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Performance anxiety affects individuals across many fields, from sports to medicine to music. Research in the area of Music Performance Anxiety (MPA) has been of particular importance to instrumental and vocal soloists and ensemble members for several decades. Throughout the COVID-19 pandemic, many musicians have been required to change the format and location of their performances. These adjustments, as well as musicians' existing unique characteristics and life experiences, may have impacted their experience of MPA. The purpose of this study was to examine the impact of the COVID-19 pandemic and other factors on MPA. Participants (N = 251) were recruited online via the Prolific platform, and completed an online survey containing demographic questions, a COVID impacts survey, and measures of individual characteristics (TIPI, NCS-18), mentorship experience (MFQ-9), retrospective state MPA in both 2020 and 2022 (CSAI-2R), and trait MPA (K-MPAI-R). A hierarchical regression was performed to explore if gender, age, musical experience (i.e., number of genres and instruments performed), extraversion, COVID impacts (general and musical), mentorship experience, and cognitive style predicted severity of trait MPA. Age, number of musical instruments performed, and extraversion were found to be significant predictors of trait MPA. Ultimately, this research has aimed to contextualize MPA within a national landscape significantly transformed by the COVID-19 pandemic.

Increased mental health difficulties were reported in Canadian children as a result of the Covid-19 pandemic. Accordingly, the pandemic has impacted families as well. The purpose of this thesis was: 1) to examine fluctuations in children’s mental health symptoms and mindful parenting across the 2020-2021 academic year; 2) to examine whether children’s symptoms of inattention and hyperactivity at the beginning of the 2020-2021 academic year were associated with mindful parenting at the end of the academic year; 3) to examine whether children’s depressive and anxiety symptoms at the end of the year moderated this relationship and; 4) to examine how child age and gender affected these relationships. Parents of 114 young children in a large Canadian city participated in this study in the Fall of 2020 and the Spring of 2021. Parents completed several self-report scales used to measure children’s mental health symptomatology and mindfulness in parenting. While there were no significant changes in children’s mental health symptoms or mindful parenting across the time points, children’s symptoms of inattention and hyperactivity were significantly, negatively associated with mindful parenting across the pandemic year, and children’s depressive symptoms moderated this relationship. Specifically, when children’s depressive symptoms were low or average it was found that higher symptoms of inattention and hyperactivity were associated with lower levels of mindful parenting among parents of young girls. Results may inform practitioners about which families require additional support during the pandemic and beyond.

This dissertation consists of three essays in Health Economics relating to the recent challenges in the U.S. The first essay studies the impact of retirement on subsequent health and investigates the mediation effect of social network in the relationship between retirement and health. Findings reveal that retirement adversely impacts physical and mental health outcomes and a considerable portion of these effects are explained by social network changes post-retirement. In particular, shrinkage in the size of social network post-retirement deteriorates physical health and increases depression in retirees. In the second essay, we assess the differential effect of social distancing on the daily growth rate of COVID-19 infections in the US counties by considering the spatial pattern of COVID-19 spread. We also conduct a comparative analysis of the effect on urban versus rural counties, as well as low versus high socially vulnerable counties. Our analysis illustrates that a high level of social distancing compliance is needed in urban counties and in socially vulnerable areas to achieve the largest impact at curve flattening, whereas moderate-compliance is enough in reaching the peak marginal impact in rural regions and counties with low social vulnerability. In the third essay, by combining multiple data sources, we investigate how racial disparities in access to healthcare contribute to the disparity in COVID-19 infections and mortality in black versus white sub-groups. The multilevel analysis demonstrates that a higher probability of having health insurance significantly reduces disparity in COVID-19 mortality in black sub-group while it has no impact on the disparity in whites. / Doctor of Philosophy / This dissertation uses various quantitative methods to investigate policy-relevant questions regarding the recent challenges in the U.S. economy. In the first chapter, we explore how the physical and mental health of individuals changes by retirement. The results show that retirement decreases physical health while increases depression and anxiety. We also analyze how social network changes after retirement might cause changes in the health of retirees. We find that retirees may experience worse physical and mental health than non-retirees due to losing some of their relationships after retirement. In particular, the loss of contacts increases depression and deteriorates general health. In the second chapter, we investigate how compliance with social distancing within a typical county and its neighbor counties can reduce the spread of COVID-19. We examine this question for urban versus rural counties in the US and socially vulnerable versus socially not vulnerable counties. We find a high compliance level of social distancing is needed in urban counties and in socially vulnerable areas to reach the highest impact at slowing down the COVID-19 virus spread. In the third chapter, we examine whether healthcare access inequalities (e.g., having health insurance) increase the risk of COVID-19 infections and mortality for black communities. Our results show that having health insurance decreases COVID-19 mortality in communities of color but not whites.

