In France, care pathways in child mental health remain complex and difficult to navigate for families, despite political efforts to strengthen outpatient support. Often mobilized as “resources,” families are still rarely recognized as full partners in the care process.

This collaborative action research, conducted in a CMPP (centre médico-psycho-pédagogique; center for medical, psychological, and educational care) located in a rural area, aimed to better understand the obstacles experienced by families and to co-construct with them concrete proposals to improve their support. The study adopted a qualitative approach based on two components: fifteen semi-structured interviews with parents, complemented by twenty-five interviews with CMPP professionals; followed by a participatory workshop with three volunteer mothers over six working sessions.

The analysis highlighted several facilitating factors, including caring professional attitudes, holistic support, and associative assistance. It also revealed persistent barriers such as diagnostic delay, administrative overload, a lack of accessible information, social isolation, and the invisibilization of the parental role. The workshops led to concrete proposals: a simplified welcome booklet, peer-support cafés, parental support groups, video capsules for professional training, and a partnership ethical charter. Some of these initiatives will be piloted from September 2025 with institutional support.

Based on the “Montreal model” of patient engagement, this study demonstrates that recognizing parental experiential knowledge shifts professional practices toward genuine co-production of care pathways.

This work opens up concrete prospects for transformation in other medico-social structures seeking to strengthen family participation.

Patient experience and safety are central to healthcare quality, yet their relationship remains underexplored. While earlier evidence suggests a positive association, policy and practice are continually developing around the world. This review systematically examines the literature to better understand how patient experience and safety are linked.

Searches were conducted via PubMed (2000-2023) using predefined terms on patient experience and safety. Articles were uploaded to Rayyan, duplicates removed and titles and abstracts screened for relevance. Full articles were reviewed and 30 eligible studies were included. A narrative synthesis was performed, with quality and evidence strength assessed using the Mixed Methods Appraisal Tool and the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) framework.

Evidence regarding the relationship between patient experience and safety was heterogeneous. Seven studies demonstrated consistent positive associations, 6 reported no association and 17 yielded mixed findings across different safety metrics. Among these 17 studies, 7 tended to support a positive association, 5 suggested no association and 5 reported results that varied according to the analytical approach.

This review found mixed evidence on the relationship between patient experience and safety, and causality remains unknown. While some research identified clear associations, others showed considerable variation, often influenced by the specific measures used. Studies focused on secondary care, leaving gaps in primary and mental health settings. Notably, no research examined links between safety and the Picker Principles of 'fast access to healthcare advice' or 'family and carer involvement'-domains considered vital to safety.The review suggests that future research should explore domain-specific links and include experimental designs to strengthen causal understanding of the granular elements of safety and experience. Further investigation across care settings and population subgroups would help to fully understand how patient experience influences safety and vice versa.Overall, this review provides evidence that patient experience and safety are related but distinct concepts that should be addressed together in quality improvement efforts.

The return to work from maternity leave is a time when the professional demands overlap with the new responsibilities of caring for children, which may result in psychological stress for nurses. Perceived social support can be a protective resource to buffer stress and promote adaptation.

To determine if perceived social support would moderate the relationship between occupational stress and psychological well-being for nurses who returned to work after childbirth.

A cross-sectional descriptive study was carried out in ten health care facilities in Dakahlia Governorate, Egypt. Four validated Arabic questionnaires were completed by a convenience sample of 200 nurses who had returned to work within 12 months after giving birth: a demographic questionnaire, a Brief Nursing Stress Scale, a 18-item Swedish adaptation of Ryff's Psychological Well-Being Scale, and a Perceived Social Support Scale for postpartum nurses. Descriptive statistics, correlation tests, multiple regression, and Hayes' PROCESS macro were used for analyses.

Occupational stress had significant negative correlation with perceived social support (r = -0.332, p < .01) and psychological well-being (r = -0.506, p < .01). Psychological well-being was positively related to perceived social support (r = 0.410, p < .01). Occupational stress was a significant negative predictor of well-being (β = -0.506, p < .001) for regression results. Moderation analysis confirmed that the negative relationship between stress and well-being was significantly mitigated by perceived social support (β = 2.500, p < .001), accounting for 52% of the variance in well-being.

The importance of perceived social support in decreasing stress and enhancing wellbeing of postpartum nurses suggests that multi-level supportive interventions are necessary.

