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The material-jetting-type (MJ) 3-D printing technology has advantages in resolution and color printing. During the printing process, a leveling technique is needed to precisely control the thickness and flatness of each layer. Roller-type leveling mechanism has been adopted in commercial MJ 3-D printers, but it is lack of research on roller leveling process parameters and establishing experimental procedures. Therefore, in this study, a roller-type leveling mechanism for a MJ color 3 D printer was developed, and experimental approaches were utilized to determine process parameters.

The roller-type leveling mechanism was chosen to provide functions of flattening and removal of excess material. The parameters studied were roller speed and rotational direction. Surface roughness, Ra, of printed single-layered specimens was measured at 15 locations for plane roughness and along five lines for line roughness to evaluate the leveling results. Adopting suitable parameters, color samples with and without leveling were printed for comparison and verification.

According to plane roughness results, forward rotation achieved better leveling. Plane roughness was the major criteria to determine roller speed with the assistance of standard deviation of line roughness. The best parameters of the self-developed MJ color 3-D printer were found to be rolling forward at 1,100 rpm. In addition, printed color samples showed great improvement in surface roughness with leveling and no obvious color mixing after leveling.

Leveling is important to achieve desired layer thickness, smooth surface and good color quality in color 3-D printing. For MJ 3-D printing, only patents were revealed regarding roller design, but paper publications have not been presented. This research practically proposed to use experimental approach to understand the effects of roller operating parameters and to find the suitable ones based on surface roughness results.

This research established the experimental procedures and also suggested guidelines of experimentally obtaining suitable roller leveling process parameters. Developers can refer to this study results to design and adjust leveling mechanism in a new MJ 3-D printer.

The experimental approach can be applied to similar MJ 3-D printing systems if different materials are introduced or the platform speed is changed. The observed trends suggested several guidelines to plan limited experiments only to obtain suitable roller process parameters.

Understanding the antecedents of patient safety culture among medical staff is essential if hospital managers are to promote explicit patient safety policies and strategies. The factors that influence patient safety culture have received little attention. The authors aim to investigate the antecedents of patient safety culture (safety climate) in relation to medical staff to develop a comprehensive approach to improve patient safety and the quality of medical care in China.

The Chinese version of the Safety Attitudes Questionnaire (CSAQ) was used to examine the attitudes toward patient safety among physicians and nurses. This medical staff was asked to submit the intra-organizational online survey via email. A total of 1780 questionnaires were issued. The final useable questionnaires were 256, yielding a response rate of 14.38%. One-way analysis of variance (ANOVA) was employed to test if different sex, supervisor/manager, age, working experience, and education result in different perceptions. Confirmatory factor analysis (CFA) was used to verify the structure of the data. Then linear regression with forward selection was performed to obtain the essential dimension(s) that affect the safety culture (safety climate).

The CFA results showed that 26 CSAQ items measured 6 safety-related dimensions. The linear regression results indicated that working conditions, teamwork climate, and job satisfaction had significant positive effects on safety culture (safety climate).

Hospital managers should put increased effort into essential elements of patient-oriented safety culture, such as working conditions, teamwork climate, and job satisfaction to develop appropriate avenues to improve the quality of delivered medical services as well as the safety of patients.

This study focused on the contribution that the antecedents of patient safety culture (safety climate) make with reference to the perspective of medical staff in a tertiary hospital in China.

The methodology of mobile commerce as a significant application for both enterprises and customers are becoming crucial, but few studies discuss the usage attitude toward and customer satisfaction with mobile application (app) services in the life insurance industry. The purpose of this paper is to investigate the effects of attitude toward using life insurers’ mobile app services on customer satisfaction.

The study is based on a questionnaire survey of 538 respondents in Taiwan. The data are analyzed through ANOVA, multiple regression, and path analysis.

The results indicate that all variables significantly and positively affected usage attitude. Among them, compatibility had the most significant influence. In addition, consumers’ perceived usefulness and perceived ease of use positively affected customer satisfaction. Furthermore, the path analysis result demonstrates that usage attitude is the most significant factor for customer satisfaction, and the second-most important factor is the cognition of compatibility’s indirect effect on usage attitude.

The paper extends our understanding of the insured’s usage attitude toward and satisfaction with life insurers’ app services by integrating the technology acceptance model and innovation diffusion theory. The results have practical implications for reinforcing customer relationship management and contribute to fulfilling the need for marketing evidence in life insurance.

The rapid changes that the healthcare services industry is undergoing pose a challenge to obtaining accurate measurements of the delivery of medical services to patients. Current Chinese measures of patient safety culture may not adequately capture how medical staff perceives the promotion of patient safety. This study aims to construct a valid and applicable patient safety culture instrument by re-estimating the Chinese version of the Safety Attitudes Questionnaire (SAQ) with medical staff in Taiwan.

Exploratory factor analysis (EFA) was conducted on data collected from a sample of 448 medical workers at a regional teaching hospital in Taiwan, and data from 804 participants at a medical center were subjected to confirmatory factor analysis (CFA). The distribution of the questions among the dimensions was different from that in the Chinese version of the SAQ.

