Satisfaction Outcomes Research Articles

Enhancing complex bioprocess learning through simulation technology and hybrid teaching: A case study in university education.

The utilization of computer simulators in university education is progressively being embraced to offer students a practical exposure to industrial bioprocesses. Bioreactor computer simulators hold various advantages over conventional laboratory experiments, such as cost-effectiveness and enhanced safety. The research objective is to assess the effectiveness of integrating bioreactor computer simulators into hybrid teaching to promote active and collaborative learning experiences and evaluate their impact on student participation and understanding. A hybrid strategy combining synchronous, face-to-face, and online teaching has been implemented to enhance the teaching-learning processes in the Industrial Bioprocesses course for Biochemistry students. The simulation software BIOSTAT®T Yeast was used. This software models the production of ethanol with Saccharomyces cerevisiae through batch cultivation and the determination of the kLa value of a bioreactor. In the first simulation activity, students analyzed the software response based on parameter values input by the instructor, while in the second simulation activity, students autonomously used the computer simulator under the primary oversight of the instructor. The survey results indicate that the pedagogical innovation was positively received and significantly motivating for the students. Comparing student satisfaction surveys between the two simulation activities suggests that fostering student autonomy and engagement through simulation technology can improve satisfaction and learning outcomes in bioprocess education.

Robotic assisted Total Knee Arthroplasty (TKA) is not associated with increased patient satisfaction: a systematic review and meta-analysis.

Total knee arthroplasty (TKA) is a common orthopedic surgery, yet postoperative dissatisfaction persists in around 20% of cases. Robotic total knee arthroplasty (rTKA) promises enhanced precision, but its impact on patient satisfaction compared to conventional TKA remains controversial (cTKA). This systematic review aims to evaluate patient satisfaction post-rTKA and compare outcomes with cTKA. Papers from the following databases were identified and reviewed: PubMed, Scopus, Web of Science, and the Cochrane Online Library, using keywords like "Knee replacement," "Total knee arthroplasty," "Robotic," and "Patient satisfaction." Extracted data included patient satisfaction measures, Knee Society Score, Oxford Knee Score, Forgotten Joint Score, SF-36, HSS, and KOOS. Statistical analysis, including odds ratio and 95% CI was performed using R software. Heterogeneity was assessed using Cochrane's Q test. The systematic review included 17 articles, involving 1148 patients (571 in the rTKA group and 577 in the cTKA group) assessing patient satisfaction following rTKA. An analysis of proportions reveals rTKA satisfaction rate was 95%, while for cTKA, it was 91%. A meta-analysis comparing rTKA and cTKA found no statistically significant difference in patient satisfaction. Additionally, various patient-reported outcome measures (PROMs) were examined, showing mixed results across different studies and follow-up periods. The results of this study found no difference in patient satisfaction outcomes in the short to mid-term for rTKA compared to conventional methods. This study does not assert superiority for the robotic approach, highlighting the need for careful consideration of various factors influencing outcomes in knee arthroplasty.

Efficacy of Postoperative Opioid-Sparing Regimens for Hand Surgery: A Systematic Review of Randomized Controlled Trials

Multiple interventions have been implemented to reduce opioid prescribing in upper extremity surgery. However, few studies have evaluated pain relief and patient satisfaction as related to failure of these protocols. We sought to evaluate the efficacy of limited and nonopioid ("opioid-sparing") regimens for upper extremity surgery as it pertains to patient satisfaction, pain experienced, and need for additional refills/rescue analgesia. We aimed to systematically review randomized controlled trials of opioid-sparing approaches in upper extremity surgery. An initial search of studies evaluating opioid-sparing regimens after upper extremity surgery from the elbow distal yielded 1,320 studies, with nine meeting inclusion criteria. Patient demographics, surgery type, postoperative pain regimen, satisfaction measurements, and number of patients inadequately treated within each study were recorded. Outcomes were assessed using descriptive statistics. Nine randomized controlled trials with 1,480 patients were included. Six of nine studies (67%) reported superiority or equivalence of pain relief with nonopioid or limited opioid regimens. However, across all studies, 4.2% to 25% of patients were not adequately treated by the opioid-sparing protocols. This includes four of seven studies (57%) assessing number of medication refills or rescue analgesia reporting increased pill consumption, refills, or rescue dosing with limited/nonopioid regimens. Five of six studies (83%) reporting satisfaction outcomes found no difference in satisfaction with pain control, medication strength, and overall surgical experience using opioid-sparing regimens. Opioid-sparing regimens provide adequate pain relief for most upper extremity surgery patients. However, a meaningful number of patients on opioid-sparing regimens required greater medication refills and increased use of rescue analgesia. These patients also reported no difference in satisfaction compared with limited/nonopioid regimens. Therapeutic II.

