Mental health has traditionally been described as the absence of mental problems, being those second ones equated to impairments, overlapping disability with mental illness. This unfounded conviction is being replaced by a positive mental health approach that recognizes them as distinct constructs. The two continua model is the first model to prove with empirical support that the presence of mental problems does not entail a lacking positive mental health. In the midst of this transformation disabled children’s voices are being acknowledged as an often-ignored presence as the United Nation’s Convention of People with Disability pushes for their recognition.  This systematic review aims to explore which instruments are being used to measure the mental health of children with disabilities, and to assess how do they compare to the Mental health Continuum Scale (MHC-SF) which emerges as the operationalization of positive mental health in the Two continuum model. Five databases were explored, eight articles were chosen from which nine questionnaires were analysed and quality assessed with the Cosmin Checklist. From those, two instruments focused on mental problems (SDQ and ChYMH), two Surveys from which items were taken and adapted to measure flourishing (NSCH 2016/2011-2012 and L&H-YP 2011), three instruments targeting quality of life on children with a disability (Kidslife, CPQoL-Teens and Kidscreen), a newly developed subjective mental health questionnaire for children with intellectual disability (WellSEQ) and the MHC-SF itself.  Results show the emotional wellbeing dimension to be the most widely used, but positive functioning is misrepresented often measured as external factors. There is a tendence towards the traditional deficit-based formulation of items, despite that, there are good quality instruments that cater to children with disabilities with self-report measures (CPQoL-Teens, WellSEQ and Kidscreen) although severe ID co-mobilities are excluded. The use of digital resources in the administration poses a promising path to allow large scale surveys in children with cognitive and motor impairments, even more so being that the School is the common place of administration without acknowledging that children with chronic health conditions present higher rates of absenteeism.

Introduktion: Buller definieras som oönskat ljud. Uppfattningen av ett oönskat ljud är mycket individuellt. Det som anses vara oljud för en person, kan upplevas som icke-oljud för en annan person. Buller anses dock generellt som störande ljud och är vanligtvis något som varje individ stöter på under sin vardag som exempelvis på arbetsplatsen, skolan, eller i hemmet. Buller anses vara den miljöstörning som berör flest människor i Sverige. Det är ett växande problem och flygtrafik anses vara en av de mest genomgripande utomhusljudkällorna. Bullerproblem som är förknippade med flygtrafik är koncentrerade i områden nära flygplatser, vilket kan påverka flera tusentals boendes hälsa. Flygtrafikbuller har länge varit ett folkhälsoproblem och många människor som är bosatta i närheten av en flygplats har utvecklat ett antal negativa hälsoeffekter av flygtrafikbuller Syfte: Att undersöka hur boende som är bosatta nära flygplatsen Linköping City Airport upplever och påverkas av flygtrafikbuller.  Metod: Studien har utförts som en enkätundersökning med en kvantitativ tvärsnittsdesign. Webbenkäten som har använts som mätinstrument har konstruerats för att besvara syftet. 292 vuxna individer (>18år), varav 158 män och 133 kvinnor, deltog i studien. Insamlad statistiska data har bearbetats och analyserats i SPSS. För att kunna besvara syftet har följande statistiska tester använts: chi2-test, spearmans-korrelationsanalys och logistisk regressionsanalys.   Resultat och konklusion: Boende som är bosatta i Tannefors visade överlag positiva upplevelser till flygtrafiken och var positivt inställda till flygplatsen. De boende som upplevde störningar minst varje vecka vissa delar av året upplevde att flygtrafikbuller medför svårigheter att utföra olika aktiviteter. Kvinnor i den yngsta åldersgruppen upplevde flygtrafikbuller som mer störande jämfört med män. Män hade en mer negativ inställning till flygplatsen jämfört med kvinnor. Boende som rapporterade sämre hälsotillstånd, sömnproblem och användande av öronproppar eller något annat hörselskydd för att kunna sova bättre, sämre sömnkvalitet, trötthet, obehagskänslor, ledsenhet och