The Art of Analgesia: A Pilot Study of Art Museum Tours to Decrease Pain and Social Disconnection Among Individuals with Chronic Pain.

OBJECTIVE: This mixed-methods study examines the feasibility of art museum tours (Art Rx) as an intervention for individuals with chronic pain. METHODS: Art Rx provided 1-hour docent-led tours in an art museum to individuals with chronic pain. Survey data were collected pre-tour, immediately post-tour, and at three weeks post-tour. Pain intensity and unpleasantness were measured with a 0-10 numerical rating scale. Social disconnection was measured with a 12-item social disconnection scale. Participants also reported percent pain relief during the tour and program satisfaction in the post-tour survey. Change in pain and social disconnection was analyzed with paired t tests, bias-corrected and accelerated bootstrap confidence intervals (BCa CIs), and Cohen's d. Thematic analysis of semistructured interviews with participants explored the feasibility and perceived impact of the program. RESULTS: Fifty-four individuals participated in this study (mean age [SD] = 59 [14.5] years, 64.8% female), and 14 were interviewed. Fifty-seven percent of participants reported pain relief during the tour, with an average pain relief (SD) of 47% (34.61%). Participants reported decreased social disconnection and pain unpleasantness pre- to post-tour (3.65, BCa 95% CI = 1.70-5.73, P < 0.001, d = 0.37; and 0.49, BCa 95% CI = 0.06-0.90, P = 0.016, d = 0.20, respectively). Participants indicated high satisfaction with the program. Interviewees remarked on the isolating impact of chronic pain and how negative experiences with the health care system often compounded this sense of isolation. Participants experienced Art Rx as a positive and inclusive experience, with potential lasting benefit. CONCLUSIONS: Art museum tours for individuals with chronic pain are feasible, and participants reported positive effects on perceived social disconnection and pain.

Bored and spoiling for a flight: capabilities lost and found in lockdown.

Human beings are dynamic; our innate faculties beg to engage in activities. To achieve fullness and human dignity, people "convert" personal capabilities into active "functionings," Amartya Sen explains. This means that staying still is not a normal state. It can feel like punishment. Forced inactivity will generate resentment, resistance, and boredom that can fester until pent-up energy explodes violently, or implodes in depression. Boredom defaults on capabilities and resources in many cases. In other cases, stillness is a gift. It can stimulate the imagination to fill in emptiness with memories and new explorations. Either boredom builds toward doing damage, or it releases energy to think and to create. What people don't do is stay put, mentally or physically. Authorities-including police, judges, teachers, parents -should take this dynamic human condition into account and reconsider the effects of conventional command and control policies. Then they can choose between violence and creativity as alternative outlets for the energy that boredom generates. Short of facing up to human dynamism, decision-making may continue to favor strong-arm tactics, which trigger the violence and pain that policing is meant to mitigate. Is it surprising that apparently peaceful peoplebecome enraged in lockdown conditions? Do adults wonder why students drop-out of school and suffer escalating rates of depression and suicide? Boredom is certainly not the only cause for these disastrous effects, but to ignore it risks remaining complicit with processes that perpetuate personal and collective dysfunctions. Complicity with harmful practices will miss opportunities to channel frustrated energy toward developing human capabilities. Authorities are responsible for promoting peaceful development. We are all responsible.[2] Normally, people stay busy with routine activities. We work, play, attend to family and to friends. Particular activities have even become our public badges of identity, as is evident in surnames (Cooper, Baker, Taylor, Farmer, etc.) that trace back to work that ancestors answered to. Lockdown during COVID-19 meant that many otherwise occupied people had few outlets for energy. Those who knew how to meditate managed to assuage anxiety through contemplation and the pursuit of ideal emptiness.

An arts-literacy intervention for adolescent depression and anxiety symptoms: outcomes of a randomised controlled trial of Pre-Texts with Kenyan adolescents.

