1. |
- Karlsson, Per, 1963, et al.
(author)
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The role of the number of uninvolved lymph nodes in predicting locoregional recurrence in breast cancer.
- 2007
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In: Journal of clinical oncology : official journal of the American Society of Clinical Oncology. - 1527-7755. ; 25:15, s. 2019-26
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Journal article (peer-reviewed)abstract
- PURPOSE: To identify groups of early breast cancer patients with substantial risk (10-year risk > 20%) for locoregional failure (LRF) who might benefit from postmastectomy radiotherapy (RT). PATIENTS AND METHODS: Prognostic factors for LRF were evaluated among 6,660 patients (2,588 node-negative patients, 4,072 node-positive patients) in International Breast Cancer Study Group Trials I to IX treated with chemotherapy and/or endocrine therapy, and observed for a median of 14 years. In total, 1,251 LRFs were detected. All patients were treated with mastectomy without RT. RESULTS: No group with 10-year LRF risk exceeding 20% was found among patients with node-negative disease. Among patients with node-positive breast cancer, increasing numbers of uninvolved nodes were significantly associated with decreased risk of LRF, even after adjustment for other prognostic factors. The highest quartile of uninvolved nodes was compared with the lowest quartile. Among premenopausal patients, LRF risk was decreased by 35% (P = .0010); among postmenopausal patients, LRF risk was decreased by 46% (P < .0001). The 10-year cumulative incidence of LRF was 20% among patients with one to three involved lymph nodes and fewer than 10 uninvolved nodes. Age younger than 40 years and vessel invasion were also associated significantly with increased risk. Among patients with node-positive disease, overall survival was significantly greater in those with higher numbers of uninvolved nodes examined (P < .0001). CONCLUSION: Patients with one to three involved nodes and a low number of uninvolved nodes, vessel invasion, or young age have an increased risk of LRF and may be candidates for a similar treatment as those with at least four lymph node metastases.
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2. |
- Alänge, Sverker, 1951, et al.
(author)
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Strategies and Practices for Sustainability: Experiences from Firm Level
- 2007
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In: 10th International QMOD Conference at Campus Helsingborg, Lund University, June 18-20, 2007, Lund.
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Conference paper (peer-reviewed)abstract
- The four system conditions for sustainability presented in Holmberg’s Ph.D. dissertation (1995) provided a foundation for the approach used by the ‘Natural Step’ both in Sweden and in several other countries (e.g. Holmberg & Robért 2000). In the 1990s Holmberg & Robért developed a ‘backcasting’ approach to strategy development in companies and was involved in several projects to introduce sustainability defined by these four system conditions. This work had a considerable impact in several firms. Electrolux established an environmental policy and a direct effect of backcasting was a decision to develop the first CFC free refrigerators, which put the company far ahead of their competitors. This is just one example that illustrates how this approach has a potential to stimulate new directions, which would not happen based on a more traditional trend-based analysis. Although these projects have been showing good results, several firms have lost their focus for working with sustainability after some time. So the question remained – how can sustainability become a natural part of strategy processes and practices in companies? An action research project was initiated in 2004 to focus on this question at three large Swedish corporations. The project aim was to further develop the backcasting approach in the context of sustainable development and to present recommendations for the process of implementation of the approach at companies. This paper discusses alternative ways of using and integrating the sustainability concept and approaches/practices in firms. The research design was an action learning approach to develop robust sustainable strategies in business units of three major firms. Representatives from the firms participated in workshops to learn together and share experiences from on-going projects in each company. Interviews were used to provide additional understanding of strategy processes within each firm.The conclusion was that sustainability can impact all parts and all processes in a firm. As a vision it is an organizing metaphor but there are also various accompanying techniques and practices. Firms choose to approach sustainability in different ways. Some view it as a major assignment for the environmental department supported by central policy committees. Others start out from the perspective that sustainability should be part of what everyone does in their normal job. In the latter case, the parallel to quality is obvious – when it really works and becomes totally integrated in the daily work - in product development, supply chain, etc. - then it becomes the paradoxical ‘invisible success’ (Book et al. 2004, Book 2006). One general observation is that it takes time to develop a thorough sustainability approach. It can be useful to view the development as a learning process where top management involvement and understanding of the link between competitive advantage and sustainability can facilitate and help speeding up the process.For strategy driven companies, the starting point is to make sustainability part of the regular strategy process, reaching the status of critical success factor. Then, there is a need for non-traditional strategy tools, such as scenario-planning and backcasting. The specific advantage of using the four system conditions as the conceptualization of sustainability is that they can be used on different levels and in different processes in an organization. First, they can provide input to different strategy processes. Second, they can support individuals’ decision-making in their daily work, e.g. choose alternatives that do not systematically increase the number of new substances in the stratosphere.
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3. |
- Holmberg, John, 1963, et al.
(author)
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10 miljarder lyckliga planetskötare
- 2007
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In: Konsumera mera –dyrköpt lycka, Formas Fokuserar. - 9789154059980 ; , s. 135-147
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Book chapter (other academic/artistic)
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5. |
- Holmberg, John, 1963, et al.
(author)
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Energianvändning i bebyggelsen – vad är det som styr?
- 2005
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In: Energi och Bebyggelse – teknik och politik, Forskningsrådet för miljö, areella näringar och samhällsbyggande. - 9154059348 ; , s. 112-118
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Book chapter (other academic/artistic)
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7. |
- Karlsson, Sten, 1951, et al.
(author)
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The societal metabolism.
- 2005
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In: H. Brattebö (ed), Introduction to industrial ecology, MIT Press.
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Book chapter (other academic/artistic)
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9. |
- Nässén, Jonas, 1975, et al.
(author)
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Direct and indirect energy use and carbon emissions in the production phase of buildings: An input-output analysis
- 2007
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In: Energy. - : Elsevier BV. - 0360-5442 .- 1873-6785. ; 32:9, s. 1593-1602
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Journal article (peer-reviewed)abstract
- There is a considerable disagreement in the literature on the magnitude of primary energy use and CO2 emissions linked to the production of buildings. In this paper we assess the Swedish building sector using top-down input-output analysis. These top-down results are then disaggregated into sectors and activities, which are compared to results from 18 previous bottom-up studies using process-LCA methodology. The analysis shows almost 90% higher specific energy use (GJ/m(2)) for the top-down methodology. The differences are only around 20% for the share coupled to production and processing of building materials, while for other involved sectors such as transport, construction activities, production of machines and service sectors, the input output analysis gives much higher values. Some of these differences can be explained by truncation errors due to the definition of system boundaries in the bottom-up studies. The apparent underestimation of energy use for transport, services etc. in bottom-up studies is only of marginal importance when comparing for example materials choices, but when comparing the production phase to the use phase of buildings such errors are likely to result in an underestimation of the relative importance of the production phase since the use phase is dominated by more easily estimated direct energy use. (c) 2007 Elsevier Ltd. All rights reserved.
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