nedstämdhet, osällskaplighet och att man föredrar att vara ifred, irritation och vresighet, stress, lock eller tinnitus i öronen meddelade också ett större besvär för flygtrafikbuller. / Introduction: Aircraft noise is an example of unwanted sound. The perception of unwanted sound is very individual. What is considered noise by one person may be perceived as non-noise by someone else. However, noise is generally regarded as disturbing noise and is usually something that each individual encounters in their daily life, such as in the workplace, at school, or at home. Noise is considered to be the form of environmental disruption that affects the most people in Sweden. It is a growing problem, and air traffic is considered to be one of the most pervasive outdoor sound sources. Noise problems associated with air traffic are concentrated in areas close to airports, which can affect the health of thousands of residents. Air traffic noise has long been a public health problem, and many people living near an airport have developed a number of negative health effects due to air traffic noise. Purpose: To study how residents living near Linköping City Airport experience and are affected by air traffic noise.   Method: The study has been conducted as a questionnaire survey with a quantitative crosssectional design. The online survey that has been used as a measuring instrument has been designed to answer the purpose. 292 adult subjects (> 18 years), including 158 men and 133 women, participated in the study. Collected statistical data has been processed and analysed in SPSS. In order to answer the purpose, the following statistical tests have been used: chi2 test, Spearman’s correlation analysis and logistic regression analysis. Results and conclusion: Residents living in Tannefors generally had positive experiences from air traffic and were positive towards the airport. The residents who experienced disturbances at least every week during certain parts of the year felt that air traffic noise caused difficulties performing various activities. Women in the youngest age group experienced air traffic noise as more disturbing compared to men. Men had fewer negative attitudes towards the airport compared to women. Residents who reported poorer health conditions, sleep problems and the use of earplugs or other hearing protectors to be able to sleep better, poorer sleep quality, fatigue, discomfort, sadness and depressed mood, low morale, a desire to be left alone, irritation and grief, stress, clogged ear or tinnitus also started that air traffic noise was a major inconvenience.

Background: The World Health Organization recommends early breastfeeding initiation, within the first hour of life. Ugandan mothers with no formal schooling appear superior in fulfilling this recommendation compared to mothers with primary, secondary, or higher education. Aim: This secondary analysis of Ugandan Demographic and Health Survey data from 2016 aimed to statistically analyze the association between maternal education and early breastfeeding initiation, to find socio-economic and health care determinants that promote the behavior. Methods: Ugandan mothers (n=9,209, 15 to 49 years) were included in statistical analysis. Chi-squared testing and logistic regression were used to assess associations between maternal education (exposure) and fulfillment of early breastfeeding initiation less than 1 hour after birth (outcome). Results: Out of the eligible mothers in a weighted sample, 68% (n=6,281) fulfilled early breastfeeding initiation and 32% (n=2,928) did not meet the criteria. Maternal primary education significantly predicted the outcome of early breastfeeding initiation (p ≤ 0.05, AOR: 0.80, with 95% CI 0.67-0.95) in a negative direction, compared to uneducated mothers. This result was adjusted for maternal residence, education, occupation, and parity, along with the husband/partner's education. Moreover, educational attainment beyond the primary level indicated a non-significant association to the criteria fulfillment when compared to uneducated mothers. Conclusions: Ugandan maternal education does not seem to significantly promote early BFI behavior. Primary level education only indicated a significantly negative association compared to uneducated Ugandan mothers. Traditional lifestyle factors (lower level education, and corresponding level of occupation, and larger families) appeared to be associated with the desired behavior.