Testing the model of judicial stress using a COVID-era survey of U.S. federal court personnel

Non-judicial court personnel, critical to a well-functioning justice system, experience overloaded dockets and the responsibility of making significant decisions, contributing to cognitive stress. Understanding and mitigating their stress is essential for maintaining judicial efficiency. We adapted Miller and Richardson’s Model of Judicial Stress to assess stress in a broad sample of non-judicial court personnel (n = 122), including judges, lawyers, and administrative staff. Participants responded to surveys about their stress levels, job performance, and health; they also completed cognitive performance tasks. The findings indicated that stress negatively affected employee outcomes including cognitive performance, job performance, job satisfaction, and health outcomes. Notably, perceived job performance had declined compared to the previous year, suggesting that the pandemic was an additional significant stressor. Based on the data, the Model of Judicial Stress is also applicable to other types of courtroom personnel, underlining its relevance across various judicial roles.

Insurer-Mandated Medication Utilization Barriers are Associated With Decreased Insurance Satisfaction and Adverse Clinical Outcomes: An Inflammatory Bowel Disease Partners Survey.

Insurer-mandated barriers to timely initiation of advanced therapies used to treat inflammatory bowel disease (IBD) have been shown to worsen clinical outcomes and increase healthcare utilization, yet rarely alter the medication ultimately prescribed. We conducted a survey within the IBD Partners longitudinal cohort to evaluate the frequency and patient-reported impacts of medication utilization barriers on insurance satisfaction and clinical outcomes. Barriers included medication denials, prior authorizations, and forced medication switches. Variables associated with insurance satisfaction, measured on a 1-7 Likert scale, were identified. The association between insurance-related barriers and downstream clinical outcomes (surgery, corticosteroid requirement, and disease activity) were evaluated. Two thousand seventeen patients (age 45 [interquartile range 34-58] years, 73% female) were included. Seventy-two percent experienced an insurer-mandated barrier, most commonly prior authorizations (51%). Fifteen percent were denied an IBD medication by their insurer, 22% experienced an insurance-related gap in therapy, and 8% were forced by their insurer to switch from an effective medication. Insurance satisfaction was negatively associated with medication denials, prior authorization-related delays, gaps in therapy, and high-deductible health plan coverage. In the year following the initial survey, several insurance barriers were linked to negative downstream clinical outcomes, including prior authorizations associated with corticosteroid rescue (odds ratio [OR] 2.24, 95% confidence interval [CI] 1.25-4.00), forced medication switches associated with continued disease activity (OR 3.28, 95% CI 1.56-6.89), and medication denials associated with IBD-related surgery (OR 8.92, 95% CI 1.97-40.39). These data illustrate the frequency and negative impacts of insurer-mandated medication barriers on patients with IBD, including decreased insurance satisfaction and negative downstream clinical outcomes.

Assessing Green Practices on Eco-Friendly Hotel Customer Loyalty: A Partial Least Squares Structural Equation Modeling and Fuzzy-Set Qualitative Comparative Analysis Hybrid Approach

