Fatigue fractures in military conscripts : A study on risk factors, diagnostics and long-term consequences

Fatigue fracture is an overuse injury commonly encountered in military and sports medicine, and known to relate to intensive or recently intensified physical activity. Bone responds to increased stress by enhanced remodeling. If physical stress exceeds bone s capability to remodel, accumulation of microfractures can lead to bone fatigue and stress fracture. Clinical diagnosis of stress fractures is complex and based on patient s anamnesis and radiological imaging. Bone stress fractures are mostly low-risk injuries, healing well after non-operative management, yet, occurring in high-risk areas, stress fractures can progress to displacement, often necessitating surgical treatment and resulting in prolonged morbidity. In the current study, the role of vitamin D as a predisposing factor for fatigue fractures was assessed using serum 25OHD level as the index. The average serum 25OHD concentration was significantly lower in conscripts with fatigue fracture than in controls. Evaluating TRACP-5b bone resorption marker as indicator of fatigue fractures, patients with elevated serum TRACP-5b levels had eight times higher probability of sustaining a stress fracture than controls. Among the 154 patients with exercise induced anterior lower leg pain and no previous findings on plain radiography, MRI revealed a total of 143 bone stress injuries in 86 patients. In 99% of the cases, injuries were in the tibia, 57% in the distal third of the tibial shaft. In patients with injury, forty-nine (57%) patients exhibited bilateral stress injuries. In a 20-year follow-up, the incidence of femoral neck fatigue fractures prior to the Finnish Defence Forces new regimen in 1986 addressing prevention of these fractures was 20.8/100,000, but rose to 53.2/100,000 afterwards, a significant 2.6-fold increase. In nineteen subjects with displaced femoral neck fatigue fractures, ten early local complications (in first postoperative year) were evident, and after the first postoperative year, osteonecrosis of the femoral head in six and osteoarthritis of the hip in thirteen patients were found. It seems likely that low vitamin D levels are related to fatigue fractures, and that an increasing trend exists between TRACP-5b bone resorption marker elevation and fatigue fracture incidence. Though seldom detected by plain radiography, fatigue fractures often underlie unclear lower leg stress-related pain occurring in the distal parts of the tibia. Femoral neck fatigue fractures, when displaced, lead to long-term morbidity in a high percentage of patients, whereas, when non-displaced, they do not predispose patients to subsequent adverse complications. Importantly, an educational intervention can diminish the incidence of fracture displacement by enhancing awareness and providing instructions for earlier diagnosis of fatigue fractures.

State Agent, Identity and the "New World Order" : Reconstructing Polish Defence Identity after the Cold War Era

National identity signifies and makes state s defence- and foreign policy behaviour meaningful. National consciousness is narrated into existence by narratives upon one s own exceptionalism and Otherness of the other nations. While national identity may be understood merely as a self-image of a nation, defence identity refers to the borders of Otherness and issues that have been considered as worth defending for. As national identities and all the world order models are human constructions, they may be changed by the human efforts as well; states and nations may deliberately promote communitarian or even cosmopolitan equality and tolerance without borders of Otherness. The main research question of the thesis is: How does Poland constitute herself as a nation and a state agent in the current world order and to what extent have contextual foreign and defence policy interactions changed the Polish defence identity during the post-Cold War era? The main empirical argument of the thesis is: Poland is a narrated idea of a Christian Catholic nation-state, which the Polish State, the Catholic Church of Poland, the Armed Forces of Poland as well as a majority of the Polish nation share. Polish defence identity has been almost impenetrable to contextual foreign and defence policy interactions during the post-Cold War era. While Christian religious ontology binds corporate Poland together, allowing her to survive any number of military and political catastrophes, it simultaneously brings her closer to the USA, raises tensions in the infidel EU-context, and restrains corporate Poland s pursuit of communitarian, or even cosmopolitan, global equality and tolerance. It is not the case that corporate Poland s foreign and defence policy orientation is instinctively Atlanticist by nature, as has been argued. Rather, it has been the State s rational project to overcome a habituated and reified fear of becoming geopolitically sandwiched between Russian and German Others by leaning on the USA; among the Polish nation, support for the USA has been declining since 2004. It is not corporate Poland either that has turned into a constructive European , as has been argued, but rather the Polish nation that has, at least partly, managed to emancipate itself from its habituation to a betrayal by Europe narrative, since it favours the EU as much as it favours NATO. It seems that in the Polish case a truly common European CFSP vis-à-vis Russia may offer a solution that will emancipate the Polish State from its habituated EU-sceptic role identity and corporate Poland from its narrated borders of Otherness towards Russia and Germany, but even then one cannot be sure whether any other perspective than the Polish one on a common stand towards Russia would satisfy the Poles themselves.

