A comprehensive scoring system to measure healthy community design in land use plans and regulations.

Comprehensive land use plans and their corresponding regulations play a role in determining the nature of the built environment and community design, which are factors that influence population health and health disparities. To determine the level in which a plan addresses healthy living and active design, there is a need for a systematic, reliable and valid method of analyzing and scoring health-related content in plans and regulations. This paper describes the development and validation of a scoring tool designed to measure the strength and comprehensiveness of health-related content found in land use plans and the corresponding regulations. The measures are scored based on the presence of a specific item and the specificity and action-orientation of language. To establish reliability and validity, 42 land use plans and regulations from across the United States were scored January-April 2016. Results of the psychometric analysis indicate the scorecard is a reliable scoring tool for land use plans and regulations related to healthy living and active design. Intraclass correlation coefficients (ICC) scores showed strong inter-rater reliability for total strength and comprehensiveness. ICC scores for total implementation scores showed acceptable consistency among scorers. Cronbach's alpha values for all focus areas were acceptable. Strong content validity was measured through a committee vetting process. The development of this tool has far-reaching implications, bringing standardization of measurement to the field of land use plan assessment, and paving the way for systematic inclusion of health-related design principles, policies, and requirements in land use plans and their corresponding regulations.

Impact of intracoronary bone marrow cell transfer on diastolic function in patients after acute myocardial infarction: results from the BOOST trial.

AIMS: We have recently shown in the randomized-controlled BOne marrOw transfer to enhance ST-elevation infarct regeneration (BOOST) trial that intracoronary autologous bone marrow cell (BMC) transfer improves left ventricular (LV) ejection fraction recovery in patients after acute myocardial infarction (AMI). However, the impact of BMC therapy on LV diastolic function in patients after AMI has remained uncertain. METHODS AND RESULTS: Using (tissue) Doppler echocardiography, we evaluated the effects of BMC transfer on LV diastolic function in patients enrolled in the BOOST trial. After successful primary percutaneous coronary intervention (PCI) for acute ST-elevation myocardial infarction (MI), patients were randomized to a control (n = 29) or BMC transfer group (n = 30). Diastolic function was determined 4.5+/-1.5 days after PCI, at 6 months, and at 18 months by measuring transmitral flow velocities (E/A ratio), diastolic myocardial velocities (Ea/Aa ratio), isovolumic relaxation time (IVRT), and deceleration time (DT). All analyses were performed in a blinded fashion. There was an overall effect of BMC transfer on E/A [0.33+/-0.12; 95% confidence interval (CI): 0.09-0.57; P = 0.008] and Ea/Aa ratios (0.29+/-0.14; 95% CI: 0.01-0.57; P = 0.04). In contrast, we found no effect of BMC transfer on DT (-5+/-14 ms; 95% CI: -33 to 22; P = 0.70), IVRT (-7+/-7 ms; 95% CI: -20 to 6; P = 0.29), and E/Ea ratio (0.35+/-0.14; 95% CI: -0.92 to 1.62; P = 0.57). CONCLUSION: Intracoronary autologous BMC transfer improves echocardiographic parameters of diastolic function in patients after AMI.