The Zurich case study of UrbanSim

Abstract-- UrbanSim is an open-source software being developed by Waddell and colleagues(Waddell and Ulfarsson, 2004), simulating land use-development in cities based on the choices of households, businesses, land owners and developers, interacting in urban Real Estate markets and with the option to be connected to a transportation simulation. SustainCity is an EU-funded project with twelve European research-institutions1, coordinated by the IVT of the Swiss Federal Institute of Technology Zurich (ETHZ). Within the project of SustainCity2, UrbanSim is being adapted to European conditions by creation of a European version (UrbanSimE) with new calibration of choice-models and additional models for households, demographics and firmographics. Focus will be on the data-structure in Europe as well as the different behaviour of companies, residents and developers. For this UrbanSim will be used in three case studies: Brussels, Paris and Zurich. Although previous studies have been implemented in all of those region, the previous study in Zurich can be considered as a new set up as it uses another version of UrbanSim. This paper will report on the implementation of this parcel-based version of UrbanSim within the Zurich case study of SustainCity. It will refer to the data acquired and necessary as basis for the simulation, discuss the approach of data preparation through PostGIS and report on the new structure of the data-models defined within UrbanSim. Finally the first results of the UrbanSim runs of the Zurich case study will be presented and compared to the runs of previous versions. Keywords: UrbanSim; Urban Simulation; SustainCity; Zurich case study 02.03.2011

Longitudinal panel data study of self-rated health among migrants in French-speaking Switzerland, 2003–2017

Introduction Studies have documented poorer health among migrants than natives of several European countries, but little is known for Switzerland. We assessed the association between country of birth, socioeconomic factors and self-reported health (SRH) in a prospective cohort of adults living in Lausanne, Switzerland.Methods We used the data from the Colaus panel data study for three periods: 2003–2006 (n=6733), 2009–2012 (n=5064) and 2014–2017 (n=4555) corresponding to 35% of the source population. The response variable was SRH. Main explanatory variables were socioeconomic status, educational level, professional status, income, gender, age and years in Switzerland. The main covariate was country of birth, dichotomised as born in Switzerland or not. We specified random effects logistic regressions and used Bayesian methods for the inference.Results Being born outside of Switzerland was not associated with worse SRH (OR 1.09, 95% CI 0.52 to 2.31). Several other patient variables were, however, predictive of poor health. Educational level was inversely associated with the risk of reporting poor health. Monthly household income showed a gradient where higher income was associated with lower odds of reporting poor SRH, for both for migrants and non-migrants. Migrant women had lower odds of reporting poor SRH than men (OR 0.73, 95% CI 0.55 to 0.98). Migrant people living in couple have less risk of reporting poor SRH than people who live alone and the risk is lower for migrant people living in couple with children (OR 0.66, 95% CI 0.55 to 0.80).Discussion Migrant status was not associated with poorer SRH. However, differences in SRH were observed based on gender, age and several social determinants of health

Migration et santé : analyse des besoins dans le canton de Vaud

[Table des matières] 1. Introduction. 2. Besoin en matière de programmes offrant une égalité des chances. 3. Programmes de promotion de la santé et de prévention évalués. 4. Mesures prises pour garantir l'égalité des chances d'accès lors de la conception et de la mise en oeuvre des programmes. 5. Participation aux programmes. 6. Quels obstacles à la participation des migrants et quels facteurs susceptibles de l'améliorer?: avis des personnes consultées. 7. Mesures recommandées. 8. Annexes. 9. Références

Use of nicotine substitute prescribed at hourly plus ab libitum intake or ad libitum for heavy smokers willing to quit: a randomized controlled trial

OBJECTIVE: To assess the impact of instructional guidance in the regular use of use nicotine nasal spray (NNS) on the true use of NNS during the first three weeks of smoking cessation for heavy smokers who are willing to quit. METHODS: This randomized, open, controlled trial included 50 patients who were heavy smokers, were willing to quit, and attending an academic outpatient clinic in Western Switzerland. Patients were randomised to instruction on NNS use as "ad libitum" (administration whenever cravings appear; control group) or to use NNS when craving appears and at least every hour when awake (intervention group). Intakes were monitored using an electronic device fixed in the spray unit (MDILog) during the first three weeks of use. Self reported abstinence from smoking at six months was confirmed by expired-air carbon monoxide. Using intention-to-treat analysis, random-effect GLS regression was used to calculate the mean difference of daily doses between groups controlling for lack of independence between measures from the same individual. RESULTS: One patient was lost to follow-up. At baseline randomization, the group receiving instruction to use NNS hourly included more women, patients with previous desires to quit, and patients with more psychiatric comorbidities and less somatic complaints compared to the group instructed to use NNS with cravings (group imbalance). Both groups self-administered more than the daily recommended dosage of 8 uses. Mean daily usage was 13.6 dose/day and 11.1 dose/day for the group instructed to use NNS hourly and with cravings, respectively. Adjusting for baseline imbalance, the increased daily doses in the intervention group (hourly use) remained nonsignificant compared to ad libitum use (-0.5 dose/day; CI 95% -6.2; 5.3, from day 1 to day 7; and 2.3 dose/day; CI 95% -5.4; 10.0, from day 8 to day 21). Instructing patients to use the NNS daily had no effect on smoking cessation at six months (RR = 0.69; CI 95% 0.34; 1.39). CONCLUSION: Heavy smokers willing to quit use NNS frequently, regardless of the instructions given. Recommending the use of NNS only when craving appears for heavy smokers willing to quit seems acceptable compared to prescribing hourly administration. TRIAL REGISTRATION: ClinicalTrials.gov: NCT00861276

