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Introduction: Active duty Navy women participate in biannual Physical Fitness Assessments (PFAs), which include height and weight measurements and a Physical Readiness Test (PRT). PFAs are waived during pregnancy and resume the cycle after 6 months following maternity leave. The purpose of this study was to compare changes in PFA results over time between women who had or did not have a live birth during the follow-up period, and identify characteristics of women with lower PFA results postpartum.Materials and Methods: This longitudinal study included 14,142 active duty Navy women, aged 19-40 years, with PFA results during July 2011-June 2015. Multivariable logistic regression, Stuart-Maxwell tests, and mixed effects modeling were used to examine changes in PRT scores and body mass index over time between women with and without a live birth during follow-up. All data were analyzed in 2017. This study was approved by the institutional review boards at the Uniformed Services University Office of Research and the Naval Health Research Center, and informed consent was waived in accordance with 32 CFR § 219.116(d).Results: Postpartum women had increased odds of PRT failures (AOR = 3.88, 95% CI: 1.44-10.40) and lower PRT scores (AOR = 1.47, 95% CI: 1.12-1.92) up to 2.5 years postpartum, versus women without a live birth. Being enlisted, obese/overweight prepregnancy, and younger were risk factors for suboptimal PFA outcomes. Mean core strength and cardiovascular endurance, but not upper body strength, scores were significantly lower in postpartum women at 1 year postpartum versus women without a live birth.Conclusions: Our findings show that additional interventions may be needed to assist women in returning to prepregnancy fitness up to 1 year postpartum. Future studies should examine additional factors that may improve postpartum fitness in addition to enhancing maternity leave policies. [ABSTRACT FROM AUTHOR]

Background: It was recently demonstrated that the Clinical Dementia Rating scale Sum of Boxes (CDR-SB) score can be used to accurately stage severity of Alzheimer dementia and mild cognitive impairment (MCI). However, to our knowledge, the utility of those interpretive guidelines has not been cross-validated or applied to a heterogeneous sample of dementia cases. Objective: To cross-validate the staging guidelines proposed in a previous study using the National Alzheimer's Coordinating Center (NACC) database. Design: The previously published cut scores were applied to the NACC sample and diagnostic accuracy estimates obtained. Next, analyses were restricted to NACC participants with a CDR global score (CDR-GS) of 0.5 and receiver operating characteristic curves generated to determine optimal CDR-SB cut scores for distinguishing MCI from very early dementia. Setting: The 2008 NACC uniform data set. Participants: There were 12 462 participants (5115 controls; 2551 patients with MCI; 4796 patients with dementia, all etiologies) in the NACC data set used for the current analysis. Main Outcome Measure: Accurate prediction of diagnoses (MCI or dementia) using the CDR-SB score. Results: The previously proposed CDR-SB ranges successfully classified the vast majority of patients across all impairment ranges with a κ of 0.91 and 94% overall correct classification rate. Additionally, the CDR-SB score discriminated between patients diagnosed with MCI and dementia when CDR-GS was restricted to 0.5 (overall area under the curve=0.83). Conclusions: These findings cross-validate the previously published CDR-SB interpretative guidelines for staging dementia severity and extend those findings to a large heterogeneous sample of patients with dementia. Additionally, the CDR-SB scores distinguished MCI from dementia in patients with reasonable accuracy when CDR-GS was restricted to 0.5. [ABSTRACT FROM AUTHOR]

As the percentage of women serving in the active-duty military continues to grow, and as their roles continue to expand, the importance of monitoring reproductive health in the military community increases. The Department of Defense Birth and Infant Health Research (BIHR) program conducts ongoing epidemiologic studies to assess potential increased risks for adverse reproductive and infant health outcomes in the military population. Military personnel endure unique physical and mental demands as a part of their occupational duties (e.g., extensive preventive care, numerous trainings, and deployments), which require special consideration as parental exposures in reproductive health research that cannot be well assessed in the general population. From 2003 to 2014, the BIHR program captured 250,604 pregnancies among approximately 2.4 million active-duty women of reproductive age when limited to non-cadet Army, Air Force, Navy, and Marine Corps personnel. Approximately 15,000 live births occurred each year, and the live birth rate ranged from 76.9 per 1,000 in 2003 to 71.0 per 1,000 in 2014. Safety of military-unique preventive measures, environmental exposures, and occupational hazards in pregnancy are summarized herein. Reproductive health is important to our service members and their families, and optimizing the health of military families ultimately contributes to force readiness., Competing Interests: None., (Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.)