Performance of geosynthetics as reinforcement in unpaved roads

O trabalho teve como objetivo avaliar o comportamento de estradas não pavimentadas construídas sobre solos moles reforçadas com diferentes geossintéticos. Foram selecionadas três estradas não pavimentadas que apresentassem um trecho com baixa capacidade de suporte de carga. A flecha foi medida pelo método fotográfico para cada número de passadas, nas condições com e sem reforço, e submetido à análise de variância, pelo teste de F, a 5% de probabilidade, e quando houve diferença significativa entre os tratamentos, suas médias foram comparadas pelo teste de Tukey. Posteriormente, realizou-se o cálculo da razão de benefício de tráfego fornecida pela inclusão do reforço. O geossintético não tecido, quando inserido no interior do solo, contribui de modo significativo para a redução das flechas, principalmente nos solos do trecho das estradas I e III. O geossintético tecido contribui para a redução das flechas, principalmente nos solos do trecho da estrada III. A geogrelha não contribui para a redução das flechas. A razão de benefício de tráfego para os reforços utilizados foram superiores a um, com valores médios de 1,28 para o trecho da estrada I, reforçado com geossintético não tecido, 1,54 para o trecho da estrada II, reforçado com geossintético tecido e de 2,7 para o trecho da estrada III, reforçado com geossintético tecido.The objective of this study was to evaluate the performance of unpaved roads built on soft soils reinforced with different geosynthetic materials. We selected three sections of unpaved roads with low load-bearing capacity. Vertical displacement (rut depth) was visually measured (photographs) for each number of passes on soils with and without reinforcement. The data underwent variance analysis by the F-test at 5% probability; when significant, means were compared by the Tukey’s test. Subsequently, we calculated traffic benefit ratio (TBR) or improvement factor due to the use of each reinforcement material. Non-woven geosynthetic materials reduced significantly the rut depths, mainly within the road sections I and III; by contrast, geosynthetic woven materials contributed in road section III. Moreover, geogrid use had no contribution to rut depth reductions. The TBR by using the reinforcements studied here showed values higher than one, with averages of 1.28 for road section I reinforced with geosynthetic nonwoven material, 1.54 for road section II reinforced with geosynthetic woven material, and 2.7 for road section III reinforced with geosynthetic woven

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely