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  • 1.
    Guo, Cheng
    et al.
    Karolinska Inst, Med Management Ctr, Dept Learning Informat Management & Eth, Stockholm, Sweden..
    Tomson, Goran
    Karolinska Inst, Med Management Ctr, Dept Learning Informat Management & Eth, Stockholm, Sweden.;Karolinska Inst, Dept Publ Hlth Sci, Stockholm, Sweden..
    Guo, Jizhi
    Weifang Med Univ, Sch Management, Weifang, Peoples R China..
    Li, Xiangyun
    Weifang Med Univ, Sch Management, Weifang, Peoples R China..
    Keller, Christina
    Jonkoping Univ, Int Business Sch, Jonkoping, Sweden..
    Söderqvist, Fredrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
    Psychometric evaluation of the Mental Health Continuum-Short Form (MHC-SF) in Chinese adolescents - a methodological study2015In: Health and Quality of Life Outcomes, ISSN 1477-7525, E-ISSN 1477-7525, Vol. 13, article id 198Article in journal (Refereed)
    Abstract [en]

    Background: In epidemiological surveillance of mental health there is good reason to also include scales that measure the presence of well-being rather than merely symptoms of ill health. The Mental Health Continuum-Short Form (MHC-SF) is a self-reported scale to measure emotional, psychological and social well-being and conduct categorical diagnosis of positive mental health. This particular instrument includes the three core components of the World Health Organization's definition of mental health and had previously not been psychometrically evaluated on adolescents in China. Methods: In total 5,399 students (51.1 % female) from schools in the urban areas of Weifang in China were included in the study (mean age = 15.13, SD = 1.56). Participants completed a comprehensive questionnaire with several scales, among them the MHC-SF. Statistical analyses to evaluate reliability, structural validity, measurement invariance, presence of floor and ceiling effects and to some extent external validity of the MHC-SF were carried out. Results: The Cronbach's a coefficients for sub-scales as well as the total scale were all above 0.80 indicating good reliability. Confirmative factor analysis confirmed the three-dimensional structure of the Chinese version of MHC-SF and supported the configural and metric invariance across gender and age. Noteworthy ceiling effects were observed for single items and sub-scales although not for the total scale. More importantly, observed floor effects were negligible. The stronger correlation found between MHC-SF and Minneapolis-Manchester Quality of Life Instrument (as measure of positive mental health) than between MHC-SF and Hospital Anxiety Depression Scale (as measure of mental illness and distress) yielded support for external validity. Conclusion: In conclusion, the main findings of this study are in line with studies from other countries that evaluated the psychometric properties of the MHC-SF and show that this instrument, that includes the three core components of the WHO definition of mental health, is useful in assessing positive adolescent mental health also in China.

  • 2.
    Guo, Cheng
    et al.
    Karolinska Inst, Dept Learning Informat Management & Eth, Med Management Ctr, Stockholm, Sweden..
    Tomson, Goran
    Karolinska Inst, Dept Learning Informat Management & Eth, Med Management Ctr, Stockholm, Sweden.;Karolinska Inst, Dept Publ Hlth Sci, Stockholm, Sweden..
    Keller, Christina
    Jonkoping Univ, Int Business Sch, Jonkoping, Sweden..
    Söderqvist, Fredrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland. Vasteras Hosp, Competence Ctr Hlth, Vasteras, Sweden.
    Prevalence and correlates of positive mental health in Chinese adolescents2018In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 18, article id 263Article in journal (Refereed)
    Abstract [en]

    Background: Studies investigating the prevalence of positive mental health and its correlates are still scarce compared to the studies on mental disorders, although there is growing interest of assessing positive mental health in adolescents. So far, no other study examining the prevalence and determinants of positive mental health in Chinese adolescents has been found. The purpose of this study was to assess the prevalence and correlates of positive mental health in Chinese adolescents.

    Methods: This cross-sectional study used a questionnaire including Mental Health Continuum-Short Form (MHC-SF) and items regarding multiple aspects of adolescent life. The sample involved a total of 5399 students from grade 8 and 10 in Weifang, China. Multivariate Logistic regression analyses were performed to evaluate the associations between potential indicators regarding socio-economic situations, life style, social support and school life and positive mental health and calculate odds ratios and 95% confidence intervals.

    Results: More than half (57.4%) of the participants were diagnosed as flourishing. The correlated factors of positive mental health in regression models included gender, perceived family economy, the occurrence of sibling(s), satisfaction of self-appearance, physical activity, sleep quality, stress, social trust, desire to learn, support from teachers and parents as well as whether being bullied at school (OR ranging from 1.23 to 2.75). The Hosmer-Lemeshow p-value for the final regression model (0.45) indicated adequate model fit.

    Conclusion: This study gives the first overview on prevalence and correlates of positive mental health in Chinese adolescents. The prevalence of positive mental health in Chinese adolescents is higher than reported in most of the previous studies also using MHC-SF. Our findings suggest that adolescents with advantageous socio-economic situations, life style, social support and school life are experiencing better positive mental health than others.

  • 3. Hardell, Lennart
    et al.
    Carlberg, Michael
    Söderqvist, Fredrik
    Department of Oncology, University Hospital, Örebro, Sweden.
    Hansson Mild, Kjell
    Case-control study of the association between malignant brain tumours diagnosed between 2007 and 2009 and mobile and cordless phone use2013In: International Journal of Oncology, ISSN 1019-6439, Vol. 43, no 6, p. 1833-1845Article in journal (Refereed)
    Abstract [en]

    Previous studies have shown a consistent association between long-term use of mobile and cordless phones and glioma and acoustic neuroma, but not for meningioma. When used these phones emit radiofrequency electromagnetic fields (RF-EMFs) and the brain is the main target organ for the handheld phone. The International Agency for Research on Cancer (IARC) classified in May, 2011 RF-EMF as a group 2B, i.e. a 'possible' human carcinogen. The aim of this study was to further explore the relationship between especially long-term (>10 years) use of wireless phones and the development of malignant brain tumours. We conducted a new case-control study of brain tumour cases of both genders aged 18-75 years and diagnosed during 2007-2009. One population-based control matched on gender and age (within 5 years) was used to each case. Here, we report on malignant cases including all available controls. Exposures on e.g. use of mobile phones and cordless phones were assessed by a self-administered questionnaire. Unconditional logistic regression analysis was performed, adjusting for age, gender, year of diagnosis and socio-economic index using the whole control sample. Of the cases with a malignant brain tumour, 87% (n=593) participated, and 85% (n=1,368) of controls in the whole study answered the questionnaire. The odds ratio (OR) for mobile phone use of the analogue type was 1.8, 95% confidence interval (CI)=1.04‑3.3, increasing with >25 years of latency (time since first exposure) to an OR=3.3, 95% CI=1.6-6.9. Digital 2G mobile phone use rendered an OR=1.6, 95% CI=0.996-2.7, increasing with latency >15-20 years to an OR=2.1, 95% CI=1.2-3.6. The results for cordless phone use were OR=1.7, 95% CI=1.1-2.9, and, for latency of 15-20 years, the OR=2.1, 95% CI=1.2-3.8. Few participants had used a cordless phone for >20-25 years. Digital type of wireless phones (2G and 3G mobile phones, cordless phones) gave increased risk with latency >1-5 years, then a lower risk in the following latency groups, but again increasing risk with latency >15-20 years. Ipsilateral use resulted in a higher risk than contralateral mobile and cordless phone use. Higher ORs were calculated for tumours in the temporal and overlapping lobes. Using the meningioma cases in the same study as reference entity gave somewhat higher ORs indicating that the results were unlikely to be explained by recall or observational bias. This study confirmed previous results of an association between mobile and cordless phone use and malignant brain tumours. These findings provide support for the hypothesis that RF-EMFs play a role both in the initiation and promotion stages of carcinogenesis.

