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This contribution reports on a symposium that aimed to collectively discuss different approaches to deal with processes of automation and artificial intelligence (AI) in the field of education. Inspired by Asimov’s Laws of Robotics and Pasquale's recently published NewLawsofRobotics, the symposium’s purpose was to collectively advance laws that would be specifically tailored to the field of education. In that regard, the term edu-automation seeks to propose ways of conceptualizing and imagining automation as an educational endeavor; that is, not as a purely technical-factual matter that is subsequently translated into educational practice, but equally as a matter of educational concern. Through three narratives and propositions, this contribution discusses similarities and differences between the concepts of automation and AI, and shows some of the different features that tie education and automation together. The variety and substantial differences between the three accounts shows that automation and AI cannot be approached single-sidedly, and that in order to come to a profound understanding of this phenomenon, we need to deploy a variety of theoretical, educational, and normative standpoints and positions.

The aim of this study was to explore the note-taking experiences of university students using paper-based (non-electronic) and paperless (electronic) resources. By means of a hermeneutic phenomenol...

Taking the European Credit and Transfer System as its departure point, this article describes the (mis)fortunes of the figure of the independent learner. This figure is conceptualized by analyzing ...

Over the last years, the European Commission has heavily promoted various forms of digital education. In this article, we draw upon two recent European policy documents as key articulations of Europe’s contemporary governing apparatus: Opening Up Education and the Digital Education Action Plan. The article more particularly conceives of both policy documents as offering a point of departure to analyze how this apparatus is presently seeking to enact a specific mode of existence of the contemporary learner. We argue that this educational mode of existence is being enacted by the fabrication of highly specific sorts of time and space. In order to highlight the particularity of the enacted sorts of time and space exemplified in the policy documents, we start this article with a discussion of how a traditional, modern governing apparatus aims to fabricate linear time and institutional space. The article proceeds by arguing that the present-day European governing apparatus that is concerned with digital education fabricates different sorts of times and spaces, namely potential (rather than linear) temporalities and ecological/networked (rather than institutional) spatialities. Likewise, the concrete instruments (such as platforms, portals, credits and certificates) presently adopted in order to do so largely differ from modern instruments. Conclusively, we argue that the presence of these newly emerging (often digital) instruments, and the times and spaces that are fabricated through these instruments, call for an opportunistic mode of existing as a contemporary learner. ispartof: Educational Philosophy And Theory vol:52 issue:6 pages:640-652 status: published

¿Un nuevo movimiento escolar?

The bankruptcy of tailor-made education. The need for pedagogic (work)places Education, youth work and youth care confront many challenges which are interpreted in many different ways and receive various responses. However, one type of response seems to be widely applauded: education and care should be tailor-made or become so: tailored to children and youngsters, to their talents and their lifeworld. This call for tailor-made education and care is often accompanied by an emphasis on the need for the development of talents and on the value of feeling-well. In this contribution we indicate how this response entails an approach to education as form of socialization. I.e. as practices that assist the (re-)production of a particular societal regime which calls upon us to conceive of ourselves as entrepreneurs and to permanently take care of our profile. The experience of a meaningful life risks thereby to become exclusively dependent on social recognition and comparison. In so doing tailor-made education risks to deny youngsters the chance for a pedagogical workplace i.e. a place where the world is presented and disclosed to them in such a way that it can provide them with a measure outside of themselves and allows them an experience of a meaningful life in relation to the work which is taking place there. ispartof: Pedagogiek vol:39 issue:3 pages:349-366 status: published

© 2019, © 2019 Informa UK Limited, trading as Taylor & Francis Group. The question concerning the relation between thinking and the university is the starting point of this paper. After a very brief outline of some reflections on this topic, the case of Campus in Camps, a Palestinian experimental university, is presented to shed light on this issue. Inspired by Isabelle Stengers’ ecology of practices, it is possible to discern four requirements on thinking in the work of Campus in Camps, namely storytelling, comparing, mapping, and using. It will be argued that the particularity of thinking at the university, is that it is done via artifices that initiate processes of composition, problematization, and attention. In the concluding section, the paper proposes to understand the study practice of Campus in Camps as an adventure that activates a sense of the possible, and hence opens up futures that are different from the ones that present themselves as obvious or unavoidable. ispartof: ETHICS AND EDUCATION vol:14 issue:2 pages:184-197 status: published

The topic of citizenship education and the promotion of democratic citizenship in schools has risen to the top of educational policy agendas in Europe over the past three decades. This rise in attention, however, appears to be accompanied by an apparent lack of attention to the specific manner in which citizenship, education and the assumed relationship between both are currently conceptualised and understood in this policy context. The currently dominant notions of citizenship education centre around a concept of citizenship-as-competence, illustrating a certain assumption of equivalence between citizenship and formal education in schools, without further elaborating on this assumption. By means of a critical re-reading of key European educational policy texts referring to citizenship education, and their use of the key concepts of citizenship and education, our analysis shows how the competence-based approach to citizenship education in European educational policymaking entails tensions with its own assumptions, therefore falling short of its own proclaimed purpose of emancipating young people in Europe to become autonomous, engaged and critical democratic citizens.

