Applying the real options theory for identifying flexibility in project delivery of health organisations

Healthcare is influenced by many uncertainties. Uncertainties affecting health organisations also influence real estate since this facilitates the primary process. Within real estate management, decisions have to be made today while there is little knowledge about the future. Therefore, flexibility is needed in the process of designing, constructing and operating real estate. A case study has been done to gain insight about how health organisations deal with flexibility. The real options approach is used to show what types of flexibility have been used, and that uncertainty can also generate opportunities. Of the five types of flexibility, only in two types real options were identified in the case study. These were stage, abandon, defer and scale within process flexibility and the options growth and switch within product flexibility. This is partly a result of the fact that the project in the case study is not further advanced than the preliminary design phase. Nevertheless it can be concluded that project managers already act as using real options. Consciously using this concept might create even more real options to be used in project management

Real options and scenario planning as a way to gain insight into flexibility in health care real estate management, a first exploration

Real estate management in health care faces many uncertainties, and more specific in the Netherlands even more because of changing regulations regarding\ud the financing of capital costs. Therefore we propose, based on literature and a\ud survey, to use scenario planning in combinations with the real option approach to deal with these uncertainties. The survey shows that limited use is made of future uncertainties and options for flexibility in the responded Dutch hospitals. Real options provide insight for real estate managers into opportunities for flexibility when making strategic decisions in real estate management, such as choosing for a building organisation form

Integrating knowledge accross disciplines. Experiences from the NeWater project

The starting question for this deliverable was how to create a new adaptive management concept that can integrate insights from various disciplines and connect people from different institutional backgrounds. From literature research and empirical research on the NeWater project we identified challenges for cross-disciplinary knowledge integration, we evaluated interventions for connecting multiple knowledge frames, we analyzed the process of group model building with UML and formulated recommendations. Cross-disciplinary research has arisen from a growing number of complex problems for which knowledge of a single scientific discipline or societal field is insufficient, but presents important challenges: (1) collaboration and integration of knowledge requires in depth discussions that are timeconsuming; (2) the recursive process of problem structuring and restructuring is often at odds with the sequential planning of project activities; (3) participation and mutual learning are crucial but need to be carefully structured and sequenced; and (4) management and leadership faces the difficult challenge of balancing in depth exploration with timely delivery of tangible results. We conclude with the following general recommendations for large cross-disciplinary projects: (1) including a preparatory proposal phase for thorough exploration of opportunities of between researchers and stakeholders (2) flexible funding, planning and operational arrangements to allow for a recursive research process; (3) a project size that allows frequent interaction opportunities between researchers and between researchers and stakeholders to allow for mutual learning and in depth exploration; and (4) enhancing learning opportunities from one project to the next

Potential dietary feed additives with antibacterial effects and their impact on performance of weaned piglets : a meta-analysis

This meta-analysis evaluated the use of potential dietary feed additives (pDFA) with antibacterial effects and their impact on the perfomance of weaned piglets. Twenty-three peer-reviewed in vivo studies, comprising 50 trials, were identified between January 2010 and January 2017. The pDFA in these studies could be grouped in 5 classes: antimicrobial peptides, chitosan, lysozyme, medium chain fatty acids/triglycerides and plant extracts. Mixed-effect meta-analyses with type of pDFA as fixed effect were performed for the growth parameters 'average daily gain' (ADG) and 'feed conversion ratio' (FCR), which are the two most important and used economic performance parameters for farmers. For each class of pDFA, results of the meta-analysis showed significantly higher average daily gain in the group with pDFA compared to the negative control group, while no significant difference with the positive control group was observed. Furthermore, a positive effect on FCR was found, i.e. significantly less feed was needed to gain 1 kg of body weight in the group with pDFA compared to the negative control group. No significant differences with positive control groups were observed for each class of pDFA, except for plant extracts, where the FCR was also significantly reduced in the treatment group. These results suggest that pDFA could reduce the use of antimicrobials without significant negative effects on performance indicators

Potential dietary feed additives with antibacterial effects and their impact on performance of weaned piglets: A meta-analysis

This meta-analysis evaluated the use of potential dietary feed additives (pDFA) with antibacterial effects and their impact on the perfomance of weaned piglets. Twenty-three peer-reviewed in vivo studies, comprising 50 trials, were identified between January 2010 and January 2017. The pDFA in these studies could be grouped in 5 classes: antimicrobial peptides, chitosan, lysozyme, medium chain fatty acids/ triglycerides and plant extracts. Mixed-effect meta-analyses with type of pDFA as fixed effect were performed for the growth parameters ‘average daily gain’ (ADG) and ‘feed conversion ratio’ (FCR), which are the two most important and used economic performance parameters for farmers. For each class of pDFA, results of the meta-analysis showed significantly higher average daily gain in the group with pDFA compared to the negative control group, while no significant difference with the positive control group was observed. Furthermore, a positive effect on FCR was found, i.e. significantly less feed was needed to gain 1 kg of body weight in the group with pDFA compared to the negative control group. No significant differences with positive control groups were observed for each class of pDFA, except for plant extracts, where the FCR was also significantly reduced in the treatment group. These results suggest that pDFA could reduce the use of antimicrobials without significant negative effects on performance indicators

Analytical method for the determination of trichlorobenzenes in marine biota (poster)

Trichlorobenzenes (TCBs) were intensively used in the last decades as essential components of dielectric fluids, intermediates in chemical synthesis, solvents, coolants, lubricants, heat-transfer medium; insecticide, additive in polyester dyeing and components of termite-control preparations (1, 2). Due to their widespread occurrence in the various environmental compartments they have been classified by OSPARCOM (Oslo and Paris Commissions) (3) as chemicals for priority action and have been proposed by the Marine Chemistry Working Group (MCWG) as chemical parameters in the Water Framework Directive (4). Based on their octanol-water partitioning coefficients (log Kow = 4.02-4.49) (5) and bioconcentration factors in fish (ranging from 182 to 3200, depending on the lipid content) (6), these chemicals are expected to bioaccumulate in aquatic organisms.Against their potential significance in the marine environment there is relatively little information available concerning the actual concentration levels and distribution of trichlorobenzenes in marine organisms (7, 8).The aim of this work was to develop an analytical method appropriate for the determination of TCBs in marine biota.The analytical method consists of saponification of the fish tissue with methanolic potassium hydroxide, liquid-liquid extraction of the solution with pentane, clean up of the concentrated extract on alumina column and analysis of the extract with gas chromatograph equipped with electron capture detector (ECD). The method proved to be appropriate for the detection of concentration levels typical of the organic contaminants in biota (7) (~1 ng /g wet weight of tissue). The relative standard deviation of the analysis of 1,3,5-, 1,2,4- and 1,2,3-trichlorobenzene was 8, 6 and 18% (n=4) respectively. Higher recoveries of the analytes were obtained with spiked fish samples than with standard solutions (88, 96 and 78 instead of 53, 50 and 32% of 1,3,5-, 1,2,4- and 1,2,3-trichlorobenzene respectively). One plausible explanation of the difference is that the proteins and glycerides of the fish tissue compete effectively with trichlorobenzenes for the base and their presence decrease their decomposition rate