The authors' results confirm that 3 correlated first-order factors, including 11 items, can be used to measure collaboration and safety, stress recognition and emotional exhaustion (EE). The authors' data suggest that the cooperation mechanism, patient safety promotion, stress management and emotional management are drivers of patient safety and should be prioritized when seeking to evaluate the perceptions of hospital staff toward patient safety culture in hospitals in Taiwan.

To improve the quality and safety of patient care, the measurement scale should be revisited and modified as the industry changes over time and to take account of cultural variation. The authors restructured the current Chinese version of the SAQ developed by the Joint Commission of Taiwan (JCT) to offer more precise measures that increase the sensitivity of the measurement of the level of care in items of patient safety and that serve as a diagnostic instrument to review patient safety management.

Hinged on the transformative service paradigm, this study investigates the relationships among employee acting, customer-perceived service quality, customer emotional well-being, and their value co-creation. Feelings of gratitude among customers may moderate the effect of perceived service quality on their emotional well-being (i.e., positive and negative affects).

A pair study using a structural equation model was conducted to gather data from a financial service organization in a rural area.

The results show how customers perceive service quality positively impacts their emotional well-being immediately after receiving a financial service, which in turn affects their value co-creation. Hence, feelings of gratitude moderate the effect of perceived service quality on customer positive affect.

This study responds to calls for more studies on how service interactions influence customer well-being in the financial services context. This study is among the few that examine moderation effects of customer feelings of gratitude on their emotional well-being to explain why a positive emotion might sway their short-term well-being.

Prior research on green innovation has shown that institutional pressure stimulates enterprises to adopt green innovation. However, an institutional perspective does not explain why firms that face the same amount of institutional pressure execute different environmental practices and innovations. To address this research gap, the authors linked institutional theory with upper echelons theory and organization performance to build a comprehensive research model.

A total of 800 questionnaires were issued. The final usable questionnaires were 195, yielding a response rate of 24.38%. AMOS 23.0 was used to analyze the data and examine the relationships between the constructs in our model.

Institutional pressures affected both green innovation adoption (GIA) and the top management team's (TMT's) response. TMT's response influenced GIA. GIA was an important factor affecting firm performance. Furthermore, TMT's response mediated the relationship between institutional pressure and GIA. Institutional pressures indirectly affected green innovation performance but did not influence economic performance through GIA. Finally, TMT's response indirectly impacted firm performance through GIA.

The authors draw on institutional theory, upper echelons theory, and a performance-oriented perspective to explore the antecedents and consequences of GIA. This study has interesting implications for leaders and managers looking to implement green innovation and leverage it for firm performance to out compete with market rivals as well as to make the changes in collaboration with many other companies including market rivals to gain success in green innovation.

Safety activities have been initiated in healthcare organizations in Taiwan, but little is known about the performance and trends of safety culture on a timely basis. This study aims to comprehensively review the articles that have conducted two worldwide patient safety culture instruments (HSPSC and SAQ) in Taiwan to provide the extent of existing knowledge about healthcare professionals' perception related to patient safety.

The Web of Science, Medline (Pubmed) and Embas were used as the database to search papers related to the patient safety culture in Taiwan from 2008 to June 30, 2019.

Twenty-four relative articles in total were found and further investigations confirmed that the regular assessment of patient safety culture among hospital staff is essentially important for healthcare organizations to reduce the rates of medical errors and malpractice. Moreover, the elements influencing patient safety culture may vary due to the difference in job positions, age, experience in organization and cultural settings.

The summary of findings enables healthcare administrators and practitioners to understand key components of patient safety culture for continuous improvement in medical quality.

Assessing the safety culture in healthcare organizations is a foundation to achieve excellent medical quality and service. The implications of this study could be useful for hospitals to establish a safer environment for patients.

The purpose of this study is to identify critical demographic variables that would significant influence each dimension of patient safety culture. Understanding nurses' attitudes toward patient safety is important for healthcare organizations to relentlessly improve medical quality and services for patients.

The internal survey data sets in 2015 and 2016 from nurses' viewpoints are used. Linear regression with forward selection is applied where nine demographic variables are the input variables, while each dimension of the Chinese version of safety attitudes questionnaire (SAQ) is the dependent variable.

Supervisor/manager is the most essential demographic variable that has significant impacts on six dimensions. Experience in organization is the other critical demographic variable.

Nurses who are in charge of supervisors/managers are more satisfied in six of eight dimensions. Nurses who have much experience in an organization tend to have less satisfaction in three dimensions. Therefore, hospital management should enhance the leader's effectiveness in engaging their subordinates' commitment.

The results enable the hospital management to pay much attention to two major demographic variables, namely supervisor/manager and experience in organization, in order to improve the patient safety culture based on the Chinese version of SAQ in this hospital. Moreover, supervisor/manager is a more critical demographic variable for nurses due to larger absolute values of standardized coefficients by linear regression with forward selection.