Use of GRADE for assessment of evidence about prognosis : rating confidence in estimates of event rates in broad categories of patients.

Main concepts : The Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) approach defines quality of evidence as confidence in effect estimates; this conceptualization can readily be applied to bodies of evidence estimating the risk of future of events (that is, prognosis) in broadly defined populations In the field of prognosis, a body of observational evidence (including single arms of randomized controlled trials) begins as high quality evidence. The five domains GRADE considers in rating down confidence in estimates of treatment effect-that is, risk of bias, imprecision, inconsistency, indirectness, and publication bias-as well as the GRADE criteria for rating up quality, also apply to estimates of the risk of future of events from a body of prognostic studies Applying these concepts to systematic reviews of prognostic studies provides a ful approach to determine confidence in estimates of overall prognosis in broad populations.

Business model design: an evaluation of paper-based and computer-aided canvases

In recent years, Business Model Canvas design has evolved from being a paper-based activity to one that involves the use of dedicated computer-aided business model design tools. We propose a set of guidelines to help design more coherent business models. When combined with functionalities offered by CAD tools, they show great potential to improve business model design as an ongoing activity. However, in order to create complex solutions, it is necessary to compare basic business model design tasks, using a CAD system over its paper-based counterpart. To this end, we carried out an experiment to measure user perceptions of both solutions. Performance was evaluated by applying our guidelines to both solutions and then carrying out a comparison of business model designs. Although CAD did not outperform paper-based design, the results are very encouraging for the future of computer-aided business model design.

Business potential evaluation of wireless local area networks: Teleoperator’s view

The objective of the thesis was to evaluate business potential of wireless local area networks (WLAN, Wireless LAN). At first, the scope of business potential evaluation of technology was introduced. Next, a general framework of business potential evaluation of technology based on literature was presented. In addition, convergence of cellular networks and data networks was studied in order to get an insight of current situation of mobile telecommunications industry. Finally, wireless local area networks business potential was evaluated. A wireless local area network is a data communication system, which combines data connectivity with mobility and is implemented in unlicensed frequency bands, allowing new business opportunities to emerge. The main markets of WLAN are corporate networks, public area networks and access networks. At the moment the penetration of WLAN terminals is low which derives to low demand of wireless LAN services. In addition, unlicensed spectrum forces the teleoperators to set the service price relatively low. The business potential is in integrating wireless LANs to cellular networks and in offering value added services to end users. The future of wireless LAN is to be complementary network to cellular networks. In this vision cellular networks provide voice and low data services and broadband wireless networks enable multimedia services.

Use of scenario analysis in studying emerging technology – Case Grid computing

Tutkimuksen selvitettiin miten skenaarioanalyysia voidaan käyttää uuden teknologian tutkimisessa. Työssä havaittiin, että skenaarioanalyysin soveltuvuuteen vaikuttaa eniten teknologisen muutoksen taso ja saatavilla olevan tiedon luonne. Skenaariomenetelmä soveltuu hyvin uusien teknologioiden tutkimukseen erityisesti radikaalien innovaatioiden kohdalla. Syynä tähän on niihin liittyvä suuri epävarmuus, kompleksisuus ja vallitsevan paradigman muuttuminen, joiden takia useat muut tulevaisuuden tutkimuksen menetelmät eivät ole tilanteessa käyttökelpoisia. Työn empiirisessä osiossa tutkittiin hilaverkkoteknologian tulevaisuutta skenaarioanalyysin avulla. Hilaverkot nähtiin mahdollisena disruptiivisena teknologiana, joka radikaalina innovaationa saattaa muuttaa tietokonelaskennan nykyisestä tuotepohjaisesta laskentakapasiteetin ostamisesta palvelupohjaiseksi. Tällä olisi suuri vaikutus koko nykyiseen ICT-toimialaan erityisesti tarvelaskennan hyödyntämisen ansiosta. Tutkimus tarkasteli kehitystä vuoteen 2010 asti. Teorian ja olemassa olevan tiedon perusteella muodostettiin vahvaan asiantuntijatietouteen nojautuen neljä mahdollista ympäristöskenaariota hilaverkoille. Skenaarioista huomattiin, että teknologian kaupallinen menestys on vielä monen haasteen takana. Erityisesti luottamus ja lisäarvon synnyttäminen nousivat tärkeimmiksi hilaverkkojen tulevaisuutta ohjaaviksi tekijöiksi.