The COVID-19 Pandemic exacerbated a multitude of systems in the United States in 2020 up to current day. The structure of non-profit organizations across the country weakened as demands escalated for free food resources with specific pressure placed on food banks and food recovery organizations. There were citizens who had not previously relied on free food services who found themselves in drive through pickups, waiting for pre-packaged food boxes or the occasional you-pick operation to feed their families and themselves. The increase in demand for free food services was reacted to by those leading and directing the free food distribution sites through a time of crisis. This qualitative study serves to analyze food recovery organization (FRO) leadership strategies and principles that guided their decision making and problem-solving skills in response to food shortages and supply chain issues. The merge of the eight pillars of transformational and servant leadership theory provided propositional pillars that were tested in practice through interviews with FRO leaders in Appalachia. The discovery of how these leadership strategies were enacted during a time of crisis will guide the development of a training curriculum for nonprofit leaders in the future. / Master of Science in Life Sciences / The COVID-19 Pandemic exacerbated a multitude of systems in the United States in 2020 up to current day. The structure of non-profit organizations across the country weakened as demands escalated for free food resources with specific pressure placed on food banks and food recovery organizations. There were citizens who had not previously relied on free food services who found themselves in drive through pickups, waiting for pre-packaged food boxes or the occasional you-pick operation to feed their families and themselves. The increase in demand for free food services was reacted to by those leading and directing the free food distribution sites through a time of crisis. This qualitative study serves to analyze food recovery organization (FRO) leadership strategies and principles that guided their decision making and problem-solving skills in response to food shortages and supply chain issues. The merge of the eight pillars of transformational and servant leadership theory provided propositional pillars that were tested in practice through interviews with FRO leaders in Appalachia. The discovery of how these leadership strategies were enacted during a time of crisis will guide the development of a training curriculum for nonprofit leaders in the future.

Students and educators around the world faced many challenges when returning to the physical school building and environment after the disruption to our educational systems throughout the height of the COVID-19 pandemic. Educational leaders across the U.S. have expressed concerns over the substantially higher levels of anxiety and chronic absenteeism among adolescents. This study examined middle school adolescents' abilities to use coping skills for managing anxiety in the school environment post-pandemic. Qualitative data were collected from eight middle school counselors through one-on-one semi-structured interviews. Findings indicated an increase in the number of students presenting with symptoms of anxiety and the severity of symptoms. Middle school counselors noted an increase in school refusal and self-harm and indicated that the majority of their direct service time is spent with individual students. In order to better support students with managing anxiety, middle school counselors expressed the need for explicit coping skills instruction and additional mental health staffing in the school buildings. / Doctor of Education / Students and educators around the world faced many challenges when returning to the physical school building and environment after the disruption to our educational systems throughout the height of the COVID-19 pandemic. Educational leaders across the U.S. have expressed concerns over the substantially higher levels of anxiety and student absenteeism among adolescents. In this study, a total of eight middle school counselors who served as counselors prior to the pandemic and in the 2023-2024 school year participated in one-on-one interviews. Counselors were asked to describe their observations of adolescent coping strategies for managing anxiety in the school environment and share any differences in how they were working to support adolescents presenting with symptoms of anxiety. Middle school counselors reported an increase in the number of students presenting with symptoms of anxiety and the severity of symptoms. They also noted an increase in school refusal and self-harm and indicated that the majority of their time is spent with individual students. In order to better support students managing anxiety, middle school counselors expressed the need for explicit coping skills instruction and additional mental health staffing in the school buildings.