Groin hernia management has a significant worldwide diversity with multiple surgical techniques and variable outcomes. The International guidelines for groin hernia management serve to help in groin hernia management, but the acceptance among general surgeons remains unknown. The aim of our study was to gauge the degree of agreement with the guidelines among health care professionals worldwide.Forty-six key statements and recommendations of the International guidelines for groin hernia management were selected and presented at plenary consensus conferences at four international congresses in Europe, the America's and Asia. Participants could cast their votes through live voting. Additionally, a web survey was sent out to all society members allowing online voting after each congress. Consensus was defined as 70% agreement among all participants.In total 822 surgeons cast their vote on the key statements and recommendations during the four plenary consensus meetings or via the web survey. Consensus was reached on 34 out of 39 (87%) recommendations, and on six out of seven (86%) statements. No consensus was reached on the use of light versus heavy-weight meshes (69%), superior cost-effectiveness of day-case laparo-endoscopic repair (69%), omitting prophylactic antibiotics in hernia repair, general or local versus regional anesthesia in elderly patients (55%) and re-operation in case of immediate postoperative pain (59%).Globally, there is 87% consensus regarding the diagnosis and management of groin hernias. This provides a solid basis for standardizing the care path of patients with groin hernias.

Despite the growing interest in deliberative and dialogue models the research literature lacks investigations of the underlying assumptions of deliberative methods. Starting from the current popularity as well as the broad use of the method of deliberative inquiry -one example of such a deliberative method- this article aims to identify approaches and underlying assumptions of deliberative inquiry. Therefor a systematic literature review of empirical research, of descriptions of practical deliberative procedures and of theoretical research of deliberative inquiry is used. This review demonstrates that the method of deliberative inquiry is elaborated and used within different contexts with a corresponding range of rationales: From (1) a procedure to tackle curriculum questions through (2) a way of investigating and agreeing upon policy actions to (3) collaboratively researching issues. By describing the three approaches and by investigating the assumptions of deliberative inquiry within each approach, we demonstrate a range of rationales behind this method. Despite the distinctions, the primary goal of all manifestations of deliberative inquiry is similar: to contemplate a practical problem in a systemic and collaborative way, to weigh arguments for possible solutions and to make (even temporarily) a decision. This article concludes with future research perspectives. ispartof: Systemic Practice and Action Research vol:32 issue:2 pages:193-217 status: published

OBJECTIVE:: To compare if watchful waiting is noninferior to elective repair in men aged 50 years and older with mildly symptomatic or asymptomatic inguinal hernia. BACKGROUND:: The role of watchful waiting in older male patients with mildly symptomatic or asymptomatic inguinal hernia is still not well-established. METHODS:: In this noninferiority trial, we randomly assigned men aged 50 years and older with mildly symptomatic or asymptomatic inguinal hernia to either elective inguinal hernia repair or watchful waiting. Primary endpoint was the mean difference in a 4-point pain/discomfort score at 24 months of follow-up. Using a 0.20-point difference as a clinically relevant margin, it was hypothesized that watchful waiting was noninferior to elective repair. Secondary endpoints included quality of life, event-free survival, and crossover rates. RESULTS:: Between January 2006 and August 2012, 528 patients were enrolled, of whom 496 met the inclusion criteria: 234 were assigned to elective repair and 262 to watchful waiting. The mean pain/discomfort score at 24 months was 0.35 [95% confidence interval (CI) 0.28–0.41)] in the elective repair group and 0.58 (95% CI 0.52–0.64) in the watchful waiting group. The difference of these means (MD) was −0.23 (95% CI −0.32 to −0.14). In the watchful waiting group, 93 patients (35·4%) eventually underwent elective surgery and 6 patients (2·3%) received emergent surgery for strangulation/incarceration. Postoperative complication rates and recurrence rates in these 99 operated individuals were comparable with individuals originally assigned to the elective repair group (8.1% vs 15.0%; P = 0.106, 7.1% vs 8.9%; P = 0.668, respectively). CONCLUSIONS:: Our data could not rule out a relevant difference in favor of elective repair with regard to the primary endpoint. Nevertheless, in view of all other findings, we feel that our results justify watchful waiting as a reasonable alternative compared with surgery in men aged 50 years and older.

