Antoine’s coups de cœur – Selection of 15 papers from SSPH+ Faculty members, 2005-2019

I always had the dream of exploring and analyzing the impressive scientific output of SSPH+ Faculty members. At present, there is no existing worldwide ranking of schools of public health. There is a ranking system specifically for American schools, but how would the European schools rank compared to the rest of the world? More specifically, how would the Swiss School of Public Health perform? Whilst I have some intuitions, I have no clear idea. As an appetizer, I have selected one paper per year, trying to reflect as much as possible the diversity of the 12 Swiss universities, which constitute our SSPH+.

It was not an easy exercise. Of course, I did not apply any objective criteria to conduct this work so I ask my colleagues to forgive me if I did not mention their papers, or if I did not select the ones they would have preferred to see listed. I tried as much as I could to select open access or easily accessible articles, which was not always feasible. It was, for me, a form of pleasant navigation in the Swiss academic public health waters. I discovered new lands, unknown territories that some of my best colleagues and friends have explored or discovered.

I extracted here a couple of notes from the logbook of my splendid journey across the Swiss academic landscape.

Swiss academic landscape

In 2005, colleagues from what was to become Swiss TPH in Basel, published a paper which was a warning signal for foodborne emerging infectious diseases. After a good meal, let us prepare a good sleep. One year later, the University of Zurich proposed a new non-pharmacological treatment against sleep apnoea syndrome. The didgeridoo game assessed in a randomized controlled trial was found effective and well accepted in patients with moderate conditions. However, waking up in bad way may lead to trauma disability. In 2007, the University of Lucerne proposed to integrate a biomedical and societal model of functioning and disability. Okay, okay, after a good sleep, we need to take a deep breath… without whistling! One year after, several university members of SSPH+ compared two instruments for assessing the quality of life in patients with asthma and showed that SF-36 remained a more valid measure. Even when we fall disabled and loose our autonomy, those who give their care and love us need to be protected… sometimes against us.

In 2009, the University of Applied Sciences of Bern conducted a systematic review of the literature to better understand to what extent caregivers can be the victims of aggressive behaviors from nursing home residents. Switzerland has a very effective healthcare system. Very expensive too. Should we transform it or adjust it? In 2010, SUPSI participated in an international survey comparing six countries facing similar pressure and engaged in health care reform. They explained what these reforms did and what happened after their implementation. A must read paper before considering any reform in health! Traveling abroad, let’s make a stop in the beautiful Africa, a continent deeply harmed by the AIDS pandemic.

In 2011, the University of Bern showed how viral load monitoring when treating patients with HIV infection in routine in South Africa led to better outcomes through earlier detection of treatment failure and adherence counselling. Allow me to make a short pause in our journey. Usually in the middle of any research article you find a section dedicated to the methods. Let’s say that we have behaved similarly in this cruise, proposing in 2012 a paper written by the new director of the Population Health Laboratory at the University of Fribourg, when he was at the former IUMSP (now Unisanté) at the University of Lausanne. He was discussing the respective interest in using confidence intervals or prediction intervals when performing meta-analyses… Something not very easy to digest!

Malnutrition in low- and middle-income countries often contributes to the double disease burden, in addition to communicable diseases. In 2013, a group of economists from Winterthur at ZHAW assessed the burden of micronutrient deficiencies as leading to substantial health costs in 6-59 month old children in the Philippines, concentrated in the lower socio-economic status.

Journey with a happy ending

After breakfast, it’s time to work, but can we work in pleasant settings focused on improving our well-being? Moreover, to what extent do such favorable environments actually have an impact on our health? Something that to date has not been studied a great deal. In 2014, a researcher from the Università della Svizzera italiana (USI) published a systematic review showing that although there are some indications that physical activity interventions in workplaces may be effective, but there remains room for improvement in research in this domain to bring more evidence. Our daily commute to work may expose us to harmful pollutants, even in Switzerland.

In 2015, a team from the Swiss TPH showed some evidence, from the Swiss cohort study SAPALDIA on air pollution and lung diseases in adults, that air pollutants can play a role in the metabolic syndrome, particularly with impaired glycemia.

During this decade the wording “global health” seemed to bloom worldwide (I should have written “globally”). Was it hype or novelty? A viewpoint from American academics published in the Lancet stated that “global health is public health”. In 2016, a group of academic members from the University of Geneva, the Swiss TPH, the Graduate Institute Geneva, EPFL and the University of Lausanne proposed a common definition for global health. In the country of consensus makers, it was easy to find our way. Let’s continue to navigate among concepts.

In 2017, the University of Neuchatel proposed the help of legal and ethical safety jackets to calm our anxiety vis-à-vis informed consent in clinical and epidemiological research, reminding us how it protects patients and people. Close to achieving this crossing, we cannot forget how social determinants affect our health. A large European team led by the University of Lausanne found a social gradient in physical functioning in older adults similar in magnitude as the one observed for non-communicable diseases.

At the very end of this journey, I would like to tell you a story with a happy ending, which was published during the preparation phase of the World Expo which will be held in 2020 in Dubai. Co-signed by the current co-presidents and director of SSPH+, this editorial strongly (and bravely) advocated for a healthy Swiss Pavilion, out of any active lobbies from the Big Tobacco companies. Fortunately, the Swiss government has wisely decided to rescind any form of sponsorship from the tobacco industry. At SSPH+, we have applauded this decision and thanked the leading Federal Councilor in charge, who is a physician and public health expert, and… an alumni of the Swiss School of Public Health!
I wish you all a happy new decade (and half)!

See the list of selected papers here.