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In recent years, advances in technology have led to an influx of mental health apps, in particular the development of mental health and well-being chatbots, which have already shown promise in terms of their efficacy, availability, and accessibility. The ChatPal chatbot was developed to promote positive mental well-being among citizens living in rural areas. ChatPal is a multilingual chatbot, available in English, Scottish Gaelic, Swedish, and Finnish, containing psychoeducational content and exercises such as mindfulness and breathing, mood logging, gratitude, and thought diaries. The primary objective of this study is to evaluate a multilingual mental health and well-being chatbot (ChatPal) to establish if it has an effect on mental well-being. Secondary objectives include investigating the characteristics of individuals that showed improvements in well-being along with those with worsening well-being and applying thematic analysis to user feedback. A pre-post intervention study was conducted where participants were recruited to use the intervention (ChatPal) for a 12-week period. Recruitment took place across 5 regions: Northern Ireland, Scotland, the Republic of Ireland, Sweden, and Finland. Outcome measures included the Short Warwick-Edinburgh Mental Well-Being Scale, the World Health Organization-Five Well-Being Index, and the Satisfaction with Life Scale, which were evaluated at baseline, midpoint, and end point. Written feedback was collected from participants and subjected to qualitative analysis to identify themes. A total of 348 people were recruited to the study (n=254, 73% female; n=94, 27% male) aged between 18 and 73 (mean 30) years. The well-being scores of participants improved from baseline to midpoint and from baseline to end point; however, improvement in scores was not statistically significant on the Short Warwick-Edinburgh Mental Well-Being Scale (P=.42), the World Health Organization-Five Well-Being Index (P=.52), or the Satisfaction With Life Scale (P=.81). Individuals that had improved well-being scores (n=16) interacted more with the chatbot and were significantly younger compared to those whose well-being declined over the study (P=.03). Three themes were identified from user feedback, including \"positive experiences,\" \"mixed or neutral experiences,\" and \"negative experiences.\" Positive experiences included enjoying exercises provided by the chatbot, while most of the mixed, neutral, or negative experiences mentioned liking the chatbot overall, but there were some barriers, such as technical or performance errors, that needed to be overcome. Marginal improvements in mental well-being were seen in those who used ChatPal, albeit nonsignificant. We propose that the chatbot could be used along with other service offerings to complement different digital or face-to-face services, although further research should be carried out to confirm the effectiveness of this approach. Nonetheless, this paper highlights the need for blended service offerings in mental health care.

Background The combination of olfactory and cognitive markers has shown promising results in classifying individuals at different risk levels of dementia. We aimed to examine the association of isolated and combined olfactory dysfunction (OD) and cognitive impairment (CI) with incident dementia across 12 years and across two timeframes (0‐6 years and 6‐12 years) to evaluate whether the association varies over time. Method The sample was comprised of 2406 older adults (Mage=71.5 years, %females=60.8%) from the Swedish National Study on Aging and Care in Kungsholmen (SNAC‐K), free of dementia at baseline with available baseline odor identification (Sniffin’ Sticks test, range 0–16) and cognition (five cognitive domains) data. Participants were classified as having OD (performance <11) and as CI no dementia (CIND, ≥1.5 SD below the age‐specific mean in at least one domain). CIND was further classified based on memory impairment (amnestic vs. non‐amnestic). Dementia hazard was estimated with Cox regression analyses for the whole study period (baseline to 12‐year follow‐up) and two timeframes (baseline to 6‐year follow‐up and 6‐ to 12‐year follow‐up) for isolated OD, isolated CIND, and their combination. Laplace regression was applied to assess the time until 5% of participants in each group received a dementia diagnosis, based on the 5% of incident dementia in the unimpaired participants (reference) over the whole period. Result There were 1403 unimpaired, 326 isolated CIND, 476 isolated OD, and 203 CIND+OD individuals. CIND+OD was associated with increased dementia risk over the first 6‐year follow‐up (HR, 95% CI: 11.38, 6.70–19.32), more pronounced for amnestic CIND (22.23, 11.79–41.90). Isolated OD was associated with increased dementia risk over both periods (baseline to 6‐year follow‐up: 2.56, 1.48–4.43, baseline to 12‐year follow‐up: 2.12, 1.41–3.19), while isolated CIND was associated with dementia only over the first period (3.38, 1.75–6.49). 5% of CIND+OD individuals progressed to dementia 5 years after baseline, while isolated CIND and isolated OD reached the same proportion after 8 years. Conclusion Concurrent CI and OD may signal incipient dementia in the coming years, especially for amnestic individuals. OD is a potential early marker of dementia on its own.

