(1) Background: The increasing level of concern over reduction non-renewable resources, global warming, pollution, and social issues has led firms to initiate green and social activities. Furthermore, there is limited empirical evidence on the potential impact of green initiatives, corporate social responsibility (CSR), and reflective moral attentiveness (RMA) on sustainable performance. The purpose of this study was to investigate the mediating effect of reflective moral attentiveness (RMA) on the relationship between green supply-chain-management practices (GSCM) and CSR on sustainable performance. Based on the natural-resource-based view, stakeholder resource-based view, and signaling theory, this study investigated the role of GSCM practices and CSR in sustainable performance using cross-sectional data from the manufacturing and services industries from Khyber Pakhtunkhwa province, in Pakistan. (2) Methods: Using a non-probability convenience-sampling method, 500 employees were selected from the firms which are listed on the Pakistan stock exchange (PSE) and questionnaires were distributed. Complete questionnaires were received from 380 employees and used in the analysis, yielding a response rate of 76%. Partial least squares structural equation modeling (PLS-SEM) software was used for the confirmatory-factor analysis (CFA) and the testing of the hypotheses. The CFA results revealed the reliability and validity of the questionnaires. (3) Results: The results of the structural model (hypotheses testing) show that four attributes of GSCM practices (internal environmental management, green purchasing, cooperation with customers, and eco-design) have a positive influence on sustainable performance, while investment recovery and CSR were found to be insignificant. Moreover, there were significant and positive influences of GSCM and RMA on sustainable performance. On the other hand, control variables, such as gender, experience, and age, were found to have no significant role in sustainable performance. A further analysis revealed that reflective moral attentiveness mediated the relationship between GSCM, CSR, and sustainable performance. (4) Conclusions/implications: This study has several implications for green services and manufacturing firms specifically and for practitioners, researchers and academics in general. The innovation and novelty of this study lie in its determination of the contribution of RMA, GSCM, and CSR to achieving sustainable performance. Firms can improve their clean production activities by incorporating this model as a strategy. Future studies may add moderators and mediators to explore the impact of CSR and GSCM practices upon sustainability.

The present study was planned to test the hypothesis that feeding lactating dairy cattle with varying levels of rumen-undegradable protein (RUP) can enhance protein utilization, milk production, milk protein, and nitrogen (N) excretion. Forty mid-lactating crossbred (Jersey × Friesian) cattle were randomly divided into four groups. Four treatment diets were formulated to contain 30%, 40%, 50%, and 60% RUP of crude protein. Dry matter (DM) and crude protein intakes were significantly reduced with increasing dietary RUP levels. Crude protein digestibility increased linearly with incremental increases in dietary RUP levels. Cattle fed 60% RUP showed a linear decrease in N intake compared to that in the other groups. A linear decrease in urinary N and linear increases in net N, milk N, and N-use efficiency were observed with increasing dietary RUP levels. Actual milk, energy-corrected milk, and 4% fat-corrected milk yields (kg/day) increased linearly with an increasing degradability of protein. However, milk protein, solids not fat and total solids, as well as the yields of protein, fat, and lactose, showed significant increases with increased RUP supplementation. Collectively, the results indicate that formulating dairy cow diets to contain 60% RUP results in better lactating performance and N-use efficiency and lower N excretion.

Objective: This study investigated Pakistani physicians’ decision-making concerning their decisions to stay in Pakistan, migrate abroad, or resettle back into their country after working abroad. Methods: This qualitative study employed a phenomenological research design. Thirteen Pakistani physicians characterised as ‘stayers’, ‘leavers’ and ‘resettlers’ were interviewed via telephone to explore their lived experience in 2008-2009. Results: Results show a dynamic nature of the physicians’ career decision-making depending on their constant weighing of complex personal, family, professional and societal factors. Stayers, leavers and resettlers are not mutually exclusive groups but rather individual physicians’ can move between these groups at different stages of career and life. Physicians vary in their decision making. Stayers and resettlers place more emphasis on personal and family reasons and societal factors providing there is a permanent job for them. Leavers focus on health system problems and recent societal problems of personal and societal insecurity. Conclusions: The findings of this study indicates that physician migration, retention and resettlement is a complex issue and there are multiple personal, social, political and economic factors that affect their decisions to stay, move abroad or resettle back into their countries. Therefore, it is recommended that future research focusing on health workers retention, migration and resettlement issues look at it from a holistic perspective rather than focusing only on the economic and professional imperatives. The findings of this study have international implications for health care managers dealing with a highly mobile international medical workforce. Strategies considering different stages of the physician career/ life cycle need to highlight the importance of identity, belonging and place as doctors weigh this with career goals.

For quality decision-making, the provision of accurate information to physicians and consultants is crucial, and this can only be possible by adopting the e-health applications and digitalization of health data. For health information data management, the adoption and implementation of electronic health records (EHRs) is essential. The purpose of this paper is to investigate the factors that are instrumental for the adoption of electronic health records (EHRs) systems in Saudi Arabia. The population of this study was project directors, general managers, directors, analysts, and the Ministry of Health (MOH) in Saudi Arabia. A survey approach research design was used. Non-probability convenience sampling was used. Convenient sampling allows the researchers to have whoever is willing and available participate in the study survey. Data was collected from project directors, directors, analysts, and supervisors. SPSS was used for statistical data analysis. Frequencies, percentages, and mean standard deviation were reported, and correlations were run to test the hypothesis. It was concluded that except for demographic variables, which were not correlated with resources, end-users, technology, knowledge, values and goals, process, management structure, and administrative support, all other constructs correlated significantly. This study is a valuable extension of knowledge regarding the adoption of EHRs in Saudi Arabia’s healthcare organizations.