Influence of a home-based exercise program on the urine pH in elderly female subjects: a secondary analysis of a randomized controlled trial

Background

A low urine pH is a characteristic metabolic feature of metabolic syndrome and type 2 diabetes. The purpose of the current study was to investigate the effects of a 12-week home-based bench step exercise on the urine pH status of elderly female subjects.

Methods

The current study is a secondary analysis of a randomized controlled trial (RCT) in which 59 postmenopausal female subjects were randomized to either the exercise group (n?=?29) or the control group (n?=?30). The subjects in the exercise group were instructed to perform home-based exercises using a bench step at the anaerobic threshold (AT), with a goal of performing ≥140 min/week at home for 12 weeks. The subjects in the control group were instructed to not change their normal lifestyle. Urine was collected after overnight fasting, and the urine pH was measured using a urinary test strip. The inter-group-differences at baseline and the pre-post changes within groups were assessed using the Mann-Whitney U test and Wilcoxon’s signed-rank test, respectively. Additionally, the difference in the post-intervention urine pH levels of the two groups, adjusted for the pre-intervention values (the estimated effect size) and the precision (95% confidence intervals) were investigated using an analysis of covariance.

Results

The pre-post comparison of the urine pH data using Wilcoxon’s signed-rank test showed a significant increase in the urine pH levels of the exercise group (p?<?0.05); there was no significant change in the urine pH levels of the control group. However, the estimated effect size (0.15) was small and the confidence interval straddled 0 (?0.25–0.55).

Conclusions

Based on the results of the current secondary analysis of an RCT, we could not clearly conclude that exercise has a beneficial effect on the urine pH. Further well-designed RCTs should be conducted to determine whether aerobic exercise is truly able to ameliorate urine acidification.

Trial registration

The study was retrospectively registered in the University Hospital Medical Information Network (UMIN) as “Effect of step exercise on aerobic fitness and progression of atherosclerosis in the elderly” under the registration number UMIN 000026743 (the date of registration: March 28, 2017).

     

A Place for Every Tool and Every Tool in Its Place: Cognitive Integrative Perspective for Coherence on the New Frontier of Mind and Body Practice

There is currently a growing research and clinical knowledge base regarding the application of Eastern traditions, especially mindfulness and other forms of meditation, to direct practice. As we incorporate new tools for intervention into our toolkit, it is important to expand our theoretical framework so that we can know when to utilize these tools, how their mechanism fits with the tools we already have, and what kinds of change or outcomes we should expect from utilizing them. These new tools are powerful across many experiences of distress, but clear guidelines are necessary to maximize their benefit. Berlin’s cognitive-integrative perspective provides a framework that allows for reflective understanding and application of mind/body/spirit that is consistent with social work values and what we currently know about the underlying science of mind. Using concrete examples from direct practice, this paper will lay out the framework that is consonant with Siegel’s interpersonal neurobiology, discussed in this volume, and also firmly rooted in the person-in-environment perspective that is characteristic of social work.     

The efficacy and safety of short-acting testosterone ointment (Glowmin) for late-onset hypogonadism in accordance with testosterone circadian rhythm

Introduction: It is well known that there is a reduction of circadian rhythm in blood testosterone levels with aging. Our previous report revealed that 3?mg of short-acting testosterone ointment (Glowmin: GL) elevated serum testosterone levels to within the physiological range for 4–6?h. The aim of this study was to clarify the clinical efficacy and safety of GL used topically once every morning, to enhance the circadian rhythm of testosterone, for late-onset hypogonadism (LOH).

Methods: A total of 61 LOH patients received 3?mg of GL topically once a day in the morning on scrotal skin for 24 weeks. The clinical efficacy of GL was evaluated by the aging males symptoms (AMS) scale, and blood sampling tests were measured before and after GL treatment.

Results: Mean patients age was 55.3?±?9.2 years old. Total AMS scores at 4, 12, and 24 weeks after GL treatments significantly decreased. The results of sub-analysis of AMS, including psychological, physical, and sexual factors also significantly improved after GL treatments. No severe adverse reactions or abnormal laboratory data were reported.

Conclusions: This study shows that TRT for LOH with once daily GL treatment supports testosterone circadian rhythm and should be considered to be an effective and safe therapy for LOH.     

When caregiving ends: the course of depressive symptoms after bereavement

This study describes depressive symptoms among caregivers following bereavement and connects these trajectories to earlier features of caregiving using life course and stress process theory. Data are from a six-wave longitudinal survey (five years) of spouses and adult children caring for someone with Alzheimer's Disease. The analytic subsample (N = 291) is defined by death of the care-recipient after the baseline interview. A latent class mixture model is used to identify distinctive clusters of depressive symptoms over time. Of the four trajectories identified, three represent stable symptom levels over time, with two-thirds being repeatedly symptomatic (medium symptom levels), compared to two smaller groups of repeatedly asymptomatic (effectively absent of symptoms) and repeatedly distressed (severe symptoms). In contrast, about one in five caregivers experiences improved emotional well-being over time, the temporarily distressed, who progress from severe to moderate symptom levels. Caregivers with few symptoms before bereavement tend to maintain these states afterwards, but emotionally distressed caregivers tend to become more distressed. Role overload before bereavement substantially increases the odds of following an unfavorable trajectory afterwards, whereas self-esteem and socioemotional support play protective roles. These results demonstrate that caregivers are not uniform in their emotional responses to bereavement, but follow several distinct trajectories. These trajectories are linked to their previous experiences as caregivers, in particular exposure to stressors and access to resources. These findings suggest that intervention during caregiving may facilitate adaptation following death of a loved one.     

Alternative Medicine and Herbal Use Among University Students

Abstract

Objective: This study sought to (1) examine perceived stress and resources to cope with stress as predictors of emotional eating during the transition to college and (2) determine whether body mass index (BMI) moderated the emotional eating-stress relationship. Participants: Participants were 97 college freshmen (73% female; BMI: M = 25.3 kg/m², SD = 5.7 kg/m²). Research was conducted in September 2012. Methods: Participants completed the Perceived Stress Scale, Emotional Eating Scale, and Eating and Appraisal Due to Emotions and Stress Questionnaire during the first month of college. Height and weight were measured objectively. Results: BMI moderated the relationship between perceived stress and emotional eating. Higher stress predicted greater emotional eating for the lower BMI groups, but not the highest group. Greater resources to cope with stress predicted lower emotional eating. Conclusions: Greater perceived stress and poorer resources to cope with stress may contribute to emotional eating during the transition to college. The relationship between perceived stress and emotional eating may vary by BMI.     

SOME REMARKS ON THE MEAN, MEDIAN, MODE AND SKEWNESS

Many sufficient conditions for inequalities about the mean, median, mode and skewness have been obtained. The paper presents a theorem that unifies already known results, gives some counter-examples, and considers the cases of Pearson distributions.