Assessing the sociology of sport: On sport organizations and critical knowledge

The purpose of this contribution is to analyse the trajectory, the challenges and the future of the sociology of sport on three levels: the internal dynamic within the specific sub-field of the sociology of sport, its interactions with sociology and sport sciences, and its relation with sport organizations. The paper notes that the changes of the trajectory of the sociology of sport, first leaning on the profession of physical education teacher and then to sport sciences, as important consequences. Because most of the sociologists specialized in sport are working in sport sciences departments, the most important consequence is the dependency on sport sciences rather than on sociology. Compared to other fields of sociology, it means challenging other sciences for recognition. The paper argues that to face the threat of a marginalization within the field of sport science, the future of sociology of sport could be to fight for an external recognition. Applying sociology could spread critical views that are necessary to sport organizations. It could also give sociologists access to very interesting data, which can help producing good research, and give it a greater legitimacy within sport sciences. However, it is a risky strategy because of the necessity for the sociologists to stay critical both on sporting organization and on their own work.

Scenario Analysis of the Location Based Services Industry

Tutkimuksen tavoitteena oli luoda erilaisia skenaariota paikka riippuvaisten palveluiden toimialan tulevaisuudesta. Tunnistamalla nykyisiä sekä tulevia alaa edistäviä ja rajoittavia tekijöitä kolme skenaariota luotiin, jotka mahdollisesti kuvaisivat paikka riippuvaisten palveluiden toimialaa viiden vuoden päästä: "Massa spämmaus", "Raju operaattori kilpailu - nousevia yksityisyyden huolia" sekä "Nokian ajama kolmannen sukupolven verkot tulevat ennen odotettua" Skenaarioiden luomiseksi ensimmäinen osa tutkimuksesta keskittyi erilaisiin skenaarioiden kirjoitus prosesseihin ja niissä huomioitaviin asioihin. Tutkimuksen tarkoituksiin sopiva skenaarion kirjoitusprosessi esiteltiin, minkä jälkeen| paikkariippuvaisten palveluiden toimialaa käsiteltiin. Lopuksi itse skenaariot esiteltiin ja nimettiin skenaarioiden teemojen mukaan. Tutkimuksen johtopäätös on, ettei toimialan tulevaisuutta voida ennustaa riittävällä varmuudella. Tutkimuksen arvo kuitenkin piilee sen antamassa ymmärryksessä liittyen tekijöihin, jotka tulevat päättämään alan tulevaisuuden sekä skenaariossa, joita nämä tekijät voivat muodostaa.

Gaining momentum: New options and opportunities for the treatment of advanced melanoma.

Before 2011, patients with advanced or metastatic melanoma had a particularly poor long-term prognosis. Since traditional treatments failed to confer a survival benefit, patients were preferentially entered into clinical trials of investigational agents. A greater understanding of the epidemiology and biology of disease has underpinned the development of newer therapies, including six agents that have been approved in the EU, US and/or Japan: a cytotoxic T-lymphocyte antigen-4 inhibitor (ipilimumab), two programmed cell death-1 receptor inhibitors (nivolumab and pembrolizumab), two BRAF inhibitors (vemurafenib and dabrafenib) and a MEK inhibitor (trametinib). The availability of these treatments has greatly improved the outlook for patients with advanced melanoma; however, a major consideration for physicians is now to determine how best to integrate these agents into clinical practice. Therapeutic decisions are complicated by the need to consider patient and disease characteristics, and individual treatment goals, alongside the different efficacy and safety profiles of agents with varying mechanisms of action. Long-term survival, an outcome largely out of reach with traditional systemic therapies, is now a realistic goal, creating the additional need to re-establish how clinical benefit is evaluated. In this review we summarise the current treatment landscape in advanced melanoma and discuss the promise of agents still in development. We also speculate on the future of melanoma treatment and discuss how combination and sequencing approaches may be used to optimise patient care in the future.

The autonomic nervous activity of hostile acting

The present talk aims to examine the heart-rate variability (HRV) indexes of two populations known to be particularly sensitive to stress condition: violent offenders and intellectually impaired patients. For both, difficulties in managing stressful and emotional events could lead to unpredictable and hostile acting. Results in favour of specific HRV baseline patterns and emotional control will be developed, as the proposition of precursors of agitation in the physiological fluctuations preceding high tensed episodes. The improvement offered by coherent breathing trainings will be discussed for both groups.