Paimen vailla hiippakuntaa : Kenttäpiispan viran synty ja vaikutus sotilaspapiston asemaan Suomen puolustusvoimissa ja kirkossa vuosina 1939 - 1944

The main purpose of this research is to shed light on the factors that gave rise to the office of Field Bishop in the years 1939-1944. How did military bishophood affect the status of the head of military pastoral care and military clergy during these years? The main sources of my research are the collections in the Finnish National Archives, and I use a historical-qualitative method. The position of the military clergy was debated within both the Church and the Defence Forces before 1939. At that stage, Church law did not yet recognize the office of the leading military priest, the Field Dean. There had been a motion in 1932 to introduce the office of a military bishop, but the bishops' synod blocked it. The concept of Field Bishop appeared for the first time in 1927 in a Finnish military document, which dealt with pastoral care in the Polish military. The Field Dean in Finland had regularly proposed improvements to the salary of the military clergy before the Winter War. After the Winter War, arguments were made for strengthening the position of the military clergy: these arguments were based on the increased respect shown towards this clergy, especially due to their role in the care of the fallen, which had become their task during the war. Younger members of the military clergy in particular supported the demands to improve their position within the Church and the army. The creation of a Field Bishop was perceived as strengthening the whole military clergy, as the Field Bishop was envisioned as a bishop within the Church and a general within the Defence Forces. During that time the Field Dean was still without any military rank. The idea of a Field Bishop was recommended to Mannerheim in June 1940, after which the Defence Forces lent their support to the cause. The status of the military clergy, in Church law, made it to the agenda of the Church council in January 1941, thanks largely to the younger priests' group influence and Mannerheim's leverage. The bishops opposed the notion of a Field Bishop mostly on theological grounds but were ready to concede that the position the Field Dean in Church law required further defining. The creation of the office of Field Bishop was blocked in the Church law committee report issued close to the beginning of the Continuation War. The onset of that war, however, changed the course of events, as the President of the Republic appointed Field Dean Johannes Björklund as Field Bishop. Speculation has abounded about Mannerheim's role in the appointment, but the truth of the matter is not clear. The title of Field Bishop was used to put pressure on the Church, and, at the same time, Mannerheim could remain detached from the matter. Later, in September 1941, the Church council approved the use of the Field Bishop title to denote the head of military pastoral care in Church law, and Field Bishops were assigned some of the duties formerly pertaining to bishops. Despite all expectations and hopes, the new office of Field Bishop did not affect the status of the military clergy within the Defence Forces, as no ranks were established for them, and their salary did not improve. However the office of the Field Bishop within Army HQ was transformed from a bureau into a department in the summer of 1942. At the beginning of the Continuation War, the Field Bishop was criticized by certain military and Church clergy for favouring Russian Orthodox Christians in Eastern Karelia. Björklund agreed in principle with most of the Lutheran clergy on the necessity of Lutheranizing East Karelia but had to take into account the realities at Army HQ. As well, at the same time the majority of the younger clergy were serving in the army, and there was a lack of parish priests on the home front. Bishop Lehtonen had actually expressed the wish that more priests could have been released from the front to serve in local parishes. In his notes Lehtonen accused Björklund of trying to achieve the position of Field Bishop by all possible means. However, research has revealed a varied group of people behind the creation of the office of Field Bishop, including in particular younger clergy and the Defence Forces.

