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The purpose of this study was to examine the relationships between transformational leadership (TL), structural empowerment (SE), job satisfaction (JS), nurse-assessed adverse patient outcomes (APO), and the quality of care (QOC). The study further investigates the mediating effects of SE and JS on TL-APO and TL-QOC relationships. A total of 600 nurses working at 17 government hospitals in Pakistan completed the survey. The hypothesized model was tested using a confirmatory factor analysis and structural equation modeling. We found a positive relationship between TL, SE, JS, and QOC but negative relationships between TL and APO, SE and APO, and JS and APO. Our study further suggests that SE and JS strongly mediate both TL-APO and TL-QOC relationships.

Pakistan holds an important geographical status, but extremism and sabotage have severely damaged the tourism industry. In the present study, we examined the impact of destination image (DI) on tourist loyalty (TL) and intension to visit (IV) in Pakistan. Additionally, the study analyzed the mediation effects of electronic word of mouth (eWOM) and tourist satisfaction (TS) on these relationships. Data was collected from 780 tourists in Pakistan. We used confirmatory factor analysis (CFA) and structural equation modeling (SEM) to obtain the results. Our results demonstrated the positive relationships among DI, eWOM, TS, TL, and IV. This study also disclosed that eWOM has a partial mediation effect on the DI–TL relationship, and both eWOM and TS fully mediate the association between DI and IV. Hence, tourist satisfaction can be enhanced by eWOM and destination image, which directly effect tourist loyalty and intention to visit in Pakistan. The proposed framework and research findings will help stakeholders significantly to recognize the multi-facet association in the tourism industry of Pakistan. Testing the above relationships through multiple mediators is a relatively novel idea.

In Pakistan, as in other developing countries, rural women make ample contributions to the economy through vital productive and reproductive roles. This study aimed to evaluate the impact of women’s traditional economic activities that supplement their household economy directly through earning income and indirectly through savings expenditure and to assess the factors that influence their productivity performance. For this purpose, six rural areas from Khyber, which is located in the Pukhtoonkhwah province, were chosen to represent the south, north, and the central plain regions. About 480 women responded out of 600, which were selected using a snowball sampling technique from the entire three regions. The data was collected by conducting face-to-face interviews and focus group discussions (FGDs). About 68.33% respondents were illiterate, 47.71% were 31 to 40 years old, and 47.92% lived in a joint family system. Due to the strict Purdah (veil) culture, about 71.88% of the women’s economic activities were confined indoors, such as stitching; embroidery; basket and candle making; preparing pickles, jams, and squash; dairy products; apiculture; sericulture; livestock; poultry; nursery raising; and some agriculture-related off-farm activities. It was reported that the major decisions in the household are made by the male members due to the strong patriarchal norms and values. Development projects by the NGOs and the government have played a significant role to provide credit, training, and awareness that has arisen specifically in the north and the south regions. All of the women were aware of the positive effects of economic independence, but some of them also revealed the negative effects on their physical and psychological health as well as the social ties within the households and communities due to the extensive workload and time issues. The study concluded that many demographic social, cultural, religious, and economic factors negatively influence the women’s productive potential.

This paper aimed to investigate the relationships between participative leadership (PL), administrative quality (AQ), medical quality (MQ), and patient satisfaction (PS) using the Malcolm Baldrige National Quality Award Healthcare Criteria (MBNQA) criteria. The study further examined the intervening influence of administrative quality and medical quality on the relationship between participative leadership and patient satisfaction. The data was obtained from 123 public sector hospitals in Pakistan. We employed confirmatory factor analysis (CFA) and structural equation modeling (SEM) techniques to test the structural model. From the study results, we found significant and positive relationships between participative, administrative quality, medical quality, and patient satisfaction. In addition, our research found administrative quality and medical quality as potential mediators on PL-PS relation. Adopting participative leadership as an exogenous factor, and both administrative and medical quality as potential mediators of patient satisfaction, provided new insights into MBNQA criteria.