On the meaning of ‘Waste’: review and definition

Waste reduction is one of the main principles of lean, but it has been taken for granted that we have a common understanding of what waste means. We first present a critical, qualitative discussion that identifies four distinct waste concepts. We then conduct a systematic review of the literature that examines the different uses of these concepts. We find that only the classic concept of the seven wastes and the concept of waste as non-value-adding activity are widely applied. However, both concepts are, at times, not only incompatible but used in a way that leads to open contradiction. A new definition, centred on an efficient, timely transformation process seeks to consolidate the literature. We outline two distinct waste types: (i) obvious waste, to refer to any waste that can be reduced without creating another form of waste; and, (ii) buffer waste, to refer to any waste that cannot be reduced without creating another waste. The paper has important implications for practice. To reduce waste, managers must undertake three interlinked tasks: the elimination of obvious waste; the reduction of variability to transform buffers into obvious waste; and, the balancing of remaining buffers to best achieve performance targets. The paper supports managers in their endeavours to identify waste, which is an important precursor to waste reduction/elimination.     

Card-based production control: a review of the control mechanisms underpinning Kanban,ConWIP, POLCA and COBACABANA systems

Since the emergence of Kanban, there has been much research into card-based control systems. This has included attempts to improve Kanban and/or develop alternative systems, particularly ConWIP (i.e. Constant Work-In-Process), POLCA (i.e. Paired-cell Overlapping Loops of Cards with Authorisation) and COBACABANA (i.e. Control of Balance by Card-Based Navigation). Yet, to date, no unifying review of the mechanisms underpinning these systems has been presented. As a consequence, managers are not provided with sufficient support for choosing an appropriate system for their shop; and researchers lack a clear picture of how the mechanisms compare, leading to several misconceptions. This paper reviews the control mechanisms underpinning the Kanban, ConWIP, POLCA and COBACABANA systems. By comparing the ‘control mechanism’ (i.e. the loop structure and card properties) and ‘contextual factors’ (i.e. routing variability, processing time variability, and whether stations are decoupled by inventory or the flow of jobs is controlled), we provide managers with guidance on which system to choose. For research, we show for example that most criticisms put forward against Kanban systems, e.g. to justify the development of ConWIP, POLCA or COBACABANA, only apply to work-in-process Kanban systems and not to production Kanban systems. Future research directions for each control system are outlined.     

Supervising Mental Health Clinicians in The Context of Complex Organisational Dynamics

This article discusses the complex dynamics and challenges of providing supervision to mental health clinicians working within an organisational context when the supervisor is not part of the organisation and has no formal managerial or accountability responsibility. It considers two models of supervision and their application to three supervisory relationships in an organisational context. It concludes that for supervision to be effective there needs to be a consideration of the social defences in operation within the organisation and how they are met by the anxieties and defences of the supervisor and supervisee. This requires a mixed approach by the supervisor of the technical with the inter-subjective as a reliance on one model of supervision risks limiting the effectiveness of the intervention. The role of the supervisor can enable the supervisee to establish a clinical framework and the necessary environment essentials for their practice.     

Management of premature menopause

There has been some confusion among women and health professionals since the publication of the Women's Health Initiative and Million Women studies about the management of premature ovarian failure (POF). Both studies were undertaken in women aged 50 and over, and cannot be extrapolated to their younger counterparts, who would normally be producing their endogenous estrogen, since they have functioning ovaries. Estrogen-based replacement therapy is the main stay of treatment for women with POF and is recommended at least until the average age of natural menopause (52 years in the UK). This view is endorsed by regulatory bodies such as the Committee on Safety of Medicines (now the Commission on Human Medicines) in the UK. No evidence shows that estrogen replacement increases the risk of breast cancer to a level greater than that found in normally menstruating women, and women with POF do not need to start mammographic screening early unless other risk factors are present, such as family history.     

Financial Attitudes and Inter vivos Resource Transfers from Older Parents to Adult Children

This exploratory study combines economic, family, and decision-making conceptual models to investigate the factors influencing resource transfers as reported by older adults. Pilot data on 61 adult children was obtained during face-to-face interviews with 18 older parents. Hierarchical multiple regressions were conducted to predict time (emotional support) and financial (cash and gifts) inter vivos transfers from demands, resources, values, and relationships. Positive health ratings, strong affection for the adult child, and money retention attitudes were associated with frequent emotional support. Small household size predicted frequent financial transfers. Results indicate the importance of values, resources, demands, and relationships in predicting resource transfers from older parent to adult child.     

‘It's complicated.’ Exploring the meaning of sibling relationships of youth in foster care

Youth in foster care may be separated from their sibling(s) for a myriad of reasons. Although empirical attention to sibling relationships has grown, an examination of what sibling(s) mean to children currently in foster care has not occurred. This study used open‐ended survey responses of campers who attended Camp To Belong, a summer camp that reunites children who are separated from their sibling because of their placement in foster care. Six different member camps across the United States of America administered camper surveys. Thematic analysis was used to examine 178 responses from campers. Five major themes were identified of what siblings mean to youth in foster care: bond, dependable, fulfillment, despair and impact of separation. Youth shared the positive and protective influence their sibling(s) have in their life as well as the challenges that are associated with being separated from their sibling while in foster care. Implications of the results of the study are provided for clinicians, foster parents, researchers and sibling policy.