With a global focus on environmental sustainability, hotels worldwide are actively transitioning their services from conventional to eco-friendly practices. This study aims to comprehensively understand the factors that contribute to visitors’ satisfaction in eco-friendly hotels and how this satisfaction influences customers’ future reactions towards such environmentally conscious establishments. Employing the Stimulus-Organism-Response theory, this study collected data from 277 respondents using a robust quantitative research strategy. A combined approach of Partial Least Squares Structural Equation Modeling (PLS-SEM) and Fuzzy-Set Qualitative Comparative Analysis (fsQCA) was employed, to uncover deep insights into visitors’ satisfaction and their reactions towards eco-friendly hotels. The PLS-SEM results reveal significant associations between customers’ satisfaction towards eco-friendly hotel services and service quality, green practices, perceived value, and environmental sensitivity. Moreover, this study highlights a positive correlation between satisfaction and crucial outcomes like revisit intention (RVI), willingness to pay a premium (WTPP), and word-of-mouth intention (WOMI). Complementing these findings, the fsQCA analysis uncovers intricate causal relationships among antecedents that influence customer satisfaction in eco-friendly hotels. By offering critical marketing insights, this study provides guidance for hotels, the tourism industry, and policymakers on attracting customers to eco-friendly hotels, to meet the increasing demands for environmental sustainability.

THE EFFECT OF OSTEOARTHRITIS GRADE ON PATIENT-REPORTED OUTCOME MEASURES AFTER TOTAL HIP ARTHROPLASTY: A SYSTEMATIC REVIEW AND META-ANALYSIS

Although total hip arthroplasty (THA) is beneficial for many patients with hip osteoarthritis (OA), a subset of patients experience minimal benefit. It is therefore pertinent to understand the predictors of poor functional outcome to facilitate shared decision making. One such predictor is preoperative radiographic OA severity. The aim of this systematic review was to determine whether preoperative radiographic OA severity could predict postoperative patient-reported outcome measures (PROMs) and satisfaction rates after THA.This systematic review was conducted according to PRISMA guidelines, and the protocol published in PROSPERO (ID:Â CRD42023445918). A literature search was performed using Embase, MEDLINE and Cochrane Library databases. Demographics, radiographic OA severity, PROMs, satisfaction, and complications after THA were collected. A meta-analysis was performed, where appropriate, using a random-effects model.Of 631 identified articles, 12 were included in the final analysis (8,034 participants; mean age 65.2, 38.1% male, mean BMI 29.1 kg/m2). There were three key findings. Firstly, those with mild OA are less likely to achieve a meaningful clinical improvement in PROMs (odds ratio (OR) 0.50, 95% confidence interval (CI) 0.38, 0.65; p < 0.00001). Secondly, two studies indicates that postoperative patient satisfaction was lower in participants with mild OA. Thirdly, participants with mild arthritis experience less improvement in SF-36 physical functioning (mean difference (MD) -8.31, 95% CI -10.97, -5.64; p < 0.00001) and role physical (MD -5.59, 95% CI -8.40, -2.77; p < 0.0001), but showed higher improvement in general health (MD 1.68, 95% CI 0.31, 3.06; p = 0.02).Patients with mild OA, as determined radiographically, are less likely to achieve meaningful clinical improvements in PROMs and have lower postoperative satisfaction after THA. This information will improve collaborative decision-making in the preoperative period.

Abstract PO3-23-04: Patient-reported outcomes and complication profiles of implant-based breast reconstruction in patients with postmastectomy radiation therapy

Abstract Objective: This study aims to investigate the patient-reported outcomes (PROs) and complications of distinct implant-based breast reconstruction (IBBR) modality for patients with postmastectomy radiation therapy (PMRT). Methods: A retrospective review was conducted on breast cancer patients with stage II-III disease who performed IBBR following with PMRT between September 2016 and April 2022. The patients were categorized into two matched groups: (1) patients receiving prepectoral breast reconstruction (PBR) or subpectoral breast reconstruction (SBR) followed by PMRT; (2) patients undergoing PMRT with the tissue expander (PMRT-TE) or permanent implant (PMRT-PI) groups. PROs were measured with BREAST-Q questionnaire. Early and late complications were recorded and analysed. Results: A total of 55 eligible patients were recruited. For PROs, patients underwent PBR reported significantly higher Satisfaction with Breasts scores (P = 0.003) compared with SBR group, and PMRT-TE group presented higher Satisfaction with Breasts (P = 0.001) but lower Physical Well-being (P = 0.029) scores compared with PMRT-PI group. Moreover, Patients in SBR cohort had a higher risk of capsular contracture (Baker grade III or IV) (20.5% vs 6.3%) and implant dislocation (48.7% vs 12.5%) than patients in PBR cohort. Patients in PMRT-PI group had a slightly higher rate of capsular contracture (Baker grade III or IV) than PMRT-TE group (20.8% vs 12.9%). Conclusions: PBR was associated with lower rates of late complications, especially for implant dislocation, and higher Satisfaction with Breasts scores compared to SBR. In addition, compared to PMRT-TE with PMRT-PI, patients in PMRT-TE cohort reported superior patient-reported outcomes of Satisfaction with Breasts. Table 1. Patient and Tumor Characteristics of 55 Patients Stratified with Prepectoral/Subpectoral and PMRT-TE/PMRT-PI Reconstructive Procedure. XX- XX Table 2. Patient-Reported BREAST-Q Scores XX- XX Table 3. Association of Reconstruction Techniques with Late Complications. XX- XX Citation Format: Jian Liu, Cong Chen, Honggang Chen, Aizhai Xiang, Ruzhen Zheng, Shufang Hu, Jufeng Guo, Li Qu, Jun Zhou, Jiong Wu. Patient-reported outcomes and complication profiles of implant-based breast reconstruction in patients with postmastectomy radiation therapy [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO3-23-04.