Olympic social responsibility : a challenge for the future

Social responsibility, especially in the fields of education, society and peace, is one of the cornerstones of the olympic ideal and strategic vision (contribute to building a better world through sport). The article reviews the literature on organizational social responsibility (OSR) and the relationship between sport/olympism and OSR in order to examine the conditions governing the implementation and success of the International Olympic Committee's strategic vision. Several ways in which the IOC could promote a more ambitious and better-integrated social strategy: revise its performance model, notably evaluate and present in a social responsibility report; promote the adoption of OSR initiatives and strategies within the Olympic System from the bottom-up, rather than from the top-down; share best practices in the different countries for promoting and developing "sport for all"; create a World Agency for Development through Sport, or partnering and funding the international platform on sport and development; creating a World Agency for the International Governance of Sport. Two possible scenarios for the future of Olympic responsibility are finally discussed: strategy of "small steps" and a more ambitious local and global social strategy through sport and olympism.

Ten years of R&D and full automation in molecular diagnosis.

A 10-year experience of our automated molecular diagnostic platform that carries out 91 different real-time PCR is described. Progresses and future perspectives in molecular diagnostic microbiology are reviewed: why automation is important; how our platform was implemented; how homemade PCRs were developed; the advantages/disadvantages of homemade PCRs, including the critical aspects of troubleshooting and the need to further reduce the turnaround time for specific samples, at least for defined clinical settings such as emergencies. The future of molecular diagnosis depends on automation, and in a novel perspective, it is time now to fully acknowledge the true contribution of molecular diagnostic and to reconsider the indication for PCR, by also using these tests as first-line assays.

Maritime transportation in the Gulf of Finland in 2007 and in 2015

The Gulf of Finland is said to be one of the densest operated sea areas in the world. It is a shallow and economically vulnerable sea area with dense passenger and cargo traffic of which petroleum transports have a share of over 50 %. The winter conditions add to the risks of maritime traffic in the Gulf of Finland. It is widely believed that the growth of maritime transportation will continue also in the future. The Gulf of Finland is surrounded by three very different national economies with, different maritime transportation structures. Finland is a country of high GDP/per capita with a diversified economic structure. The number of ports is large and the maritime transportation consists of many types of cargoes: raw materials, industrial products, consumer goods, coal and petroleum products, and the Russian transit traffic of e.g. new cars and consumer goods. Russia is a large country with huge growth potential; in recent years, the expansion of petroleum exports has lead to a strong economic growth, which is also apparent in the growth of maritime transports. Russia has been expanding its port activities in the Gulf of Finland and it is officially aiming to transport its own imports and exports through the Russian ports in the future; now they are being transported to great extend through the Finnish, Estonian and other Baltic ports. Russia has five ports in the Gulf of Finland. Estonia has also experienced fast economic growth, but the growth has been slowing down already during the past couples of years. The size of its economy is small compared to Russia, which means the transported tonnes cannot be very massive. However, relatively large amounts of the Russian petroleum exports have been transported through the Estonian ports. The future of the Russian transit traffic in Estonia looks nevertheless uncertain and it remains to be seen how it will develop and if Estonia is able to find replacing cargoes if the Russian transit traffic will come to an end in the Estonian ports. Estonia’s own import and export consists of forestry products, metals or other raw materials and consumer goods. Estonia has many ports on the shores of the Gulf of Finland, but the port of Tallinn dominates the cargo volumes. In 2007, 263 M tonnes of cargoes were transported in the maritime traffic in the Gulf of Finland, of which the share of petroleum products was 56 %. 23 % of the cargoes were loaded or unloaded in the Finnish ports, 60 % in the Russian ports and 17 % in the Estonian ports. The largest ports were Primorsk (74.2 M tonnes) St. Petersburg (59.5 M tonnes), Tallinn (35.9 M tonnes), Sköldvik (19.8 M tonnes), Vysotsk (16.5 M tonnes) and Helsinki (13.4 M) tonnes. Approximately 53 600 ship calls were made in the ports of the Gulf of Finland. The densest traffic was found in the ports of St. Petersburg (14 651 ship calls), Helsinki (11 727 ship calls) and Tallinn (10 614 ship calls) in 2007. The transportation scenarios are usually based on the assumption that the amount of transports follows the development of the economy, although also other factors influence the development of transportation, e.g. government policy, environmental aspects, and social and behavioural trends. The relationship between the development of transportation and the economy is usually analyzed in terms of the development of GDP and trade. When the GDP grows to a certain level, especially the international transports increase because countries of high GDP produce, consume and thus transport more. An effective transportation system is also a precondition for the economic development. In this study, the following factors were taken into consideration when formulating the future scenarios: maritime transportation in the Gulf of Finland 2007, economic development, development of key industries, development of infrastructure and environmental aspects in relation to maritime transportation. The basic starting points for the three alternative scenarios were: • the slow growth scenario: economic recession • the average growth scenario: economy will recover quickly from current instability • the strong growth scenario: the most optimistic views on development will realize According to the slow growth scenario, the total tonnes for the maritime transportation in the Gulf of Finland would be 322.4 M tonnes in 2015, which would mean a growth of 23 % compared to 2007. In the average growth scenario, the total tonnes were estimated to be 431.6 M tonnes – a growth of 64 %, and in the strong growth scenario 507.2 M tonnes – a growth of 93%. These tonnes were further divided into petroleum products and other cargoes by country, into export, import and domestic traffic by country, and between the ports. For petroleum products, the share of crude oil and oil products was estimated and the number of tanker calls in 2015 was calculated for each scenario. However, the future development of maritime transportation in the GoF is dependent on so many societal and economic variables that it is not realistic to predict one exact point estimate value for the cargo tonnes for a certain scenario. Plenty of uncertainty is related both to the degree in which the scenario will come true as well as to the cause-effect relations between the different variables. For these reasons, probability distributions for each scenario were formulated by an expert group. As a result, a range for the total tonnes of each scenario was formulated and they are as follows: the slow growth scenario: 280.8 – 363 M tonnes (expectation value 322.4 M tonnes)

