Are complications after repairing acute Achilles tendon ruptures related to the surgical approach or the patient’s comorbidities?*

Objective: Analyze the postoperative complications after repairing acute Achilles tendon rupture and compare them according to the surgical approach (open surgery (OS) or minimally invasive surgery (MIS)) and the patient’s comorbidities. Methods: A retrospective analytical study including 154 consecutive patients with an acute Achilles tendon rupture submitted to surgery and divided into OS and MIS cohorts. The following relevant comorbidities were analyzed: obesity, diabetes mellitus, smoking, dyslipidemia, gout, chronic corticosteroid use, connective tissue pathologies, transplant history, cancer treatment patients, and postoperative complications. Results: Seventy-eight patients (50.6%) were treated surgically with an OS technique and 76 (49.4%) with an MIS approach. Twenty patients (13%) had postoperative complications between the two cohorts (OS 11.5%; MIS 14.5%; p = 0.588). No statistically significant difference was found in the logistic regression of the risk of the surgical approaches and complications. Obesity had a significant statistical difference when complications and comorbidities were compared. Conclusions: Patients with obesity have a higher risk of developing postoperative complications with both OS and MIS techniques. No relationship was found between the type of surgical approach and a higher percentage of postoperative complications in treating acute Achilles tendon rupture

Facilitating access to further languages: trialling materials combining parallel texts with reflective learning

This article reports on the practitioner research conducted by the English participants in a European Co-operation Programme project entitled Lateral Language Learning. The project was based on the belief that there is much that teachers of a first foreign language can do to prepare heir students to access other languages in the future, and, starting from this premiss, it aimed to develop resources for teachers to use in the classroom. In the English context, a college of further education, the researchers investigated the use of parallel texts within a reflective learning environment. An intitial set of materials using parallel texts in English, Spanish and Portuguese was devised and trialled with four students of A Level Spanish in order to explore how learners could use a parallel text in a related unknown language to identify rules or patterns of correlation and then use this knowledge to access the unknown language. From their observations and evaluation of the students' performance, the researchers drew up a set of principles to inform the design of a second set of aterials. These materials are offered as the basis for a second cycle of practitioner research, to be undertaken by teachers in their own teaching context, and are suitable for use with students learning any foreign language

Challenges for freshwater biodiversity research: science plan and implementation strategy

The environmental vitality of freshwater ecosystems and their inherent biodiversity are at the heart of social and economic sustainability. Fresh water is essential for nearly any form of human activity, including industrial production, navigation, domestic water requirements, waste assimilation, health, and food production. Moreover, the roles of biodiversity in freshwater processes (e.g., self-purification, protein production) are of crucial importance for sustaining goods and services underpinning the vitality of human populations. Globally, freshwater biodiversity is under critical threat because there are, in addition to environmental needs, expanding human demands for water. However, economic expansion and environmental integrity do not need to be mutually exclusive as long as the environmental requirements for water are thoughtfully and effectively incorporated into economic development. The critical importance of fresh water is now widely recognized. In December 2003, the United Nations General Assembly adopted resolution 58/217 proclaiming 2005 to 2015 as an International Decade for Action – ‘Water for Life’. The resolution calls for a greater focus on water issues and development efforts, and recommits countries to achieving the water-related goals of the 2000 Millennium Declaration and of Agenda 21; in particular, to halve by 2015 the proportion of people lacking access to safe drinking water and basic sanitation. These are highly important matters, yet their importance should not obscure the fact that the ‘Water for Life’ resolution comes at a time when biodiversity and the biological resources of inland waters are facing unprecedented and growing threats from human activities. Fresh water makes up only ~0.01% of the world’s water and ~0.8% of the Earth’s surface. Yet over 10,000 fish species live in fresh water, making up 40% of global fish diversity and one quarter of global vertebrate diversity. When amphibians, aquatic reptiles and mammals are added, around one third of vertebrate species are confined to fresh water. This disproportionate richness is also evident from the fact that approximately 100,000 species out of ~1.3 million thus far described by scientists (~8%) live in fresh water. Conservation of freshwater biodiversity represents thus a great challenge to scientists, local managers and policy makers. Management of freshwater biodiversity has to take into account trade offs between biodiversity protection and sustainable use. A first requisite in developing an effective conservation strategy, given the current impediment of insufficient data, is to improve the geographic and taxonomic knowledge of freshwater biodiversity. A second requisite is to better understand linkages between freshwater biodiversity and ecosystem functioning and the numerous valuable goods and services supported by freshwater biodiversity. A final requisite is to develop a network of freshwater users (e.g., local populations, managers of water resources, scientists and political institutions) because effective conservation actions and conflict resolutions require a close collaboration between the different users of fresh water. The international programme of biodiversity science, DIVERSITAS, has identified a science agenda for conservation and sustainable use of freshwater biodiversity to inspire and facilitate a new generation of research on this topic. This science agenda recognises the importance of freshwater biodiversity as a basic support for all life on Earth and for the provision of valuable human-related goods and services. The intention of DIVERSITAS is to advance knowledge on topics of international concern that are not receiving sufficient attention or are newly emerging issues with potential consequences for ecosystems and for humanity. This document, the science plan and implementation strategy of a new DIVERSITAS cross-cutting theme called “freshwaterBIODIVERSITY” is the result of numerous meetings, consultations and discussions over the past two years involving scientists of diverse backgrounds, disciplines and countries. This document is by no means an end in itself, but is meant to evolve as new knowledge is generated. We hope that it will involve more and more scientists working on freshwater biodiversity issues and that it will contribute, in the context of the post Millennium Ecosystem Assessment era, to a new generation of scientific work and to an expanded perspective on the overwhelming importance of freshwater biodiversity

