Anne Marie Novak

Intensive programs such as retreats and workshops are widely promoted for occupational burnout, but their evidence base is limited and fragmented. This critical narrative review searched PubMed, Google Scholar, and APA PsycInfo for peer-reviewed studies published from January 2000 to March 2026. Eligible studies evaluated structured, high-dose interventions delivered in a condensed format, reported burnout or closely related outcomes, and involved adult working or occupationally relevant training populations. Evidence was organized by four immersion dimensions: contextual containment, dose density, experiential multimodality, and social density. Forty studies met the criteria: 22 residential retreats and 18 non-residential intensives. No virtual synchronous program qualified, so adjacent virtual evidence was appraised narratively. Studies commonly reported short-term gains in stress and well-being and high satisfaction, but effects on validated burnout measures were less consistent. Most studies were small, uncontrolled, and drawn from healthcare and student samples, with little long-term follow-up; controlled trials yielded more conservative results. No study compared the same curriculum across formats. Delivery format may itself be an active ingredient, with facilitated social connection the best-supported candidate. Three testable pathways are proposed: contextual containment as a reset for exhaustion, shared group experience and communitas for disengagement and cynicism, and dose density as a catalyst for professional fulfillment and efficacy. Head-to-head format comparisons, standardized burnout measures, longer follow-up, and economic evaluation are needed.

Purpose: To examine the relationship between political county-level partisanship and COVID-19 and flu vaccination uptake in the United States following the 2020 and 2024 presidential elections. Design: Ecological, cross-sectional analysis utilizing public datasets. Setting: All 3224 US counties and county equivalents. Sample: Data includes 3224 counties; 3192 had complete COVID-19 vaccination data, and 3125 had complete flu vaccination data. Measures: Dependent variables were county-level flu and full COVID-19 vaccination rates. Independent variables included 2020 and 2024 GOP vote share, median household income, education, healthcare access, and county-level health indicators. Analysis: Spearman correlation, independent t-tests, and multivariate linear regressions. Results: GOP vote share is strongly negatively correlated with COVID-19 vaccination ( r = −.699, P < .001) and moderately with flu vaccination ( r = −.427, P < .001). Counties in the highest GOP quartile had significantly lower vaccination rates than Democratic quartile counties (COVID-19: 45% vs 60%, t = −39.64, P < .001; flu: 35% vs 46%, t = −23.10, P < .001). Each percentage-point increase in GOP vote share is associated with a 0.45% decrease in COVID-19 uptake in 2024 ( β = −.449, P < .001) and a 0.13% decrease in flu uptake ( β = −.128, P < .001), independent of socioeconomic controls. Conclusions: Partisan alignment has become a significant determinant of vaccination, with the divide persisting between 2020 and 2024. Findings underscore the need for localized, depoliticized public health strategies.

Adolescents diagnosed with pediatric-onset multiple sclerosis (POMS) face a distinct set of challenges as they cope with a chronic neuroinflammatory disease during a formative stage of life. This review examines the growing body of literature on the psychosocial and cognitive consequences of POMS, from the trauma of diagnosis to disruptions in identity development, academic difficulties, and increased vulnerability to mental health issues. Many young people with MS experience fatigue, cognitive decline, depression, and anxiety, all of which can significantly interfere with their daily lives and overall well-being, even if physical symptoms of the disease remain limited. Yet, current care systems often fall short in addressing their needs, and interventions tailored to adolescents remain scarce. There is a pressing need for developmentally sensitive, family-centered, and integrated models of care. Targeted research and policy action are essential to better support this underserved group. This review builds on prior research by integrating recent findings with adolescent-development frameworks and by proposing a multicomponent health-promotion intervention model specific to POMS. The review describes relevant evidence-based approaches including cognitive behavioral therapy, mindfulness, peer-based interventions, and cognitive rehabilitation that were validated in adults with MS and chronically ill adolescents. The objective is to synthesize evidence and translate it into actionable recommendations for clinical care and research.