Assessment of Patient-reported Satisfaction and Metabolic Outcomes Following Initiation of the Second Generation of Flash Glucose Monitoring in Patients with Type 1 Diabetes.

This study aims to assess patient-reported satisfaction and metabolic outcomes following the initiation of the second generation of the Freestyle Libre 2 (FSL2) system in patients with type 1 diabetes (T1D). This non-randomized single-arm observation study was conducted on 86 patients with T1D living in Saudi Arabia, who were asked to wear the FSL2 for 12 weeks. The demographic data were collected at baseline, while the continuous glucose monitoring (CGM) metrics were gathered, i.e., Glucose Variability (GV) (%), mean Time in Range (TIR), Time Above Range (TAR), Time Below Range (TBR), and average duration of hypoglycemic events were collected at baseline, 6th week and 12 weeks. Further, the Continuous Glucose Monitoring Satisfaction (CGM-SAT) was collected at the end of the follow-up. Compared to the 6th week, significant differences were observed in the low glucose events (p = 0.037), % TIR (p = 0.045), and % below 70 mg/dL (p = 0.047) at 12 weeks. Improvement was seen in the other glucometric variables, but no significant changes were evident (p > 0.05). On completion of the study period, the ambulatory glucose profile (AGP) metrics showed a 74.3 ± 5.01 (mg/dL) FSL2 hypoglycemia alarm threshold and a 213 ± 38.1 (mg/dL) hyperglycemia alarm threshold. A majority of the patients stated that CGM-SAT had benefits (mean score > 3.58), although they felt FSL2 had 'additional benefits. With regard to the problems with the use of FSL2 majority of the patients stated that FSL2 has minimal discomfort. Using second-generation FSL2 in patients with T1D is positively associated with patient- reported satisfaction and metabolic outcomes.

A case of SIADH following uncomplicated mild traumatic brain injury: Did cognitive bias delay treatment?

Key Clinical MessageTo optimize clinical care, it is imperative for providers to recognize their own inherent cognitive biases and the impact that has on their clinical decision making, thereby minimizing complications such as prolonged hospitalization, unnecessary healthcare spending, and impaired patient satisfaction and functional outcomes.

AB029. SOH24AB_096. Health-related quality of life, patient satisfaction and surgical outcomes following deep inferior epigastric perforator reconstruction in low body mass index patients

AB029. SOH24AB_096. Health-related quality of life, patient satisfaction and surgical outcomes following deep inferior epigastric perforator reconstruction in low body mass index patients

Bilateral Implant-based Breast Reconstruction with Unilateral Radiotherapy: A Matched Cohort Study Comparing Nipple-sparing Mastectomy and Skin-sparing Mastectomy.