Background: Both mesh and suture repair are used for the treatment of umbilical hernias, but for smaller umbilical hernias (diameter 1–4 cm) there is little evidence whether mesh repair would be beneficial. In this study we aimed to investigate whether use of a mesh was better in reducing recurrence compared with suture repair for smaller umbilical hernias. Methods: We did a randomised, double-blind, controlled multicentre trial in 12 hospitals (nine in the Netherlands, two in Germany, and one in Italy). Eligible participants were adults aged at least 18 years with a primary umbilical hernia of diameter 1–4 cm, and were randomly assigned (1:1) intraoperatively to either suture repair or mesh repair. In the first 3 years of the inclusion period, blocked randomisation (of non-specified size) was achieved by an envelope randomisation system; after this time computer-generated randomisation was introduced. Patients, investigators, and analysts were masked to the allocated treatment, and participants were stratified by hernia size (1–2 cm and >2–4 cm). At study initiation, all surgeons were invited to training sessions to ensure they used the same standardised techniques for suture repair or mesh repair. Patients underwent physical examinations at 2 weeks, and 3, 12, and 24–30 months after the operation. The primary outcome was the rate of recurrences of the umbilical hernia after 24 months assessed in the modified intention-to-treat population by physical examination and, in case of any doubt, abdominal ultrasound. This trial is registered with ClinicalTrials.gov, number NCT00789230. Findings: Between June 21, 2006, and April 16, 2014, we randomly assigned 300 patients, 150 to mesh repair and 150 to suture repair. The median follow-up was 25·1 months (IQR 15·5–33·4). After a maximum follow-up of 30 months, there were fewer recurrences in the mesh group than in the suture group (six [4%] in 146 patients vs 17 [12%] in 138 patients; 2-year actuarial estimates of recurrence 3·6% [95% CI 1·4–9·4] vs 11·4% (6·8–18·9); p=0·01, hazard ratio 0·31, 95% CI 0·12–0·80, corresponding to a number needed to treat of 12·8). The most common postoperative complications were seroma (one [

In the age of web 2.0, the university is constantly challenged to re-adapt its ‘old-fashioned’ pedagogies to the new possibilities opened up by digital technologies. This article proposes a rethink...

There are no clear guidelines when an additional CT scan should be obtained for the treatment of displaced intra-articular distal radius fractures (DRF). This study aimed to investigate whether surgeons can predict the usefulness of CT scans to facilitate choice of treatment plan and/or pre-operative planning for DRF. Four surgeons evaluated 51 patients with displaced DRF. The choice of treatment (operative or nonoperative) was based on conventional radiographs. Subsequently, the surgeons were asked whether they would have requested an additional CT scan to determine this treatment choice, and also whether they required a CT scan for pre-operative planning. After 4 weeks, the additional CT scan was provided and the cases were assessed again. Based on these data, we calculated the number needed to scan (NNS) and number needed to harm (NNH) for two decision models. Model 1: Only provide a CT scan if the surgeon requested one based on their judgment of the X-rays. Model 2: CT scans for all displaced intra-articular DRF. For choice of treatment, the NNS was lower for model 1 than for model 2 (2.6 vs. 4.3) and the NNH is higher for model 1 (3.1 vs. 1.3). For pre-operative planning, the NNS (1.3 vs. 1.4) and NNH (3.7 vs. 3.4) were comparable for both models. Surgeons are able to predict the usefulness of an additional CT scan for intra-articular displaced DRF for OR indication. However, for pre-operative planning the usefulness of a CT scan is much harder to predict.

Background and purpose — The reliability of conventional radiography when classifying distal radius fractures (DRF) is fair to moderate. We investigated whether reliability increases when additional computed tomography scans (CT) are used. Patients and methods — In this prospective study, we performed pre- and postreduction posterior–anterior and lateral radiographs of 51 patients presenting with a displaced DRF. The case was included when there was a (questionable) indication for surgical treatment and an additional CT was conducted within 5 days. 4 observers assessed the cases using the Frykman, Fernández, Universal, and AO classification systems. The first 2 assessments were performed using conventional radiography alone; the following 2 assessments were performed with an additional CT. We used the intraclass correlation coefficient (ICC) to evaluate reliability. The CT was used as a reference standard to determine the accuracy. Results — The intraobserver ICC for conventional radiography alone versus radiography and an additional CT was: Frykman 0.57 vs. 0.51; Fernández 0.53 vs. 0.66; Universal 0.57 vs. 0.64; AO 0.59 vs. 0.71. The interobserver ICC was: Frykman: 0.45 vs. 0.28; Fernández: 0.38 vs. 0.44; Universal: 0.32 vs. 0.43; AO: 0.46 vs. 0.40. Interpretation — The intraobserver reliability of the classification systems was fair but improved when an additional CT was used, except for the Frykman classification. The interobserver reliability ranged from poor to fair and did not improve when using an additional CT. Additional CT scanning has implications for the accuracy of scoring the fracture types, especially for simple fracture types.

Unter Bezugnahme auf den bisher nur auf Franzosisch erschienenen Text Rancieres ‚Ecole, production, egalite‘ (1988), versuchen die Autoren den haufig anzutreffenden Eindruck zu korrigieren, dass mit dem ‚unwissenden Lehrmeister‘ die Schule als solche, als institutionelle Form grundsatzlich infrage gestellt werde. Im fokussierten Text argumentiert Ranciere fur ein Verstandnis der schulischen Form als eines Freiraums, in dem weder die Herkunft noch andere Merkmale der Schuler*innen eine Rolle spielen und der gleichzeitig von gesellschaftlichen oder okonomischen Erfordernissen und Zielvorgaben entkoppelt ist. In dieser scholastischen Fabel bildet die Schule einen Raum, der per se mit anderen gesellschaftlichen Zugehorigkeiten bricht und so ein Spiel des Lernens (einen ‚espace de jeu‘) ermoglicht, in dem unter gleichen Voraussetzungen und in einer geteilten Gemeinschaft, Handlungsfahigkeiten erworben werden, die keiner vorgegebenen Ordnung entsprechen mussen. Jene Fabel erzahlt davon, dass hier jeder grundsatzlich alles lernen kann. Fur die Autoren bildet diese Form der Erzahlung einen Bezugspunkt, um die mit den industriellen Revolutionen einsetzende funktionale Ausrichtung schulischer Lernprozesse zu kritisieren.

