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Environmental degradation has emerged as one of the major limitations of industrial revolution and has led to an increased focus towards developing sustainable strategies and techniques. This paper aims to highlight the sustainability aspects of three-dimensional (3D) printing technology that helps towards a better implementation of Industry 4.0. It also aims to provide a brief picture of relationships between 3D printing, Industry 4.0 and sustainability. The major goal is to facilitate the researchers, scholars, engineers and recommend further research, development and innovations in the field.

The various enabling factors for implementation of Industry 4.0 are discussed in detail. Some barriers to incorporation of 3D Printing, its applications areas and global market scenario are also discussed. A through literature review has been done to study the detailed relationships between 3D printing, Industry 4.0 and sustainability.

The technological benefits of 3D printing are many such as weight savings, waste minimization and energy savings. Further, the production of new 3D printable materials with improved features helps in reducing the wastage of material during the process. 3D printing if used at a large scale would help industries to implement the concept of Industry 4.0.

This paper focuses on discussing technological revolution under Industry 4.0 and incorporates 3D printing-type technologies that largely change the product manufacturing scenario. The interrelationships between 3D printing, Industry 4.0 and sustainability have been discussed.

The purpose of this study is to assess the key determinants of green human resource management (GHRM) and investigate its impact on environmental performance (EP) and business performance (BP).

The research employed SmartPLS 3 and follows a cross-sectional research design. Data from 179 employees were collected using a convenience sampling technique from the firms that adopted GHRM practices.

The research found a significant relationship of GHRM with EP and also reported the significant relationship between EP and BP. Moreover, EP significantly mediates the relationship of GHRM with BP.

A relatively small sample size of employees was used that may suggest the need for a diverse and more representative sample. The paper is based on data collected from the Malaysian manufacturing industry – other economic sectors and Asian countries may offer different results.

The paper identifies the need for incorporating GHRM practices and culture at the workplace to encourage positive green behavior in employees which will increase the EP and BP of the firm.

This paper reported the initial empirical findings after the March 7th incident on EP of businesses in Malaysia, where businesses have initiated the adoption of GHRM practices.

The purpose of the study is to measure the performance of Indian hospitals, both operationally and financially, by using hospital KPI's. The assessment is predominantly done by linking it to the existing Lean practices in Indian hospitals.

An empirical study based on cross-sectional survey of hospital managers and specialists in various private healthcare facilities across India was conducted to validate the proposed Lean framework. From an extensive literature survey, the authors identified quality, delivery, efficiency, accessibility and patient centeredness to be the main operational performance (OP) indicators for hospitals. Business or financial performance was measured based on parameters which are average revenue per occupied bed (ARPOB), earnings before interest, tax, depreciation and amortization (EBITDA) and operating revenue. Confirmatory Factor Analysis (CFA) was carried out using a specialized technique, called Structural Equation Modelling(SEM) and an explicit factor structure was hypothesized.

Management commitment towards Lean in hospitals is statistically proven to have impacted operational and financial performance. However, leanness in technology and business processes showed no statistical significance on either operational or financial performance parameters. Hospital stakeholders showed statistical significance on though it had no impact on the financial performance. Results obtained from the statistical analysis indicate a positive impact of hospital Lean practices on timely delivery of services and improved service quality. Efficiency, accessibility of services and patient centered behavior in hospital operations could not be statistically proven to have impacted the financial performance.

Effectiveness of Lean management (LM) principles in improving hospital operations is largely dependent on patient centered behavior. Empowered employees who are trained to add value from a customer view point, make hospital operations safe and improved. Properly trained and communicated employees who are committed to quality improvements can make a positive impact on patients' quality of life and thus positively impact the society. The study lists ways to attain the required outcomes.

This paper is among the very few that has attempted to suggest ways to link implementation of Lean practices more effectively in Indian hospitals to improve hospital performance at operational and financial levels.

This paper outlines how Design for Lean Six Sigma methods aided a medical device manufacturing company in developing a new strategic space management and approval process for its manufacturing site.

