During the Trump administration it was widely asserted in the news media that the administration\'s agency appointees were less professional than appointees from previous administrations. Using qualitative data from 35 interviews with lobbyists, congressional staffers, and executive branch officials, and quantitative and qualitative data on years of relevant experience and job type at the date of nomination, it is demonstrated that indeed the Trump administration attracted less talent than the Obama and Biden administrations, which resulted in less supply and demand for expertise and thus a diminished role of expertise in the policymaking process.

Chatbots, an integral part of Digitalization, are becoming the cornerstone of modern-day marketing practices. This study\'s main objective is to identify the Chabot traits that have a bearing on users\' confidence, acceptability, and engagement. Chatbots hold much potential for customer support in terms of service efficiency, cost savings, and customer experience. In addition to saving business costs, chatbots improve customer engagement, by reducing time and effort they need to spend in doing their business transactions. Aspiring, well-educated, and tech-savvy Gen Z customers perceive chatbots as highly compatible with their preferred method of seeking product-related information. As chatbots play a significant role in the marketing process, this study aims to identify the chatbot traits that influence customers\' confidence, acceptance, and engagement with chatbots. Using the PLS-SEM tool/technique we computed a structural equation measurement model to test the traits leading to Chabot trust. The study also found that perceived ease of use, performance expectations, and social influence of chatbots are all greatly enhanced by trust on the part of the customers. Detailed statistical analysis showed that the trust that consumers have in chatbots strongly influences consumers\' intentions, loyalty, and engagement levels. While gender had no impact on consumer intentions to use chatbots, the age of the respondents played a substantial role in their plans to use chatbots.

BACKGROUND: Hospitals use Press Ganey surveys to evaluate patient satisfaction. The goal of our study was to evaluate whether surgeon-driven gifting to patients postoperatively affects Press Ganey Survey responses.
METHODS: There were 1,468 patients undergoing arthroplasty at our institution who were randomized to receive a thank-you gift, a small bouquet of flowers, and a note from their provider after surgery, or nothing for completing their preoperative arthroplasty registry questionnaire. Press Ganey surveys were sent to patients who received and did not receive flowers immediately after their hospital stay and after the patients\' first postoperative visit. Scores were reported as the mean score and the fraction of responses with a top-box rating. One-sided student t-tests and Fisher\'s exact tests were used to assess statistical significance.
RESULTS: Hospital Discharge: Patients who received flowers had higher Press Ganey survey scores than patients who did not receive flowers. For example, for \"physician\'s concerns for questions,\" they had higher scores (mean difference: 3.7 ± 1.6 points, P = .012) and a 9% higher top-box rating (P = .032). For \"staff attitude toward visitors,\" they also had higher scores (mean difference: 2.8 ± 1.3 points, P = .019) and a 7% higher top-box rating (P = .049). First Follow-up: Patients who received flowers had a higher top-box rating for \"concern provider showed for questions\" and \"amount of time provider spent with you\" by 6% (P = .046) and 11% (P = .009), respectively. They also had higher scores for \"information provider gave about medications\" (mean difference: 4.0 ± 1.6 points, P = .009) and 11% higher top-box rating (P = .006).
CONCLUSIONS: Press Ganey Surveys were higher in orthopaedic patients who received bouquets of flowers from their arthroplasty surgeons compared to patients who did not. At follow-up, improved Press Ganey scores persisted if the patient received flowers. The gift of flowers generates patient loyalty to their surgeon.

Doctor-patient communication is pivotal for the delivery of effective health care, patient satisfaction and retention, and the development of patient loyalty to the provider. However, the interactional dynamics of loyalty in real-life communication are left underexplored. In this regard, this study aims to examine and analyze loyalty in naturally occurring routine chronic encounters. Based on audio-recordings collected in a state-run tier-three hospital in China, the study uses conversation analysis to examine the sequential placement of loyalty display and its interactional functions in different environments. The findings report two sequential environments where loyalty display emerges: the opening and closing phases. The findings also show that loyalty is mainly produced by the patient to display affiliation and commitment, indicate their preferred treatment options, and rekindle a disconnected relationship. This work contributes to a more nuanced understanding of loyalty display in service and institutional encounters.

Amidst the burgeoning interest in rural Intangible Cultural Heritage (ICH) tourism, this study, anchored in the Stimulus-Organism-Response (S-O-R) theoretical framework, chose Meizhou Island in Fujian Province as a case study to examine the impacts of tourists\' perceptions of authenticity and their engagement levels on the destination image and loyalty towards rural ICH tourism. Utilizing Structural Equation Modeling (SEM) to analyze survey data, findings revealed that higher perceptions of a destination\'s preservation of original characteristics and traditional values correlate with a more favorable overall perception of the destination, albeit with smaller impact on emotional connections. Conversely, depth of tourist engagement was shown to enhance both understanding and emotional bonds with the destination. Further, familiarity with the destination was found to foster affection, thereby increasing the likelihood of repeat visits or recommendations. The more tourists know about a place, perceiving it as authentic, the more likely they are to remain loyal; similarly, deeper engagement enhances understanding and affection, increasing the probability of revisiting or recommending the place. These outcomes not only offer new insights into tourist behavior but also provide theoretical and practical guidance for the protection and development of rural ICH tourism, destination marketing, and management strategies, thus promoting the sustainable development of rural ICH tourism.

