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In this article, the authors analyse a complex social process affecting historic public paths in rural areas in southern Spain. Despite the fact that urban populations are demanding the enhancement of this type of natural heritage for tourism, sports and recreational use, some parts of the network have been abandoned or usurped.

The study is multidisciplinary, comprising three interlinked studies. The cartographic study comprises an inventory of public paths in rural areas based on administrative sources. The legal study analyses local, regional and national regulations governing agricultural, environmental, heritage, sports and tourism uses of the infrastructure. The sociological study analyses social discourses on the uses of public paths, and identifies conflicts between farmers, landowners, environmentalists, sportspeople and tourists.

The preliminary results identified an important public paths network in Andalusia, approximately 160,000 km. The legal study found that there are laws regulating use, although local authorities do not monitor compliance or provide solutions to enhance management. The sociological study determined the attribution of environmental, cultural and economic value to public paths, but also the existence of conflicts between rural and urban populations.

Given that this is ongoing research, only state of the art and some preliminary albeit sufficiently consistent results are presented.

The results could help to guide public policy and governance of public paths.

Public paths promote rural development and a green/sustainable economy.

The research results and conclusions are original.

This study aims to examine how an educational intervention, using the lens of the LEADS framework, can influence the development of primary care doctors’ leadership skills in Aceh, Indonesia. In order to persevere in the face of inadequate resources and infrastructure, particularly in rural and remote settings of low- and middle‐income countries, physicians require strong leadership skills. However, there is a lack of information on leadership development in these settings.

This study applied an educational intervention consisting of a two-day workshop. The authors evaluated the impact of the workshop on participants’ knowledge and skill by combining quantitative pre- and post-intervention questionnaires (based on Levels 1 and 2 of Kirkpatrick’s model) with qualitative post-intervention in-depth interviews, using a phenomenological approach and thematic analysis.

The workshop yielded positive results, as evidenced by participants’ increased confidence to apply and use the information and skills acquired during the workshop. Critical success factors were as follows: participants were curiosity-driven; the use of multiple learning methodologies that attracted participants; and the use of authentic scenarios as a critical feature of the program.

The intervention may offer a preliminary model for improving physician leadership skills in rural and remote settings by incorporating multiple teaching approaches and considering local cultural norms.

The escalating levels of greenhouse gas emissions have become a growing global concern, with household energy consumption emerging as a significant contributor. To develop effective public policies, it is crucial to understand the energy-saving behavior of households. This study delves into the determinants of energy-saving practices in a developing country.

The authors chose a multivariate probit model, as it allowed to look after possible correlations among seven energy-saving practices within households.

The findings underscore the significant influence of sociodemographic variables, such as gender, civil status, income and education, on energy-saving practices. Furthermore, the authors discovered that households where the head actively volunteers in social organizations are more likely to adopt energy-saving behaviors. Additionally, internet access positively contributes to pro-environmental behavior. This research reveals that certain energy-saving practices are interconnected, acting as complements or substitutes.

Recommendations for public policy include prioritizing education in rural areas to boost energy-saving practices, improving internet access in nonurban regions and promoting citizen involvement in social organizations to enhance environmental awareness and encourage energy-saving behavior. The authors contribute to literature evidencing that certain energy-saving practices are not independent of each other, they are rather complementary and, in some cases, substitutes.

Recommendations for public policy include prioritizing education in rural areas to boost energy-saving practices, improving Internet access in nonurban regions and promoting citizen involvement in social organizations to enhance environmental awareness and encourage energy-saving behavior.

Previous studies have overlooked these interdependencies, highlighting the necessity of a system of equations to yield more efficient estimates by considering correlations between error terms.

This study aims to facilitate access to vascular disease screening for low-income individuals living in remote and conflict areas based on the results of a pilot trial in Colombia. Also, to increase the amount of diagnosis training of vascular surgery (VS) in civilians.

The operation method includes five stages: strategy development and adjustment; translation of the strategy into a real-world setting; operation logistics planning; strategy analysis and adoption. The operation plan worked efficiently in this study’s sample. It demonstrated high sensibility, efficiency and safety in a real-world setting.

The authors developed and implemented a flow model operating plan for screening vascular pathologies in low-income patients pro bono without proper access to vascular health care. A total of 140 patients from rural areas in Colombia were recruited to a controlled screening session where they underwent serial noninvasive ultrasound assessments conducted by health professionals of different training stages in VS.

The plan was designed to be implemented in remote, conflict areas with limited access to VS care. Vascular injuries are critically important and common among civilians and military forces in regions with active armed conflicts. As this strategy can be modified and adapted to different medical specialties and geographic areas, the authors recommend checking the related legislation and legal aspects of the intended areas where we will implement this tool.