Nipple-sparing mastectomy (NSM) preserves the natural nipple-areola complex and entire native breast skin, with the goal of better cosmetic outcomes in breast reconstruction. In bilateral TE/implant-based reconstruction requiring unilateral postmastectomy radiotherapy (PMRT), progressive radiation-induced fibrosis can lead to increasing nipple asymmetry with cosmetic dissatisfaction. Thus, PMRT may ultimately negate the intended positive cosmetic value of NSM compared with skin-sparing mastectomy (SSM). This study compares (1) surgical complications, (2) patient satisfaction, and (3) aesthetic outcomes between NSM versus SSM in bilateral implant-based reconstruction with unilateral PMRT. This retrospective matched cohort study included consecutive NSM patients with bilateral TE/implant breast reconstruction + unilateral PMRT matched 1:2 to SSM group. Patients completed PMRT and TE exchange to implants. Demographics, oncologic stage, comorbidities, and complications were collected. Patient satisfaction was evaluated by BREAST-Q. Aesthetic outcomes were assessed by blinded reviewers with a five-point Likert scale. Among 58 patients who underwent bilateral TE/implant reconstruction with unilateral PMRT, 17 NSM patients were matched to 41 SSM patients by age, body mass index, and comorbidities. No significant differences existed in overall surgical complications and individual BREAST-Q questionnaire scores between cohorts. However, aesthetic outcomes scores were higher in SSM compared with NSM. Although NSM is generally associated with superior cosmetic outcomes compared with SSM, it has far less impact in bilateral implant-based breast reconstruction with unilateral PMRT due to the negative postradiotherapy effect on nipple symmetry.

Effective treatment of corticosteroid-induced facial erythema using fractional radiofrequency microneedling.

To investigate the efficacy of Fractional Radiofrequency Microneedling (FRM) in treating corticosteroid-induced facial erythema. A retrospective study was conducted involving eight patients diagnosed as corticosteroid-induced facial erythema. Each patient underwent a single session of FRM. Evaluative measures included Clinician's Erythema Assessment (CEA), Patient's Self-Assessment (PSA), assessment of telangiectasia severity, procedure-associated pain (10-point scale), patient satisfaction (3-point scale) and secondary outcomes. The study found a 75% success rate and 100% effectiveness rate in alleviating erythema symptoms. CEA and PSA scores decreased by 67.7% and 78.1%, respectively. No cases of erythema rebound were recorded during the 3-month follow-up period. FRM demonstrated effectiveness and safety in treating facial erythema, offering promising advancement in dermatologic therapeutics.

Unveiling Promising Modalities and Enhancing Patient Outcomes in Graves' Disease Treatment: A Systematic Review and Meta-Analysis.

Graves' disease (GD) is an autoimmune condition of the thyroid. The hyperthyroidism manifested by patients affected by this disease is caused by the production of autoantibodies against the thyroid-stimulating hormone (TSH, or thyrotropin) receptor (TSHR), which mimic the effects of the hormone on thyroid cells, thereby stimulating autonomic production of thyroxine and triiodothyronine. Deciding on a therapeutic approach to this condition presents intricate dilemmas for both clinicians and patients. Each of the three available treatment modalities is grounded in evidence-based medicine, affirming its efficacy. This systematic review and meta-analysis aimed to assess the effect of carbimazole (CBM), radioactive iodine (RAI), and surgery in treating GD and provide evidence-based recommendations for healthcare providers regarding the optimal management of the condition based on a comprehensive analysis of effectiveness, safety, patient satisfaction, and recovery outcomes. This systematic review and meta-analysis adhered to the Preferred Reporting Items for Systematic Reviews andMeta-Analyses (PRISMA) guidelines. We used the PubMed and Google Scholar databases to conduct a thorough web search for articles published between January 2019 and September 2023. The meta-analysis was carried out using Resource Manager (Revman) 5.4.1. The study found that propylthiouracil (PTU) ormethimazole/carbimazole (MMI/CBM) treatment increases the risk of hyperlipidemia in patients with hyperthyroidism. Once in a euthyroid state, glucose tolerance increases; for children with GD, a computer model for customized dosing has been created. To sum up, CBM, surgery, and RAI are all useful treatment options for GD. Using steroids in conjunction with radiation therapy may help prevent Graves' ophthalmopathy (GO).

