Programs and Communities

Polypharmacy among psychiatric patients is a concerning trend. From 2007-2010, 58.2% of women and 41.8% of men reported taking five or more prescription drugs within the last 30 days (CDC, 2014). Negative outcomes include prescription drug abuse, side effects, interactions, treatment failure, patient dissatisfaction, and lack of treatment control. The associated practice challenges have led to the following PICOT question. In persons with mental health issues receiving care at an outpatient mental health clinic, does engaging in mindfulness practice versus no mindfulness practice change polypharmacy use over a 3-month period?

The project purpose was to evaluate the effectiveness of Insight Timer mobile mindfulness app at helping patients self-manage distressing symptoms and reduce polypharmacy. Over three weeks, mental health clinic nurse practitioners (NPs) voluntarily recruited patients (n=12) over age 18 using as needed prescriptions (PRNs), and agreed to use Insight Timer mobile mindfulness app for adjunct symptom management. Consenting participants downloaded the mobile app, and completed a brief questionnaire measuring PRN use at the start of app use, and PRN use at their next visit. A Wilcoxon signed-rank test indicated a 10-week mindfulness app trial did not significantly lower total PRN doses compared with pre-app dosing (Z = -.534, p = .593). Paired t-tests revealed no significant change in pre (M = 65.17, SD = 28.64) versus post (M = 67.75, SD = 20.22) OQ45 life functionality results (t(11) = -.420, p = .683) (d = .121) as a result of app use.

Clinically relevant results illustrated 83.33% of participants taking greater than nine PRN doses over the study period used the app six times or more in place of medication. High PRN users employed the app frequently in place of medication regardless of total PRN doses taken. Practice implications and sustainability recommendations include incorporating mobile app use in treatment plans for high PRN users and educating NP’s on the tangible benefits of mindfulness apps in reducing polypharmacy and easing symptom distress on an ongoing basis.
Keywords: mindfulness, mhealth, mobile apps, mobile smart phone, online, RCT, behavior change, polypharmacy.

The demand for interdisciplinary and cross campus courses has increased substantially over the past few years resulting in increased program offerings and modifications to existing coursework in universities across the nation. This is very clearly evident in the arts realm. However, there is no clear agreement of knowledge, skills and abilities deemed important to the success of selfemployed artists and arts entrepreneurs. This essay presents qualitative data collected from personal conversations and other data collected over the past several years from students and faculty members engaged in lessons learned from The Coleman Foundation Faculty Fellows Program, a national initiative of The Coleman Foundation. Building upon the lessons learned from this initiative a framework is presented to embed entrepreneurship content across several arts subjects. Suggestions for conceiving and designing entrepreneurship course content are portrayed. The “modules” approach to the infusion of entrepreneurship within the arts and other disciplines are presented. Assessment methods to measure the impact of using such modules to infuse entrepreneurship are explained. Pedagogical constructs and pedagogical resources are presented. The implications for future research are postulated and suggested.

This essay looks at pedagogies that can be deployed to teach the habits of mind that support arts entrepreneurship through the lenses of frameworks developed by Gardner, Duening, and Costa & Kallick for conceptualizing ways of thinking. It draws a network of connections between these frameworks for ways of thinking on which are mapped various pedagogies for teaching arts entrepreneurs as employed in educational programs and as described in recent literature. After first briefly summarizing each of these frameworks, I graphically describe the ways these various frameworks may overlap and then offer examples of pedagogies that support the development of entrepreneurial habits of mind for artists and others.

In this essay, I investigate the relationship between local political context and entrepreneurship in the arts, specifically entrepreneurship by cultural institutions, which I refer to as “cultural entrepreneurship.” I look at cultural entrepreneurship as a discourse and discuss one locus in particular, the city of Utrecht in The Netherlands. The discourse on cultural entrepreneurship in the Dutch context is influenced by diminishing government responsibility for financial support of the arts. Entrepreneurship is seen in that context as finding new sources of income. Entrepreneurial values such as curiosity and experimentation are dominant in the routine relationship between cultural organizations and their subsidizing administrations but are not incorporated in the understanding of cultural entrepreneurship. After applying these considerations to the observation of the culture-political practice in the city of Utrecht, I suggest a framework that allows us to understand the discourse on the relationship between cultural entrepreneurship and political context along two axes. One axis moves between risk acceptance and aversion, and the other between the private and public interests.

This article argues that the current economic design of the US not-for-profit arts sector, specifically theatre, fails to support the long-term wellness of the cultural worker and the cultural commons. As a solution, we propose a global, commons-based alternative economy and complementary currency called Culture Coin that creates new wealth, abundance, and virtuous social behaviors by matching unmet needs with underutilized resources that our current economy fails to circulate. The current design of our arts economy results in generative artists being disproportionately poorer, unjust disparities in how resources are distributed, and social behaviors in the nonprofit sector that mimic for profit, commercial enterprises. The arts sector has an over-dependence on uncompensated or undercompensated “sweat equity” and volatile philanthropic funding. We detail the value and characteristics of a commons framework for entrepreneurial activity and describe internet-enabled peer production as a way to build cultural commons as well as the most effective way to collectively co-create and deploy the Culture Coin project.