Background: Postoperative rehabilitation after primary total hip arthroplasty (p-THA) differs between the Netherlands and Germany. Aim is to compare clinical effectiveness and to get a first impression of cost effectiveness of Dutch versus German usual care after p-THA. Methods: A transnational prospective controlled observational trial. Clinical effectiveness was assessed with self-reported questionnaires and functional tests. Measurements were taken preoperatively and 4 weeks, 12 weeks, and 6 months postoperatively. For cost effectiveness, long-term economic aspects were assessed from a societal perspective. Results: 124 working-age patients finished the measurements. German usual care leads to a significantly larger proportion (65.6% versus 47.5%) of satisfied patients 12 weeks postoperatively and significantly better self-reported function and Five Times Sit-to-Stand Test (FTSST) results. German usual care is generally 45% more expensive than Dutch usual care, and 20% more expensive for working-age patients. A scenario analysis assumed that German patients work the same number of hours as the Dutch, and that productivity costs are the same. This analysis revealed German care is still more expensive but the difference decreased to 8%. Conclusions: German rehabilitation is clinically advantageous yet more expensive, although comparisons are less straightforward as the socioeconomic context differs between the two countries. Trial registration: The study is registered in the German Registry of Clinical Trials (DRKS00011345, 18/11/2016).
The interaction of stakeholders is regarded key in modern environmental and spatial planning. Marine/maritime spatial planning (MSP) is an emerging marine policy domain, which is of great interest worldwide. MSP practices are characterized by diverse approaches and a lack of transnational cooperation. Actors with various backgrounds have to identify mismatches and synergies to jointly aim towards coherent and coordinated practices. The ‘Living Q’ is a communication method to make actors aware systematically about their viewpoints in an interactive, communicative and playful environment, while it draws on results of a proceeding ‘Q Methodology’ study. Results from ‘Living Q’ exercises with international expert’s groups from European Sea basins show that the method is capable to foster communication and interaction among actors participating in ‘Living Q’ exercises, while having the potential to generate added value to planning processes by actor interaction in a collaborative setting.
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In this article we look at the various paths taken by transnational and domestic entrepreneurs based on their education and work experience. These act as catalysts for skills that allow migrant entrepreneurs to better position themselves in different markets. Differences in migrant entrepreneurs allow us to better understand the strategies employed and the consequences for society and the economy at both domestic and transnational levels. Earlier research has extensively analysed individual characteristics of migrant entrepreneurs and, to a much lesser extent, the geographical nature of their business activities.This article addresses this gap by looking at the geographical orientation of migrant entrepreneurs’ businesses. The research question is as follows: In what ways are transnational or domestic activities of Moroccan migrant entrepreneurs in the Netherlands and Italy influenced by skills acquired in earlier experiences? We provide empirical evidence on the different paths leading to domestic and transnational activities using a micro-level perspective of the experiences collected in the narratives of first-generation Moroccan migrant entrepreneurs who have migrated to Milan or Amsterdam (N=70).Four different paths combining these two life experiences emerged from the interviews: #1 Job-based, #2 Education-driven, #3 Job-education merger, and #4 By chance (neither education nor work experience). The most relevant paths for migrant entrepreneurs seem to be the first (#1) and third (#3) paths. Furthermore, our findings show that transnationally oriented entrepreneurs have an extended business-oriented education and rely on skills learned, in contrast to domestically oriented entrepreneurs who become entrepreneurs ‘by chance’.