Purpose This study is a scoping literature review of research into post-traumatic stress disorder (PTSD) and moral injury (MI) in active-duty military personnel and veterans in Ukraine. This study aims to explore the existing research regarding the relationship between PTSD and MI in Ukrainian military personnel to identify the need for future research in a vulnerable social group that is exposed to a high level of conflict. Design/methodology/approach This scoping review includes the results of peer-reviewed articles from online databases (PubMed, Science Direct, PsycArticles, Military Database, Sociological Abstract, Psychology Database, PTSD Pubs, Web of Science), which were searched for publications in English, Ukrainian and Russian. The data obtained was organized using Preferred Reporting Items for Systematic Reviews extension for scoping reviews and Meta-Analyses, the Critical Appraisal Skills Programme Qualitative Studies Checklist and Joanna Briggs Institute Critical Appraisal Checklist. Data was analyzed and categorized using an inductive thematic analysis. Findings According to the thematic analysis, the following themes were identified in a Ukrainian military context: sources of PTSD, sources of moral injury, symptoms of PTSD, symptoms of moral injury and treating and prevention mechanisms. All studies included in the scoping review (32) report on PTSD and/or MI in military groups in Ukraine. They find the gap in research and in numerous comprehensive studies problematic and underline the need for more effective rehabilitation programs. Practical implications A scoping review was conducted to thematically map the research in the area, identify any knowledge gaps deficit about PTSD and MI in Military personnel in Ukraine and contribute to further development of effective rehabilitation programs. Originality/value The sparsity of the existing literature highlights the need for further research into enhancing the mental health services provided to military personnel. In addition, there is a growing need to further explore trauma exposure and potentially morally injurious events related to PTSD and MI, in particular. Such a review has not yet been carried out, which adds value to the current paper.

IntroductionIn the context of international military operations, officers and soldiers are exposed to various service-related stressors that may have long-lasting effects on their health and daily functioning. This study explored (1) the prevalence of symptoms indicative of both post-traumatic stress disorder (PTSD) and moral injury (MI), (2) the relationship between these conditions, and (3) the relationship between these conditions and a selection of background variables in Swedish military veterans who have previously been deployed in operations.MethodsThe study was a self-report survey. Of 6000 individuals invited to participate, 1940 completed the questionnaire, resulting in a response rate of 32%. Data was analyzed using correlation and regression analyses to explore potential statistical relationships between variables of interest. Additionally, the data were also analyzed using between-group analyses (t-tests) to examine differences between different groups.ResultsThe results indicate that a low proportion of participants showed a prevalence of indications of PTSD, which are comparable to previous Swedish studies on deployed veterans. An even smaller proportion was found to show indications of moral injury when compared to the assessment of PTSD. However, besides the small group that fulfilled the cutoff score criteria, a number of respondents reported milder symptoms of both psychological and moral distress. The second goal of the study was to examine the relationship between indications of PTSD and indications of moral injury. The findings suggest that there is a considerable overlap between the two constructs. In addition, the results suggest that the risk of PTSD and MI is highest when an event is perceived as both highly stressful (fear-based) and morally challenging. The MI symptom subcluster shame accounts for the largest variance in the PTSD indicator scale within the study sample. Health- and deployment-related background variables were identified that may be related to indications of moral injury.DiscussionThe study results highlight the type(s) of stressful experience and the health- and deployment-related factors that should be monitored post-deployment, which may serve as risk factors in developing indications of moral injury. The higher prevalence of indication of PTSD and MI in the past month, despite receiving various forms of support upon returning from deployment, highlights the need for MI-specific treatment.

The dominating emphasis of psychological research into moral injury has focused on clinical assessment, diagnosis, and treatment. This article focuses on the particular case of the role of the leader/leadership in moral injury in a military context. To address this objective, a systematic scoping literature review was conducted with the aim of investigating the scope of existing research to identify gaps and encourage future research and interventions. Thematic analysis was used to structure the data in an explorative inductive manner and an attempt was made to integrate the themes identified to gain a more holistic understanding of the subject matter. The results show that a significant portion of the literature views leadership failure or leader betrayal as a potentially morally injurious event (PMIE), a primary cause (predictor) of moral injury. However, a significant number also view leadership as a key factor in the prevention and mitigation of moral injury. Consequently, the lack of empirical evidence focusing on the role of leadership in moral injury must be regarded as problematic and should be given greater emphasis to advance understanding and guide the development of effective, evidence-based interventions.