Introduktion: Hälsan är ojämnt fördelad redan i tidig ålder och förskolan har möjlighet att verka kompenserande för barnens ojämlika uppväxtvillkor. Förskolans agerande i pandemitider kan påverka barnens utveckling och framtid. Barnkonventionen slår fast att barn har rätt att uttrycka sin åsikt i alla frågor som rör barnet, dock saknas barns egna perspektiv i kartläggningen kring pandemirekommendationer i förskolemiljö. Nivån av health literacy har betydelse för vilken effekt olika insatser får, dock är barns nivå av health literacy sparsamt undersökt. Syftet med studien var att ur förskolebarns perspektiv undersöka deras förståelse och inställning till pandemirekommendationer i förskolemiljö, under covid-19 pandemin 2020–2021. Metod: Femton förskolebarn intervjuades med en semistrukturerad intervjuguide med bildstöd. Empirin analyserades genom kvalitativ innehållsanalys med deduktiv ansats. Kategorierna bestämdes utifrån pandemirekommendationerna i intervjuguiden. Sorteringen till tema utfördes enligt Nutbeams (2000) nivåbeskrivning av health literacy som analysredskap. Resultat: På funktionell nivå av health literacy framkom att rekommendationerna accepterades, samtidigt som det inte upplevdes bra att behöva undvika något. På interaktiv och kritisk nivå framkom reflekterande tankar kring rekommendationerna, framförallt vilken inverkan de hade på den sociala samvaron. Om rekommendationen innebar hinder för den sociala samvaron blev inställningen till rekommendationen mer negativ. Positiv inställning visades till handtvätt, utomhuslek samt att lämnas och hämtas utomhus. Negativ inställning visades till att stanna hemma när man endast var lite sjuk, hålla avstånd samt att inte ta på andras ansikten. Neutral inställning visades till att tillämpa hostetikett samt att undvika att röra sitt ansikte. Slutsats: Den sociala gemenskapen i förskolemiljön har stor betydelse för barn. Barn bör inte rekommenderas hålla avstånd till varandra på förskolan. De preventiva åtgärderna bör alltid vara i bruk, med särskilt fokus på handhygien och uteaktiviteter. / Introduction: Unequal health can be seen at an early age. Preschools can compensate for the unequal upbringing conditions. The actions in preschool environment in the era of a pandemic can affect the children's development and future. The Convention on the Rights of the Child states that children have the right to express their opinion on all issues concerning children, however, children's own perspectives are missing in the exploration of pandemic recommendations in preschool environments. The outcome of a pandemic intervention is related to the level of health literacy; however, children's level of health literacy has barely been investigated. Aim: From preschoolers´ perspective examine their understanding and attitude towards pandemic prevention and control in preschool environments, during covid-19 pandemic 2020–2021. Methods: Fifteen preschoolers were interviewed with a semi-structured interview guide with image support. Qualitative content analysis with a deductive approach were used to analyze the empirical data. The categories were formed based on the pandemic recommendations in the interview guide. Nutbeam's (2000) description of health literacy levels was used as an analysis tool when themes sorting out. ResultsThe results presented, at a functional level of health literacy, that the pandemic recommendations were accepted, but it didn´t feel good to have to avoid anything. The result presented, at an interactive and critical level, reflective thoughts about the recommendations, especially what impact they had on social interactions. If the recommendation meant obstacles against social interactions, the attitude towards the recommendation became more negative. Positive attitudes were presented towards handwashing and outdoors activities. Negative attitudes were expressed towards staying at home with only mild symptoms and towards physical distance. Neutral attitudes were expressed towards applying cough etiquette and avoiding touching your face. Conclusion: The social gathering that preschools provide are important for children. Children shouldn´t be advised to keep physical distance from each other in preschool. The preventive measures should always be in use, with a special focus on hand hygiene and outdoor activities.

The purpose of this study was to explore the association between problematic social media use (PSMU) and self-rated health (SRH) among Swedish adolescent boys and girls, and additionally to examine whether perceived familial social support buffers against poor health in the same association. The study was based on the Health Behaviour in School-aged Children (HBSC) survey from 2017/2018. The study sample consisted of 3371 adolescents from 213 schools across Sweden. PSMU was used as the exposure variable, SRH as theoutcome variable, age and gender as control variables, and perceived familial social support was applied as a moderator between PSMU and SRH. The analyses performed in the current study was cross-tabulations, binary logistic regression, multiplicative and additive interaction analysis. The results revealed that there is a significant association between PSMU and SRHamong Swedish adolescents. Adolescents with moderate level PSMU had 2.77 higher odds of reporting less than good health (95% CI 2.00-3.84) in comparison to adolescents with low levels of PSMU. Adolescents with high level PSMU had furthermore 4.16 odds of reporting less than good health PSMU (95% CI 2.41-7.20) in comparison to adolescents with low levelPSMU. The association between PSMU and SRH remained statistically significant even after adjusting for age, gender, and perceived familial social support. The interaction analyses did moreover reveal that perceived familial social support may play a crucial role by mitigating the effects of high level PSMU on SRH among Swedish adolescents. In a conclusion, it is of vital importance to understand PSMU in relation to the social context to better understand PSMU and prevent young people from poor SRH. Future research may address the same association but in relation to other social factors, such as socioeconomic status, to achieveenhanced understanding over the association between PSMU and SRH and how to better prevent poor health among young people. Policy makers could furthermore introduce support programs for families/parents who feel they lack confidence in the ability to act as sufficient support, which may reduce the risk for poor health among young people.