Background: Pain self‐management (PSM) programs have demonstrated effectiveness as a pain management strategy, yet evidence remains scarce for patients with chronic pain treated with medical cannabis. We aimed to explore feasibility aspects and practical applications of developing and implementing a group‐based PSM intervention in this context.Methods: Twenty‐two semi‐structured qualitative interviews were conducted with 10 chronic pain patients treated with cannabis and 12 clinicians from a range of expertise.Results: Overall, the interviewees believed that the proposed intervention is feasible; yet it is essential to consider the following aspects during program planning and implementation. Inductive thematic analysis of interview transcripts identified five major themes. The first is that the program enablers include the intrinsic benefits of therapeutic group dynamics, aligning expectations, and setting individual goals at program initiation. The second theme is the program barriers. These include expected challenges for participants due to behavioral and mental changes that necessitate high commitment, the challenge for the group leader in delivering an appropriate response to each participant's emotional narrative; and managing logistical issues. The third theme is the psychological experience of living with pain, with an emphasis on addressing patients' emotional perspectives within the program's framework, namely, their perceptions of pain, fear of pain, and the relations of such to past experiences. The fourth theme is the psychoeducation on pain and cannabis use, including the brain‐pain connection and informed guidance regarding cannabis use. The fifth theme is the integration of guided movement and relaxation techniques in pain management, thus underscoring the importance of practice during the group sessions.Conclusions: Our findings suggest key elements that may inform planning PSM‐approach therapy groups, tailored to the particular needs of patients with chronic pain using medical cannabis.

Background: Delirium is a common neuropsychiatric syndrome characterized by the acute and fluctuating impairment of cognition, attention, and consciousness, which is prevalent in older adults following surgical procedures. Despite the recognized impact of delirium on recovery, its specific effects on motor rehabilitation outcomes in the geriatric population remain underexplored. This historical cohort study aimed to evaluate the association between the presence of delirium upon admission to a rehabilitation hospital and the motor functional gain at discharge among older patients following hip fracture surgery. Methods: The collected data included socio-demographic characteristics, comorbidities, medications, Mini-Mental State Examination (MMSE) scores, and the Functional Independence Measure (FIM). Motor rehabilitation outcomes were assessed using Motor Absolute Functional Gain (mAFG), the Montebello Rehabilitation Factor Score (mMRFS), and Rehabilitation Efficiency (mRE). Results: Of the 143 hip fracture patients admitted for rehabilitation, 38 (26.6%) were diagnosed with delirium. Patients with delirium had lower MMSE scores (18.1 ± 5.8 vs. 22.4 ± 6.0, p < 0.001), higher benzodiazepine prescription rates (50.0% vs. 14.3%, p < 0.001), and longer lengths of stay in acute care and rehabilitation (42.7 ± 10.4 vs. 37.3 ± 11.2 days, p = 0.01). Despite significant improvements in the FIM scores for both groups (p < 0.001), patients with delirium had lower mAFG (11.87 ± 7.26 vs. 15.91 ± 8.73, p = 0.01), mMRFS (0.22 ± 0.14 vs. 0.31 ± 0.15, p = 0.001), and mRE (0.28 ± 0.17 vs. 0.44 ± 0.25, p < 0.001). However, the multivariate regression models showed no association between delirium and functional improvement after adjusting for confounders. Conclusions: While both patients with and without delirium showed improvement in their motor functions by the time they were discharged from a rehabilitation hospital, patients with delirium showed lower absolute and relative improvements. Tailored programs addressing the special needs of patients with delirium after hip fracture surgery may enhance outcomes for this vulnerable population. A specialized, multidisciplinary approach tailored to the patient’s cognitive status and overall condition is key to maximizing the recovery of older hip fracture patients with delirium.

Background: Attention Deficit Hyperactivity Disorder (ADHD) is a pressing concern in pediatric public health, with its prevalence rising among children and teenagers. This study explored the relationship between group-based physical activity and the well-being, resilience, and distress levels of Israeli youth, with a specific focus on those with ADHD symptoms. Methods: This cross-sectional study surveyed 699 Israeli teenagers, assessing their participation in three types of physical activities: unorganized, structured, and the “Five Fingers” program. Data were collected through an online platform and analyzed using ANOVA, t-tests, and multivariable regression models to identify predictors of resilience. Results: Structured, group-based sport activities are associated with higher resilience (p < 0.01) and lower distress (p < 0.01) in adolescents. Adolescents with ADHD symptoms exhibited lower resilience (p < 0.001) and well-being (p < 0.001), and higher distress (p < 0.001). However, those with ADHD symptoms who participated in group-based activities fared better in terms of distress (p < 0.01) and well-being (p = 0.018) than those who did not. Participation in any sport activity, older age, male gender, and a higher socio-economic status predicted greater resilience in youth, generally. Conclusions: This study presents the potential of structured physical activities that involve psychosocial and group integration training to improve the mental health of adolescents, especially in the context of ADHD symptoms.