Yes / We interviewed people with dementia and carers from the IDEAL cohort to find out how the COVID-19 lockdown and continuing restrictions affected those living with dementia. Some people with dementia coped well, while others coped with difficulty or were only just coping. The additional stress of COVID-19 exacerbated pre-existing coping difficulties. For many, social isolation increased anxiety. Some felt that lack of activity or lack of social contact caused a decline in their abilities to manage everyday tasks. Confusion about COVID-19 rules or difficulty remembering what to do led to anxiety when leaving the house. People felt that members of the public might not understand their particular needs. While some carers felt they were coping well, others experienced stress when having to leave the home because the person with dementia might not be safe if left alone. Some experienced increased strain in the caring relationship compounded by an uncertainty about future availability of respite. Some were concerned about the complex health needs of the person with dementia alongside COVID-19 risk and lack of personalised information. Both people with dementia and carers talked about the importance of access to safe outdoor space. People were anxious about how others would react or behave towards them regarding keeping a distance if they went out. Being connected to friends, family and wider community or support groups was important to help combat the effects of isolation. People from BAME communities worried about their increased vulnerability to the virus. A lack of trust in Government guidance and in health care services added to their anxiety. However, some benefitted from strong community and faith group involvement. What might be helpful for people with dementia? • Reablement to help regain or maintain skills • Personalised health advice regarding managing COVID-19 risk and the opportunity to ask questions. • Identification of people with dementia who live alone and an assessment of their needs. What might be helpful for carers? • Needs assessment in regard to respite. • Novel forms of respite care that incorporate social distancing. What might be helpful for both carers and people with dementia? • Access to COVID-safe outdoor spaces. • Continuation and expansion of ‘just checking’ services. • Support to get online and use the internet. • Communication and information through non-digital means. • Community COVID-19 ‘dementia awareness’ initiatives. What might be helpful for people from Black and minority ethnic groups? • Addressing concerns about their increased risk of COVID-19. • Directing information and support through existing community and faith groups. / This report presents independent research funded by the National Institute for Health Research Policy Research Unit in Older People and Frailty.

The outbreak of the COVID-19 pandemic has had an enormous impact worldwide and is posing a threat to the physical and mental health of world citizens. The present study examines the extent to which a sample of Swedish university students have experienced loneliness during COVID-19. Furthermore, it also examines if there is a correlation between a high degree of loneliness and increased alcohol consumption. Participants consisted of Swedish university students recruited online using opportunity sampling (N=224). Loneliness was measured using the UCLA Loneliness Scale translated into Swedish. Results showed that the sample displayed higher levels of loneliness compared to normative scores but lower levels when compared to students elsewhere who have been quarantined. A logistic regression found no connection between high degrees of loneliness and increased alcohol consumption in the sample. The results and their implications are discussed. A pre-post measurement design and longitudinal studies are encouraged for future research to evaluate long term consequences of loneliness, along with an increased focus on ways to reduce loneliness. Finally, we suggest that loneliness should continue to be a priority in research in order to fully understand the psychological impact of COVID-19. / Utbrottet av COVID-19 pandemin har haft en enorm påverkan världen över och utgör ett hot mot den fysiska och mentala hälsan. Vår studie syftade till att undersöka i vilken utsträckning ett urval av svenska universitetsstudenter upplevt ensamhet under COVID-19. Vidare har studien undersökt om det fanns ett samband mellan en hög grad av upplevd ensamhet under COVID-19 och ökad alkoholkonsumtion. Deltagarna bestod av svenska universitetsstudenter vilka rekryterades online genom bekvämlighetsurval (N=224). Deltagarna fyllde i en enkät där subjektiv ensamhet mättes med hjälp av en översatt version av UCLA Loneliness Scale till svenska. Resultaten visade att studenterna i vårt urval uppvisade högre nivå av ensamhet jämfört med normvärden, men lägre jämfört med studenter i andra länder som suttit i karantän. En logistisk regression fann inget samband mellan upplevd ensamhet och ökad alkoholkonsumtion. Resultaten och deras implikationer diskuteras. För framtida forskning uppmuntras en för- och eftermätningsdesign samt longitudinella studier att utvärdera långsiktiga konsekvenser av ensamhet, samt ett ökat fokus på sätt att minska ensamhet. Slutligen föreslås att ensamhet blir ett fortsatt fokus i forskningen för att fullt ut förstå psykologiska effekterna av COVID-19.

PURPOSE: The purpose of this qualitative descriptive study was to describe critical care nurses’ experiences of moral challenges, moral distress, and moral resilience during the COVID-19 pandemic. The specific aims of this study were to: 1. Describe the moral challenges experienced by ICU nurses. 2. Describe moral resilience in terms of integrity, buoyancy, moral efficacy, self-regulation, and self-stewardship among ICU nurses (from Rushton’s framework). 3. Explore the relationship between moral distress and moral resilience to advance the concept of moral resilience in the face of the COVID-19 pandemic. FRAMEWORK: This study was undergirded by an adaptation of Rushton’s conceptual framework of moral concepts. DESIGN: A qualitative descriptive design was used. Participants were recruited between January to May 2021, and a semi-structured interview guide was utilized to interview participants. RESULTS: 17 participants were interviewed for the study. Participants described the four themes of moral challenges: death and dying, pain and suffering, being alone, and being helpless and not in control. Moral resilience was described as: integrity, buoyancy, moral efficacy, self-regulation, self-stewardship, and self-perception. The relationship between moral distress and moral resilience was described as iterative and fluid. CONCLUSION: The findings of the study provided a new domain of moral resilience called self-perception and a revised adaptation of the conceptual framework for moral resilience.