PURPOSE:The aim was to explore if self-rated psychological symptoms in military veterans covary strong enough with established PTSD scales to make a symptom checklist a useful screening tool. METHODOLOGY:A Swedish sample of military veterans (n = 1,859) responded to a questionnaire which contained a checklist of ten psychological symptoms and a test of PTSD indication. The items measured the situation during the last month. All symptoms had the following response choices: 1 (Never), 2 (Seldom), 3 (Sometimes), 4 (Often) and 5 (Very often). The choices Often and Very often were combined and form the basis of the analysis. FINDINGS:The majority of individuals in the military sample reported that they had not experienced any of the ten psychological symptoms often or very often during the last month. Approximately 5% of the men and 9% of the women scored five symptoms or more. Among the men who reported five symptoms or more, about one third scored above a higher established PTSD cut-off value (PCL-4 > 44). ORIGINALITY:The psychological symptom checklist represents a new approach to PTSD indication screening and identification of individuals who may need further support. RESEARCH LIMITATIONS AND STRENGTHS:Clinical assessment of PTSD would be a necessary complement for those that indicate further need. Study strengths include a large sample, use of established scales and a straightforward and simple statistical analysis. PRACTICAL IMPLICATIONS:The checklist is easy to administer and score. After a brief introduction, it takes about two minutes to complete.

The aim was to explore the relationship between moral injury symptoms, individual and military potential antecedent variables, and mental health scales. Responses were obtained from 504 Swedish military veterans. Findings showed that moral injury symptoms were modestly related to emotional stability and combat exposure. Moral injury symptoms were moderately strongly related to stress-related physical and psychological symptoms and strongly related to PTSD indication. The results suggest a strong conceptual overlap between moral injury symptoms and PTSD indication. The association between moral injury symptoms and stress-related physical and psychological symptoms was discussed from an intervention perspective. The study also adds to previous research in that the sample had more favorable mental health, when measured by stress-related symptoms and PTSD indication. Possible reasons for this are strict selection criteria and a lower frequency and intensity of combat exposure.

This article gives a brief insight into the types of problems encountered by, and the well-being and health of, Swedish veterans who have deployed abroad since 1990 and onwards. More specifically, it gives an overview of work-related stressors and health outcomes among Swedish deployed military veterans related to (a) trauma exposure, PTSD, and moral distress/moral injury; (b) milder stress reactions/symptoms and everyday hassles and uplifts; and (c) social outcomes in terms of deployment implications on family and close relationships.

Our first aim was to explore the relationship between daily uplifts, daily hassles, and coping styles the first year after returning from international military missions and post-deployment work, family, and private reintegration in military veterans. Our second aim was to identify individual patterns regarding daily uplifts, daily hassles, and coping styles and to explore how they relate to the above-mentioned aspects of post-deployment reintegration. Questionnaire responses were received from 446 Swedish military veterans. Regression analyses showed that daily hassles and an escape-avoidance coping style made significant contributions in the predicted, negative direction to the amount of explained variance on reintegration indicator scales. A high level of perceived threat during the last mission also contributed to more negative integration. Using a person-centered approach, three unique profiles of response patterns were identified using a cluster analysis based on the uplift, hassles, and coping style scores. One profile was labeled "resilient and well-functioning"; its members showed favorable reintegration scores. A second profile was called "ambitious and struggling." These individuals scored medium-high on the reintegration scales. The third profile consistently indicated the least favorable reintegration scores and was labeled "worried and avoidant." The results confirm and deepen our existing knowledge.

The aim was to test a hypothesized model which indicates that a favorable balance between daily uplifts and functional coping on the one hand, and daily hassles and dysfunctional coping on the other, will be associated with fewer stress-related physical and psychological symptoms and a lower PTSD indication. An unfavorable balance was expected to show the reverse pattern. Questionnaire responses were obtained from 2512 Swedish military veterans (43.4% response rate). Four different statistical analyses were employed: bivariate correlations, multiple regression analyses, a cluster analysis and within-strata comparisons. All four analyses pointed to the same finding, a clear support of strong relationships between the balance box score and the frequency of physical and psychological symptoms as well as values on a PTSD indication scale. In addition, it appears as if the negative side of the balance box, a high frequency of perceived daily hassles and much use of an escape-avoidance coping style, account for stronger health associations than the positive side. Practical implications include that efforts should be made to limit the use of dysfunctional coping strategies, which, at least partly, can be trained, and to reduce a negative balance between perceived daily hassles and uplifts.

