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This article addresses the problem of the quantification of higher education by introducing a theoretical framework for power relations and agency within this process. Instead of treating evaluation regimes as external and imposed on the sector, it argues for a relational approach to the problem of exercising power over the higher education sector through means of evaluation. To develop such an approach, the article draws on two sources: Guy Neave's account of the evaluative state and Bob Jessop's strategic-relational approach (SRA) to the state. By using the latter to further develop our understanding of the logic under which the evaluative state operates, the article offers a general framework for inquiring about the conditions that shape power relations and impact the degree of agency at the disposal of the actors involved in the evaluative state. For this purpose, the article operationalises the six general dimensions of the state developed on the grounds of the SRA in the context of the evaluative state. In turn, to demonstrate its heuristic value, the article refers to the emergence of the evaluative state in Poland and how scholarly communication was quantified and made commensurate in this process.

The study investigates the process of creating evaluative homogeneity within a performance-based research funding system. It does so in reference to the experience of creating a national journal ranking in Poland in 2019. It refers to the cases of two disciplines: biology and history. The use of this case is justified by its unique character, that is creating the ranking through means of both bibliometric indicators and expert panels. We therefore asked: What guided the actors who participated in the process of creating the ranking through the use of bibliometric indicators when introducing changes to its initial form? To answer this question, a mixed-methods approach was used. First, we conducted a quantitative analysis of changes made to the ranking during the consecutive steps of its creation. Second, we conducted a qualitative analysis of semi-structured interviews regarding actors' motivations. By reflecting on the qualitative analysis along with the results of the quantitative part, this study reveals the extent to which actors impacted the form evaluative homogeneity took within the system. It further argues that this is dictated by how actors position themselves in relation to two opposing forces: those favouring the homogenization of research and those maintaining its heterogeneity. As these forces remain imbalanced, the study concludes with a call for further exploration of the interplay between the forces of homogenization and heterogenization and how the tensions between them are mediated within a performance-based research funding system.

This article addresses the inadequacy of the universal approach to academic freedom, which fails to account for the extent to which academic freedom can be exercised. Instead of considering the fixed meaning of academic freedom, the article proposes a relational approach. One that focuses on the relation between academic freedom and the common good, as particular articulations of academic freedom are legitimized through reference to the quasi-universal concept of the common good. To ground this argument, the article examines different historical meanings of the idea of the common good in the relations between the state and the university sector in Poland, and the effect they had on the content and extent of academic freedom. In doing so, it contributes to the discussion on the cultural and national specificities of both academic freedom and the common good.

Introduction: Snoring, as a first symptom of impaired breathing during sleep, seems to be an important risk factor for behavioural disturbances in children. The study was conducted to find out how sleep disordered breathing (SDB) in a population of first graders in one province of Poland influences their behaviour. Materials and methods: A population single-stage cross-sectional study using a parent-reported questionnaire was applied. 1480 first graders were involved. We collected data about snoring, age, weight, height and parent-reported problems with child behaviour. The data were analysed in terms of BMI, breathing disturbances and aggressive behaviour. Results: We’ve got completed 1107 (74.8%) of 1480 sent questionnaires. 560 girls and 547 boys were recruited. The mean age of the children was 7.31. There were 64.7% children considered non-snorers, and 35.3% snorers. 7.5% were considered habitual snorers. We also divided children into two subgroups: normal-weight and overweight. There was a linear association of aggressive behaviour with the increasing severity of snoring on a 5-point scale with highly significant differences (p 0.00001). In both the overweight and normal-weight subgroups, snorers showed statistically more aggressive behaviour (p 0,0019; p 0,0098) than non-snorers. Conclusion: Snoring can drive to aggressive behaviour in population of first graders. The severity of breathing disturbances during sleep is associated with increasing aggressive behavioural problems, both in the subgroups of normal weight and overweight children. Acknowledgements: The Authors thank Wielka Orkiestra Swiatecznej Pomocy Foundation (The Great Orchestra of Christmas Charity) which supported the study. [Copyright &y& Elsevier]

Obstructive sleep-disordered breathing (SDB) is a common clinical problem. An unrecognized and untreated SDB is a serious threat for an intensively developing organism of a child. The consequences of SDB include cardiovascular and neurological complications, growth disorders and enuresis. Therefore, SDB in children becomes an important subject of many scientific investigations, publications, and congresses. In 2015 the European Respiratory Society Task Force published a document concerning the conclusions about the diagnostics and treatment of SDB in children and youth from 2 to 18 years of age (Fig. 1). The scientific data from 362 publications were presented in a condensed form of "seven steps", very useful in diagnosing and treatment planning (1). The authors underline the limited number of reliable evidence about SDB: prospective studies, randomized double-blinded studies with placebo. The presented evidence was categorized depending on their quality according to the classification of the American Academy of Neurology (ANN) into classes I - IV. Previously, in 2012, the guidelines of the American Academy of Pediatrics on obstructive sleep apnea syndrome (OSAS) in children with tonsillar hypertrophy and/or obesity were published (2, 3) and they were a valuable diagnostic and therapeutic compendium. The European guidelines discussed in this article result from the progress of knowledge in recent years, they cover the subject broadly, consider rare and difficult cases and present the spectrum of potential therapeutic actions. The aim of the guidelines is a better recognition of SDB, a systematization of diagnosis and treatment at every stage of medical care, including the causes of this disorder and its complications.