Background Attention Deficit Hyperactivity Disorder (ADHD) is a pressing concern in contemporary pediatric public health, with its prevalence rising among children and teenagers. This study explored the relationship between group-based physical activity and the well-being, resilience, and distress levels of Israeli youth, with a specific focus on those with ADHD. Methods This was a survey-based, cross-sectional study that included 699 Jewish Israeli teenagers aged 16 to 19. In addition to quantitative questionnaires that examined sociodemographic factors, resilience, distress, and well-being levels, the youth were asked about participation in group-based physical activities and the significance they ascribe to various facets of the activities. Results Our findings indicated that structured and group-based physical activities, especially the Five Fingers program which emphasizes psychosocial development and leadership skills, are associated with higher resilience (p<.01) and lower distress levels (p<.01) in adolescents. Generally, Israeli adolescents with ADHD exhibited lower levels of resilience (p<.001) and well-being (p<.001), and higher levels of distress (p<.001) compared to their counterparts. However, adolescents with ADHD who participated in group-based activities fared better in terms of distress (p<.01) and well-being (p=.018) than adolescents with ADHD who did not participate in organized sports. Further, participation in any form of sport activity, older age, male gender, and a higher socio-economic status predicted greater resilience in youth generally. Conclusions The study presents the potential of structured, engaging physical activities that involve psychosocial training and group integration activities to improve the mental health of adolescents, especially in the context of ADHD.

Despite great interest in how dynamic fluctuations in psychological states such as mood, social safety, energy, present-focused attention, and burnout impact stress, well-being, and health, most studies examining these constructs use retrospective assessments with relatively long time-lags. Here, we discuss how ecological momentary assessments (EMAs) address methodological issues associated with retrospective reports to help reveal dynamic associations between psychological states at small timescales that are often missed in stress and health research. In addition to helping researchers characterize daily and within-day fluctuations and temporal dynamics between different health-relevant processes, EMAs can elucidate mechanisms through which interventions reduce stress and enhance well-being. EMAs can also be used to identify changes that precede critical health events, which can in turn be used to deliver ecological momentary interventions, or just-in-time interventions, to help prevent such events from occurring. To enable this work, we provide examples of scales and single-item questions used in EMA studies, recommend study designs and statistical approaches that capitalize on EMA data, and discuss limitations of EMA methods. In doing so, we aim to demonstrate how, when used carefully, EMA methods are well poised to greatly advance our understanding of how intrapersonal dynamics affect stress levels, well-being, and human health.

Mental health disorders are an increasing global public health concern that contribute to morbidity, mortality, disability, and healthcare costs across the world. Biomedical and psychological research has come a long way in identifying the importance of mental health and its impact on behavioral risk factors, physiological health, and overall quality of life. Despite this, access to psychological and psychiatric services remains widely unavailable and is a challenge for many healthcare systems, particularly those in developing countries. This review article highlights the strengths and opportunities brought forward by digital mental health in narrowing this divide. Further, it points to the economic and societal benefits of effectively managing mental illness, making a case for investing resources into mental healthcare as a larger priority for large non-governmental organizations and individual nations across the globe.

Despite great interest in how dynamic fluctuations in psychological states such as mood, social safety, energy, present-focused attention, and burnout impact stress, well-being, and health, most studies examining these constructs use retrospective assessments. Here, we discuss how ecological momentary assessments (EMAs) address methodological issues associated with retrospective reports, able to reveal dynamic associations between psychological states at small timescales that are often missed in stress and health research. In addition to helping researchers characterize daily and within-day fluctuations and temporal dynamics between different health-relevant processes, EMAs can elucidate mechanisms through which interventions reduce stress and enhance well-being. EMAs can also be used to identify changes that precede critical health events, which can in turn be used to inform the delivery of ecological momentary interventions (EMIs of just-in-time interventions) that prevent such events from occurring. To enable this work, this narrative review provides examples of scales and single-item questions used in EMA studies, makes concrete recommendations for researchers seeking to employ EMAs in their research, and discusses limitations of EMA methods. In doing so, we aim to encourage the use of these methods in research given that, when used carefully, EMA methods are well-poised to greatly advance our understanding of how intrapersonal dynamics affect stress levels, well-being, and human health.