Two structural-priming experiments investigated how bilinguals represent syntactic structures. According to the shared-syntax account (Hartsuiker, Pickering, & Veltkamp, 2004), bilinguals have a single syntactic representation for structures that exist in both languages, whereas separate-syntax accounts claim that the representations for these structures are language specific. Our experiments tested native speakers of Swedish who were highly proficient in English. The results showed that structural priming within language and between languages was equally strong. This indicates that representations of syntactic structures from different languages are shared and, therefore, supports the shared-syntax account.

The concept of hegemonic masculinity has been used in gender studies since the early-1980s to explain men's power over women. Stressing the legitimating power of consent (rather than crude physical or political power to ensure submission), it has been used to explain men's health behaviours and the use of violence. Gender activists and others seeking to change men's relations with women have mobilised the concept of hegemonic masculinity in interventions, but the links between gender theory and activism have often not been explored. The translation of 'hegemonic masculinity' into interventions is little examined. We show how, in South Africa and Sweden, the concept has been used to inform theoretically-based gender interventions and to ensure that men are brought into broader social efforts to build gender equity. We discuss the practical translational challenges of using gender theory broadly, and hegemonic masculinity in particular, in a Swedish case study, of the intervention Machofabriken [The Macho Factory], and illustrate how the concept is brought to life in this activist work with men. The concept has considerable practical application in developing a sustainable praxis of theoretically grounded interventions that are more likely to have enduring effect, but evaluating broader societal change in hegemonic masculinity remains an enduring challenge.

OBJECTIVE: This study investigates the association between parental precarious employment (PE) and the mental health of their adolescent children, with a particular focus on how the association differs based on whether the mother or father is in PE. METHODS: This register-based study used the Swedish Work, Illness, and Labor-market Participation (SWIP) cohort. A sample of 117 437 children aged 16 years at baseline (2005) were followed up until 2009 (the year they turned 20). A multidimensional construct of PE (SWE-ROPE 2.0) was used to classify parental employment as either precarious, substandard or standard. The outcome, adolescents’ mental disorders, was measured as a diagnosis of a mental disorder using ICD-10 codes or by prescribed psychotropic drugs using ATC codes. Crude and adjusted Cox regression models produced hazard ratios (HR) with 95% confidence intervals (CI) to estimate the association between parental PE and adolescents’ mental health. RESULTS: Adolescents with parents in PE exhibited a higher risk of developing mental disorders. The association was more pronounced for paternal PE (HR 1.22, 95% CI 1.10–1.35) compared to maternal PE (HR 1.11, 95% CI 1.00–1.21). These associations largely persisted after adjusting for important confounders, including parental mental health. CONCLUSION: This study addresses a significant gap in the literature on parental PE and adolescents’ mental health. As PE is growing more common across countries, this study provides relevant insights into the intergenerational role that parental low-quality employment may have in terms of mental health within families.

Purpose: Intelligibility is a core concept of speech-language pathology, central both to the assessment of speech disorders and to intervention in such disorders. One purpose of this study was to investigate the reliability and usability of a single-word assessment procedure, the Swedish Test of Intelligibility for Children (STI-CH), in a clinical setting. Another purpose was to investigate the validity and reliability of an assessment method designed to assess functional intelligibility: the Intelligibility in Context Scale (ICS). Method: Thirty children aged 4;1-10;1 years;months were recruited from speech-language pathology clinics in Western Sweden. Each child's treating speech-language pathologist served as listener in the STI-CH assessment while the ICS was completed by each child's parents. External listeners (2 last-year speech-language pathology students) were used to assess the validity of the speech-language pathology. Results: The mean duration of the test procedure for the STI-CH was about 19 min, and 57% of the test sessions were reported as difficult. There was a weak but statistically significant correlation between the results from the STI-CH and the ICS (r = 0.40, p < 0.05), and both methods showed high reliability in terms of interlistener reliability (intraclass correlation exceeding 0.97) and internal consistency, respectively. Conclusions: The STI-CH had high reliability and was time efficient but had some procedural problems. The ICS had moderate validity but high reliability. The STI-CH is promising for clinical use but needs to be developed further. The validity of the ICS can be discussed and needs to be further investigated.