A high number of military veterans seek professional help at primary healthcare centers for mental health problems. The main aim of this study was to map veterans’ perception of the quality of the care they received when seeking such help after their last tour of duty. A secondary aim was to explore personality and mission-related characteristics of veterans who seek professional help for mental health problems after missions. Questionnaire responses were obtained from 2512 Swedish veterans (43.4% response rate). Among the responders, 210 individuals had sought help for mental health problems at primary healthcare centers. Their perception of the quality of the healthcare was measured using the Quality from the Patient’s Perspective (QPP) questionnaire, which is derived from a theoretical model. Comparisons between the military help seekers and an age and gender matched group of civilian outpatients showed that the military group perceived the information they had received, and the commitment, empathy and respect shown by the physicians, considerably more negatively than the civilian patients. Comparisons between the help-seeking veterans and those who had not sought help, showed that the help seekers were younger and scored significantly lower on emotional stability and higher on conscientiousness. In addition, they perceived the leadership of their immediate commander during the last tour of duty more negatively and they reported fewer daily uplifts and more daily hassles during the tour. It was concluded that a more extensive collaboration between the armed forces and the healthcare system is strongly recommended and that it is necessary to provide education to healthcare providers.

This study investigates the role of work-life balance in a recent relocation decision made by the Swedish Armed Forces. Applying the “What is the problem represented to be?” (WPR) discourse analysis method to documents concerning budget submissions over a five-year period (2020–2024) and a relocation decision from 2017, this study identifies a common focus on the reduction of organizational vulnerability. The way the problem of organizational vulnerability is presented, however, neglects considerations of employees’ work-life balance and serves to make effects of organizational changes at the individual level invisible. Founded on a social constructivist perspective, the study therefore argues that this neglect of work-life balance in official discourse on organizational change may be counterproductive to the proposed aim of a reduction in organizational vulnerability.

This study investigates the relationship between moral stress reactions and resulting coping efforts in severely morally challenging situations. Long-term positive reactions and post-traumatic stress disorder (PTSD) indicators following morally challenging situations are also studied. The sample consisted of cadets and officers (n = 332) from Norway and Sweden. Long-term positive reactions were found to be associated with limited moral stress reactions during the challenging episode and frequent use of acceptance and positive reappraisal coping strategies. Long-term high scores on a PTSD indicator scale covaried with high scores on Openness, a strong moral stress reaction, and frequent use of instrumental coping strategies. The main conclusion is that the immediate moral stress reaction and coping strategies following morally challenging situations appear to be related to both positive long-term reactions and to indicators of PTSD.

Drawing on previous research, two hypotheses were tested: (1) the higher the frequency of daily uplifts and use of functional coping strategies, and the lower the frequency of daily hassles and use of dysfunctional coping strategies, the lower the prevalence of stress-related symptoms will be, and vice versa; and (2) the direct relationship between the personality dimension emotional stability and stress-related symptoms, will be moderated by daily hassles, daily uplifts and coping processes. A quantitative test of a qualitatively developed model was performed. A questionnaire was sent to all Swedish military veterans who had served in the period 2011-2015 and 1859 individuals (1,614 men and 199 women, 46 individuals did not mark gender) responded (40.5% total response rate). All analyses were made separately for men and women. Comparisons between theoretically favorable and unfavorable profiles across the model variables, daily uplifts, daily hassles, functional coping and dysfunctional coping (based on a cluster analysis), showed considerable differences regarding the prevalence of stress-related symptoms as predicted by the model and supporting the first hypothesis. Regression and moderation analyses yielded limited support for the second hypothesis. As predicted, female veterans reported a higher frequency of physical, emotional and cognitive stress-related symptoms than male veterans. The main conclusion is that the theoretical model stood up well when empirically tested and offers a promising approach to future studies on everyday stress and health. The results contribute with new knowledge of military veterans compared to the main stream PTSD, depression and drug abuse-oriented studies.

