A sustainable development can be understood as social and economic development within ecological sustainability limits. The operationalisation of a sustainable development presupposes integration of resource concepts covering relevant disciplines and systems levels. In this paper descriptive domains within physical resource theory (PRT), nutrition theory (NT), economic theory (ET) and emergy theory (EmT) are joined in what we call a ''sustainability map.'' The sustainability map represents a conceptual model of the economic production system in its ecological and social contexts. It is a contribution within the field integrated assessment. The relevance domain of each resource concept is analysed by comparison with the sustainability map. It is concluded that resource concepts that well supports a sustainable development should recognise the process restrictions that defines ecological, economic and social sustainability limits; thus recognise and in a relevant way treat threshold-and resilience phenomena; and capture the use-value of resources for human well-being. We suggest that the integration of NT, ET and EmT may contribute, while we find the value of PRT limited, as physics, thus PRT, is indifferent to life as a system characteristic, while life of microbes, plants, animals and humans is central in the sustainability context. The paper contributes to a theoretical foundation supporting a bridging of the implementation gap of a sustainable development, e.g. through its proposal of how to develop more accurate natural resource concepts.Readers should send their comments on this paper to: BhaskarNath@aol.com within 3 months of publication of this issue.

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There is an increasing demand to quantify the footprints, ecological, economic and social, in terms of the effect of different interventions in healthcare. The aim of this study was to compare two systems providing patients with diabetes with insoles in terms of their ecological, economic and social footprints. Prefabricated insoles (PRI) were compared with custom-made insoles (CMI). Using a welfare-economic monetary approach, costs were estimated for (1) treatment, (2) travelling to and from the hospital in terms of both fuel and time consumed by the patients and (3) society through emissions contributing to climate change. The proportion of patients/year that could be supplied within the same budget, for each individual treatment, was calculated. The cost of the insoles was 825 SEK (PRI) and 1450 SEK (CMI), respectively. The cost, mean value/patient due to the consumption of patients' time at the department, was 754 SEK (PRI) and 1508 SEK (CMI), respectively. Emissions, in terms of CO 2 equivalent, were 13.7 (PRI) and 27.4 (CMI), respectively. Using PRI, a total of 928 patients could be provided/year compared with 500 patients if CMI are used. By using PRI, the cost/treatment was reduced by 46%. The cost of treatment dominated and the cost of time consumed by patients were also substantial. The societal cost of contributing to climate change was of low importance. By using PRI, the needs of 86% more patients could be met within the same budget. Using these methods, the contribution of healthcare systems to the 17 Sustainable Development Goals approved by the UN can be quantified.

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The concept of sustainable development is forcing standard economic analysis to acknowledge and address the existence of dimensions of performance, which are not reducible to monetary accounting. In particular, the implementation of this concept in practice requires: (a) the simultaneous handling of indicators developed in different disciplinary fields; and (b) an approach more related to the procedures adopted by consultants (Participatory Integrated Analysis), rather than theoretical academic analysis looking for 'the' optimal solution. The case study considered in this paper is a multi-criteria analysis of changes, which occurred in the Swedish milk production sector for the period 1989-1999. Multi-criteria impact matrices and multi-criteria representations are used to provide a transparent method of integrated analysis. Changes are characterized and quantified in a way that makes it possible to relate the impact of existing trends in relation to different sub-objectives (variation in performance in relation to social, economic and ecological indicators). The results of this analysis confirm a few well known predicaments of sustainability associated with agriculture. The growth of Sweden economy is driving a major increase in material throughputs within its agricultural sector. The need of increasing agricultural throughput (especially labour productivity) has moved the Swedish dairy sector in a clear situation of decreasing marginal return (=large increases in inputs are not reflected in a proportional increase in output). Therefore, sound policies of development of this sector aimed at increasing the goal of sustainability have to be developed by considering several indicators of performance, and not only economic variables. Abbreviations: AAT: = Amino acids absorbed in the small intestine; DM: = Dry matter; ECM: = Energy corrected milk; GDP: = Gross domestic production; IA: = Integrated assessment; ME: = Metabolizable energy; MCIM: = Multi-criteria impact matrix; MCR: = Multi-criteria representation; RAM: = Result analysis milk-production; SEK: = Swedish crowns; TPES: = Total primary energy supply.