Indoor soundscapes at home during the COVID-19 lockdown in London - Part II: A structural equation model for comfort, content, and well-being.

The present work constitutes the sequel to the analysis of data from an online survey administered to 464 home workers in London in January 2021 during the COVID-19 lockdown. Perceived affective quality of indoor soundscapes has been assessed in the survey through a previously developed model, as the combination of two perceptual dimensions, one related to comfort (a comfortable - annoying continuum) and the other to content (a full of content - empty continuum). Part I of the study reported on differences in comfort, content, and soundscape appropriateness based on the activity performed at home during the lockdown, i.e. working from home (WFH) and relaxation. Moreover, associations between soundscape dimensions and psychological well-being have been highlighted. Part II of the study deals with the exploration of the influences of several acoustical, building, urban and person-related factors on soundscape dimensions and well-being. A mixed-method approach has been adopted by combining multivariate regression of questionnaire scores with the qualitative analysis of spontaneous descriptions given by respondents. Results showed that several sound sources, urban features, housing characteristics, working modes and demographic factors can influence (positively and negatively) soundscape dimensions differently depending on the task at hand. Notably, the perceived dominance of neighbours' noises during relaxation, moderated by noise sensitivity, and the number of people at home were common factors negatively affecting both comfort and well-being, that partially explained the association between comfortable indoor soundscapes and better mental health. The discussion points out the importance of considering the different impacts that acoustical factors (e.g. sound typology), building (e.g., house size), urban (e.g., availability of a quiet side), situational (e.g., number of people at home), and person-related factors (e.g., noise sensitivity) can provide on building occupants depending on the specific activity people are engaged with at home and the opportunities to foster people's well-being through building, urban and acoustic design.

Indoor soundscapes at home during the COVID-19 lockdown in London - Part I: Associations between the perception of the acoustic environment, occupants activity and well-being.

Since the outbreak of the COVID-19 pandemic, as a result of the adoption of worldwide lockdown measures, the home environment has become the place where all the daily activities are taking place for many people. In these changed social and acoustical contexts, we wanted to evaluate the perception of the indoor acoustic environment in relation to traditional and new activities performed at home, i.e., relaxation, and working from home (WFH). Taking London as a case study, the present paper presents the results of an online survey administered to 464 home workers in January 2021. The survey utilized a previously developed model for the assessment of indoor soundscapes to describe the affective responses to the acoustic environments in a perceptual space defined by comfort (i.e. how comfortable or annoying the environment was judged) and content (i.e., how saturated the environment is with events and sounds) dimensions. A mixed-method approach was adopted to reinforce result validity by triangulating data from questionnaires and spontaneous descriptions given by participants. In this first part of the study, the main objectives were: (1) evaluating differences in soundscape evaluation, in terms of comfort and content dimensions, based on the activity performed at home, (2) identifying appropriate conditions for WFH and relaxation, and (3) investigating associations between psychological well-being and indoor soundscapes. The results showed that the environments were perceived as more comfortable and slightly fuller of content when rated in relation to relaxation than for WFH, thus suggesting a stricter evaluation of the acoustic environment in the latter case. As regards the second objective, spaces that were more appropriate for relaxation had high comfort, whereas spaces appropriate for WFH resulted more private and under control, i.e. with high comfort and low content scores. Lastly, better psychological well-being was associated with more comfortable soundscapes, both for WFH (rs = 0.346, p < .0005), and relaxation (rs = 0.353, p < .0005), and with lower content while WFH (rs = -0.133, p = .004). The discussion points out the need of considering the implications of changed working patterns to rethink the design of soundscapes in residential buildings, also in relation to potential well-being outcomes that will be further investigated in the Part II of the study.

Development of a Self-Administered Questionnaire to Detect Psychosis at High Altitude: The HAPSY Questionnaire.

Aims: Psychotic symptoms during exposure to high altitude (HA) have been linked to accidents or near accidents on the mountains. It is thus of great importance to directly identify psychotic symptoms in individuals who are exposed to HA quickly and reliably on the mountain, even in the absence of experienced medical personnel. Psychotic features at HA frequently include positive psychotic symptoms such as hallucinations, delusions, or disorganized thinking/speech. The aim of the current study was to develop the first self-administered questionnaire (High Altitude Psychosis [HAPSY] Questionnaire), which individuals may use in the future to self-assess altitude-related psychotic symptoms on the mountain. Methods: We utilized two existing self-rating questionnaires for psychotic symptoms (the Psychotomimetic States Inventory, PSI and the Cardiff Anomalous Perception Scale, CAPS) as the basis for a two-round Delphi process. As part of this process, additional statements were suggested by the 40 Delphi participants. Results: Eleven self-administered statements-all of them related to positive psychotic symptoms-were identified to be most useful for the self-detection of HA-related psychotic symptoms on the mountain. Conclusion: This is the first self-administered questionnaire that allows the identification of HA-related psychotic symptoms on the mountain. A subsequent validation study is needed to address the psychometric properties of this questionnaire. Clinical validation will have to be performed in a field study.

Intercultural Competence of Western Teachers for Nepalese Rescuers.

INTRODUCTION: Educational projects in mountain rescue in Nepal have a long tradition. They are usually led by Western experts who train their Nepalese colleagues using teams of people with diverse cultural background. To better understand the challenges of these encounters, we conducted a prospective cohort study during the first mountain rescue instructor course in Nepal. METHODS: Western instructors (WIs) and Nepalese instructor candidates (NICs) were asked to self-assess their intercultural competence with the help of questionnaires. The responses were compared and analyzed for differences between WIs and NICs and differences in a pre-post assessment of the WIs. In addition, semistructured interviews were conducted with randomly selected NICs. RESULTS: We found significant differences in communication styles between NICs and WIs: NICs showed a preference to establish relationships before discussing business and not to speak openly in conflict situations. WIs were much more direct and preferred dispassionate exchanges. In an assessment after the course, WIs had changed their attitude toward the host culture. CONCLUSIONS: We found differences in communication styles between WIs and NICs that are relevant to globalized medical education. Faculty members should be prepared before implementing medical training abroad and should have time to experience the host culture.

Knowledge of the Avalanche Victim Resuscitation Checklist and Utility of a Standardized Lecture in Italy.

INTRODUCTION: To explore baseline knowledge about avalanche guidelines and the Avalanche Victim Resuscitation Checklist (AVReCh) in Italy and the knowledge acquisition from a standardized lecture. METHODS: Standardized lecture material discussing AVReCh was presented during 8 mountain medicine courses from November 2014 to April 2016 in different regions of Italy. To determine the knowledge acquisition from the lecture, a pre- and postlecture survey was utilized. RESULTS: A total of 193 surveys were analyzed. More than 50% of the participants had never participated in lectures/courses on avalanche guidelines, and less than 50% of the participants knew about the AVReCh before the lecture. The correct temporal sequence of reportable information in the basic life support section of the AVReCh was selected by 40% of the participants before the lecture and by 75% after the lecture (P<0.001). Within subgroups analysis, most groups saw significant improvement in performance (P<0.05). The selection of the correct burial time increased from 36 to 84% (P<0.05). CONCLUSIONS: Health care providers and mountain rescue personnel are not widely aware of avalanche guidelines. The standardized lecture significantly improved knowledge of the principles of avalanche management related to core AVReCh elements. However, the effect that this knowledge acquisition has on avalanche victim survival or adherence to the AVReCh in the field is yet to be determined.