Freshwater biodiversity: importance, threats, status and conservation challenges

Freshwater biodiversity is the over-riding conservation priority during the International Decade for Action – ‘Water for Life’ – 2005 to 2015. Fresh water makes up only 0.01% of the World's water and approximately 0.8% of the Earth's surface, yet this tiny fraction of global water supports at least 100000 species out of approximately 1.8 million – almost 6% of all described species. Inland waters and freshwater biodiversity constitute a valuable natural resource, in economic, cultural, aesthetic, scientific and educational terms. Their conservation and management are critical to the interests of all humans, nations and governments. Yet this precious heritage is in crisis. Fresh waters are experiencing declines in biodiversity far greater than those in the most affected terrestrial ecosystems, and if trends in human demands for water remain unaltered and species losses continue at current rates, the opportunity to conserve much of the remaining biodiversity in fresh water will vanish before the ‘Water for Life’ decade ends in 2015. Why is this so, and what is being done about it? This article explores the special features of freshwater habitats and the biodiversity they support that makes them especially vulnerable to human activities. We document threats to global freshwater biodiversity under five headings: overexploitation; water pollution; flow modification; destruction or degradation of habitat; and invasion by exotic species. Their combined and interacting influences have resulted in population declines and range reduction of freshwater biodiversity worldwide. Conservation of biodiversity is complicated by the landscape position of rivers and wetlands as ‘receivers’ of land-use effluents, and the problems posed by endemism and thus non-substitutability. In addition, in many parts of the world, fresh water is subject to severe competition among multiple human stakeholders. Protection of freshwater biodiversity is perhaps the ultimate conservation challenge because it is influenced by the upstream drainage network, the surrounding land, the riparian zone, and – in the case of migrating aquatic fauna – downstream reaches. Such prerequisites are hardly ever met. Immediate action is needed where opportunities exist to set aside intact lake and river ecosystems within large protected areas. For most of the global land surface, trade-offs between conservation of freshwater biodiversity and human use of ecosystem goods and services are necessary. We advocate continuing attempts to check species loss but, in many situations, urge adoption of a compromise position of management for biodiversity conservation, ecosystem functioning and resilience, and human livelihoods in order to provide a viable long-term basis for freshwater conservation. Recognition of this need will require adoption of a new paradigm for biodiversity protection and freshwater ecosystem management – one that has been appropriately termed ‘reconciliation ecology’