The project demonstrates the application of the Design for Lean Six Sigma and structured Define, Measure, Analyse, Design, and Verify methodology in designing and implementing a process that enables the case study manufacturing site to improve its space utilisation and free up space.

The project was validated in one manufacturing department, and the Design for Lean Six Sigma methodology resulted in creating 15% new space for that area, with opportunities identified to free up 44.7% of the total manufacturing floor space and realise over €2.2 million cost savings as well as start to manufacture new products launched.

The manuscript highlights for the first time how the Design for Lean Six Sigma methodology can be utilised for space utilisation and can be leveraged by other manufacturers. The current study's limitations are that it is a single-site case study application. Future longitudinal case studies on Design for Lean Six Sigma application in more manufacturing space utilisation projects would be useful. This study has implications for identifying best practices for Design for Lean Six Sigma methodology application in the device industry, thus improving the state of the art for introducing new manufacturing lines.

This is the first published work to utilise Design for Lean Six Sigma methodology for space utilisation in a medical device company. This review will provide medical devices and other manufacturing organisations with recommendations on utilising Design for Lean Six Sigma and design for improved space utilisation to reduce costs.

The aim of this study is to determine the effect of the application of the lean methodoloy in the pathology laboratory and to evaluate the results on the turnaround time.

This study was a prospective intervention study formed of the three stages of pre-intervention, determination of problem areas and the application of lean techniques and quality improvement. The study was conducted between February 2019 and August 2020. In the first stage, research was made through interviews, observations, questionnaires and seminars; in the second stage, observations, brain-storming, process flowcharts and fishbone diagram were used; and in the third stage, Kaizen, A3 method and spaghetti diagram were applied.

Following the application of lean techniques, turnaround time in the pathology laboratory was decreased, and the changes made in the working methods and placement of the units in the laboratory were found to have prevented unnecessary steps. The lean method was also determined to have had positive effects on the workplace satisfaction of the laboratory employees and of the physicians working with the laboratory.

The results showed that applying lean techniques could reduce waste and increase participation in processes. This article demonstrates its originality and relevance by proving that the lean techniques can be applied in the hospital laboratory. Actions to improve turnaround time are also crucial for the efficient use of resources.

Although there are general methodologies for lean implementation in manufacturing companies, a specific methodology for the implementation of lean healthcare in hospitals has not been addressed by the literature. Addressing this gap, the purpose of this paper is to develop a practice-driven methodology for implementing lean in hospital operations.

Three case studies were conducted to collect evidence on the lean implementation process in Brazilian hospitals. From empirical evidence and literature, the implementation methodology was proposed and submitted to critical assessment by experts from the field.

The process of lean implementation was very similar in all cases, triggered by strategic planning and operationalized by continuous improvement projects. On the other hand, in all cases, the lean implementation teams had to deal with employees’ resistance. These findings were valuable inputs to the development of the implementation methodology. After refinement, it was proposed a feasible, useful and user-friendly methodology.

The proposed methodology was raised from the practice through case study research. However, the proposed methodology was not fully applied, and the associated performance measures were not elaborated in this paper. Therefore, more case studies and applications will be necessary to generalize the findings.

The methodology provides practical guidelines that support lean implementation in hospital operations. Although it demands adaptations for each specific hospital setting, this initial step may encourage hospital managers to start the lean journey.

This study addressed the gap in the literature regarding the lack of methodologies for implementing lean healthcare in hospital operations. The methodology synthesizes the knowledge, principles and tools of lean thinking that can be applied in hospital operations.

The purpose of the study was to examine the factors affecting eating behavior of adolescents aged 17–19 years, residing in a college hostel and to assess the effectiveness of nutrition education in improving their knowledge, attitude and practices (KAP).