  • 4. Hardell, Lennart
    et al.
    Carlberg, Michael
    Söderqvist, Fredrik
    Department of Oncology, University Hospital, Örebro.
    Hansson Mild, Kjell
    Pooled analysis of case-control studies on acoustic neuroma diagnosed 1997-2003 and 2007-2009 and use of mobile and cordless phones2013In: International Journal of Oncology, ISSN 1019-6439, Vol. 43, no 4, p. 1036-1044Article in journal (Refereed)
    Abstract [en]

    We previously conducted a case-control study of acoustic neuroma. Subjects of both genders aged 20-80 years, diagnosed during 1997-2003 in parts of Sweden, were included, and the results were published. We have since made a further study for the time period 2007-2009 including both men and women aged 18-75 years selected from throughout the country. These new results for acoustic neuroma have not been published to date. Similar methods were used for both study periods. In each, one population-based control, matched on gender and age (within five years), was identified from the Swedish Population Registry. Exposures were assessed by a self-administered questionnaire supplemented by a phone interview. Since the number of acoustic neuroma cases in the new study was low we now present pooled results from both study periods based on 316 participating cases and 3,530 controls. Unconditional logistic regression analysis was performed, adjusting for age, gender, year of diagnosis and socio-economic index (SEI). Use of mobile phones of the analogue type gave odds ratio (OR) = 2.9, 95% confidence interval (CI) = 2.0-4.3, increasing with >20 years latency (time since first exposure) to OR = 7.7, 95% CI = 2.8-21. Digital 2G mobile phone use gave OR = 1.5, 95% CI = 1.1-2.1, increasing with latency >15 years to an OR = 1.8, 95% CI = 0.8-4.2. The results for cordless phone use were OR = 1.5, 95% CI = 1.1-2.1, and, for latency of >20 years, OR = 6.5, 95% CI = 1.7-26. Digital type wireless phones (2G and 3G mobile phones and cordless phones) gave OR = 1.5, 95% CI = 1.1-2.0 increasing to OR = 8.1, 95% CI = 2.0-32 with latency >20 years. For total wireless phone use, the highest risk was calculated for the longest latency time >20 years: OR = 4.4, 95% CI = 2.2-9.0. Several of the calculations in the long latency category were based on low numbers of exposed cases. Ipsilateral use resulted in a higher risk than contralateral for both mobile and cordless phones. OR increased per 100 h cumulative use and per year of latency for mobile phones and cordless phones, though the increase was not statistically significant for cordless phones. The percentage tumour volume increased per year of latency and per 100 h of cumulative use, statistically significant for analogue phones. This study confirmed previous results demonstrating an association between mobile and cordless phone use and acoustic neuroma.

  • 5. Hardell, Lennart
    et al.
    Carlberg, Michael
    Söderqvist, Fredrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
    Mild, Kjell Hansson
    Mobile Phones and Cancer Next Steps2014In: Epidemiology, ISSN 1044-3983, E-ISSN 1531-5487, Vol. 25, no 4, p. 617-618Article in journal (Refereed)
  • 6.
    Melder, Cecilia A
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Theology, Department of Theology, The Social Sciences of Religion, Psychology of Religions.
    Jyrell, Ida P.
    Child and adolescent psychiatry, Department: Psychiatry, Falun, Sweden.
    Söderqvist, Fredrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
    Measuring adolescents health-related quality of life [HRQL] in a secular context-introducing a Swedish WHOQOL-SRPB-adolescent instrument2016In: Quality of Life Research, ISSN 0962-9343, E-ISSN 1573-2649, Vol. 25, p. 88-88Article in journal (Refereed)
    Abstract [en]

    Aims:

    To present the adaptation of the WHOQOL-SRPB (BREF) for Swedish adolescents, emphasising the qualitative process with existentialissues. This is important when understanding adolescentHRQL, especially in Sweden, one of the most secularised countries inthe world where traditional arenas for existential issues, such asreligion and politics, play decreasing roles.