The Gendered Social Organisation of Defence: Two Ethnographic Case Studies in the Finnish Defence Forces

In Finland the organising of defence is undergoing vast restructuring. Recent legislation has redefined the central tasks of the Finnish Defence Forces. At the same time, international security cooperation, economic pressures and new administrative paradigms have steered the military towards new ways of organising. National defence is not just politics and principles; to a large extent it is also enacted in day-to-day life in organisations. The lens through which these realities of defence are analysed in this study is gender. How is the security sector – and national defence as part of it – organised in the changing security environment? What is the new division of labour between different societal actors in the face of security challenges? What happens ‘at work’ within the military and the defence sector more broadly? How does gender affect the way in which defence is organised and understood, and how do the changes in the organising of security affect gender relations? The thesis searches for answers to these questions in the context of two organisational settings in the male-dominated defence sector. The case study on a Finnish peacekeeping unit in the Balkans opens a critical view on men’s social practices and the everyday life of crisis management organisations. In the second case study, reorganising of provisioning in the Finnish Defence Forces turns out to be a complicated process where different power relations and social divisions intermingle. Tallberg’s extensive ethnographic fieldwork in the two focal organisations has produced a detailed set of data that lays the basis for critical analysis and policy development in terms of defence organising, cooperation around peace and security issues, and gender equality in organisations. Observations and results are provided for understanding social networks, militarisation, authority relations, care, public-private partnerships, personnel policies, career planning, and humour.

Ühis- ning erijooni Soome ja Eesti Kaitseliitude puhkpillimuusikas aastatel 1925-1934.

This study focuses on the similarities and differences between the Estonian Defence League and the Finnish Civil Guard brass bands during the period 1925-1934. By 1934 this paramilitary volunteer state defence organisation had reached stability in its development, such that social, cultural and patriotic education of the people - with the help of brass band music among other means- had acquired a significant role, in addition to prioritised military and sports activities. The study begins with introductory paragraphs I and II, which describes the founding of the organisations, their participation in the Wars of Independence and their subsequent peace time activities as well as their representation in the media at the time. The thesis also briefly introduces military music in Finland and Estonia, as well as describes the influence of military music on the Defence League brass bands. The period under review includes the global economic crisis, which undoubtedly concerned the Defence League/Civil Guard and the Lapua and War of Independence movements, which greatly affected the apolitical principles of the organisations. The main emphasis of the thesis is the Defence League/Civil Guard brass band`s musical activities in two counties - Etelä-Pohjanmaa and Pärnumaa, while also including a general overview of the Estonian Defence League brass bands´ activities. One of the most important benefits of the thesis is its introduction of the brass band repertoire in use at the time, which was played by both professional and as well as amateur orchestras the latter of which also included the brass bands of the Defence League/Civil Guard and the Fire Services. Brass band music held a secondary, yet significant position in the Defence League/Civil Guard, where the orchestra as a musical grouping was obliged to perform not only at inner-organisational and national celebrations but also at any event requiring brass band music, such as song festivals, singing days, and other local cultural events. The professional preparation of the band conductors at the beginning of the period under review was not well specialised, but the training of the Defence League/Civil Defence brass band conductors was carried out regularly in both republic according to the opportunities and dedicated training programmes available. The musicians of the Defence League/Civil Defence brass bands were at the same time members of the military organisations as well as amateur musicians, which placed upon them extra demands - they were under close public supervision in all situations. Based on the principle of chronology it appeared that both Finnish and Estonian respective organisations´ brass bands used the gradually improving economic situation for purchasing musical instruments, obtaining repertoire and training musicians/conductors. Despite the fact that brass band music in the Defence League/Civil Guard was considered an amateur activity and a hobby, the more far-reaching objective of the organisation was to resemble the Defence Forces´ orchestras as closely as possible in all aspects. The Defence League/Civil Guard brass band music definitely had a significant influence on forming, developing and enriching music life in both republics. The reviewed nine-year period introduced the musical activities of the Defence League/Civil Guard against the background of the everyday life of the organisation and the need for brass band music and its continuity in the voluntary state defence institutions of both republics.