Background This study investigates the potential of speech analysis, using a digital Speech Biomarker for Cognition (SB‐C), to non‐invasively discriminate between Alzheimer's disease (AD) biomarker groups, specifically amyloid‐β (Aβ) and p‐tau status. Methods Data were obtained from the Swedish BioFINDER‐Primary Care study, which includes patients undergoing evaluation for cognitive symptoms in primary care. Participants with subjective cognitive decline (SCD) or mild cognitive impairment (MCI) and available cerebrospinal fluid (CSF) Alzheimer's disease (AD) biomarkers were included. SB‐C scores, including subscores (executive function, memory, and processing speed), were extracted from Semantic Verbal Fluency (SVF) and RBANS List Learning task recordings using ki:elements’ proprietary speech analysis pipeline. Optimal SB‐C score cut‐offs to differentiate AD pathology (presence/absence) were determined using an independent separate cohort. These cut‐offs were validated then on the Swedish BioFINDER‐Primary Care cohort to discriminate between CSF Aβ42/Aβ40 (A+/‐) and CSF p‐Tau181/Aβ40 (soluble T+/‐, where Aβ40 acts as a reference protein), with classification performance assessed through sensitivity, specificity, balanced accuracy, and ROC‐AUC metrics. Results Data were collected from 241 participants from which 79 showed no evidence of AD pathology (mean [SD]age:71.2[8]; 43 women) and 162 showed evidence of AD pathology (mean [SD]age:77.6[6.28]; 95 women). The cutoff analysis showed optimal cut‐offs of the SB‐C normed z‐scores of 0.43 to discriminate presence of AD pathology versus no AD pathology (see Figure 1). The area under the ROC curve (AUC) was 0.79 for the SB‐C score using CSF p‐Tau181/Aβ40 as outcome. With the optimized cut‐offs the accuracy was 71% (sensitivity = 70%, specificity = 73%). For CSF Aβ42/Aβ40 positivity/negativity classification performance was at 69% accuracy (sens = .64, spec = .74) and the AUC at 0.74. Conclusion The SB‐C demonstrates potential as a non‐invasive and scalable tool for discriminating between presence and absence of AD pathology, particularly in primary care settings. By leveraging automated speech analysis, it offers a practical approach to enhance screening efficiency, reduce costs, and minimize patient burden.

Purpose: The present study aimed to compare acoustic models of speech intelligibility in individuals with the same disease (Parkinson's disease [PD]) and presumably similar underlying neuropathologies but with different native languages (American English [AE] and Korean). Method: A total of 48 speakers from the 4 speaker groups (AE speakers with PD, Korean speakers with PD, healthy English speakers, and healthy Korean speakers) were asked to read a paragraph in their native languages. Four acoustic variables were analyzed: acoustic vowel space, voice onset time contrast scores, normalized pairwise variability index, and articulation rate. Speech intelligibility scores were obtained from scaled estimates of sentences extracted from the paragraph. Results : The findings indicated that the multiple regression models of speech intelligibility were different in Korean and AE, even with the same set of predictor variables and with speakers matched on speech intelligibility across languages. Analysis of the descriptive data for the acoustic variables showed the expected compression of the vowel space in speakers with PD in both languages, lower normalized pairwise variability index scores in Korean compared with AE, and no differences within or across language in articulation rate. Conclusions: The results indicate that the basis of an intelligibility deficit in dysarthria is likely to depend on the native language of the speaker and listener. Additional research is required to explore other potential predictor variables, as well as additional language comparisons to pursue cross-linguistic considerations in classification and diagnosis of dysarthria types.

How does genetic liability to suicide attempt (SA), suicide death (SD), major depression (MD), bipolar disorder (BD), schizophrenia (SZ), alcohol use disorder (AUD), and drug use disorder (DUD) impact on risk for SA and SD? In the Swedish general population born 1932-1995 and followed through 2017 ( = 7 661 519), we calculate family genetic risk scores (FGRS) for SA, SD, MD, BD, SZ, AUD, and DUD. Registration for SA and SD was assessed from Swedish national registers. In univariate and multivariate models predicting SA, FGRS were highest for SA, AUD, DUD, and MD. In univariate models predicting SD, the strongest FGRS were AUD, DUD, SA, and SD. In multivariate models, the FGRS for SA and AUD were higher in predicting SA while the FGRS for SD, BD, and SZ were higher in predicting SD. Higher FGRS for all disorders significantly predicted both younger age at first SA and frequency of attempts. For SD, higher FGRS for MD, AUD, and SD predicted later age at SD. Mediation of FGRS effects on SA and SD was more pronounced for SD than SA, strongest for AUD, DUD, and SZ FGRS and weakest for MD. FGRS for both SA and SD and for our five psychiatric disorders impact on risk for SA and SD in a complex manner. While some of the impact of genetic risk factors for psychiatric disorders on risk for SA and SD is mediated through developing the disorders, these risks also predispose directly to suicidal behaviors.