Pathways to Environmental Inequality: How Urban Traffic Noise Annoyance Varies across Socioeconomic Subgroups.

The article investigates how socioeconomic background affects noise annoyance caused by residential road traffic in urban areas. It is argued that the effects of socioeconomic variables (migration background, education, and income) on noise annoyance tend to be underestimated because these effects are mainly indirect. We specify three indirect pathways. (1) A "noise exposure path" assumes that less privileged households are exposed to a higher level of noise and therefore experience stronger annoyance. (2) A "housing attributes path" argues that less privileged households can shield themselves less effectively from noise due to unfavorable housing conditions and that this contributes to annoyance. (3) Conversely, an "environmental susceptibility path" proposes that less privileged people are less concerned about the environment and have a lower noise sensitivity, and that this reduces their noise annoyance. Our analyses rest on a study carried out in four European cities (Mainz and Hanover in Germany, Bern and Zurich in Switzerland), and the results support the empirical validity of the three indirect pathways.

Annoyance due to residential road traffic and aircraft noise: Empirical evidence from two European cities.

Based on a study in two European cities, Mainz in Germany and Zurich in Switzerland, the article investigates both acoustical and non-acoustical factors affecting indoor annoyance due to residential road traffic and aircraft noise. We specifically focus on three factors: (1) the role of windows as a feature of the building where people live; (2) the role of individual environmental concern as a general attitude; and (3) the role of household income as an indicator of socioeconomic resources. Empirical results show that closed windows in general and closed high-quality windows in particular are an important barrier against outdoor road traffic and aircraft noise, as well as a helpful subjective coping tool against corresponding annoyances. Environmental concern, too, proves to be a significant predictor of noise annoyance. Environmentally highly concerned people articulate feelings of annoyance more often than environmentally less concerned ones. As expected income is negatively related to road traffic noise annoyance. However, we find a positive association of income with annoyance from aircraft noise. Although objective exposure to aircraft noise is lower for high-income households, they feel stronger annoyed by noise from airplanes. Income shows various indirect effects on noise annoyance. A comparative analysis of road traffic and aircraft noise annoyance yields similarities, but also remarkable differences in terms of their influence factors.

An analysis of core EPAs reveals a gap between curricular expectations and medical school graduates' self-perceived level of competence.

BACKGROUND: Entrustable Professional Activities (EPAs) are being implemented worldwide as a means to promote competency-based medical education. In Switzerland, the new EPA-based curriculum for undergraduate medical education will be implemented in 2021. The aim of our study was to analyze the perceived, self-reported competence of graduates in 2019. The data represent a pre-implementation baseline and will provide guidance for curriculum developers. METHODS: Two hundred eighty-one graduates of the Master of Human Medicine program of the University of Zurich who had passed the Federal Licensing Exam in September 2019 were invited to complete an online survey. They were asked to rate their needed level of supervision ("observe only", "direct, proactive supervision", "indirect, reactive supervision") for 46 selected EPAs. We compared the perceived competence with the expected competence of the new curriculum. RESULTS: The response rate was 54%. The need for supervision expressed by graduates varied considerably by EPA. The proportion of graduates rating themselves at expected level was high for "history taking", "physical examination" "and documentation"; medium for "prioritizing differential diagnoses", "interpreting results" and "developing and communicating a management plan"; low for "practical skills"; and very low for EPAs related to "urgent and emergency care". CONCLUSIONS: Currently, there are significant gaps between the expectations of curriculum developers and the perceived competences of students. This is most obvious for practical skills and emergency situations. The new curriculum will either need to fill this gap or expectations might need to be revised.