Abstract

Cost-benefit analysis (CBA) is the root of Health Economics and is based on the welfare theory. CBA is the broadest economic evaluation (EE) method that assesses all benefits and costs in monetary units; the production of welfare is expressed in terms of net benefit (the difference between benefits and costs). The main goal in the welfarist approach is to maximize welfare according to individuals’ preferences. The application of CBA principles faces multiple obstacles, mainly because valuing health in terms of monetary units is challenging and raises ethical and methodological constraints. In the health sector, CBA has received relevant criticism, leading to the emergence and adoption of other methods of EE, such as cost-effectiveness analysis (CEA) and cost-utility analysis (CUA). However, attempts to apply welfarist principles to CEA were far of being accepted, and consensus among health economists in this regard still does not exist. The extra-welfarist approach encompassing CEA and CUA has progressed toward maximizing health outcomes and focusing on equity and fairness issues. The most common technique used in CBA to elicit preferences is the contingent valuation (willingness to pay). Despite the challenging task of valuing mental health outcomes, some studies demonstrate the feasibility of this technique in people with mental disorders, though some level of inconsistency and inaccuracy in respondents’ answers was reported. Despite methodological limitations among all EE methods applied to health, there is a growing interest in CBA and, more specifically, in discrete choice experiment, especially for health services and public health policies, and in exploring patients’ treatment preferences. The Mental Health field adds challenges to CBA regarding the complexity of defining and measuring outcomes representing mental health maximization. Document type: Book

Abstract

This paper analyzes the changes in spatial–temporal job accessibility by car in the Netherlands during the economic crisis (2009–14). It also assesses which component change is the most determinant in accessibility changes per municipality and part of the day. The paper shows that changes in job distribution reduced accessibility in almost the entire country, except around Amsterdam. Improvements in the road network capacity increased accessibility in the central provinces, particularly during peak hours. In summary, the values of job accessibility by car in the Netherlands became more transport dependent, except in the Amsterdam region. Document type: Article

Abstract

Recent developments in molecular biology and metabolic engineering have resulted in a large increase in the number of strains that need to be tested, positioning high-throughput screening of microorganisms as an important step in bioprocess development. Scalability is crucial for performing reliable screening of microorganisms. Most of the scalability studies from microplate screening systems to controlled stirred-tank bioreactors have been performed so far with unicellular microorganisms. We have compared cultivation of industrially relevant oleaginous filamentous fungi and microalga in a Duetz-microtiter plate system to benchtop and pre-pilot bioreactors. Maximal glucose consumption rate, biomass concentration, lipid content of the biomass, biomass, and lipid yield values showed good scalability for Mucor circinelloides (less than 20% differences) and Mortierella alpina (less than 30% differences) filamentous fungi. Maximal glucose consumption and biomass production rates were identical for Crypthecodinium cohnii in microtiter plate and benchtop bioreactor. Most likely due to shear stress sensitivity of this microalga in stirred bioreactor, biomass concentration and lipid content of biomass were significantly higher in the microtiter plate system than in the benchtop bioreactor. Still, fermentation results obtained in the Duetz-microtiter plate system for Crypthecodinium cohnii are encouraging compared to what has been reported in literature. Good reproducibility (coefficient of variation less than 15% for biomass growth, glucose consumption, lipid content, and pH) were achieved in the Duetz-microtiter plate system for Mucor circinelloides and Crypthecodinium cohnii. Mortierella alpina cultivation reproducibility might be improved with inoculation optimization. In conclusion, we have presented suitability of the Duetz-microtiter plate system for the reproducible, scalable, and cost-efficient high-throughput screening of oleaginous microorganisms. Electronic supplementary material The online version of this article (10.1007/s00253-018-8920-x) contains supplementary material, which is available to authorized users. Document type: Article