Although new technologies and artificial intelligence promise to improve mental health care, few scientifically validated applications are available, particularly in French. To address this issue, Centre de recherche de l'Institut universitaire en santé mentale de Montréal founded the Axel Center to accelerate the digital health strategy and to facilitate technological innovation for mental health research and care. The Axel Center thus addresses a tripartite ecosystem composed of research, clinical practice, and entrepreneurship. The purpose of this article is to introduce an example of an application developed in collaboration with the Axel Center and to present how the center can meet the needs of research teams. This example is Tadeus, a bilingual web application that allows mental health specialists and their partners (e.g. family members, caregivers, service recipients) to enter and share data to more rigorously monitor mental health interventions. In addition to presenting the application, the article discusses the challenges that can arise in the development, sustainability and dissemination of such applications, as well as how the Axel Centre can support research teams in overcoming these challenges.

Continuous improvement of practices is a constant challenge for healthcare organizations, managers, and decision-makers. Despite knowledge of evidence-based data and recommended health practices, integrating best practices into care and services remains difficult and requires tailored support approaches. Over the past 30 years, several initiatives have been implemented to support the continuous improvement of practices in the field of mental health in Quebec. Within these continuous improvement processes, close collaboration with stakeholders at all stages of the process, under collaborative leadership, has been an essential component. Objectives The aim of this article is to present 3 initiatives supporting the continuous improvement of practices in the field of mental health in Quebec, which involved a participatory research approach as well as a close partnership of more than 15 years between researchers and managers. Method The article draws on 3 different initiatives supporting continuous improvement of practices in the mental health field, as described by the researchers involved. It takes an auto-ethnographic approach and cross-reflection with the aim of identifying points of convergence and findings from experience. The 3 initiatives are as follows: (1) the À portée de main program, supporting the implementation of practices that foster personal recovery; (2) the cross-training program, supporting exchanges and transformation of practices in concurrent disorders; (3) the COMPAS+ program, supporting quality improvement in primary care services. These initiatives involved different stakeholders. Results Several points of convergence were identified regarding the challenges and facilitators of such approaches. They highlight the importance of spaces for exchange and co-creation to enable a redefinition of ways of doing things, as well as what is referred to as "transformative learning." They also illustrate the importance of participatory evaluative research in fostering reflective practice that leads to action and practice change. Conclusion This article provides an opportunity to engage in critical reflection on the complexity of continuous improvement initiatives in our healthcare systems. Despite structural reforms to Quebec's healthcare system, managers and other stakeholders must be able to rely on the expertise of researchers and their ability to inject agility into systems that, unfortunately, are not very flexible. Close collaboration between managers and researchers deserves to be protected and better valued.

Objectives Firefighters are repeatedly confronted with critical incidents (CIs) at work, which are events that significantly disrupt an individual's normal functioning (e.g. failed interventions, serious accidents, media criticism). Repeated exposure to such incidents increases their vulnerability to developing post-traumatic stress injuries (PTSIs). In Canada, approximately 30% of firefighters meet the clinical thresholds for at least one PTSI; the most commonly observed being depression, post-traumatic stress disorder (PTSD), anxiety, alcohol use, and suicidal ideations. The objectives of this study are to 1) describe the frequency of CIs that firefighters encounter at work and 2) identify the different types of CIs associated with PTSIs. Method This research is based on secondary use of cross-sectional data collected in 2018 as part of a partnership with a Quebec fire department. In this context, 690 firefighters responded to a survey designed to assess their overall psychological health. Participants reported on the CIs they had experienced during their careers. Standardized questionnaires were used to measure symptoms of depression, generalized anxiety, post-traumatic stress disorder, alcohol use disorder, substance use, and suicidal ideations. Results The results indicate that rare and serious incidents, particularly critical equipment failure, are strongly linked to various PTSI, while frequent incidents are associated with generalized anxiety and depression. Negative media criticism also appears to be a major stress factor associated with several PTSIs. Conclusion Given firefighters' increased vulnerability to PTSIs, this study highlights the importance of considering the diversity of CIs encountered at work as well as the influence of contextual factors such as media criticism. It also emphasizes the need for transdiagnostic approaches and intervention measures rooted in the professional reality of these workers to better support their mental health.