A convenient sampling technique was used to recruit 200 adolescent female participants of age 17–19 years. The obesity and underweight status of the participants were assessed using body mass index (BMI). Diet history was obtained using a 24-h dietary recall and food frequency questionnaire. A standard pretested questionnaire was used to analyze the factors affecting the eating behavior of adolescents. A nutrition education program was conducted to improve the KAP of the adolescents. A structured questionnaire was used to assess the improvement in KAP after the education program. Descriptive statistics was used to examine the factors affecting eating behavior. Paired t-test was used to check the effectiveness of the nutrition education program.

The findings of the study indicated that 50.5% of the adolescents were underweight (20%), overweight (12%) and obese (18.5%). The mean nutritional adequacy of the adolescents was 68.1%. Social factor had the highest impact on the eating behavior of adolescents (70.8%), followed by the environmental factor (69.7%). Imparting nutrition education was significant in improving the KAP of adolescents with a p-value < 0.05. Thus, it is necessary to analyze the factors affecting the eating behavior of adolescents and establish corrective measures such as community education intervention programs and awareness programs on healthy eating habits to modify the eating behavior of adolescents.

The dietary intake and the factors influencing eating behavior of the adolescents were assessed considering the transition in the intrapersonal, social and community food environment. The inadquate food intake affected the nutritional status of 50% of the adolescents.The taste, temptation, sight of the food, peer pressure, parental influence and unmindful eating practices majorly influenced the eating behavior of adolescents. Unhealthful eating behavior can increase the risk of chronic diseases during the adolescence and may extend in to adulthood. Hence it is necessary to bring a positive change in the eating behavior of the adolescents through a well planned comprehensive nutrition education program. The findings of the study proved that the knowledge, attitude and behavior of the adolescents could be significantly improved through a well planned nutrition eduation program. Further the study also provide insights to plan and implement community food policies targeted to improve the eating behavior and health status of the adolescents. One of the limitations of the study was, in addition to anthropometric measurements and diet history including biochemical parameters would be a better indicator of nutritional status. The cultural and religious influence on eating behavior would also be studied. In future a study on gender differences on the dietary intake and eating behavior of the adolescents can be conducted.

The study reflects the eating behavior of late adolescents and major factors affecting eating behavior of adolescents residing in college hostel. The findings will add on to the existing knowledge on the factors affecting eating behavior of adolescents. As eating behavior is correlated to the health status of the adolescents understanding the factors affecting eating behavior would help in modifying the eating behavior of late adolescents by implementing appropriate measures and help develop programs and policies that aid in improving the nutritional status. Since nutrition education is effective in improving the KAP of adolescents’ nutrition literacy is imperative in schools and colleges to improve the eating behavior and health status of the adolescents.

The research provides a scientific basis for understanding the factors affecting eating behavior of adolescents and the interaction between personal, social and environmental factors. It also acts as basis to be aware of one’s own eating behavior, modify and model healthy eating behavior. Inappropriate eating behavior in late adolescents can continue into adulthood affecting nutritional status and leading to an increase in the prevalence of diseases and disorders in adulthood. This can affect human potential and capital and thereby economic development. Hence, it is imperative to improve the nutritional status of the adolescents by creating awareness and implementing corrective measures to modify unhealthy eating behavior. The research also supports devising policy and programs regarding the nutritional behavior of adolescents.

Eating behavior is a complex interplay of various factors at multiple levels. The adolescents’ eating behavior correlates directly with their nutritional status. In total, 50.5% of adolescents were malnourished. The nutrient intake of the majority of the adolescents was less than the recommended intake. The mean nutrient adequacy was 68.1%. The quality of the diet was largely affected as they did not include 5–7 food groups in a day. The social factors such as peer group influence and parental influence had the predominant impact on eating behavior followed by environmental factors. The nutrition education program helped improve the nutrition KAP. Hence, it is necessary to create awareness and make policies and programs that can improve the eating behavior of adolescents.

The purpose of this paper is to make a lean assessment of a chemical analyst training laboratory in a higher education institution and identify the main types of waste on a daily basis and understand the lean maturity of the laboratory and establish priority areas of intervention to make the laboratory leanest.