Denna studie undersöker förståelsen för behovet av vård av psykisk ohälsa bland nyanlända flyktingar och asylsökande i Sverige under 1990–2021. Studien tillämpar ett krisnarrativ perspektiv för att kontextualisera varför och hur förändringar i lagstiftningen sker och förståelsen av den. Vidare undersöker studien hur detta beskrivs och förstås i lagtexter, propositioner, offentliga utredningar och rapporter från 1990–2021 med en analytisk ram av krisnarrativ. Denna krisberättelse är konstruerad genom vittnesmål från socialsekreterare, migrationstjänstemän, journalister och professorer kopplade till migration. Detta kommer att förstås utifrån de teoretiska perspektiven om vem som har rätt till rättigheter (Arendt, 2017) och vem som är sörjbar (grievable) (Butler, 2016), samt ett holistiskt perspektiv på hälsa med hjälp av begreppen health-lifestyle (Cockerham, 2005), empowerment och KASAM- känsla av sammanhang.  Genom följande frågeställningar: (1) Hur beskrevs behovet av vård och rättigheter för flyktingar och asylsökande i officiella dokument? (2) Hur har förskjutningen av rättigheter till hälsa och synen på behovet av vård bland flyktingar och asylsökande sett ut? och (3) Vilken inverkan kan rätten att ha rättigheter och att vara sörjbar ha över hälsofrågor hos flyktingar och asylsökande? En kvalitativ tematisk dokumentanalys antogs med en explorativ design baserad på ett induktivt förhållningssätt till det empiriska materialet. En hermeneutisk tolkning har tillämpats som innebar att skapa en djupare tolkning än den intellektuellt begripliga kunskapen. Resultatet visar att lagtexterna, propositionerna, offentliga utredningarna och rapporterna, har skiftat mot en mer decentraliserad struktur och med ett mer holistiskt perspektiv på hälsa. Tillsammans med vittnesseminarierna vittnar detta om att det paradoxalt nog har lett till en mer individualiserad syn på flyktingar, att de i större utsträckning tar ansvar för sin egen hälsa där en osäkerhet till följd av tillfälliga uppehållstillstånd är kopplad till en otrygg och prekär tillvaro. / This study investigates the understanding of the need for care for mental illness among newly arrived refugees and asylum seekers in Sweden during 1990-2021. The study applies a crisis narrative perspective to contextualise why and how changes in legislation occur and the understanding of it. Furthermore, the article investigates how this is described and understood in legal texts, propositions, public investigations, and reports from 1990–2021 with an analytical frame of a crisis narrative. This crisis narrative is constructed through testimonies by social secretaries, migration officers, journalists, and professors linked to migration. This will be understood from the theoretical perspectives of who has the right to have rights (Arendt, 2017) and who is grievable (Butler, 2016), as well as a holistic perspective on health using the concepts of health-lifestyle (Cockerham, 2005), empowerment and SOC- sense of coherence. This study asks: (1) How was the description of the need for care and rights for refugees and asylum seekers described in official documents? (2) How has the displacement shift in rights to health and the view of the need for care among refugees and asylum seekers looked like? and (3) What impact can the right to have rights and to be grievable have on the health issues of refugees and asylum seekers? A qualitative thematic document analysis was adopted with an exploratory design based on an inductive approach to the empirical material. A hermeneutic interpretation has been applied which means creating a deeper interpretation than the intellectually comprehensible knowledge. The result shows that the legal texts, propositions, public investigations, and reports have shifted towards a more decentralised structure with a more holistic perspective on health. Together with the witness seminars, this testifies that, paradoxically, it has led to a more individualised view of refugees, that they take responsibility for their health to a greater extent, where uncertainty because of temporary residence permits is linked to an insecure and precarious existence.