Today the issue of ‘educational change’ is widely discussed. Such change, so we can hear, is needed because of increasing linguistic heterogeneity and cultural diversity, because of technological developments and because of the persisting correlation between social background and educational success. In this context ‘educational’ seems to refer to the institutional practice of the school. But what do we mean by school? In our contribution, we offer some elements of what we call an internal pedagogical perspective on school and on scholastic learning which clarifies its emancipatory potential as pedagogic form. This will allow us to address the issue of educational change differently and to substantiate a plea for bringing more ‘school’ into our educational institutions. We (1) distinguish between an internal perspective and various external perspectives on the school. We, than, (2) sketch the basic assumptions, operations and experiences of the school as pedagogic form emphasizing (3) that school is technically, pedagogically and practically composed and (4) indicating very briefly how school has and is been tamed. Finally (5) we suggest some challenges for making or reinventing school today, relating it briefly to the issue of teacher education.

Is there (still) something specific about academic practice in contemporary neoliberal times? This article reports on a sociomaterial, ethnographic study informed by Deleuze’s untimely empiricism conducted at two research centres of a research university. We unfold the specificity of ‘the academic’ by elaborating upon two central notions: relational aspirations (the attachments of these academics, and the operations that such attachments generate) and mode of existence (the way academic practice comes into being by and through these attachments). The article discerns four types of relations that are typical for academic practice and argues that the way in which academic practice exists nowadays is characterized by a continuous distancing in action, that is, by drawing things together and by slowing things down. ispartof: Critical Studies in Education vol:60 issue:2 pages:226-244 status: published

© 2016 Pedagogy, Culture & Society. Although a large amount of ethnographic research has been conducted in schools, little is known about the particularity of the school, about what makes the school–as a school–different from other (learning) environments. As school ethnographies focus primarily on the perspectives and interpretations of pupils and teachers, the school itself remains largely ignored. Drawing on ethnographic research within six Flemish secondary schools, the particularity of the school is examined through its possible regime of enunciation. By focussing on both sociomaterial and discursive elements within school practices, we look for markers which point at a specific pedagogical regime of enunciation within these practices. Attention is then paid to the manner of speech, to the elements at stake when sayings occur, to the knitting together of objects, time(s) and space(s) as they are enacted through and as part of practices at school. ispartof: Pedagogy, Culture and Society vol:25 issue:1 pages:105-119 status: published

This paper discusses the constructivist, negotiated perspective to INGO accountability. According to this perspective, INGO accountability is a process of mutual negotiations between different INGO stakeholders who hold different accountability demands. Acknowledging that this perspective provides a good starting point for a better understanding of INGO accountability, we comment on this conceptualization of INGO accountability. Through an analysis of accountability instruments and procedures, we examine closely how the demands of the INGO’s stakeholders are embedded in particular relationships of accountability which are sustained by particular accountability logics. From this analysis, we point out that, due to the differences that exist between these accountability logics, processes of negotiation are likely to be filled with complex tensions and trade-offs. Moreover, as some accountability logics are much clearer and more compelling than others, a constructivist perspective on INGO accountability does not automatically coincide with an understanding of INGO accountability in which primordial importance is given to the beneficiaries. ispartof: Voluntas vol:28 issue:4 pages:1529-1561 status: published

During the last years, MOOCs (massive open online courses) are part of the most discussed developments in educational technology. MOOCs swept the landscape of educational technology in no time. However, through all this enthusiasm, it is difficult to see the contribution of MOOCs to computer-based education. Even though there is a surge in MOOCs as well as in MOOC-research, it is unclear how an effective MOOC-pedagogy can be developed. What is this MOOC-phenomenon? And how can we, as educators, teachers, pedagogues, educational researchers, develop MOOC-pedagogy? In the first part of this paper, we’ll start with an overview of the MOOC-phenomenon. In the second part, we’ll discuss the implicit philosophical attitudes towards educational technology that underlies much of the MOOC-debates. We then argue that, rather than a theoretically grounded approach to educational technology, common sense attitudes of essentialism and instrumentalism prevail. In the last part of the paper, we suggest to concentrate on the educational design of technology and on the development of practices of study necessary to deal with technology, in order to develop a meaningful educational practice.

In this review essay we examine the consequences for education of the insights shared in the book Scarcity by Mullainathan and Shafir (2013). After a brief summary of the book, we describe three possible links between scarcity and 1) the creation of slack at school, 2) the student’s personal environment and 3) and the turning of learning into a production process. Based on these three possible consequences further avenues for research are presented.