This article discusses the potential of digital health interventions (DHIs) in mental health care, emphasizing the importance of designing them to foster genuine humanistic care. It highlights current challenges in measuring engagement and outcomes, advocating for integrating human-centered endpoints such as dignity, autonomy, and therapeutic alliance into evaluation frameworks. The authors call for mechanistic research to identify effective engagement strategies and context-specific implementation approaches. Ultimately, successful DHIs should demonstrate both clinical efficacy and the preservation of humane, person-centered care, ensuring ethical and meaningful mental health support through technology.

This article reviews contemporary issues in telepsychiatry and telepsychotherapy. The authors examine ethics within a larger social context, particularly access to care and cost of care. They consider the evolving scientific validation of telepsychiatry and the ethical significance of telepsychiatry in various practice settings. They also focus on the doctor-patient relationship, assessments, and provision of psychiatric treatments such as medication management and psychotherapy. The authors consider concerns about malpractice liability and medicolegal constraints on telepsychiatry. They do not address artificial intelligence in virtual mental health care, nor online communications outside the clinical encounter (eg, social media, email).

Physical activity (PA) is vital for health. Yet, participation levels in Saudi Arabia remain among the lowest globally. While Saudi Arabia's southern region has a cooler climate and a natural environment more conducive to activity, surprisingly, rates are lower than in the rest of the country. This area presents distinct cultural, social, and environmental challenges that influence how people engage in PA. This study explored how adults in the southern region of Saudi Arabia make sense of their decisions and experiences regarding PA. Semistructured interviews were conducted with 15 participants from various backgrounds. The interview questions were informed by the social-ecological model, and the data were analyzed inductively to identify themes. Two overarching themes were generated: "Release with Restrictions," which captures the apparently liberating mental and physical aspects of PA, and "PA as Investment," which highlights a strategic approach to decision making regarding engagement in PA. Participants often saw PA as a physical and mental outlet, but their ability to participate was constrained by safety concerns, social norms, and competing demands. Gender-specific barriers were particularly notable, with women facing higher costs, fewer accessible facilities, and stricter cultural expectations. While recent reforms under Saudi Vision 2030 have expanded access to female PE in schools, increased women-only fitness facilities, and improved public spaces for PA, cost-related barriers for women remain a challenge. Environmental issues, such as poor infrastructure and safety risks, further limited PA engagement. Participants also viewed PA as a form of investment in their well-being, driven by both immediate benefits, like stress relief, and longer-term health outcomes. Decisions around PA often reflected a personal cost-benefit analysis, weighing time, money, and opportunity. While recent government initiatives have helped shift norms and improve infrastructure, persistent gender inequities and unequal access highlight the need for inclusive policies and targeted campaigns that promote PA and active transport, especially among women. Systemic change where PA promotion is complemented by addressing gender inequity in access to facilities, greater local investment in safe walking and cycling infrastructure, and monitoring of response to changes in the policy and physical context is needed.

Chronic pain is a growing global public health challenge and the leading cause of years lived with disability. It significantly impacts various aspects of daily life, including participation in working life, resulting in increased sick leave and substantial burdens at both the personal and societal levels. Person-centered care (PCC) is a practiced ethic that recognizes the patient as a partner in care. Partnership is established through incorporating the person's narrative, shared decision-making, and documentation of jointly agreed goals. Remotely delivered PCC interventions have been shown in other studies to improve self-efficacy and facilitate return to work among persons on sick leave. However, little is known about how self-efficacy and sick leave are affected when a PCC intervention is delivered remotely to persons with chronic pain.

This study aimed to evaluate the efficacy of a home-based person-centered intervention consisting of telephone support and an eHealth platform among persons on sick leave due to chronic pain.

A 2-arm, nonblinded randomized controlled trial was conducted. Participants aged 18 to 65 years on sick leave due to chronic, nonmalignant pain lasting more than 3 months were recruited from 10 primary health care centers in Gothenburg, Sweden. Participants were randomly allocated 1:1 to either the control group or the intervention group. Both groups received usual care; the intervention group additionally participated in a 6-month PCC intervention via telephone and an eHealth platform. The primary outcome was a composite score consisting of change in general self-efficacy and sick leave at the 6-month follow-up. Self-efficacy was assessed using the Swedish version of the 10-item General Self-Efficacy Scale, and sick leave was assessed based on participants' self-reported percentage of sick leave in relation to full-time work. The primary outcome was analyzed according to the intention-to-treat principle using the Mantel-Haenszel chi-square trend test.