Background: Mental health problems are prevalent among youth in low-resource countries and are further compounded by stigma and limited access to traditional treatments. The need for scalable, accessible, and stigma-free mental health interventions is urgent. We developed and tested Pre-Texts, an arts-literacy intervention that targets adolescent depression and anxiety, in Kenya. Methods: We conducted a universal RCT (Randomized Controlled Trial). Students from Kenyan high schools (N = 235, ages 13-19, 53.19% female) were randomized to either Pre-Texts or a study skills control intervention. Pre-Texts involves the use of a text-such an excerpt from a novel, a physics lesson, or a technical manual-to inspire art-making that is followed by collective reflection on the process of interpretation through artmaking. Participants met daily for a week in groups of 6-12 youths for 1-h sessions. Groups were facilitated by high school graduates trained as lay-providers. This study was pre-registered at the Pan African Clinical Trials Registry (PACTR; registration number: PACTR202111497122432). The trial took place between August 11th 2021 and December 18th 2021. Findings: Pre-Texts produced a greater reduction in depression (d = 0.52, 95% CI [0.19, 0.84]) and anxiety (d = 0.51, 95% CI [0.20, 0.81]) symptoms from baseline to 1-month follow-up compared to the control group. Similarly, in a sub-sample of participants with elevated depression and anxiety symptoms, Pre-Texts produced a greater reduction in depression (d = 1.10, 95% CI [0.46, 1.75]) and anxiety (d = 0.54, 95% CI [-0.07, 1.45]) symptoms. Interpretation: Our findings suggest that a brief arts-literacy intervention with challenging school material in a group setting, implemented as an afterschool program, can reduce depression and anxiety symptoms in adolescents in Sub-Saharan Africa. Future replication trials with larger sample sizes with extended follow-ups will help assess the strength and sustainability of these effects. Funding: The study was funded by grants from the Mind, Brain, and Behaviour (MBB) Initiative at Harvard University and the Center for African Studies at Harvard University.

The disruptive innovation and the pre-texts methodology / A inovação disruptiva e a metodologia pré-textos

Abstract: Introduction: The experience report describes the protocol used in one of the activities carried out during the initiative aimed at the search for health impact solutions through disruptive innovation - "IDEA2 Global, Guidance and transforming connections for innovators in medical technology", in May 2019, at the Institute of Medical Engineering and Science, Massachusetts Institute of Technology (IMES MIT). Experience report: The Pre-Texts methodology was chosen to stimulate creativity and instill the curiosity inherent in the search for solutions to complex problems, through the reading of a challenging text and related activities in a workshop format. Bringing together professionals from various segments and nationalities, the two-hour and forty-five-minute period was the time spent on the workshop inspired by practices from some Latin American countries. Discussion: Through observation, it was observed that participants were engaged and fascinated by hands-on activities, amid the active reading of a text on neural connections in creative processes. The feedback from the evaluation on the workshop confirmed the facilitators' impression. Conclusion: The Pre-Texts methodology is a strategy that can be applied in heterogeneous groups and can include skills such as creativity and collaboration. Thus, the use of this methodology should be encouraged in other similar situations.

Resumo: Introdução: O relato de experiência descreve o protocolo utilizado em uma das atividades realizadas durante a iniciativa destinada à busca por soluções de impacto em saúde através da inovação disruptiva - "IDEA2 Global, Orientação e conexões transformadoras para inovadores em tecnologia médica", em maio de 2019, no Instituto de Engenharia Médica e Ciência, Massachusetts Institute of Technology (IMES MIT). Relato de Experiência: A metodologia Pré-Textos foi escolhida para estimular a criatividade e instigar a curiosidade inerentes à busca por soluções de problemas complexos, através da leitura de um texto desafiador e atividades relacionadas, em formato de workshop. Reunindo profissionais de vários segmentos e nacionalidades, o período de duas horas e quarenta e cinco minutos foi o tempo dispensado ao workshop inspirado em práticas oriundas de alguns países da América Latina. Discussão: Por meio da observação participante, constatou-se que os partícipes se mostraram entusiasmos e engajados por atividades "mão na massa", em meio a leitura ativa de um texto sobre conexões neurais em processos criativos. A devolutiva da avaliação sobre o workshop confirmou a impressão dos facilitadores. Conclusão: A metodologia Pré-Textos é uma estratégia passível de aplicação em grupos heterogêneos, podendo contemplar habilidades como a criatividade e a colaboração. Assim, estimula-se a utilização desta metodologia em outras situações semelhantes.