This article reports of an ethnographic study conducted in two academic research centers. The article is centrally directed at the role of digital technologies and devices in contemporary academic work, and more particularly at the role of the screen in the daily composition of this work. Three central questions are raised. First, which positional relations do academics need to uphold with the screen in order for the screen to be able to operate? Second, in which forms do these digital devices come into being? Third, which sorts of (in)compatibility between activities are established because of the mutual interplay between academics and screens? By adopting a relational, sociomaterial approach, the study gives an account of the established choreographies that are enacted likewise, provides an overview of the role and operations of the screen in contemporary academic work, and analyzes which sorts of time and space are generated likewise.

Introduction: Worldwide, more than 20 million patients undergo groin hernia repair annually. The many different approaches, treatment indications and a significant array of techniques for groin hernia repair warrant guidelines to standardize care, minimize complications, and improve results. The main goal of these guidelines is to improve patient outcomes, specifically to decrease recurrence rates and reduce chronic pain, the most frequent problems following groin hernia repair. They have been endorsed by all five continental hernia societies, the International Endo Hernia Society and the European Association for Endoscopic Surgery. Methods: An expert group of international surgeons (the HerniaSurge Group) and one anesthesiologist pain expert was formed. The group consisted of members from all continents with specific experience in hernia-related research. Care was taken to include surgeons who perform different types of repair and had preferably performed research on groin hernia surgery. During the Group’s first meeting, evidence-based medicine (EBM) training occurred and 166 key questions (KQ) were formulated. EBM rules were followed in complete literature searches (including a complete search by The Dutch Cochrane database) to January 1, 2015 and to July 1, 2015 for level 1 publications. The articles were scored by teams of two or three according to Oxford, SIGN and Grade methodologies. During five 2-day meetings, results were discussed with the working group members leading to 136 statements and 88 recommendations. Recommendations were graded as “strong” (recommendations) or “weak” (suggestions) and by consensus in some cases upgraded. In the Results and summary section below, the term “should” refers to a recommendation. The AGREE II instrument was used to validate the guidelines. An external review was performed by three international experts. They recommended the guidelines with high scores. Results and summary: The risk factors for inguinal hernia (IH) include: family history, previous contra-lateral hernia, male gender, age, abnormal collagen metabolism, prostatectomy, and low body mass index. Peri-operative risk factors for recurrence include poor surgical techniques, low surgical volumes, surgical inexperience and local anesthesia. These should be considered when treating IH patients. IH diagnosis can be confirmed by physical examination alone in the vast majority of patients with appropriate signs and symptoms. Rarely, ultrasound is necessary. Less commonly still, a dynamic MRI or CT scan or herniography may be needed. The EHS classification system is suggested to stratify IH patients for tailored treatment, research and audit. Symptomatic groin hernias should be treated surgically. Asymptomatic or minimally symptomatic male IH patients may be managed with “watchful waiting” since their risk of hernia-related emergencies is low. The majority of these individuals will eventually require surgery; therefore, surgical risks and the watchful waiting strategy should be discussed with patients. Surgical treatment should be tailored to the surgeon’s expertise, patient- and hernia-related characteristics and local/national resources. Furthermore, patient health-related, life style and social factors should all influence the shared decision-making process leading up to hernia management. Mesh repair is recommended as first choice, either by an open procedure or a laparo-endoscopic repair technique. One standard repair technique for all groin hernias does not exist. It is recommended that surgeons/surgical services provide both anterior and posterior approach options. Lichtenstein and laparo-endoscopic repair are best evaluated. Many other techniques need further evaluation. Provided that resources and expertise are available, laparo-endoscopic techniques have faster recovery times, lower chronic pain risk and are cost effective. There is discussion concerning laparo-endoscopic management of potential bilateral hernias (occult hernia issue). After patient consent, during TAPP, the contra-lateral side should be inspected. This is not suggested during unilateral TEP repair. After appropriate discussions with patients concerning results tissue repair (first choice is the Shouldice technique) can be offered. Day surgery is recommended for the majority of groin hernia repair provided aftercare is organized. Surgeons should be aware of the intrinsic characteristics of the meshes they