Medical care of asylum seekers: a descriptive study of the appropriateness of nurse practitioners' care compared to traditional physician-based care in a gatekeeping system

<p>Abstract</p> <p>Background</p> <p>Medical care for asylum seekers is a complex and critical issue worldwide. It is influenced by social, political, and economic pressures, as well as premigration conditions, the process of migration, and postmigration conditions in the host country. Increasing needs and healthcare costs have led public health authorities to put nurse practitioners in charge of the management of a gatekeeping system for asylum seekers. The quality of this system has never been evaluated. We assessed the competencies of nurses and physicians in identifying the medical needs of asylum seekers and providing them with appropriate treatment that reflects good clinical practice.</p> <p>Methods</p> <p>This cross-sectional descriptive study evaluated the appropriateness of care provided to asylum seekers by trained nurse practitioners in nursing healthcare centers and by physicians in private practices, an academic medical outpatient clinic, and the emergency unit of the university hospital in Lausanne, Switzerland. From 1687 asylum seeking patients who had consulted each setting between June and December 2003, 450 were randomly selected to participate. A panel of experts reviewed their medical records and assessed the appropriateness of medical care received according to three parameters: 1) use of appropriate procedures to identify medical needs (medical history, clinical examination, complementary investigations, and referral), 2) provision of access to treatment meeting medical needs, and 3) absence of unnecessary medical procedures.</p> <p>Results</p> <p>In the nurse practitioner group, the procedures used to identify medical needs were less often appropriate (79% of reports vs. 92.4% of reports; p < 0.001). Nevertheless, access to treatment was judged satisfactory and was similar (p = 0.264) between nurse practitioners and physicians (99% and 97.6% of patients, respectively, received adequate care). Excessive care was observed in only 2 physician reports (0.8%) and 3 nurse reports (1.5%) (p = 0.481).</p> <p>Conclusion</p> <p>Although the nursing gatekeeping system provides appropriate treatment to asylum seekers, it might be improved with further training in recording medical history and performing targeted clinical examination.</p

A Health Behaviour Cross-Sectional Study of Immigrants and Non-immigrants in a Swiss Urban General-Practice Setting

Background Little is known about smoking, unhealthy use of alcohol, and risk behaviours for sexually transmitted diseases (STDs) in immigrants from developed and developing countries. Method We performed a cross-sectional study of 400 patients who consulted an academic emergency care centre at a Swiss university hospital. The odds ratios for having one or more risk behaviours were adjusted for age, gender, and education level. Results Immigrants from developing countries were less likely to use alcohol in an unhealthy manner (OR=0.35, 95% CI 0.22-0.57) or practise risk behaviours for STDs (OR=0.31, 95% CI 0.13-0.74). They were also less likely to have any of the three studied risk behaviours (OR=2.5, 95% CI 1.5-4.3). Discussion In addition to the usual determinants, health behaviours are also associated with origin; distinguishing between immigrants from developing and developed countries is useful in clinical settings. Surprisingly, patients from developing countries tend to possess several protective characteristic

In Their Own Words: The Health and Sexuality of Immigrant Women with Infibulation Living in Switzerland

Female genital mutilation (FGM) is a significant public health problem. It is estimated that around 14,700 women affected by FGM live in Switzerland, primarily among women with a history of migration. Our qualitative research investigated the sexual health of immigrant women living with FGM in Switzerland, describing their own perception of health, reproductive life and sexuality. We conducted semi-structured, in-depth interviews with a group of eight immigrant women of sub-Saharan origin living in Switzerland with Type III FGM (infibulation). Seven of the women were from Somalia and one was from the Ivory Coast. All of the Somali women were mothers and married (two separated), and the Ivorian woman was a single mother. The women in our study reported a low level of sexual satisfaction and reproductive health. They affirmed their desire to improve, or at least change, their condition. Although they rarely talk with their husbands about sexual subject matter, they would like to include them more and improve dialogue. Specific socio-sexual management is recommended when caring for immigrant women living with FGM in order to respond to their specific health care needs. Multidisciplinary approaches may be able to offer more comprehensive health care, including facilitated communication to improve dialogue between women and health care professionals, and eventually between women and their husbands in discussing sexual subject matter