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Transition road maps – an investigative approach to map the daily life consumption of individuals
(2014)
The present paper aims at investigating an innovative approach to guide consumers’ daily life choices in Germany towards a more sustainable way of acting. This should be achieved by introducing a new concept: transition road maps. Transition road maps bear the capability of illustrating courses of consumption behaviour without being prohibitive. These schemes foster self-determined behaviour and encourage the consumer to rethink and restructure his or her habits of consumption, with a focus on sustainability. The innovative thought is, not to simply stick to the usual triad of spheres of activity, consisting of nutrition, mobility and housing. Instead further aspects of consumers’ daily routines are considered, such as leisure activities, time usage or financial activities. Moreover the transition road maps are based on a new ideology of combining and connecting the qualitative algorithm of time use, financial spending and resource impact of social practices in the area of private consumption. In the long-term, the transition road maps could e.g. be used in sustainability communication or consumer counselling.
Background:
Etomidate is typically used as an induction agent in cardiac surgery because it has little impact on hemodynamics. It is a known suppressor of adrenocortical function and may increase the risk for post-operative infections, sepsis, and mortality. The aim of this study was to evaluate whether etomidate increases the risk of postoperative sepsis (primary outcome) and infections (secondary outcome) compared to propofol.
Methods:
This was a retrospective before–after trial (IRB EA1/143/20) performed at a tertiary medical center in Berlin, Germany, between 10/2012 and 01/2015. Patients undergoing cardiac surgery were investigated within two observation intervals, during which etomidate and propofol were the sole induction agents.
Results:
One-thousand, four-hundred, and sixty-two patients, and 622 matched pairs, after caliper propensity-score matching, were included in the final analysis. Sepsis rates did not differ in the matched cohort (etomidate: 11.5% vs. propofol: 8.2%, p = 0.052). Patients in the etomidate interval were more likely to develop hospital-acquired pneumonia (etomidate: 18.6% vs. propofol: 14.0%, p = 0.031).
Conclusion:
Our study showed that a single-dose of etomidate is not statistically associated with higher postoperative sepsis rates after cardiac surgery, but is associated with a higher incidence of hospital-acquired pneumonia. However, there is a notable trend towards a higher sepsis rate.