimental, and 2 qualitative). Results of these initial studies are promising and suggest that regular exercise is inversely correlated with PTSD and its symptoms in military veterans. However, the longitudinal effect of exercise on PTSD in military veterans remains unclear because the current research lacks a common focus and suffers from several methodological limitations. Recommendations for the development of future trials are included.

Direct and indirect effects of exercise on posttraumatic stress disorder symptoms: A longitudinal study

OBJECTIVE Emerging evidence suggests that exercise may have beneficial effects on posttraumatic stress disorder (PTSD), and that this relationship may be indirectly affected by sleep, pain, and alcohol/substance use. The present study examined the longitudinal direct and indirect effects of exercise on PTSD symptoms. METHOD A national sample of 182 individuals, screening positive for PTSD, completed online assessments of PTSD symptoms, exercise behavior, psychological distress, sleep quality, and alcohol/substance use at baseline and three-month follow-up. RESULTS There were direct effects of strenuous intensity exercise on avoidance/numbing (b=-2.18, SE=1.12, p=0.05) and hyperarousal symptoms (b=-1.87, SE=0.82, p=0.03); and direct effects of total exercise on avoidance/numbing symptoms (b=-1.76, SE=0.94, p=0.05). Strenuous intensity exercise was indirectly associated with total PTSD symptoms (ab=-2.53, 95% CI: -5.72 to -0.38), avoidance/numbing (ab=-0.99, 95% CI: -2.43 to -0.05), and hyperarousal symptoms (ab=-0.78, 95% CI: -1.88 to -0.07) through sleep, while total exercise was indirectly associated with total PTSD symptoms through alcohol use (ab=0.32, 95% CI: 0.18-1.42). CONCLUSION Findings suggest that exercise has a complex, longitudinal, and beneficial association with PTSD symptoms. Future studies should continue to examine this relationship and any direct and indirect effects exercise may have on PTSD and its related conditions.

Acute effects of resistance exercise on affect, arousal, and urge to drink in temporarily abstinent young adult hazardous drinkers

BACKGROUND AND OBJECTIVE Young adults frequently engage in hazardous alcohol consumption, and many meet the diagnostic criteria for an alcohol use disorder. The urge to drink is a defining symptom of alcohol dependence, and it is closely tied to and exacerbated by negative affect. This study examined the acute effect of resistance exercise on affect, arousal, and drinking urges in young adult (ages 21-40) hazardous drinkers. METHODS On two separate occasions, 14 participants underwent an 18-hour alcohol abstinence before completing, in a counter-balanced manner, a 20-minute session of resistance exercise and a 20-minute video control. RESULTS Significant improvements in affect (t = 2.07, p = .04) and arousal (t = 4.09, p < .01), but not urge to drink, were found with exercise. CONCLUSION Single sessions of resistance exercise can positively alter affect and arousal during alcohol abstinence. SCIENTIFIC SIGNIFICANCE Practical exercise interventions designed to alter affect and arousal could potentially alter drinking. (Am J Addict 2016;25:623-627).

Exercise and mental health of people living with HIV: A systematic review

Objective Mental illness is highly prevalent among people living with HIV. Poor mental health is linked to HIV disease progression, making the treatment of mental illness alongside HIV essential. While the benefits of exercise on the physical health of people living with HIV are well established, the effect of exercise on mental health in this population is less examined. Therefore, this study aimed to conduct a systematic literature review of the effects of exercise on mental health in people living with HIV. Methods A search of electronic databases (PubMed, Web of Science, PsycINFO) through 30 November 2016 was completed. The methodological framework for scoping studies was used to conduct the review process. RISMA guidelines were used to report the results. Results The search resulted in 2273 articles and 52 were determined to be relevant. After review of the full text of potentially relevant studies, 24 studies were included for the analysis. Discussion Both aerobic and resistance exercise have independent and combined positive effects on various indicators of mental health in people living with HIV. Major limitations include high attrition rate, small sample size, and poor study designs. Higher quality studies with more diverse populations such as women, older adults, and transgender individuals are required.