Different sub-specialties can implement the described method to be translated into significant areas of medicine, as the authors can adjust the deployment and execution for the assessment in peripheral areas, conflict zones and other public health crises that require a faster response. This is necessary, as the amount of training to which VS trainees are exposed is low. A simulated exercise offers a novel opportunity to enhance their current diagnostic skills using ultrasound in a controlled environment.

Evaluating and assessing patients with limited access to vascular medicine and other specialties can decrease the burden of vascular disease and related complications and increase the number of treatments available for remote communities.

It is essential to assess the most significant number of patients and treat them according to their triage designation. This management is similar to assessment in remote areas without access to a proper VS consult. The authors were able to determine, classify and redirect to therapeutic interventions the patients with positive findings in remote areas with a fast deployment methodology in VS.

Access to health care is limited due to multiple barriers and the assessment and response, especially in peripheral areas that require a highly skilled team of medical professionals and related equipment. The authors tested a novel mobile assessment tool for remote and conflict areas in a rural zone of Colombia.

This study aims to assess the online presence of three Portuguese low-density territories and analyze the communication strategies employed by public and private entities within each municipality. The alignment between public and private entities within each municipality is also examined as a potential factor that could impact the effectiveness of digital communication strategies.

A qualitative methodology that employed content analysis and interviews to gather data from selected public and private entities in each of the municipalities under study was used.

Despite the widespread availability of digital communication tools, the municipalities under study are yet to fully exploit their potential to promote and publicize their offerings. This could be attributed to several factors such as a lack of knowledge and/or resources and a defective strategic approach to digital communication.

The major obstacle in maximizing the potential of digital communication tools in low-density destinations was not solely a result of restricted access. Rather, it was largely due to insufficient knowledge and resources required for their effective utilization, coupled with a lack of aligned vision among various stakeholders.

The competitive landscape in which tourist actors operate has transformed significantly because of the widespread adoption of digital communication led by social networks. However, studies exploring digital communication in low-density territories are still scarce. This study adds new insights into the main factors that hinder the efficient use of digital communication in these regions.

Research on online user privacy shows that empirical evidence on how privacy literacy relates to users' information privacy empowerment is missing. To fill this gap, this paper investigated the respective influence of two primary dimensions of online privacy literacy – namely declarative and procedural knowledge – on online users' information privacy empowerment.

An empirical analysis is conducted using a dataset collected in Europe. This survey was conducted in 2019 among 27,524 representative respondents of the European population.

The main results show that users' procedural knowledge is positively linked to users' privacy empowerment. The relationship between users' declarative knowledge and users' privacy empowerment is partially supported. While greater awareness about firms and organizations practices in terms of data collections and further uses conditions was found to be significantly associated with increased users' privacy empowerment, unpredictably, results revealed that the awareness about the GDPR and user’s privacy empowerment are negatively associated. The empirical findings reveal also that greater online privacy literacy is associated with heightened users' information privacy empowerment.

While few advanced studies made systematic efforts to measure changes occurred on websites since the GDPR enforcement, it remains unclear, however, how individuals perceive, understand and apply the GDPR rights/guarantees and their likelihood to strengthen users' information privacy control. Therefore, this paper contributes empirically to understanding how online users' privacy literacy shaped by both users' declarative and procedural knowledge is likely to affect users' information privacy empowerment. The study empirically investigates the effectiveness of the GDPR in raising users' information privacy empowerment from user-based perspective. Results stress the importance of greater transparency of data tracking and processing decisions made by online businesses and services to strengthen users' control over information privacy. Study findings also put emphasis on the crucial need for more educational efforts to raise users' awareness about the GDPR rights/guarantees related to data protection. Empirical findings also show that users who are more likely to adopt self-protective approaches to reinforce personal data privacy are more likely to perceive greater control over personal data. A broad implication of this finding for practitioners and E-businesses stresses the need for empowering users with adequate privacy protection tools to ensure more confidential transactions.

The purpose of this study is to examine the effect of polarisation on trust in government.

The authors use the ordered probit technique to model trust as a function of polarisation and various control variables. The authors apply the instrumental variables approach to address potential endogeneity in polarisation, using ethnic diversity as an instrument.

The results reveal that an increase in polarisation reduces trust in central government. However, trust in local government is non-responsive to this polarisation. The estimations controlled for government performance, and the authors found a positive association between government performance and trust in government, which, however, does not alter the relationship between polarisation and trust in government.

In ethnically polarised nations, policymakers should consider decentralisation measures. This can help sustain trust and development support, particularly in regions where citizens prioritise ethnicity over nationality.

The social implications of this research underscore the importance of promoting trust in government to foster social cohesion and stability, particularly in ethnically diverse societies.

The authors find that increased ethnic polarisation reduces trust in the central government, particularly among those prioritising their ethnicity over nationality. This adds a non-performance dimension to government trust literature, suggesting that policies focusing solely on performance may yield limited results. The research extends beyond central government trust to include local governments. Unlike central government, local government trust remains tied to performance attributes unaffected by polarisation. Hence, investing resources through local governments is a viable strategy for enhancing citizen support while mitigating polarisation’s adverse effects.