Back to the island of calm: mallorcan human traditional medicine and ethnobotany

This study reveals that a successful ethnobotanical survey can take place still nowadays, even close to one of the hotspots of tourism in the Mediterranean coast. This is the first approach in this field entirely based on interviews with local people in Mallorca. An amount of 235 informants has been inquired from all the 53 municipalities of the island. The data collected have been analyzed from the botanical and ethnographical points of view, and managed using the online platform of our research team (details at www.etnobiofic.cat). The Mallorcan ethnopharmacopoeia includes 255 plant taxa referring more than 150 medicinal use categories. Ethnomedical queries as the one here presented contribute to the knowledge of the traditional use of plants of the island and appreciate the benefits of this knowledge, applied to the present and future of its society.

Back to the island of calm: Mallorcan human traditional medicine and ethnobotany

This study reveals that a successful ethnobotanical survey can take place still nowadays, even close to one of the hotspots of tourism in the Mediterranean coast. This is the first approach in this field entirely based on interviews with local people in Mallorca. An amount of 235 informants has been inquired from all the 53 municipalities of the island. The data collected have been analyzed from the botanical and ethnographical points of view, and managed using the online platform of our research team (details at www.etnobiofic.cat). The Mallorcan ethnopharmacopoeia includes 255 plant taxa referring more than 150 medicinal use categories. Ethnomedical queries as the one here presented contribute to the knowledge of the traditional use of plants of the island and appreciate the benefits of this knowledge, applied to the present and future of its society.

Past, present and future - assessing changes in aquatic environments using subfossil diatoms