    Methods:

    Valid andreliable instruments for measuring adolescent HRQL that alsoincludes existential issues are rare. An English (UK) version ofWHOQOL-BREF has been tested on adolescents, but is neitherculturally validated to a Swedish context nor does it address theexistential domain. Recently, the WHOQOL-SRPB and WHOQOLSRPB-BREF has been translated the Swedish adult context, butrequires adaptation towards younger people. WHO ResearchInstructions for pre-testing and cognitive interviewing guided translationand adaption was followed. Based on students between 15 and19 years old, the instrument was tested in two steps; surveys, andinterviews with focus groups. Firstly, 94 students answered theoriginal questionnaire, and then two focus groups were organized,focusing on relevance, understanding and equivalency of the SRPBfacet. Secondly, a revised WHOQOL-SRPB-adolescent form wastested among 112 students, and two new groups were interviewed,focusing on understanding and relevance.

    Results:

    First interviewsindicated that SRPB items Meaning, Awe, Wholeness, Peace andHope were possible for the students to understand. Faith, SpiritualConnection, and Spiritual Strength items were mostly interpreted intraditionally religious terms, rather than according to the WHOQOLSRPBperspective (which also includes secular beliefs). Studentssuggested alternative wording which resulted in replacing some of theSRPB-BREF items with other items from the same SRPB facet, andincluding a item to replace the sex item. Using the revised instrument,the students understanding was found to be good, although theirinterpretation of ‘‘Spiritual’’ and ‘‘Faith’’ was still primarily religious,spiritual and not related to secular belief. The students emphasizedthat the survey was good and fun to answer; they considered theSRPB items relevant for understanding their HRQL.

    Conclusions:

    Our results shows the importance of empirically-based, qualitativeprocess adaptation of the WHO instruments to specific cultural(secularised) contexts and demographics, in order to better access andunderstand existential HRQL among adolescents.

  • 7.
    Melder, Cecilia A
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Theology, Department of Theology, The Social Sciences of Religion, Psychology of Religions.
    Söderqvist, Fredrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
    Modern Meaning-making: Adolescent understanding of existential aspects in Health-related quality of life [HRQL]2017In: IAPR Conference in Hamar 2017: Culture, Context and Existential Challenges, 2017, p. 30-30Conference paper (Other (popular science, discussion, etc.))
    Abstract [en]

    Aims: Present results from focus interviews concerning existential aspects related to the adaptation of the WHOQOL-SRPB(BREF) for Swedish adolescents.

    Background: Exploring existential aspects of HRQL are important when mental ill-health is increasing among adolescents in a secular context. WHO introduced WHOQOL-SRPB in 2002 for measuring HRQL, including Spiritual, Religious and Personal beliefs [SRPB]. It is validated for Swedish adults. Now it requires adaptation for youth, even internationally.

    Methods: Pupils (age 15–19) in four groups were interviewed following WHO instructions for cognitive interviewing. Content analysis of the transcribed interviews was conducted.

    Results: The pupils considered existential aspects important for HRQL. The items: Meaning, Awe, Wholeness, Peace and Hope were comprehensible for them. Faith and Personal beliefs were related to e.g. insecurity, individualism:”To believe in yourself” and traditional aspects:”I personally believe in Jesus but I do not believe in God”. Spiritual Strength and Spiritual Connection did not require transcendence and could relate to various ideas e.g. nature or popular culture:”The first thing that pops up is the Lion King that talks to Simba in the clouds. It is his inner spirituality”.

    Conclusion: Results show the importance of adaptation of existential aspects in HRQL to the cultural (secularized) context.

  • 8.
    Melder, Cecilia A
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Theology, Department of Theology, The Social Sciences of Religion, Psychology of Religions.
    Söderqvist, Fredrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
    Haglund, Bo J A
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Public Health.
    Health Promotion Intervention: with Emphasis on Existential Aspects of Quality of Life for Adolescents.2016In: 8th Nordic Health Promotion Research Conference: Abstract Book, Jyväskylä, Finland, 2016, p. 55-55Conference paper (Refereed)
    Abstract [en]

    Objectives:

    This presentation introduces a health promotion initiative emphasising existential issues related to spiritual,religious and personal beliefs [SRPB], undertaken in a Swedish upper secondary school.