EFFECTIVENESS OF THE BRADLEY METHOD ON LABOUR OUTCOME IN PRIMIGRAVIDA WOMEN

During pregnancy, women and birthing people build an entourage of support, including a birth companion of choice to provide individualised care by actively participating in the childbirth process. This article examines the Bradley Method, which teaches the birth companion (husband) to coach birthing people using hands-on approaches, including massages, breathing exercises, relaxation techniques and verbal encouragement and its effect on labour outcome, coping response and maternal satisfaction with the childbirth experience.

Intramuscular versus enteral penicillin prophylaxis to prevent progression of rheumatic heart disease: Study protocol for a noninferiority randomized trial (the GOALIE trial)

Rheumatic Heart Disease (RHD) persists as a major cardiovascular driver of mortality and morbidity among young people in low-and middle-income countries. Secondary antibiotic prophylaxis (SAP) with penicillin remains the cornerstone of RHD control, however, suboptimal treatment adherence undermines most secondary prevention programs. Many of the barriers to optimal SAP adherence are specific to the intramuscular form of penicillin and may potentially be overcome by use of oral penicillin. This noninferiority trial is comparing the efficacy of intramuscular to oral penicillin SAP to prevent progression of mild RHD at 2 years. The Intramuscular vs Enteral Penicillin Prophylaxis to Prevent Progression of Rheumatic Heart Disease (GOALIE) trial is randomizing Ugandan children aged 5 to 17 years identified by echocardiographic screening with mild RHD (Stage A or B as defined by 2023 World Heart Federation criteria) to Benzathine Benzyl Penicillin G (BPG arm, every-28-day intramuscular penicillin) or Phenoxymethyl Penicillin (Pen V arm, twice daily oral penicillin) for a period of 2 years. A blinded echocardiography adjudication panel of 3 RHD experts and 2 cardiologists is determining the echocardiographic stage of RHD at enrollment and will do the same at study completion by consensus review. Treatment adherence and study retention are supported through peer support groups and case management strategies. The primary outcome is the proportion of children in the Pen V arm who progress to more advanced RHD compared to those in the BPG arm. Secondary outcomes are patient-reported outcomes (treatment acceptance, satisfaction, and health related quality of life), costs, and cost-effectiveness of oral compared to intramuscular penicillin prophylaxis for RHD. A total sample size of 1,004 participants will provide 90% power to demonstrate noninferiority using a margin of 4% with allowance for 7% loss to follow-up. Participant enrollment commenced in October 2023 and final participant follow-up is expected in December 2026. The graphical abstract (Fig. 1) summarizes the flow of echocardiographic screening, participant enrollment and follow-up. The GOALIE trial is critical in global efforts to refine a pragmatic approach to secondary prevention for RHD control. GOALIE insists that the inferiority of oral penicillin be proven contemporarily and against the most important near-term clinical outcome of progression of RHD severity. This work also considers other factors that could influence the adoption of oral prophylaxis and change the calculus for acceptable efficacy including patient-reported outcomes and costs. ClinicalTrials.gov: NCT05693545.

EFFECTIVENESS OF EXERCISE VIA TELEHEALTH FOR CHRONIC DISEASE: UPDATED SYSTEMATIC REVIEW AND META-ANALYSIS OF EXERCISE INTERVENTIONS DELIVERED VIA VIDEOCONFERENCING