A large part of Swedish medical care is expected to be provided from the primary health centers. However, these centers are experiencing challenges in terms of shortages of personnel, an increased volume of patients, higher workload, increasing queue lengths, and increasing costs. Addressing these issues at the primary health centers is important for both improving the operation at the local centers and the functionality of the Swedish healthcare system. This thesis aims to explore the primary health center operation, focusing on a typical public primary health center in Stockholm. This is done to find parameters that affect the flow of patients and develop a graphical model that serves as a foundation for further model development, simulations and optimization of good health. To address the complex and dynamic primary health center system, a system dynamics approach is adopted. A literature review was conducted to gain an understanding of the primary health center environment and to identify parameters that impact the primary health centers ability to operate and/or affect the quality of service towards patients. The model development involved constructing cases and extracting parameters that change over time. The parameter relationships were determined through interpretation and are supported by literature. The model was qualitatively validated with the assistance of expert feedback. The presented result is determined to capture the basic operation of the primary health center and the model can be used as a foundation for further simulations. / En stor del av den svenska sjukvården förväntas levereras från vårdcentraler. Vårdcentralerna står dock inför utmaningar när det gäller brist på personal, ökad patientvolym, högre arbetsbelastning, ökade kölängder och ökande kostnader. Att hantera dessa problem på vårdcentralerna är viktigt både för att förbättra den lokala verksamheten och funktionaliteten i svensk hälso- och sjukvård. Syftet med detta arbete är att undersöka vårdcentralens verksamhet och fokuserar på en typisk offentlig vårdcentral i Stockholm. Detta görs för att hitta parametrar som påverkar patientflödet, för att utveckla en grafisk modell som utgör en grund för vidare modellutveckling, simuleringar och optimering av god hälsa. För att adressera det komplexa och dynamiska vårdcentral-systemet antas ett system dynamiskt tillvägagångssätt. En litteraturgenomgång genomfördes för att få en förståelse för vårdcentralens miljö och identifiera parametrar som påverkar vårdcentralens förmåga att driva verksamheten och/eller påverkar kvaliteten på vården för patienter. Modellutvecklingen innebar att konstruera fall och extrahera parametrar som förändras över tid. Parametrarnas relationer bestämdes genom tolkning och stöds av litteratur. Modellen genomgick en kvalitativ valideringsprocess baserad på expertutlåtanden. Resultatet, den grafiska modellen, som presenteras anses fånga vårdcentralens grundläggande funktion och kan användas som grund för vidare simuleringar.

Grupper blir i dagens samhälle diskriminerade utifrån deras ålder som baseras på fördomaroch stereotyper där ålder ses som en indikator på en persons förmåga att bidra till samhället.Denna uppsats handlar om hur de medverkande i serien Hotell Romantik framställs idagspress kopplat till deras ålder. Vi har genom en textanalys som metod, synliggjort vilkadiskurser som skapats kring ålder i serien. Dessa diskurser har sedan identifierats som femolika teman. Teorierna som har använts är ålderism, stereotypisering, erotofobi ochexotifiering som ligger till grund för den analyserande delen. Analysen belyser hur demedverkande i serien kritiseras, diskrimineras, hyllas och värderas utifrån deras ålder. Vi kanockså se hur många diskurser baseras på en negativ inställning gentemot äldre och attålderism återkommer i flera artiklar.

Introduktion: Enligt World Health Organisation (WHO) definieras hälsa som ett tillstånd av fysiskt, mentalt och socialt välbefinnande och inte endast frånvaro av sjukdom. Utifrån denna definition kan en människa uppleva hälsa och livskvalitet hela livet, oavsett ålder, diagnos eller prognos. Förhållningssättet till livet påverkar den självskattade psykiska, fysiska och sociala hälsan. I Sverige används begreppet existentiell medan begreppet andlig oftast används internationellt. Både existentiell och andlig relaterar till en inre dimension som interagerar med den yttre världen; den egna kroppen, andra människor och de sekulär eller religiösa system som en individ kan relatera till. Syfte: Syftet är att bedöma hur WHO:s åtta faktorer för existentiell hälsa definieras och hur de används i vetenskapliga studier. Metod:Studien bygger på en litteraturstudie i vilken tjugo vetenskapliga artiklar granskats och analyserats. Både kvalitativa och kvantitativa studier, som undersöker existentiell hälsa har inkluderats. För att besvara forskningsfrågan och uppfylla studiens syfte har en kvalitativ metod med induktiv ansats valts för att söka en slutsats utifrån tidigare forskning. De vetenskapliga artiklarna som valts ut har inhämtats via tillförlitliga databaser som PsychInfo, PubMed, SwePub,Google Scholar, och från Socialmedicinsk tidskrift. Resultat: Vid analys av artiklarnas innehåll har vi använt följande teman: andlig kontakt, mening och syfte med livet, upplevelse av förundran, helhet och integration, andlig styrka, harmoni och inre frid, hoppfullhet och optimism samt tro som resurs. Av dessa kom behovet av optimism, inre