Introduction: In recent years there has been an increasing number of cases of cancer, including cancer of the larynx. The choice of treatment should be primarily dictated by the complete elimination of cancer, but from the point of view of the patient, an important factor to keep in mind, is the quality of the voice that will be created at the end of the therapeutic process., Aim: The aim of this study was to evaluate the voice quality of patients after partial surgery of the larynx with vocal fold reconstruction pedunculated sterno-thyroid muscle flap., Materials and Methods: The study included 30 men aged 53-72 years who were treated at the Clinic of Otorhinolaryngology Department of Medical-Dental Medical University of Warsaw on account of cancer of the larynx, qualified according to the TNM classification T1 or T2. The radical removal of cancer was associated with resection of one vocal fold, laryngeal pouches and ventricular fold. In 15 patients, included to the group I at the end of phase oncology surgery, a reconstruction of "vocal fold" pedunculated sterno-thyroid muscle flap were performed simultaneously. The group II consisted of 15 patients who underwent surgery that removed only the cancerous lesions. Impact assessments arising after surgery of voice disorders on quality of life were made using the self-test failure of the voice (Voice Handicap Index in the Pruszewicz modification). The nature of the created voice was studied using GRBAS scale. All patients performed the laryngostroboscope examination. With "IRIS" program, prepared by a team at Wrocław University of Technology, the voice was recorded, and then was subjected to acoustic analysis. In addition, noise level and the maximum phonation time was measured., Results: The results indicate that the patients of group I gained a better voice confirming the values of objective acoustic analysis. The assessment made by the scale GRBAS patients who supplemented the resulting loss after tumour removal, with much less hoarseness of voice, did not have the hyperkinesis and there was no puff character. They had the better flow of voice and phonation time of vowels "a" was much longer. The assessment of quality of life of patients in group I made in a test of the VHI was higher than in group II. The laryngostroboscope examination confirmed a good phonatory occlusion and a nearly regular, healthy vocal fold vibration in patients who had received flap of muscle., Conclusions: Evaluation of the quality of voice after removing the tumor multiplicity in the glottis with simultaneous reconstruction "vocal fold" has confirmed that this is a very good surgical technique, which allows radically curing cancer for the simultaneous preservation of a good voice. The operation has limited indications for radiotherapy because of the desire to preserve the phonatory function of the larynx, and thus avoids the negative effects of radiation., (Copyright © 2014 Polish Otorhinolaryngology - Head and Neck Surgery Society. Published by Elsevier Urban & Partner Sp. z.o.o. All rights reserved.)

Unlabelled: During last decades Draf III procedure gained popularity in treatment of different pathologies of the frontal sinus such as chronic sinusitis or benign tumors. We present a series of 10 patients treated with this procedure from a 2-year-period. Indications included: chronic rhinosinusitis--four patients, frontal sinus mucocele--four patients (one with destruction of the posterior table), osteoma--one patient (stage 3 according to Kennedy's grading system), and inverted papilloma--one patient (Krouse T3 lesion). Observation period ranged from 4 months to 2 years., Results: There were no early complications. Gradual narrowing of the created ostium was observed in all of the patients. This led to total obstruction in two, and stenosis (not allowing for passing with 4 mm endoscope) in another two patients. The patient after inverted papilloma removal showed no recurrence in 11 months follow-up., Conclusion: Draf III procedure is alternative for external approach that can be used for treatment of chronic rhinosinusitis and benign frontal sinus tumors of different size.

The Aim of the Study: to evaluate CSF leak as a complication of osteoplastic flap surgery of the frontal sinus., Material and Methods: Medical recordings of the patients that underwent osteoplastic flap surgery of the frontal sinus were analyzed., Results: among 62 patients operated between 2000 and 2007 there were 4 cases of intraoperative CSF leak (6.5% of cases). In all complicated cases indication for surgery was benign large tumor of the frontal sinus, among them there were two cases of osteoma, one cholesterol granuloma and ossifying fibroma. All CSF leaks were successfully closed with multilayer underlay or overlay graft. The technical aspects of the osteoplastic flap surgery of the frontal sinus are discussed.