INTRODUCTION & AIMS Videoconferencing exercise interventions (VC) involve the synchronous and remote delivery of exercise via a video-linked appointment. A 2022 review investigated the effectiveness and feasibility of VC for people with chronic disease. Considering the emergence of recent trials, this review aimed to investigate these findings with high-quality contemporary evidence. METHODS Databases were searched from 1st August 2021 (last date searched in previous review) to April 30th 2023 for randomised controlled trials (RCTs) VC in chronic disease. Meta-analyses were conducted for between-group comparisons of exercise capacity and quality of life for RCTs to determine effectiveness. Standardised Mean Difference (SMD) for pre-post quality of life data was used to combine assessment methods. Feasibility was assessed via session attendance rates, adherence to exercise prescription, safety, technical issues and participant satisfaction. Risk of bias was analysed using the Downs & Black (D&B) quality checklist and the certainty of evidence with GRADE. RESULTS Sixteen trials were included in the updated review. RCT-only meta-analyses identified effects favouring VC for exercise capacity (6MWT; Mean Difference (MD)=31.0m (95% CI: 8.3 to 53.6m), p=0.007) and quality of life (SMD=0.365 (95% CI: 0.096 to 0.633), p=0.008) in studies with non-exercising comparators. An effect favouring VC was observed for quality of life in exercising comparator studies (SMD=0.335 (95% CI: 0.078 to 0.592), p=0.011) but not for exercise capacity (MD=4.6m (95% CI: -7.4 to 16.7m), p=0.451). The RCT-only analysis identified good risk of bias (D&B: 20.7±2.7/28), with GRADE certainty ratings of ‘Moderate’ for quality of life and exercise capacity outcomes. Of the new RCTs, session attendance was 74%, no serious adverse events related to VC were identified, 33% of sessions experienced technical issues and positive satisfaction outcomes were identified. CONCLUSION In patients with chronic disease, videoconferencing exercise interventions are feasible and effective for improving exercise capacity and quality of life.

Impact of Online Teaching and Learning on Perception, Satisfaction and Learning Outcome During COVID-19

The study was conducted to find the Impact of Online Teaching and Learning (OTAL) during COVID-19. Moreover, the perception, satisfaction and outcome were the major factors of the study. Study consisted of four objectives and four hypotheses. The population of the study comprised of the undergraduate students of the University of the Karachi. The sample consisted of 100 respondents who were randomly selected from the different departments of the University of Karachi. A questionnaire, consisted of 30 items, was developed and used for collecting data with five points likert scale. The questionnaire was filled using interview method. Responses were recorded by the researcher and tabulated for interpretation. The collected data were tabulated, calculated, analyzed, and interpreted in the light of objectives of the study. The findings reveal that though online learning was introduced due to Covid, but it had a positive impact on teaching /learning approaches at universities academia as well as students’ academic growth and development. The study will benefit all concerned stakeholders to improve teaching and develop students’ motivation for online engagement at the higher education level. The implications, limitations, discussion, and recommendations for future research will be incorporated. New themes were discussed, such as the use of artificial intelligence (AI) and blended learning approaches to improve the OTAL. Moreover, recording and uploading the lectures would also be beneficial for further use.

A Study on Consumer Perceptions Towards Telemedicine in Vadodara

A Study on Consumer Perceptions Towards Telemedicine in Vadodara

Examining the impact of sustainable leadership on green knowledge sharing and green learning: Understanding the roles of green innovation and green organisational performance

Despite the enhanced significance of leadership in the effectual transformation of universities towards sustainability, literature on the role and practices of sustainable leadership (SL) in higher education institutions (HEIs) remains scarce. To address this gap, this study investigated the direct effect of SL on teachers' green learning outcomes (green cognitive, social, self-growth, and satisfaction with university green experiences) in Chinese HEIs, guided by stakeholder theory. Green knowledge sharing was examined as a mediator between SL and green learning outcomes. The direct impact of teachers' green learning outcomes on green innovation (green speed and quality) and green organisational performance (customer green satisfaction, green curriculum development, green responsiveness, green research productivity, and green research ranking) were also analysed. This study also investigated whether green innovation fosters green performance in Chinese HEIs. A quantitative and cross-sectional research method was employed to analyse the data (N = 393). Partial least squares structural equation modelling (PLS-SEM) was applied to execute hypothetical relationships. The results showed that SL directly and positively affected green learning outcomes; however, green knowledge sharing enacted direct-only non-mediation between SL and green learning outcomes. Additionally, green learning outcomes endorsed a direct and positive relationship between green innovation and organisational performance. Similarly, a direct and positive association was found between green innovation and green organisational performance. This study focused on abandoned research, that is, the direct effect of SL on teachers' green learning outcomes in HEIs, revealing that teachers' green knowledge sharing, learning outcomes, and innovation are vital to their green organisational learning and performance. This study examined the direct effects of SL on teachers’ green learning outcomes in HEIs, which is unique to the sector. Further, the investigation of green knowledge sharing between SL and green learning outcomes is a novel contribution. Similarly, the combination of green learning outcomes, green innovation, and green performance in HEIs is original.