The deterioration of surface waters is one of the most important issues in the environmental management of the European Union. Thus, the EU Water Framework Directive 2000/60/EC (WFD) requires “good ecological and chemical status” of surface waters by 2015 allowing only a slight departure from ecological reference conditions characterized by the biological communities typical for the conditions of minimal anthropogenic impact. The WFD requires the determination of ecological reference conditions and the present ecological status of surface waters. To meet this legislative demand, sedimentary diatom assemblages were used in these studies with various methods 1) to assess natural and human activity induced environmental changes, 2) to characterize background conditions 3) to evaluate the present ecological status and 4) to predict the future of the water bodies in the light of palaeolimnological data. As the WFD refers to all surface waters, both coastal and inland sites were included. Two long and two short sediment cores from the Archipelago Sea in the northern Baltic Sea were examined for their siliceous microfossils in order to assess (1) the Holocene palaeoenvironmental history and (2) the recent eutrophication of the area. The diatom record was divided into local diatom assemblage zones (LDAZ, long cores) and diatom assemblage zones (DAZ, short cores). Locally weighted weighted averaging regression and calibration (LWWA) was applied for the quantitative reconstruction of past TN concentrations (short cores). An age model for the long cores was constructed by using independent palaeomagnetic and AMS-14C methods. The short cores were dated using radiometric (210Pb, 226Ra and 137Cs) methods. The long cores date back to the early history of the Archipelago Sea, which was freshwater – no salinity increase referable to the brackish phase of the Yoldia Sea is recognized. The nutrient status of the lacustrine phase was slightly higher in the Archipelago Sea than in the Baltic Proper. Initial brackish-water influence is observed at 8 150 ±80 cal. BP (LDAZ4), but fully brackish conditions were established at 7 700 ±80 cal. BP (LDAZ5). The diatom assemblages indicate increasing salinity, warming climate and possible eutrophic conditions during the lacustrine to brackish-water transition. The decreasing abundance of Pseudosolenia calcar-avis (Schultze) Sundström and the increasing abundance of the ice-cover indicator species Pauliella taeniata (Grunow) Round and Basson indicate decreasing salinity and climatic cooling after ca. 5 000 cal. BP. Signs of eutrophication are visible in the most recent diatom assemblage zones of both short cores. Diatom-inferred total nitrogen (DI-TN) reconstructions partially fail to trace the actual measured total nitrogen concentrations especially from the late 1980s to the mid 1990s. This is most likely due to the dominating diatom species Pauliella taeniata, Thalassiosira levanderi Van Goor and Fragilariopsis cylindrus (Grunow) W. Krieger being more influenced by factors such as the length of the ice-season rather than nutrient concentrations. It is concluded that the diatom assemblages of the study sites are principally governed by climate fluctuations, with a slight influence of eutrophication visible in the most recent sediments. There are indications that global warming, with reduced ice cover, could impact the spring blooming diatom species composition in the Archipelago Sea. In addition, increased sediment accumulation in the early 90s coincides with the short ice-seasons suggesting that warming climate with decreasing ice-cover may increase sedimentation in the study area. The diverse diatom assemblages dominated by benthic species (54 %) in DAZ1 in the Käldö Fjärd core can be taken as background diatom assemblages for the Archipelago Sea. Since then turbidity has increased and the diatom assemblages have been dominated by planktonic diatoms from around the mid 1800s onwards. The reconstructed reference conditions for the total nitrogen concentrations fluctuate around 400 μg l-1. Altogether two short sediment cores and eight short cores for top-bottom analysis were retrieved from Lake Orijärvi and Lake Määrjärvi to assess the impact of the acid mine drainage (AMD) derived metals from the Orijärvi mine tailings on the diatom communities of the lakes. The Cu (Pb, Zn) mine of Orijärvi (1757 – 1956) was the first one in Finland where flotation techniques (1911 – 1955) were used to enrich ore and large quantities of tailings were produced. The AMD derived metal impact to the lakes was found to be among the heaviest thus far recorded in Finland. Concentrations of Cu, Pb and Zn in Lake Orijärvi sediments are two to three orders of magnitude higher than background values. The metal inputs have affected Lake Orijärvi and Lake Määrjärvi diatom communities at the community levels through shifts in dominant taxa (both lakes) and at the individual level through alteration in frustule morphology (Lake Orijärvi). At present, lake water still has elevated heavy metal levels, indicating that the impact from the tailings area continues to affect both lakes. Lake Orijärvi diatom assemblages are completely dominated by benthic species and are lacking planktonic diatoms. In Lake Määrjärvi the proportion of benthic and tychoplanktonic diatoms has increased and the planktonic taxa have decreased in abundance. Achnanthidium minutissimum Kützing and Brachysira vitrea (Grun.) R. Ross in Hartley were the most tolerant species to increased metal concentrations. Planktonic diatoms are more sensitive to metal contamination than benthic taxa, especially species in the genus Cyclotella (Kützing) Brébisson. The ecological reference conditions assessed in this study for Lake Orijärvi and Lake Määrjärvi comprise diverse planktonic and benthic communitites typical of circumneutral oligotrophic lakes, where the planktonic diatoms belonging to genera Cyclotella , Aulacoseira Thwaites, Tabellaria Ehrenberg and Asterionella Hassall dominate in relative abundances up to ca. 70%. The benthic communities are more diverse than the planktonic consisting of diatoms belonging to the genera Achnanthes Bory, Fragilaria Lyngbye and Navicula St. Vincent. This study clearly demonstrates that palaeolimnological methods, especially diatom analysis, provide a powerful tool for the EU Water Frame Work Directive for defining reference conditions, natural variability and current status of surface waters. The top/bottom approach is a very useful tool in larger-scale studies needed for management purposes. This “before and after” type of sediment sampling method can provide a very time and cost effective assessment of ecological reference conditions of surface waters.