A total of 654 patients were assessed for eligibility, of whom 59 were included in the final analysis: 29 in the intervention group and 30 in the control group. More participants in the control group (11/30, 36.7%) than in the intervention group (3/29, 10.3%) showed deterioration, resulting in a significant difference in the composite score between the groups at the 6-month follow-up (P=.04), favoring the intervention. This significance also remained in the nonimputed analysis (P=.04).

This study suggests that PCC via telephone and an eHealth platform may influence the level of sick leave and self-efficacy among persons with chronic pain. Since the control group deteriorated while the intervention group largely remained unchanged, PCC may play a protective role in supporting persons with chronic pain in returning to work. Further studies are warranted to confirm these findings.

The central vein sign (CVS) was included in 2024 McDonald criteria but remains underutilized in clinical practice. Implementation of CVS may reduce the requirement for lumbar punctures (LPs). At Nottingham, UK academic multiple sclerosis (MS) center, we implemented a fast-track (FT) pathway incorporating CVS analysis for people referred with imaging suggestive of MS as part of a quality improvement project. We retrospectively reviewed consecutive patients diagnosed with MS referred between March 1, 2024, and July 31, 2025.

Data from 59 consecutive patients were analyzed. The mean time to diagnosis was 2.9 months in FT pathway and 5.6 months in usual outpatient pathway (Student t test mean 83-day difference, p = 0.003). No people with MS in FT pathway received a LP. The mean cost per patient was £707 (FT) vs £999 (outpatient).

Routine application of CVS within a structured diagnostic pathway accelerated diagnosis, eliminated LPs, and reduced costs. Our findings support a broader adoption of CVS to streamline MS workup.

Evidence-Based Parenting Supports (EBPS) have demonstrated efficacy in addressing child behavioral and emotional problems. However, despite their proven benefits, EBPS still reach a minority of families. Online parenting interventions offer a promising solution to this gap, enhancing accessibility and demonstrating effectiveness in various contexts. This study evaluates the effectiveness of three online parenting programs: Triple P Online (TPOL), Fear-less Triple P Online (FLTPOL), and Triple P Online for Baby (TPOLB) which were disseminated nationally through the Australian Government's Parenting and Education Support Program.

Using a practice-as-usual approach, the study followed a non-randomized, open trial design with pre-, post-, and follow-up assessments. Data were collected from 2,254 participants who completed the baseline evaluation and at least one additional data collection time point.

Results indicated that participation in an online intervention was associated with significant improvements in parenting practices, parent self-efficacy, child behavioral and emotional adjustment, and parental mental health. Key moderators of program effectiveness included baseline parenting difficulties, parent age, education, relationship to the child, number of children and family cultural background. However, none of the demographic factors were consistently found to moderate outcomes across programs.

Findings underscore the potential of scalable, digital parenting interventions in public health contexts, offering a robust, inclusive approach to promoting positive parenting. The study calls for ongoing evaluation to optimize engagement and address barriers, thereby strengthening the long-term impact of digital parenting supports.

Individuals with disabilities have a right to live independently, be included within their communities, and have adequate standards of living and social protections. However, individuals with fetal alcohol spectrum disorder (FASD) experience elevated obstacles to obtaining and maintaining housing. In addition to brain-based differences that can create barriers to successful navigation of daily demands, many individuals with FASD experience mental health concerns, substance use, or trauma, and the experience of being houseless is, in itself, traumatic. These factors often compound, leaving individuals with FASD disproportionately affected by the ongoing housing and cost of living crisis.

This study brought together 47 Canadian housing providers, youth with FASD, caregivers, researchers, and policy makers to understand the challenges and opportunities for housing options for individuals with FASD. Reflexive thematic analysis was conducted to explore the aim of the research: individuals' living experiences, perspectives, and recommendations on what safe and stable housing for individuals with FASD could look like.

Four themes were generated describing how housing experiences for individuals with FASD could be improved: (1) being able to access all that is needed for housing; (2) embracing individuality and the pitfalls of blanket approaches; (3) working as a team to foster interdependency; and (4) the need for greater understanding of FASD across all sectors.

The results of this study provide vital insights on the needs of individuals with FASD in the context of housing and suggest ways forward to reduce the disproportionate impact of the Canadian housing crisis on individuals with FASD and their families.