use. Use of so-called low-weight mesh may have slight short-term benefits like reduced postoperative pain and shorter convalescence, but are not associated with better longer-term outcomes like recurrence and chronic pain. Mesh selection on weight alone is not recommended. The incidence of erosion seems higher with plug versus flat mesh. It is suggested not to use plug repair techniques. The use of other implants to replace the standard flat mesh in the Lichtenstein technique is currently not recommended. In almost all cases, mesh fixation in TEP is unnecessary. In both TEP and TAPP it is recommended to fix mesh in M3 hernias (large medial) to reduce recurrence risk. Antibiotic prophylaxis in average-risk patients in low-risk environments is not recommended in open surgery. In laparo-endoscopic repair it is never recommended. Local anesthesia in open repair has many advantages, and its use is recommended provided the surgeon is experienced in this technique. General anesthesia is suggested over regional in patients aged 65 and older as it might be associated with fewer complications like myocardial infarction, pneumonia and thromboembolism. Perioperative field blocks and/or subfascial/subcutaneous infiltrations are recommended in all cases of open repair. Patients are recommended to resume normal activities without restrictions as soon as they feel comfortable. Provided expertise is available, it is suggested that women with groin hernias undergo laparo-endoscopic repair in order to decrease the risk of chronic pain and avoid missing a femoral hernia. Watchful waiting is suggested in pregnant women as groin swelling most often consists of self-limited round ligament varicosities. Timely mesh repair by a laparo-endoscopic approach is suggested for femoral hernias provided expertise is available. All complications of groin hernia management are discussed in an extensive chapter on the topic. Overall, the incidence of clinically significant chronic pain is in the 10–12% range, decreasing over time. Debilitating chronic pain affecting normal daily activities or work ranges from 0.5 to 6%. Chronic postoperative inguinal pain (CPIP) is defined as bothersome moderate pain impacting daily activities lasting at least 3 months postoperatively and decreasing over time. CPIP risk factors include: young age, female gender, high preoperative pain, early high postoperative pain, recurrent hernia and open repair. For CPIP the focus should be on nerve recognition in open surgery and, in selected cases, prophylactic pragmatic nerve resection (planned resection is not suggested). It is suggested that CPIP management be performed by multi-disciplinary teams. It is also suggested that CPIP be managed by a combination of pharmacological and interventional measures and, if this is unsuccessful, followed by, in selected cases (triple) neurectomy and (in selected cases) mesh removal. For recurrent hernia after anterior repair, posterior repair is recommended. If recurrence occurs after a posterior repair, an anterior repair is recommended. After a failed anterior and posterior approach, management by a specialist hernia surgeon is recommended. Risk factors for hernia incarceration/strangulation include: female gender, femoral hernia and a history of hospitalization related to groin hernia. It is suggested that treatment of emergencies be tailored according to patient- and hernia-related factors, local expertise and resources. Learning curves vary between different techniques. Probably about 100 supervised laparo-endoscopic repairs are needed to achieve the same results as open mesh surgery like Lichtenstein. It is suggested that case load per surgeon is more important than center volume. It is recommended that minimum requirements be developed to certify individuals as expert hernia surgeon. The same is true for the designation “Hernia Center”. From a cost-effectiveness perspective, day-case laparoscopic IH repair with minimal use of disposables is recommended. The development and implementation of national groin hernia registries in every country (or region, in the case of small country populations) is suggested. They should include patient follow-up data and account for local healthcare structures. A dissemination and implementation plan of the guidelines will be developed by global (HerniaSurge), regional (international societies) and local (national chapters) initiatives through internet websites, social media and smartphone apps. An overarching plan to improve access to safe IH surgery in low-resource settings (LRSs) is needed. It is suggested that this plan contains simple guidelines and a sustainability strategy, independent of international aid. It is suggested that in LRSs the focus be on performing high-volume Lichtenstein repair under local anesthesia using low-cost mesh. Three chapters discuss future research, guidelines for general practitioners and guidelines for patients. Conclusions: The HerniaSurge Group has developed these extensive and inclusive guidelines for the management of adult groin hernia patients. It is hoped that they will lead to better outcomes for groin hernia patients wherever they live. More knowledge, better training, national audit and specialization in groin hernia management will standardize care for these patients, lead to more effective and efficient healthcare and provide direction for future research.