Both the models of moral distress and of moral injury place an emphasis on various types of moral challenges that may violate the individual’s conscience, evoking moral emotions. Yet, there appears to be great conceptual confusion as regards both scholarly perspectives. The purpose of this article is to further elaborate on the qualitative content and conceptual demarcations of the theories of moral injury and moral distress. In the light of this theoretical elaboration, we propose an integrated moral distress and injury scale that provides a more holistic overview of these moral challenges. We suggest that the utility and applicability of the moral injury and moral distress theories may benefit from the integration of these concepts. A practical implication of our theoretical understanding is that processes of recovery, which involve moral dimensions, are complex. In line with this understanding, we advocate a holistic approach to health and well-being among military service members and Veterans.

Machine learning techniques have gained ground in macroeconomic forecasting in recent years. Estimations with the elastic net technique have yielded good results. There is currently not much research on how statistical techniques can be used to estimate the financial result in Swedish municipalities. This study adds to the current body of research by investigating how the elastic net technique can be used to forecast the financial result in Swedish municipalities. Data is collected from several sources and is used to forecast the financial result in Swedish municipalities. Estimations are carried out using an elastic net and a baseline in the form of OLS and are then compared and discussed. The results show that the estimations using an elastic net give more accurate forecasts than OLS in Swedish municipalities between 2002 and 2018. The most accurate forecasting method in this study was the Ridge regression. The study concludes by suggesting how the financial result in Swedish municipalities could be more thoroughly investigated using statistical methods.

Sjalvledarskap i byggbranschen : En studie om betydelsen av medarbetarnas sjalvledarskap for sakerhetsarbetet i byggforetag.

Previous research on media framing of wildfire has chiefly been concerned with the nature of wildfire in the context of climate change and with framing effects on policy and public opinion. Empirical studies on media content, hence what is mediated to crisis managers and the public concerning authorities' and the public's response, seem to be largely missing. This is remarkable, given that the media represent main sources of information that may influence crisis management and shape public opinion. Thus, the aim of this study was to identify key media frames relating to portrayals of public and authority responses during and after a wildfire crisis. The study is based on media articles from two time periods: immediately after the fire and 1 year later. We used a thematic method of analysis (TA), thus an inductive, "bottom-up" approach. A core frame, Responsibility/accountability is identified, underpinned by two sub-themes. One sub-theme relates to the causes of the fire and its escalation, revealing a number of different interrelated blame frames. The second sub-theme refers to management of the crisis, reflecting both authorities' and citizens' responses. The deficiencies of the former are implicitly suggested to have forced citizens to act to compensate for their inadequacy. The main theoretical contribution is the identification of an interrelationship between frames in relation to different groups of individuals responding to a crisis, pointing to a more complex view of framing effects. In addition, results show how media tend to assess crisis management based on idealistic criteria, inevitably making the evaluation negative. This contributes to an understanding of how media blame frames, thus "blame games," may unfold. Practical implications of these results are discussed.

Bakgrund: Banksektorn agerar inom en foranderlig miljo dar digitaliseringen driver utvecklingen framat. Okad digitaliseringen resulterar i nya direktiv och darmed en stark utveckling av fintech-los ...

Syftet med detta examensarbete grundar sig i att vi som studenter upplevt en avsaknad till ett pedagogiskt synsatt nar det kommer till utevistelse och utomhusmiljon under vara verksamhetsforlagda utbildningar. Dessa situationer ar ofta nagot som blir bortglomda och upp till eleverna att sjalva sysselsatta sig med. Detta har resulterat i att vi velat ta reda pa om skolor med narhet till gronomraden anvander dessa i storre bredd. Det teoretiska perspektiv som ligger till grund for arbetet kopplas till ett utomhus- och fritidspedagogiskt perspektiv dar begrepp som formellt, informellt och kontextuellt larande samt autentiska miljoer blir centrala. Fallstudier ar det metodval vi har anvant for att ta oss an detta arbete. Intervjuer med verksamma pedagoger har genomforts pa tva skolor i samma stad. Resultatet i detta arbete visar att anvandandet av och uppfattningen om utomhusmiljon skiljer sig mellan skolorna. Dock visar det empiriska materialet att det inte ar laget som paverkar undervisningen utan snarare vilken erfarenhet de verksamma pedagogerna har samt vilket intresse som finns for sjalva amnet.