This study examines user engagement and loyalty in mobile applications for restaurant home deliveries during the COVID-19 pandemic. It explores the concepts of loyalty, engagement, and interactivity, with convenience and safety as drivers for continued use. Using Partial Least Squares Structural Equations Modelling (PLS-SEM), data from 349 users of restaurant ordering apps in Colombia was analysed. Results indicate that engagement, convenience, and safety positively influence loyalty. Interactivity indirectly affects loyalty through engagement. This research sheds light on the factors impacting engagement and loyalty, specifically during the pandemic. It addresses underexplored marketing relationships and guides companies operating such apps to understand key drivers of user loyalty.

BACKGROUND: In Japan, medical doctors have traditionally been assigned from university medical offices, under the medical office system. The present study examined the effects of the medical office system on job satisfaction, engagement, loyalty, and organizational commitment among cardiologists.
METHODS: In this study, a survey of 156 cardiologists was conducted, from April 22, 2023, to May 21, 2023, to examine the effect of the medical office system on employee job satisfaction, employee engagement, and organizational commitment.
RESULTS: Compared with the group that belonged to a medical office system (affiliated group, n = 117), the group that did not belong to a medical office system (non-affiliated group, n = 39) was affiliated to hospitals with a smaller number of beds. The results of the factor analysis showed that four types of hospital management styles were generated, namely, environment-, loyalty-building-, treatment-, and philosophy-oriented hospitals. There is an indication that the philosophy-oriented management style was adopted at the workplaces of the non-affiliated group. The treatment-oriented style also tended to be higher in the non-affiliated group than in the affiliated group. Furthermore, the non-affiliated group had higher organizational commitment, indicating that they were more likely to agree with the management philosophy set forth by hospital executives.
CONCLUSIONS: Although the medical office system did not affect job satisfaction, compared with medical doctors with the affiliated group, those with the non-affiliated group tended to work in hospitals that emphasized philosophy-oriented management, and they received moderate compensation while practicing in an environment suitable for their specialty. These results suggest that the medical office system makes it difficult for medical doctors to have high workplace loyalty, engagement, and commitment to the hospital to which they are dispatched.

Corporate social responsibility has been extensively discussed and linked to the firm performance by the researchers. However, a significant research gap remains unexplored and that is measuring the association between corporate social responsibility, passenger satisfaction, and loyalty in the context of two international airports in China. This research also measures the moderating impact of green human resources management on the relationship between CSR, passengers\' satisfaction, and loyalty. Data from two international airports in China were collected through a questionnaire. A total of 269 questionnaires were used for statistical analysis using Smart PLS 3.3. The findings from the statistical analysis revealed that corporate social responsibility in the airport affected passenger satisfaction and loyalty positively and significantly. Moreover, green human resource management in an airport plays a moderating role between corporate social responsibility, passengers\' satisfaction, and loyalty. Overall, the study\'s findings enrich the literature on CSR, customer satisfaction, and loyalty, portray GHRM\'s role in the airport setting, and suggest practical indications for services industries. Discussions, limitations, and future recommendations are also given.

UNASSIGNED: Loyalty card programs have become prevalent in the retail industry, offering various benefits and rewards to customers. This study aims to analyze the impact of loyalty card programs on customer behavior in the Albanian market.
UNASSIGNED: A survey was conducted among a diverse sample of customers from different retail sectors in Albania. The survey collected data on awareness, satisfaction, loyalty, and customized benefits. The survey was distributed between March and May 2023, and responses were collected electronically. The survey responses were analyzed to address the research questions and test the hypotheses.
UNASSIGNED: The findings indicate a significant level of awareness among respondents regarding loyalty card programs. Higher satisfaction with specific benefits, such as discounts and accumulating points, is associated with higher levels of customer loyalty. Customers who reported higher frequencies of loyalty card usage demonstrated greater loyalty. Customized benefits, particularly discounts and accumulating points, significantly influenced customer satisfaction. However, other benefit categories did not show statistically significant associations with loyalty.
UNASSIGNED: The study highlights the importance of promoting loyalty card programs to enhance awareness among customers. Improving and optimizing loyalty card benefits based on customer feedback is recommended. Encouraging frequent usage of loyalty cards and personalizing benefits to align with customer preferences are key strategies to foster customer loyalty. The findings provide valuable insights for practitioners in the retail sector to enhance customer engagement, satisfaction, and loyalty.

The aim of this work is to shed light on the characteristics and relationship between customer loyalty and publications by the companies on social networks; it has been undertaken with the aid of an exhaustive review of previous studies from 1994 up to the present time. The purpose of the research is to generate a model that can tackle the practical characteristics of the publications on social networks to encourage loyalty. With a view to this, a model is developed that is an extension of the traditional \"Four Stage Loyalty Model\" based on other constructions of the same model, and combined with the characteristics of social networks publications defined in earlier literature. This reflexive approach is particularly important here due to the fact that companies have to be closer to customers\' requirements and customers have the option to choose from which type of communication they wish to be the object.