Metacognitive monitoring, or the capacity to assess and regulate one's cognitive activities, is essential for maintaining optimal mental functioning. Metacognitive monitoring may be particularly important for individuals as they age, fostering self-awareness of cognitive strengths and limitations, guiding strategy selection to enhance performance, compensating for age-related changes to cognitive abilities, and identifying the earliest cognitive symptoms of disease. By evaluating one's own understanding, individuals can align their confidence with actual ability, promoting better decision making and behavioral control. This review synthesizes the current literature on age-related differences in the accuracy of metacognitive monitoring across different types of metacognitive judgments, including judgments of learning, feelings of knowing, and post-decision confidence. We begin by discussing two key components of metacognitive monitoring: metacognitive sensitivity and metacognitive calibration. Then, we examine existing studies to address two main questions: whether age-related differences in one component (e.g., metacognitive calibration) can be explained by variations in the other (e.g., metacognitive sensitivity), and whether these differences can be attributed to age-related changes in underlying cognitive or perceptual processes. We find that the current literature does not provide definitive evidence for or against the decline of metacognitive monitoring in older adults. Rather, findings suggest that aging may differentially affect metacognitive accuracy depending on the type of judgment and task demands, with some domains showing preserved or even enhanced performance. These mixed findings underscore the conceptual and methodological complexity of studying metacognition in aging. We conclude by outlining key theoretical and empirical directions to clarify mechanisms and advance the field.

Neuropsychiatric disorders are of great health concerns, and despite the availability of drugs, effective therapies are poor, emphasizing the need for novel therapeutics. Among the natural substances screened for neuromodulation properties, Spirulina platensis, a cyanobacterium, and its main bioactive compound (phycocyanin) have attracted great attention. Substantial evidence demonstrates that spirulina and phycocyanin possess neuroprotective properties by targeting multiple interconnected cellular and molecular pathways, including apoptosis, oxidative stress, neuroinflammation, and regulators of synaptic plasticity. Consequently, these compounds have shown therapeutic potential in experimental models of Alzheimer's disease, Parkinson's disease, multiple sclerosis, cerebral ischemia, epilepsy, schizophrenia, depression, and autism spectrum disorder. Herein, we summarize various cellular and molecular pathways which are affected by spirulina and phycocyanin in neuropsychiatric disorders.

To estimate the prevalence of driving under the influence of cannabis (DUIC) and identify associated factors among US young adult drivers reporting past-year cannabis use.

This cross-sectional study analyzed pooled 2021-2024 National Survey on Drug Use and Health. The analytic data were restricted to drivers aged 18-25 years who reported past-year cannabis use (N = unweighted 17,141; weighted N = 10,814,381). The outcome was self-reported past-year DUIC. Independent variables included demographics, substance use, mental health, cannabis-related perceptions, and driving behaviors. These relationships were assessed by modified Poisson regression.

The weighted prevalence of DUIC was 28.0%, representing approximately over three million young adults. DUIC prevalence increased with cannabis use frequency, from 2.51 times higher among those using cannabis 12-49 days (adjusted prevalence ratio [APR]: 2.51; 95% confidence interval [CI]: 2.29-2.75) to 3.63 times higher among those reporting use on 300-365 days (APR: 3.63; 95% CI: 3.60-3.76), compared with those using cannabis 1-11 days. Cannabis use disorder (APR: 2.34; 95% CI: 2.06-2.65), simultaneous alcohol and cannabis use (APR: 1.29; 95% CI: 1.28-1.30), and perceived easy cannabis availability (APR: 2.36; 95% CI: 2.33-2.39) were also associated with higher prevalence of DUIC. Nonenrollment in school and living in a state with a medical cannabis law were associated with lower DUIC prevalence.

DUIC is highly prevalent among US young adults who use cannabis, with a clear graded association across categories of cannabis use frequency. Public health interventions should address frequent use, cannabis use disorder, alcohol-cannabis co-use, and perceived cannabis availability.

Co-design of health services is an increasingly used method to meaningfully enable patient and public involvement, especially when working with priority populations whose perspectives are often overlooked in traditional top-down approaches. However, differences in power and influence among stakeholders can lead to asymmetry and the marginalisation of certain voices. We used persona dyads (patient and provider) to co-design improvements in Emergency Department care for people presenting with mental health concerns.

Persona dyads were used in two Experience-Based Co-Design workshops with patients and providers. Transcripts were analysed to understand how personas were used, when and by whom. Participants completed surveys to evaluate the persona dyads and their co-design experience.

Persona dyads humanised and contextualised Emergency Department experiences, fostering trust and safety by shifting attention from participants' personal histories to fictional representations without requiring personal disclosure. In the workshops, participants used the personas to establish shared understanding, enhance communication and generate creative, person-centred solutions responsive to both sides of the care relationship. We observed differences in persona use across the workshops; there was greater reliance on the personas as participants navigated more complex patient and professional dynamics. The persona dyads facilitated empathy through not only presenting the patient but also the provider, a perspective often under-represented in co-design.

