Aktiiviseen kansalaisuuteen kasvattaminen yläkoulun maantieteen opetuksessa

Tutkielmassa tarkasteltiin aktiivista kansalaisuutta perusopetuksen yläkoulun (luokat 7–9) maantieteen opetuksessa. Tutkielman taustana olivat aktiiviseen kansalaisuuteen liittyvät viralliset ja epäviralliset diskurssit: opetussuunnitelman perusteiden aihekokonaisuudet, kouluun kohdistuvat kansalaiskasvatushankkeet sekä nuoriin, kansalaisuuteen ja kansalaisyhteiskuntaan liittyvät keskustelut. Maantieteen opetuksen osalta taustana olivat opetussuunnitelman velvoitteet huomioida aktiivinen kansalaisuus yläkoulun maantieteen opetuksessa sekä (pääasiassa brittiläinen) kirjallisuus, jossa maantieteen ja kansalaiskasvatuksen/aktiivisen kansalaisuuden välillä nähdään yhtäläisyyksiä. Tutkielmassa pyrittiin selvittämään, mitä aktiivinen kansalaisuus on yläkoulun maantieteen opetuksessa ja miten maantieteen opettajat suhtautuvat tehtäviinsä nuorten kansalaisten kasvattajina ja yhteiskunnallisina vaikuttajina. Tutkielmaa varten kerättiin teemahaastatteluaineisto kuudelta yläkoulun maantieteen opettajalta. Haastatteluihin pyrittiin löytämään mahdollisimman aktiivisia maantieteen opettajia. Haastatteluaineiston analyysissa käytettiin sisällönanalyysia, ja aineiston avulla pyrittiin kuvaamaan ilmiötä. Haastateltujen opettajien mukaan yläkoulun maantieteen opetuksessa luonnonmaantieteelliset sisällöt painottuvat enemmän kuin kulttuurimaantieteelliset. Aktiivisen kansalaisuuden kannalta keskeisiä sisältöjä, kuten vaikutusmahdollisuuksia oman ympäristön suunnitteluun ja kehittymiseen sekä kotikunnan ja lähiympäristön tutkimista käsitellään opetuksessa vain vähän, jos ollenkaan. Aktiivinen kansalaisuus on yläkoulun maantieteen opetuksessa eniten tiedon jakamista, ajattelun taitojen ja mielipiteen muodostamisen harjoittelua sekä ympäristövastuullisuuteen kansalaisuuteen kasvattamista. Opetuksessa käytetään myös aktiivisen kansalaisuuden kannalta keskeisiä työtapoja, mutta työtapojen käyttö vaihtelee. Haastatellut opettajat eivät koe opetussuunnitelman aihekokonaisuuksia juurikaan omakseen. Opettajat eivät myöskään määrittele kansalaisvaikuttamiseen kasvattamista koulun tärkeimpien tehtävien joukkoon. Osa opettajista kokee kuitenkin olevansa yhteiskunnallinen vaikuttaja opettajana. Opettajien puheessa koulun kansalaiskasvatuksen tavoite, kunnon kansalainen, ei määrity kovin aktiivisena tai poliittisena. Opettajien puhe sisältää kuitenkin monenlaisia näkemyksiä suhteessa nuoriin kansalaisina ja aktiivisuuteen: toisaalta nuoret eivät ole kiinnostuneita yhteiskunnallisista asioista eikä heiltä vaaditakaan sitä, toisaalta maaperä nuorten kasvattamiseen aktiivisiksi kansalaisiksi on hyvä ja aktiivisuus on pieniä asioita lähiympäristössä sekä yhdessä tekemiseen uskomista. Haastattelujen pohjalta todettiin, että lukuun ottamatta joidenkin opettajien ympäristökasvatuksellista otetta, aktiivinen kansalaisuus ei ole täysin tiedostettu tavoite yläkoulun maantieteen opetuksessa.

Coffee and risk of type 2 diabetes

Type 2 diabetes is one of the diseases that largely determined by lifestyle factors. Coffee is one of the most consumed beverages in the world and recently released data suggest the effects of coffee consumption on type 2 diabetes. The objective of the present study was to evaluate the effects of habitual coffee consumption on various aspects of type 2 diabetes and its most common complications. This study is part of the national FINRISK studies. Baseline surveys were carried out between 1972 and 1997. The surveys covered two eastern regions in 1972 and 1977, but were expanded to include a third region in southwestern Finland in 1982, 1987, 1992, and 1997. The Helsinki capital area was included in the survey in 1992 and 1997 and the Oulu province, in northern Finland, in 1997. Each survey was drawn from an independent random sample of the national register of subjects aged 25-64. In 1997, an additional sample of subjects aged 65-74 was conducted. The blood pressure, weight, and height of subjects were measured. By using self-administered questionnaires data were collected on medical history, socioeconomic factors, physical activity, smoking habits, and alcohol, coffee, and tea consumption. Higher coffee consumption was associated with higher body mass index, occupational physical activity and cigarette smoking, and lower blood pressure, education level, leisure time physical activity, tea consumption and alcohol use. Age, body mass index, systolic blood pressure and current smoking were positively associated with the risk of type 2 diabetes, however, education, and occupational, commuting and leisure time physical activity were inversely associated. The significant inverse association between coffee consumption and the risk of type 2 diabetes was found in both sexes but the association was stronger in women. Coffee consumption was significantly and inversely associated with fasting glucose, 2-hour plasma glucose, fasting insulin, impaired fasting glucose, impaired glucose regulation, and hyperinsulinemia among both men and women and with isolated impaired glucose tolerance among women. Serum gamma-glutamyltransferase modified the association between coffee consumption and incident diabetes. Among subjects with high serum -glutamyltransferase (>75th percentile), coffee consumption showed an inverse association for women, as well as men and women combined. An inverse association also occurred between coffee consumption and the risk of total, cardiovascular disease, and coronary heart disease mortality among patients with type 2 diabetes. The results of this study showed that habitual coffee consumption may be associated with a reduced risk of type 2 diabetes. Coffee consumption may have some effects on several markers of glycemia, and may lower the incident of type 2 diabetes in high normal serum -glutamyltransferase levels. Total, cardiovascular disease, and coronary heart disease mortality rate among subjects with type 2 diabetes may also be reduced by coffee consumption.

