Health region development from the perspective of system theory - An empirical cross-regional case study

Governments are increasingly establishing health regions to deal with current challenges of public health service. These regions are seen as instruments to balance public and private stakeholders, and offer health care to regional citizens as well as to medical/health tourists. However, it is still unclear how the development of such health regions as well as their governance may be conceptualized. We apply Luhmann's system theory approach in the context of a cross-regional case study that compares health region developments in the Autonomous Province of Bolzano-South Tyrol (Italy) with particular regard to the Eastern Dolomites and in the province of Zeeland (the Netherlands). We suggest that Luhmann's system theory provides a useful set of criteria to evaluate and judge health region development. Fully developed health regions can be understood as auto-poietic systems. By emphasizing programs, personnel, and communication channels, these case studies illustrate the suitability of the system theory toolset to analyze the governance and spatial embeddedness of health regions. Additionally, the study contributes to literature by indicating that health regions are closely related to identity issues and to decision making in regions

Cooperative core competencies in tourism: Combining resource-based and relational approaches in destination governance

Community-based tourist destinations can be understood as networks of tourism service providers, which need to combine their resources and competencies to generate the overall holiday experience. Building on strategic management theories, the study aims at exploring the relationship between the destinations management’s reflexive capabilities and the cooperative core competencies of a tourist destination. By means of reflexive capabilities, destination management is suggested to be able to induce a high level of network quality, which in turn may be a pre-condition for the interlacing of the service providers’ competencies and resources, i.e. for the development of cooperative core competencies. Based on a quantitative survey in Bavaria, the results support these assumptions and indicate that reflexive capabilities may promote the development of cooperative core competencies in tourist destinations. The paper advances tourism literature by introducing, operationalizing and testing the idea of cooperative core competencies in the context of tourist destinations

On-Chip Contactless Four-Electrode Conductivity Detection for Capillary Electrophoresis Devices

In this contribution, a capillary electrophoresis microdevice with an integrated on-chip contactless fourelectrode conductivity detector is presented. A 6-cm-long, 70-µm-wide, and 20-µm-deep channel was etched in a glass substrate that was bonded to a second glass substrate in order to form a sealed channel. Four contactless electrodes (metal electrodes covered by 30-nm silicon carbide) were deposited and patterned on the second glass substrate for on-chip conductivity detection. Contactless conductivity detection was performed in either a two-or a four-electrode configuration. Experimental results confirmed the improved characteristics of the fourelectrode configuration over the classical two-electrode detection setup. The four-electrode configuration allows for sensitive detection for varying carrier-electrolyte background conductivity without the need for adjustment of the measurement frequency. Reproducible electrophoretic separations of three inorganic cations (K + , Na + , Li + ) and six organic acids are presented. Detection as low as 5 µM for potassium was demonstrated. In the development and optimization of miniaturized analytical systems, a delicate combination of science and technology originating from microelectronic device fabrication, electrical engineering, and analytical chemistry is essential. In this multidisciplinary field, microtechnology experts combine the demands from analytical chemistry and electronic instrumentation in the design and fabrication of novel analytical devices. 1,2 Chemical analysis systems, such as high-performance liquid chromatography (HPLC) or capillary electrophoresis (CE), always consist of the combination of a separation and a detection system. For separation, CE or CE-based separation techniques are highly suitable for implementation on the microchip format. Electrokinetic control of fluid transport eliminates the need for external components such as pumps and valves. The separation efficiency is relatively independent of the separation path length and is, therefore, more compatible with miniaturization than, for instance, chromatographic techniques. As far as detection is concerned, laser-induced fluorescence (LIF) is, at present, the most widely used detection technique in miniaturized analysis systems because of its high sensitivity. The drawbacks of LIF are its limited compatibility with miniaturization and on-chip integration and the requirement for labeling of most (bio) chemically relevant compounds. External devices such as the relatively large laser and the photodetector system strongly prohibit further miniaturization. The development of alternative detection methods compatible with miniaturization and full onchip integration is highly desirable. Since electrode deposition is a well-established process in microfabrication, the implementation of detection techniques utilizing integrated electrodes has become an attractive approach. Successful coupling of conventional CE with potentiometry, 3 amperometry, 4,5 and conductometry 6-10 has been reported in the literature. In addition, both amperometric and potentiometric detection were also implemented in chip-based CE systems. [11][12][13] The primary advantage of amperometric and potentiometric detection over conductivity detection is the high selectivity induced by the electrochemical reactions that take place at the electrode surface. Only electrochemically active compounds * Corresponding author: (tel) +31 (0) 15 278 6518; (fax) +31 (0) 15 278 5755