Personas can be a useful person-centred, participatory tool in health service co-design, with dyads being particularly useful for cultivating empathy, levelling power, amplifying lived experience and creating safe opportunities for priority populations to contribute meaningfully to service improvement.

Individuals with lived experience of mental health concerns and Emergency Department healthcare providers were actively involved in the study. People with lived experience contributed to the co-design of the persona dyads and participated in the workshop sessions. One author, who has lived experience of mental illness, provided critical input into the design and facilitation of the workshops, with particular emphasis on creating psychologically safe spaces for participation. Two authors are Emergency Department healthcare providers and study co-investigators. The patient and provider contributors were involved in validating the findings, and ensuring interpretations were grounded in lived and professional experience.

Motor competence (MC) has been proposed as an important correlate of physical and mental health during youth. However, evidence examining its associations with both health-related physical fitness and mental health in Spanish adolescents remains limited.

To examine the associations between objectively assessed MC and health-related physical fitness and mental health in Spanish adolescents.

This cross-sectional study included 273 adolescents (46.9% girls; 12-17 years). MC was assessed using the Bruininks-Oseretsky Test of Motor Proficiency Short Form (BOT-2 SF). Anthropometric measures, physical fitness, and mental health were assessed using validated protocols and questionnaires. Two-level linear mixed-effects and generalized estimating equation logistic regression models were adjusted for sex, biological maturation, socioeconomic status, and self-reported physical activity.

Higher MC was consistently associated with more favorable health-related physical fitness outcomes (all p < 0.001) and with a greater likelihood of meeting established health-related physical fitness criteria. MC was inversely associated with waist-to-height ratio (p = 0.028), whereas no consistent associations were observed with other anthropometric measures or mental health outcomes.

Higher MC was consistently associated with health-related physical fitness in Spanish adolescents, whereas associations with anthropometric measures and mental health were limited. Future adequately powered longitudinal and intervention studies are warranted to clarify the directionality of these relationships.

There is growing interest in the role of sleep-related factors, particularly perceived sleep quality, in the relationship between occupational stress and depression. Work engagement has been proposed as a potential protective factor against depression. This study aimed to examine the relationships among occupational stress, perceived sleep quality, and depression, as well as the role of work engagement in these relationships.

A total of 2,425 Korean employees participated in this study. The participants completed a series of questionnaires, including the Korean Occupational Stress Scale, the Center for Epidemiologic Studies Depression Scale, a single-item measure of perceived sleep quality, and the Utrecht Work Engagement Scale-9. The mediating and moderating effects were analysed using the PROCESS macro in the Statistical Package for the Social Sciences.

Perceived sleep quality mediated the association between occupational stress and depressive symptoms (b = 0.051; 95% confidence interval [CI], 0.040-0.062). Work engagement moderated the effects of both occupational stress and perceived sleep quality on depressive symptoms.

This study highlights the role of perceived sleep quality and work engagement as mediators and moderators of occupational stress and depressive symptoms, respectively. Improving perceived sleep quality and promoting work engagement may help reduce the risk of depression among employees experiencing occupational stress.

The mental health risks of internal migrants have become increasingly prominent, yet traditional diagnosis and treatment pathways face structural barriers including the uneven distribution of medical resources, insufficient service accessibility, high time costs, and the stigma surrounding mental health that prevent them from adequately addressing the mental health problems of this population. Cultural participation, as a low-threshold, low-stigma daily practice, may provide preventive support before mental health conditions deteriorate through fostering social connection and cultivating a sense of belonging and identity. Although public cultural services are not designed exclusively for internal migrants, their universally accessible and daily-embedded institutional characteristics may offer this population an alternative pathway for mental health support that complements the barriers to formal help-seeking. The Public Cultural Service Guarantee Law of the People's Republic of China, as the foundational legislation in this field, establishes a normative framework centered on guaranteeing basic cultural rights and interests, enriching spiritual and cultural life, and advocating healthy and civilized activities. Thus it provides normative space for public cultural services to undertake health promotion functions. In practice, however, resource allocation and performance assessment remain heavily oriented toward physical indicators such as the number of venues, facility size, and event frequency, with insufficient attention paid to whether service content matches users' actual needs, whether access arrangements accommodate diverse groups, and whether participation processes are conducive to social interaction and emotional regulation. Under this logic, internal migrants are mostly regarded as service recipients rather than subjects of cultural participation, constraining the release of the mental health support potential that public cultural services inherently possess. Accordingly, the cultural participation opportunities, expression rights, and identity recognition needs of internal migrants should be incorporated into the framework of legal protection, and public cultural services should be transformed from general cultural supply into institutionalized public resources oriented toward mental health prevention.