Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Are Central Banks’ Monetary Policies the Future of Housing Affordability Solutions

Housing affordability is one of the major social problems in many countries, with some advocates urging governments to provide more accessible mortgages to facilitate more homeownership. However, in recent decades more and more evidence has shown that unaffordable housing is the consequence of monetary policy. Most of the previous empirical studies have been based on econometric analyses, which make it hard to eliminate potential endogeneity biases. This cross-country study exploited the two global interest rate shocks as quasi-experiments to test the impacts and causality of monetary policy (taking real interest rates as a proxy) on house prices. Global central banks’ synchronized reduction in interest rates after the outbreak of the COVID-19 pandemic in 2020 and then the global synchronized increase in interest rates after the global inflation crisis in 2022 provided both a treatment and a treatment reversal to test the monetary policy hypothesis. The stylized facts vividly reveal the negative association between interest rate changes and house price changes in many countries. This study further conducted a ten-country panel regression analysis to test the hypothesis. The results confirmed that, after controlling for GDP growth and unemployment factors, the change in real interest rate imposed a negative effect on house price growth rates. The key practical implication of this study pinpoints the mal-prescription of harnessing monetary policy to solve housing affordability issues, as it can distort housing market dynamics

Urban Zoning for Sustainable Tourism: A Continuum of Accommodation to Enhance City Resilience

While governments around the world are embarking on the path to recovery from the COVID-19 crisis, sustainable tourism planning is crucial, in particular in the hospitality sector, which enhances the resilience of destinations. However, many destination management models overlook the role of urban zoning. Little is known about the impacts of land-use zoning on the hospitality and property industries, especially with the current disruption of short-term peer-to-peer accommodation like Airbnb. Euclidean zoning, also known as effects-based planning, has long been criticised in destination management for its exclusionary nature and lack of flexibility. With exclusionary zoning, property owners may only be able to use their land sub-optimally, and cities will be less efficient in responding to market changes in short-term and long-term accommodation demands, but planning intentions can be better controlled, and the property supply can be more stable. Taking Hong Kong as a noteworthy case, this study puts forward a conceptual framework that enables comparison of a novel zoning approach with the traditional zoning approach. This novel zoning approach encompasses both the short- and long-term rental sectors as a continuum of accommodation, ranging from hotels and serviced apartments to Airbnb and rental housing units under a unified regulatory and planning regime to enhance the switching options value. This novel zoning system can gear up the tourism sector with the rapid growth of the sharing economy and aligns with sustainable tourism to ensure long-term socioeconomic benefits to related stakeholders. We extract the data of Airbnb listings to construct the first Airbnb ADR Index (ADRI) by Repeat-sales method, and the results support our Switching Option Hypothesis

Why House Prices Increase in the COVID-19 Recession: A Five-Country Empirical Study on the Real Interest Rate Hypothesis

There are substantial rebounds in house prices in many developed economies after the outbreak of COVID-19. It provides a special opportunity to test the real interest rate hypothesis empirically as a “synchronized” price rebound implies a common cause of house price hikes across the economies. This study conducts a panel regression analysis on five economies, namely Australia, Canada, European Union, New Zealand, the United Kingdom, and the United States of America, to test the hypothesis. The data range from 2017Q1 to 2021Q1. The results confirm that the real interest rate imposes a negative and significant effect on house price growth rate after controlling for economic growth factors, unemployment factors, and cross-country fixed effects. The empirical result of the five housing markets shows that a 1% fall in the real interest rate caused a 1.5% increase in house prices, ceteris paribus, in this period. It also provides casual evidence refuting the economic growth hypothesis and the migrant hypothesis in New Zealand. The results provide far-reaching practical implications on housing policy and on the ways forward to solve housing affordability problems