The cultural dimension in focus : promoting awareness of diversity and respect for difference in a Finland-Swedish EFL classroom

This study addresses the role of EFL education, its potential and shortcomings, and the challenges the future of EFL education will bring. It is argued that new societal demands and the limited time we have at our disposal in the classroom make it necessary to rethink goals and content and move away from the transmissionof limited sets of facts and information to helping students develop awareness and competences that can be applied in many different situations, also in a perspective of lifelong learning. The overall aim of the current study is to problematize and increase understanding of the implementation of cultural aspects in the language classroom by addressing the interrelated what, why and how of the cultural dimension within EFL education. This has been conducted by means of theoretical explorations into the area, alongside an attempt at promoting intercultural competence (IC) in a more systematic and insightful manner within my own educational praxis. The focus of the intercultural work in the classroom was on the promotion of awareness of difference and diversity, as well as respect for such difference through the ability to decenter from cultural norms and behavior that previously have been taken for granted. These are two elements that have been suggested as fundamental for other work with IC in the classroom and for the realization of important aspects of the underlying values of basic education. In the context of this study, IC comprises several interconnected components supportingeach other in a variety of ways, with the further aim being interaction with and respect for difference in general, not only concerning e.g. representatives ofcertain English-speaking communities. The methodology was informed by action research, with myself in the role of the teacher-researcher or the reflective practitioner. For the purpose of the project I was authorized to take on the EFL education for the three years of upper comprehensive school of one random class of students originally assigned to one of the language teachers of the selected Finland-Swedish school. Thus, the class of 17 students was not specifically chosen for the project, and the aims and contents chosen for the development project were placed within the framework of the ordinary curriculum. By exploring the students¿ insights concerning different English-speaking cultural groups, mainly through a set of questionnaires, it was possible to outline the work with the cultural dimension in the classroom for the following three years. Work progress was evaluated at specific stages, and the final project evaluations were conducted through individual student interviews in grade 9. The interviews were focused on possible development of students¿ insights concerning different aspects of the cultural dimension. In particular this concerned awareness of difference and diversity, including modification of stereotypes, as well as the ability to decenterin order to be better able to respect such difference. I also explored students¿ awareness and views of the activities and approaches used in class, as well asaffordances both inside and outside the EFL classroom in relation to these intended insights. A further focus area was the perceived relevance to students of different aspects of the cultural dimension. The frameworks and approaches adopted for the work in the classroom all have in common that they are based on a constructivist framework, where knowledge is constructed and reconstructed through interaction with one¿s social and cultural environment, including interaction with others. Reflective processes precede or are simultaneous with the learning of basic factual knowledge. This entails a view of learning as a progression from simple to more complex models rather than as a progression from facts to understanding and analysis. Here, the development of intercultural competence is seen asa cyclical process, or along a spiral curriculum, from simple to more complex levels through a combination of cognitive, affective and behavioral elements within a framework of experiential learning. This project has shown one possible wayforward concerning the development of intercultural competence within EFL education through a more systematic and comprehensive approach regarding linguistic and cultural aspects. The evaluation of the educational process explored in the study suggests the possibilities for work with the promotion of awareness of difference and diversity concerning some specific context that, based on students¿ prior knowledge and preconceptions, would benefit from further work. In this case, the specific context primarily concerned different aspects of both cultural and linguistic conditions in the UK. It is also suggested that many students developed the ability to decenter, described in the study as integral to being able to respect otherness. What still remains to be explored are more individualized approaches considering students¿ different levels of departure. Further work alsoneeds to be put into how to apply insights gained in these specific situations to more general contexts. It is also necessary to explore the use of the suggested approaches in a wider range of different contexts.