This paper aims to explore the rationale, the process and the outcomes and risks of place branding in rural China.

An in-depth case study analysis, including interviews, has been conducted.

Place branding in the case of China is practiced and dominated through administrative entities by using subsidies and regional development programs to coordinate, organize and promote local agricultural resources. Although this government-led place branding has effective effects on rural development, it is unsustainable and unstable because it lacks sufficient market and stakeholder participation.

The effectiveness of place branding in China has been examined and proved.

The government’s role in place branding in China should be adjusted. The government should position itself as a service and auxiliary role. Simultaneously, it should strengthen market-oriented operations and stakeholder participation in place branding.

This paper is one of the first contributions to examine the impact of place branding as a rural development policy tool in China, and the in-depth case study examines and proves the effectiveness of place branding in rural China.

The purpose of this study is shed light on the underlying forces behind entrepreneurship within a regional innovation system (RIS) in a remote rural region. The authors examine the following questions: Which are the main underlying forces behind the entrepreneurial process in a rural RIS characterized by traditionally low-tech, small-scale businesses? How can the development of a low-tech regional innovation system be conceptualized?

The design of the study is based on entrepreneurship theory. Data analysis followed practices used in phenomenography, a research approach used to analyse and identify commonalities and variations in populations' perceptions of a certain phenomenon. Data are composed using semi-structured interviews and a database composed of company information of all firms in the population.

A proactive mobilization of regional stakeholders and resources can be an important driving force behind the entrepreneurial process and generation of a rural RIS. Innovation can be generated within low-tech industries turning the rural context into an asset. An RIS in a remote rural context can be initiated and orchestrated by regional authorities, but knowledge brokering and orchestration can also be managed by networks of small-scale businesses brought together by mutual benefit and common interests.

Regional innovation systems theory is most often used to study high-tech industries. But by combining regional innovation systems with rural entrepreneurship and entrepreneurship context theory is a fruitful avenue to understand the role of rural entrepreneurship in regional development, even in remote and peripheral regions. Innovation does not need to entail high-tech international environments; it can appear as the result of efforts in low-tech industries in rural and remote environments. The authors’ findings need to be scrutinized; therefore, the authors call for more research on regional innovation systems in rural environments.

It is possible for regional authorities to orchestrate a development process through the actions of a strong regional agent but also by supporting the creation of networks of small businesses that are built on trust and common interests.

This study contributes to the literature with a new perspective to the study of entrepreneurship and of regional innovation systems. Entrepreneurship research with focus on rural contexts most often highlight limits to entrepreneurship and see entrepreneurship as “just running a business”. A perspective that starts from innovation and innovative behaviour, despite the rural context and embedded resources, helps to generate new knowledge that can enrich the understanding of entrepreneurship and also be the foundation for more precise business development policies in rural settings.

As healthcare continues to become more expensive and complex, considering the voice of the patient in the design and operation of healthcare practices is important. Wound care and rural healthcare scenarios pose additional complexities for providers and patients. This study sought to identify key determinants of patient service quality in wound care.

Patients at the wound care/ostomy clinic (WOC) in a rural hospital were surveyed using the Kano model. The Kano model enables the categorization of quality attributes based on the attributes' contribution to the subject's overall satisfaction (and dissatisfaction). Chi-square goodness-of-fit testing, multinomial analysis and power analysis were then used to determine the Kano categories for each satisfaction-related attribute.

The analyses resulted in 14 one-dimensional attributes and 3 indeterminable attributes. For the one-dimensional attributes, customer satisfaction is directly proportional to the level of performance for that attribute. The one-dimensional attributes included providing correct care on the first, provision of necessary supplies for care, appropriately qualified medical staff and confidence in care provided by medical staff, among others. Understanding the attributes important to the patient drive patient-centered care, which improves positive patient outcomes and recovery. These attributes can then be used by healthcare professionals to design patient-centric processes and services. This research provides a framework for incorporating the voice of the patient into healthcare services.

While the research methodology can be used in other healthcare settings, the findings are not generalizable to other wound care clinics. This research was conducted in one small, rural hospital. In addition, the sample size was small due to the size of the wound clinic; therefore, an analysis of the differences between demographics could not be performed.

Considering the perspectives of rural wound care patients is important, as the patients are an under-served population with unique challenges related to patient care. The research findings detail rural patients' expectations during wound care treatments, which enable the clinic to focus on improving patient satisfaction. This research contributes to understanding the factors that are important to patient satisfaction in wound care. Further, the methodology presented can be applied to other healthcare settings.

While studies exist using the Kano model in healthcare and the literature is sparse in rural healthcare, this is the first case study using the Kano model in wound care to understand patient preferences.