    Background:

    International research shows that the existential domain accounts for an important part of variation in healthrelatedquality of life [HRQL]. Such findings are worthy of attention in countries like Sweden, which areexperiencing increased mental health problems in adolescents, and where traditional arenas for existentialissues, such as religion and politics, play decreasing roles in everyday life for young people. In 2002, WHOintroduced an instrument for measuring HRQL comprising physical, psychological, levels of independence,social relationship, environmental, and SRPB facets (WHOQOL-SRPB). The BREF versions of the instrumentwere developed from this, with 32 items.

    Material & Methods:1

    20 students were involved. 45 were selected in three intervention groups with additional school staff, whichmet once a week for eight weeks. Tools were developed to facilitate the participants’ thoughts, feelings andactions regarding issues related to the eight existential SRPB aspects in WHOQOL-SRPB: Spiritualconnection, Meaning and purpose in life, Experience of awe and wonder, Wholeness and integration, Spiritualstrength, Inner peace, Hope and optimism, and Faith. The promotion included cards for staff-supervised groupdiscussions related to existential issues. Interim tasks were also distributed between the meetings that focusedon each theme. The control groups continued with student centred conversations as normal, during the time.

    Results & Conclusion:

    A mixed-method evaluation follows the classic before and after design with control groups. Qualitative datawas generated from focus groups with students and staff, and quantitative data was based on a modified andpsychometrically tested adolescent version of the WHOQOL-SRPB BREF instrument. This presentation willfocus on the basis of the intervention procedures, including the tools related to the existential domaindeveloped for this intervention.

  • 9.
    Söderqvist, Fredrik
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
    Carlberg, Michael
    Hardell, Lennart
    Biomarkers in volunteers exposed to mobile phone radiation2015In: Toxicology Letters, ISSN 0378-4274, E-ISSN 1879-3169, Vol. 235, no 2, p. 140-146Article in journal (Refereed)
    Abstract [en]

    For some time it has been investigated whether low-intensity non-thermal microwave radiation from mobile phones adversely affects the mammalian blood-brain barrier (BBB). All such studies except one have been either in vitro or experimental animal studies. The one carried out on humans showed a statistically significant increase in serum transthyretin (TTR) 60 min after finishing of a 30-min microwave exposure session. The aim of the present study was to follow up on the finding of the previous one using a better study design. Using biomarkers analyzed in blood serum before and after the exposure this single blinded randomized counterbalanced study, including 24 healthy subjects aged 18-30 years that all underwent three exposure conditions (SAR(10G) = 2 W/kg, SAR(10G) = 0.2 W/kg, sham), tested whether microwaves from an 890-MHz phone-like signal give acute effects on the integrity of brain-shielding barriers. Over time, statistically significant variations were found for two of the three biomarkers (TTR; beta-trace protein); however, no such difference was found between the different exposure conditions nor was there any interaction between exposure condition and time of blood sampling. In conclusion this study failed to show any acute clinically or statistically significant effect of short term microwave exposure on the serum levels of S100 beta, TTR and b-trace protein with a follow up limited to two hours. The study was hampered by the fact that all study persons were regular wireless phone users and thus not naive as to microwave exposure.

  • 10.
    Söderqvist, Fredrik
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
    Melder, Cecilia
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Theology, Department of Theology, The Social Sciences of Religion, Psychology of Religions.
    Psychometric testing of the WHOQOL-BREF scale in Swedish adolescents2016In: Quality of Life Research, ISSN 0962-9343, E-ISSN 1573-2649, Vol. 25, no Supplement 1, p. 103-103, article id Meeting abstract 1070Article in journal (Other academic)
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