Anthropometric measures of obesity-their association with type 2 diabetes and hypertension across ethnic groups

Clinical trials have shown that weight reduction with lifestyles can delay or prevent diabetes and reduce blood pressure. An appropriate definition of obesity using anthropometric measures is useful in predicting diabetes and hypertension at the population level. However, there is debate on which of the measures of obesity is best or most strongly associated with diabetes and hypertension and on what are the optimal cut-off values for body mass index (BMI) and waist circumference (WC) in this regard. The aims of the study were 1) to compare the strength of the association for undiagnosed or newly diagnosed diabetes (or hypertension) with anthropometric measures of obesity in people of Asian origin, 2) to detect ethnic differences in the association of undiagnosed diabetes with obesity, 3) to identify ethnic- and sex-specific change point values of BMI and WC for changes in the prevalence of diabetes and 4) to evaluate the ethnic-specific WC cutoff values proposed by the International Diabetes Federation (IDF) in 2005 for central obesity. The study population comprised 28 435 men and 35 198 women, ≥ 25 years of age, from 39 cohorts participating in the DECODA and DECODE studies, including 5 Asian Indian (n = 13 537), 3 Mauritian Indian (n = 4505) and Mauritian Creole (n = 1075), 8 Chinese (n =10 801), 1 Filipino (n = 3841), 7 Japanese (n = 7934), 1 Mongolian (n = 1991), and 14 European (n = 20 979) studies. The prevalence of diabetes, hypertension and central obesity was estimated, using descriptive statistics, and the differences were determined with the χ2 test. The odds ratios (ORs) or  coefficients (from the logistic model) and hazard ratios (HRs, from the Cox model to interval censored data) for BMI, WC, waist-to-hip ratio (WHR), and waist-to-stature ratio (WSR) were estimated for diabetes and hypertension. The differences between BMI and WC, WHR or WSR were compared, applying paired homogeneity tests (Wald statistics with 1 df). Hierarchical three-level Bayesian change point analysis, adjusting for age, was applied to identify the most likely cut-off/change point values for BMI and WC in association with previously undiagnosed diabetes. The ORs for diabetes in men (women) with BMI, WC, WHR and WSR were 1.52 (1.59), 1.54 (1.70), 1.53 (1.50) and 1.62 (1.70), respectively and the corresponding ORs for hypertension were 1.68 (1.55), 1.66 (1.51), 1.45 (1.28) and 1.63 (1.50). For diabetes the OR for BMI did not differ from that for WC or WHR, but was lower than that for WSR (p = 0.001) in men while in women the ORs were higher for WC and WSR than for BMI (both p < 0.05). Hypertension was more strongly associated with BMI than with WHR in men (p < 0.001) and most strongly with BMI than with WHR (p < 0.001), WSR (p < 0.01) and WC (p < 0.05) in women. The HRs for incidence of diabetes and hypertension did not differ between BMI and the other three central obesity measures in Mauritian Indians and Mauritian Creoles during follow-ups of 5, 6 and 11 years. The prevalence of diabetes was highest in Asian Indians, lowest in Europeans and intermediate in others, given the same BMI or WC category. The  coefficients for diabetes in BMI (kg/m2) were (men/women): 0.34/0.28, 0.41/0.43, 0.42/0.61, 0.36/0.59 and 0.33/0.49 for Asian Indian, Chinese, Japanese, Mauritian Indian and European (overall homogeneity test: p > 0.05 in men and p < 0.001 in women). Similar results were obtained in WC (cm). Asian Indian women had lower  coefficients than women of other ethnicities. The change points for BMI were 29.5, 25.6, 24.0, 24.0 and 21.5 in men and 29.4, 25.2, 24.9, 25.3 and 22.5 (kg/m2) in women of European, Chinese, Mauritian Indian, Japanese, and Asian Indian descent. The change points for WC were 100, 85, 79 and 82 cm in men and 91, 82, 82 and 76 cm in women of European, Chinese, Mauritian Indian, and Asian Indian. The prevalence of central obesity using the 2005 IDF definition was higher in Japanese men but lower in Japanese women than in their Asian counterparts. The prevalence of central obesity was 52 times higher in Japanese men but 0.8 times lower in Japanese women compared to the National Cholesterol Education Programme definition. The findings suggest that both BMI and WC predicted diabetes and hypertension equally well in all ethnic groups. At the same BMI or WC level, the prevalence of diabetes was highest in Asian Indians, lowest in Europeans and intermediate in others. Ethnic- and sex-specific change points of BMI and WC should be considered in setting diagnostic criteria for obesity to detect undiagnosed or newly diagnosed diabetes.