There are several ways to discuss how the work of Michel Foucault has been used in educational philosophy and theory. After retracing some of the main references and debates, this contribution clarifies how Foucault discusses two traditions in philosophy – the analytic and the existential-ethical – in order to locate himself within the second, the existential-ethical tradition. This perspective allows us to explore Foucault’s relevance for philosophy of education at the level of philosophical ethos. This raises the question of the extent to which Foucault was often circling around educational issues, without really focusing on education.

Against the background of the many attacks on the school as being outdated, alienating, ineffective and reproducing inequalities we offer a morphological understanding of the school as distinguished from functionalist understandings (sociological or economical perspectives in terms of functions and roles) and idealistic understandings (philosophical ones in terms of ‘ideas of education’). Our educational morphology approaches the school as a particular scholastic ‘form of gathering’ i.e. a particular time–space–matter arrangement (including concrete architectures, technologies, practices and figures) that deals in a specific way with the new generation, allows for a particular relation to the world, and for a particular experience of potentiality and of commonality (of making things public). We elucidate how this form performs particular operations of suspension, profanation and formation of attention and how these operations imply a slowing down and an opening of future. Finally, we emphasise the potenti...

Objectives Current studies on the additional benefit of using computed tomography (CT) in order to evaluate the surgeons’ agreement on treatment plans for fracture are inconsistent. This inconsistency can be explained by a methodological phenomenon called ‘spectrum bias’, defined as the bias inherent when investigators choose a population lacking therapeutic uncertainty for evaluation. The aim of the study is to determine the influence of spectrum bias on the intra-observer agreement of treatment plans for fractures of the distal radius. Methods Four surgeons evaluated 51 patients with displaced fractures of the distal radius at four time points: T1 and T2: conventional radiographs; T3 and T4: radiographs and additional CT scan (radiograph and CT). Choice of treatment plan (operative or non-operative) and therapeutic certainty (five-point scale: very uncertain to very certain) were rated. To determine the influence of spectrum bias, the intra-observer agreement was analysed, using Kappa statistics, for each degree of therapeutic certainty. Results In cases with high therapeutic certainty, intra-observer agreement based on radiograph was almost perfect (0.86 to 0.90), but decreased to moderate based on a radiograph and CT (0.47 to 0.60). In cases with high therapeutic uncertainty, intra-observer agreement was slight at best (-0.12 to 0.19), but increased to moderate based on the radiograph and CT (0.56 to 0.57). Conclusion Spectrum bias influenced the outcome of this agreement study on treatment plans. An additional CT scan improves the intra-observer agreement on treatment plans for a fracture of the distal radius only when there is therapeutic uncertainty. Reporting and analysing intra-observer agreement based on the surgeon’s level of certainty is an appropriate method to minimise spectrum bias. Cite this article: Bone Joint Res 2015;4:190–194.

The transnational independent learner has become the new hero of the European learning space. In order to describe the mode of existence of the independent learner, an analysis in terms of deinstitutionalization falls short. Such analysis focuses on what disappeared but easily loses out of sight what comes instead. Especially in the case of the independent learner, the risk is taking the proclaimed ambition of liberation and emancipation of the learner from institutional settings for real. The person of the learner is not just what simply appears when the student is liberated from national and institutional frames. It is the carefully measured, calculated, monitored and framed architecture of new learning spaces that allow for recognizing oneself as a person, that is, as someone with specific learning needs. The need for authorization and recognition is part of the learner’s ontological make-up and means that the learner’s mode of existence is susceptible to verification, calculation and tracing. It is argued that this is the present-day manifestation of what Foucault termed as the ‘double bind’; what turns someone into an independent learner is subjecting her at once to governmental intervention.

It is striking to notice how learning and education are treated by philosophers and political and social theorists. In our contribution we will discuss the 'social learning philosophers' (e.g.Habermas, Latour), the 'enfance-philosophers' (e.g. Lyotard, Agamben, Arendt) and the 'game-philosophers' (e.g. Wittgenstein). From the perspective of these adult or grown-up philosophies and theories, learning is instrumentalized and, as a consequence, it is often marginalized, ridiculed or – when acknowledged – celebrated as a unique case, example or metaphor. To the extent that the importance of learning is recognized, it is about ‘natural’ learning and certainly not about ‘artificial’ schooling. In our contribution we exactly want to speak pedagogically about what is at stake in school learning. Instead of narrating about the (good, bad, great, sad) experiences of learning at school, this pedagogical language seeks to give voice to the experience while school learning. Not the experience of a condition where someone is not (yet) being able to, for instance, write or count. But also not the experience of (already) being able to write or count. School experience is what is experienced at the moment that writing or counting becomes a possibility; what is experienced before being able to write, but after not being able to write. School experiences refer to the collective experience of being-in-the-middle (of things), the experience of an interrupted course of life where new courses become possible, the experience of knowledge and ability after making a mistake. We want to argue that from a pedagogical perspective school is not an institution but the always artificial arrangement of time, space and matter you have to go to for these experiences. However, philosophers and social and political theorists often (rather) forget they too went to school.

