Specialization in sports: A theoretical approach.

Nations have been competing in sporting competitions for centuries. Therefore, explaining the success of different countries has a long history in sports science. At first, researchers tried to explain success patterns with the help of divergent geographical factors. Later, literature included other determinants on the macro-level which provide evidence that especially the GDP as a proxy for the prosperity of a country has a significant impact on success in sports. Within this broader field of research, also specialization patterns in sports developed into an important topic of research. In line with the literature on factors which lead to (national) success, so far, the discussion mostly concentrates on determinants on a macro-level. We identify the problem that different specialization patterns can be observed in countries that have similar factors on the macro-level, as well. There seems to be a research gap concerning the influencing factors on a meso-level. As a result, the aim of this paper is to show which determinants on the meso-level can affect sports specialization patterns. We provide a model based on the findings of lobbying theory that explains not only different specialization patterns between, e.g., Europe and Africa, but also different specialization patterns within a continent and dissimilar patterns of countries with a similar macro-level can be understood. Overall, our paper contributes to the discussion on specialization in elite sports from an economic perspective, so that future research can build on our work, in particular concerning empirical tests of our approach.

EU's Ordering of COVID-19 Vaccine Doses: Political Decision-Making under Uncertainty.

Worldwide, politicians, scientists, and entrepreneurs are operating under high uncertainty and incomplete information regarding the adequacy of measures to deal with the COVID-19 pandemic. It seems indisputable that only widespread and global immunity can bring normalization to social life. In this respect, the development of a vaccine was a milestone in pandemic control. However, within the EU, especially in Germany, the vaccination plan is increasingly faltering, and criticism is growing louder. This paper considers the EU's political decision in general and the decisions of the German government to procure vaccine doses against the background of modern economics as a decision under uncertainty and critically analyzes the process.

Political Decision Making in the COVID-19 Pandemic: The Case of Germany from the Perspective of Risk Management.

The COVID-19 pandemic is permanently changing modern social and economic coexistence. Most governments have declared infection control to be their top priority while citizens face great restrictions on their civil rights. A pandemic is an exemplary scenario in which political actors must decide about future, and thus uncertain, events. This paper tries to present a tool well established in the field of entrepreneurial and management decision making which could also be a first benchmark for political decisions. Our approach builds on the standard epidemiological SEIR model in combination with simulation techniques used in risk management. By our case study we want to demonstrate the opportunities that risk management techniques, especially risk analyses using Monte Carlo simulation, can provide to policy makers in general, and in a public health crisis in particular. Hence, our case study can be used as a framework for political decision making under incomplete information and uncertainty. Overall, we want to point out that a health policy that aims to provide comprehensive protection against infection should also be based on economic criteria. This is without prejudice to the integration of ethical considerations in the final political decision.

An active city approach for urban development.

With an increasing percentage of the global population living in cities and the concurrent decrease in physical activity in daily life, public health issues for urban development have arisen. This study responds to that trend by presenting an approach to measure city-wide physical activity levels. Comparing of city indices for active sports and the active transportation shows differences between subject cities and activity level of age groups in sports as well as walking and cycling. Therefore, our study lends itself to implications for urban development towards creating a healthier city.

Teleneurology in stroke management: costs of service in different organizational models.

Telemedicine is in increasing use in clinical neuroscience such as acute stroke care, especially by applying remote audiovisual communication for patient evaluation. However, telephone consultation was also used linking stroke centres to smaller hospitals. We compared costs of telestroke services using audiovisual and telephone communication in different organizational models. Within a small network in Northern Bavaria video-based teleconsultation (VTC) and telephone advice (TA) was provided for evaluation of acute stroke patients on a weekly rotation. The costs of the admissions process with or without one of both methods of telemedicine were calculated and compared from the perspective of the spoke hospital. Different levels of service and network size were modelled and costs of transfers as well as loss of revenues were calculated. Yearly total labour costs were 415,000 € for an on-site service VTC-service compared to 61,000 € in an on-call service. Additional costs for one teleconsultation were 109.55 € in VTC and 49.82 € in TA (VTC/TA ratio 2.2). The ratio decreased to 0.8 when accounting for costs of transfer and loss of reimbursement for all patients transferred as transfer of patients to the stroke centre was more frequent after TA (9.1 vs. 14.9%full-time on-site ser). Costs of one QALY gained by using VTC instead of TA ranged from 115.00 € to 515.86 € depending on the different models. In the first view TA looks like the less expensive method as it is easy to access and works without additional costs. When accounting for all disadvantages TA becomes slightly more expensive. In telestroke care VTC should be recommended as the method of choice also from an economic perspective.