A single descriptive case study methodology was used to carry out the lean laboratory evaluation. The lean manufacturing waste terminology was adapted to a lean analytical laboratory environment, and a lean waste assessment step-by-step procedure was developed to reach the study goal.

Three types of waste (i.e. transport, waiting and defects) were the main contributors of the problem. The Pareto analysis results showed that 37.5% of the different types of waste contributed to almost 51.4% of the problems. The case study allowed on diagnosing wastes, understanding the lean maturity in a teaching laboratory setting and priority areas of intervention

Some data collection methods were used, and tools were developed to answer the research questions. A waste measurement instrument was created to evaluate lean waste in a chemical analytical laboratory, and a lean classification scheme was built to understand the lean maturity of the laboratory. The lessons learnt of the lean assessment in a teaching laboratory and the developed tools will be helpful for future research and for practitioners in a teaching chemical analytical laboratory setting.

The number of lean assessment studies in teaching laboratories is not very significant, and this work contributes to overcome this gap illustrating the lean waste assessment foundation with a step-by-step procedure and tools used in a teaching laboratory to perform a lean assessment and identify opportunities for improvement. A generic roadmap to lean laboratory waste assessment and continuous improvement is proposed with the key elements to take into consideration.

Several authors have examined the lean healthcare literature, but besides all efforts made, articles comparing conceptual and analytical studies were not found. Thus, a systematic review is conducted aiming to understand the state of the art of lean healthcare by investigating and comparing how conceptual and analytical articles address tools/methods, application fields, implementation barriers and facilitators and positive and negative impacts.

Articles in English about lean healthcare, published in journals in the last ten years (2009–2018) and indexed in Web of Science (WoS) or Scopus were examined and assessed by following the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA) protocol. A qualitative content analysis on the eligible articles was conducted, and results from the conceptual and analytical studies were compared.

There is a literature gap regarding tools/methods in both conceptual and analytical approaches once they prioritize for different items. Barriers, facilitators and negative impacts are perceived differently within both categories and might require more extensive analysis. The same items prevail in both conceptual and analytical categories when analyzing healthcare fields and positive impacts.

There is a lack of articles comparing conceptual and analytical studies concerning lean healthcare. So, this study's relevance is in identifying theoretical and applied research gaps to strengthen the lean healthcare state of the art and to integrate theoretical-applied knowledge. For healthcare professionals, it might provide an overview of the key factors that can promote lean implementation.

The requirement of high-quality government-supported healthcare services has necessitated the significance of recognizing new management practices to enhance patient satisfaction. Hence, the purpose of this study is to address the patient's enhanced custom needs through the implementation of supply chain value stream mapping (SCVSM) in government-supported drug distribution system (DDS) for enhanced patient's satisfaction.

This study elucidates the role of one popular emerging management technique (i.e. SCVSM) in the healthcare sector by an investigative case study. The DDS in Rajasthan (India) was selected for this study. The data for this analysis were gathered in three ways (i.e. direct observation, documentary analysis and semi-structured interviews).

The outcome of this current study reveals that it is possible to apply the tool (SCVSM) to investigate the wastes in DDS to deliver the medicines at right time, right quantity and right quality. The application of SCVSM concluded that the various Kaizens (areas needed to improve) in lead time; transportation and routing should be adopted. The study further implemented kaizen on the current SCVSM and developed future SCVSM.

Although various stages and functions exist in the healthcare supply chain, the current study is focused on the distribution system of drugs. The proposed approach provides a platform for both researchers and academicians to understand the existing DDS and to implement the SCVSM approach in the healthcare environment. The results show that the proposed SCVSM model is able to identify some operational bottlenecks and wastes which interfere in DDS.

It was observed that limited literature related to lean implementation on DDS and implementation of SCVSM on the healthcare environment in general and government-supported or public in specific are available. The current study on the application of SCVSM in DDS is unique in nature and will definitely add value to the existing literature of the application of value stream mapping (VSM) on the healthcare supply chain management field.