A escola frequentemente é acusada como uma maquinaria normalizadora, colonizadora e alienante que está mais ou menos impondo e reproduzindo violentamente uma certa ordem social, principalmente mediante a língua usada e (a ser) aprendida. Algumas dessas análises são famosas. Uma delas, a sociolinguística de Basil Bernstein, faz uma distinção entre o uso de um código restrito e um elaborado, e sugere uma clara relação disso com a classe social. Outra delas é o ataque afiado de Illich à maneira pela qual várias autoridades políticas impõem uma língua ‘nacional’, desvalorizando desse modo línguas vernáculas. E outra, obviamente, é a crítica de Paulo Freire à maneira pela qual as ‘palavras’ (língua) do grupo social dominante (os opressores) não somente alienam os oprimidos de suas experiências, mas também operam como um mecanismo que instala e reproduz a injusta ordem social existente. Ainda que reconheçamos a importância e o valor dessas análises, em nossa contribuição argumentaremos, desde uma perspectiva estritamente pedagógica, que a escola sempre implica uma ruptura e um impacto (violentos) nas línguas ‘naturais’ (incluindo, de qualquer forma, também a língua do grupo dominante). E tentaremos indicar que, se a escola de fato opera como uma escola (isto é, não como uma instituição, mas como um tipo muito específico de se reunir pessoas e coisas, o qual espacializa ‘tempo livre’ e gramaticaliza o mundo), então a língua da escola também é uma língua por vir (ou em-form-ação), que invoca também uma comunidade por vir. Por consequência, a língua escolar é sempre artificial e em formação, e precisamente por isso, é também realmente emancipadora. The school has often been accused of being a normalizing, colonizing and alienating machinery that is more of less violently imposing and reproducing a certain social order and this mainly through the language which is used and (to be) learned. Some of the analyses are famous. The sociolinguistic one of Basil Bernstein making a distinction between the use of a restricted and an elaborated code and suggesting a clear relation to social class. Illich’ sharp attack of the way in which various political authorities imposed one ‘national’ language thereby devaluating vernacular languages. And of course, Paulo Freire’s critique of the way in which the ‘words’ (language) of the dominant social group (the oppressors) not only alienate the oppressed from their experiences but also operates as a mechanism to install and reproduce the existing unjust social order. While recognizing the importance and value of these analyses, in our contribution we will argue from a strictly pedagogical perspective that school always implies a (violent) rupture and impingement on the ‘natural’ language (including however also the language of the dominant group). And we will try to indicate that if the school actually operates as a school (that is not as an institution, but as a very particular kind of gathering of people and things that spatializes ‘free time’ and grammatizes the world), then the language of the school is also always a language to come (or in-form-ation) which invokes also a community to come. And hence, school language is always artificial and in the making and precisely therefore also truly emancipating. La escuela frecuentemente es acusada como una maquinaria normalizadora, colonizadora y alienante que está más o menos imponiendo o reproduciendo violentamente una cierta orden social, principalmente mediante la lengua usada y (a ser) aprendida. Alguno de esos análisis son famosos. Uno de ellos, la socioliguistica de Basil Berntein, hace una distinción entre el uso de un código restricto y uno elaborado y sugiere una clara relación de eso con la clase social. Otra de ellas es el afilado ataque de Illich, la manera por la cual varias autoridades políticas impone una lengua “nacional” desvalorizando de este modo lenguas vernáculas. Y otra, obviamente, es la crítica de Paulo Freire a la manera por la cual las “palabras” (lengua) del grupo social dominante (los opresores) no solamente alienan los oprimidos de sus experiencias, sino también operan como un mecanismo que instala y reproduce la injusta orden social existente. Aunque reconozcamos la importancia y el valor de esos análisis, en nuestra contribución argumentamos, desde una perspectiva estrictamente pedagógica, que la escuela siempre implica una ruptura y un impacto (violento) en las lenguas “naturales” (incluyendo, de cualquier forma, también la lengua del grupo dominante). E intentaremos indicar que, si la escuela de hecho opera como una escuela (esto es, no como una institución, pero como un tipo específico de reunir personas y cosas, lo cual espacializa “tiempo libre” y gramatizaliza el mundo), entonces la lengua de la escuela es también una lengua por venir (o en-forma-ción), que invoca también una comunidad por venir. En consecuencia, la lengua escolar es siempre artificial y en formación, y precisamente por eso, es también realmente emancipadora.

There is a substantial burden of disease in countries where the majority of the world’s groin hernia patients live. Although herniorrhaphy is one of the most commonly performed surgeries in undeserved areas, needs exceed capacity. This surgical “under-production” over time results in high hernia prevalence in populations. This in turn results in a high proportion of emergency surgery and significant morbidity and mortality. This, despite the fact that groin hernia repair is highly cost effective.

Over the last few years, different sociomaterial research orientations have emerged. In this article, we argue that most of these orientations are relying on a relational mode of thinking, that is, a way of conceiving of educational practices in terms of the relations between the different actors present in these particular practices. In doing so, these various sociomaterial studies share many of their theoretical assumptions with social topology, an approach inspired by the mathematical field of topology. In educational research, however, this connection between sociomaterial and sociotopological accounts is not commonly made. Therefore, this article calls for a more intricate interweaving of topological thinking with better-known sociomaterial approaches. Furthermore, we assert that using visualisations might play a crucial role in this respect. To that effect, we introduce the Foucauldian and Deleuzian notion of the diagram. This notion of the diagram, as the technique that brings the orders of...

NOSSAS CRIANÇAS NÃO SÃO NOSSAS CRIANÇAS OU PORQUE A ESCOLAR NÃO É UM AMBIENTE DE APRENDIZAGEM

This article explores the so-called studies of governmentality that address the field of education policy at the level of the enacted modes of government and self-government. Governmentality is a neologism introduced by Michel Foucault and refers to a perspective on the assembly of particular rationalities and forms of thought (‘mentalities’) with specific technologies and strategies to govern. ‘To govern’ is to be understood in a very broad sense: the structuring, guiding or shaping of people’s behaviour in very different contexts and in very different areas. Except for a specific approach of educational policy, the point of departure of studies of governmentality is a particular concern for the present and for how we live the present. The article reports on a research project that focuses on a particular region of what is considered to be important in ‘our’ present education: the collection and distribution of feedback information. By taking this case as a point of departure, the article discusses what is at stake in a so-called ontology of the present, the exact focus of an ‘interpretative analytics’ and the critical ambitions of studies of governmentality.