frid och hopp först. På andra plats kom behovet av mening och syfte med livet. Resultat visade att det är notoriskt svårt att definiera och mäta andlighet på grund av dess omtvistade definition, förhållandet till religiositet och olika kulturer. De olika definitionerna utmanar tillämpningen av begreppen i olika kontexter och kulturer. Slutsats: Då forskning kring existentiell hälsa är begränsad och relativt outforskat behöver framtida forskning fler kvalitativa och kvantitativa forskningsinsatser för att analysera faktorer som påverkar den existentiella hälsan utifrån ett kulturellt och kontextuellt perspektiv. Teorier och metoder kan på så sätt utvecklas för att skapa en evidensbaserad existentiell hälsointervention. / Introduction: According to the World Health Organisation (WHO), health is defined as a state of physical, mental and social well-being and not merely the absence of disease. Based on this definition, a person can experience health and quality of life throughout their life, regardless of age, diagnosis or prognosis. The approach to life affects the self-assessed mental, physical and social health. In Sweden, the term existential is used, while the term spiritual is most often used internationally. Both existential and spiritual relate to an inner dimension that interacts with the outer world; one's own body, other people and the secular or religious systems to which an individual can relate. Purpose: The purpose is to assess how the WHO's eight factors of existential health are defined and how they are used in scientific studies. Method: The study is based on a literature study in which twenty scientific articles were reviewed and analyzed. Both qualitative and quantitative studies investigating existential health have been included. In order to answer the research question and fulfill the purpose of the study, a qualitative method with an inductive approach has been chosen to seek a conclusion based on previous research. The scientific articles that have been selected have been obtained via reliable databases such as PsychInfo, PubMed, SwePub, Google Scholar, and from the Journal of Social Medicine. Results: When analyzing the content of the articles, the following themes were used to categorise findings: spiritual contact, meaning and purpose in life, experience of wonder, wholeness and integration, spiritual strength, harmony and inner peace, hopefulness and optimism and faith as a resource. Out of theseeight themes, the need for optimism, inner peace and hope came first. In second place came the need for meaning and purpose in life. Results showed that it is notoriously difficult to define and measure spirituality due to its contested definition, relationship to religiosity and different cultures. The different definitions challenge the application of the concepts in different contexts and cultures. Conclusion: As research on existential health is limited and relatively unexplored, future research needs more qualitative and quantitative research efforts to analyze factors that affect existential health from a cultural and contextual perspective. Theories and methods can thus be developed to create an evidence-based existential health intervention.

Two years after the first recorded outbreak of Covid-19 its long-term effects are still not completely understood. An unknown proportion of all covid patients go on to develop post-acute covid syndrome and suffer long-term symptoms and health effects long after the initial infection subsides. Project Crowdsourcing Långtidscovid-Sverige sent out in summer of 2021 an open online survey and gathered respondents through crowdsourcing to gather info about people in Sweden with prolonged health effects lasting at least three months after confirmed or suspected Covid-19 infection. In this thesis an explorative analysis of the aforementioned survey is conducted with its initial focus placed onthe progression of symptoms. Descriptive statistics are provided for the survey sample; hierarchical clusteringon principal components is performed; and association rule mining as well as sequence rule mining is used toextract frequently co-occurring symptoms. Women stand for 85.2% of all respondents, possibly indicating a skewed gender distribution in the sample. The average age of a respondent is 50 years old, but ranges between 18 and 80 years of age. The number of reported symptoms tend to diminish over time and symptoms within the 'air passages' category diminish on average quicker than other categories. Hierarchical clustering with Ward’s criterion revealed 4 clusters with an average silhouette coefficient of 0.246. The resulting clusters are not well-separated from each other and have some overlap in their bordering regions, and should therefore be interpreted with caution. Broadly speaking, individuals from cluster 1, 3 and 4 are distinguished primarily by their total number of symptoms reported, meanwhile cluster 2 is characterized by individuals that experience many symptoms early on and fewer symptoms later on. The most prevalent symptom over the entire period is fatigue (90.2%), closely followed by worsening symptomsafter physical activity (87.1%), problems with concentration (82.3%), headaches (79.5%), and brain fog (77.9%). There are several strong associations between various symptoms, especially for symptoms within the same category. Most symptoms have a sequential correlation with themselves and have an increased tendency to occur several times.