Ontogenetic changes in jaw leverage and skull shape in tufted and untufted capuchins.

The ontogeny of feeding is characterized by shifting functional demands concurrent with changes in craniofacial anatomy; relationships between these factors will look different in primates with disparate feeding behaviors during development. This study examines the ontogeny of skull morphology and jaw leverage in tufted (Sapajus) and untufted (Cebus) capuchin monkeys. Unlike Cebus, Sapajus have a mechanically challenging diet and behavioral observations of juvenile Sapajus suggest these foods are exploited early in development. Landmarks were placed on three-dimensional surface models of an ontogenetic series of Sapajus and Cebus skulls (n = 53) and used to generate shape data and jaw-leverage estimates across the tooth row for three jaw-closing muscles (temporalis, masseter, medial pterygoid) as well as a weighted combined estimate. Using geometric morphometric methods, we found that skull shape diverges early and shape is significantly different between Sapajus and Cebus throughout ontogeny. Additionally, jaw leverage varies with age and position on the tooth row and is greater in Sapajus compared to Cebus when calculated at the permanent dentition. We used two-block partial least squares analyses to identify covariance between skull shape and each of our jaw muscle leverage estimates. Sapajus, but not Cebus, has significant covariance between all leverage estimates at the anterior dentition. Our findings show that Sapajus and Cebus exhibit distinct craniofacial morphologies early in ontogeny and strong covariance between leverage estimates and craniofacial shape in Sapajus. These results are consistent with prior behavioral and comparative work suggesting these differences are a function of selection for exploiting mechanically challenging foods in Sapajus, and further emphasize that these differences appear quite early in ontogeny. This research builds on prior work that has highlighted the importance of understanding ontogeny for interpreting adult morphology.

Examination of protective factors that promote prosocial skill development among children exposed to intimate partner violence.

This retrospective cohort study examined prosocial skills development in child welfare-involved children, how intimate partner violence (IPV) exposure explained heterogeneity in children's trajectories of prosocial skill development, and the degree to which protective factors across children's ecologies promoted prosocial skill development. Data were from 1,678 children from the National Survey of Child and Adolescent Well-being I, collected between 1999 and 2007. Cohort-sequential growth mixture models were estimated to identify patterns of prosocial skill development between the ages of 3 to 10 years. Four diverse pathways were identified, including two groups that started high (high subtle-decreasing; high decreasing-to-increasing) and two groups that started low (low stable; low increasing-to-decreasing). Children with prior history of child welfare involvement, preschool-age IPV exposure, school-age IPV exposure, or family income below the federal poverty level had higher odds of being in the high decreasing-to-increasing group compared with the high subtle-decreasing group. Children with a mother with greater than high school education or higher maternal responsiveness had higher odds of being in the low increasing-to-decreasing group compared with the low stable group. The importance of maternal responsiveness in fostering prosocial skill development underlines the need for further assessment and intervention. Recommendations for clinical assessment and parenting programs are provided.

Illuminating the landscape of sibling relationship quality: An evidence and gap map.

This paper used an evidence and gap map (EGM) to advance the scientific understanding of sibling relationship quality among children aged 2 to 18 years by synthesizing literature on 277 empirical studies from 1985 to 2022 to delineate patterns of study design, sampling, and measurement. Most existing research has utilized majority of White, middle-to-upper class, and/or two-caregiver family samples. Nearly 85% (n = 235) of studies used quantitative methods to measure sibling relationship quality across eight domains: conflict, warmth/affection, quality, cohesion, hostility, power/control, positive engagement, and conflict management. A total of 122 studies used a measure of sibling relationship quality as a predictor of sibling behavior, social, psychological, cognitive, health, or physiological outcomes. Future directions for research are discussed.

Prenatal Exposure to Intimate Partner Violence and Child Developmental Outcomes: A Scoping Review Study.

Pregnant women face an increased risk of intimate partner violence (IPV). In addition to the risk of violence faced by women, there is a dual concern for risk of harm to the fetus. Expanding knowledge on childbirth outcomes, other domains of children's development have been examined in recent literature. Yet, there is limited comprehensive knowledge in the area. This scoping review study, informed by ecobiodevelopmental theory, mapped evidence associating prenatal IPV exposure and children's development. We searched eight databases, including PubMed, CINAHL, and ERIC. Thirty-one empirical studies published in English that associated prenatal IPV exposure and children's development were eligible for our review. Included studies were published between 2006 and 2022, with 39% published in the most recent 5 years. Eighteen studies had sample sizes smaller than 500, and 21 were atheoretical; six failed to consider covariates. Reviewed studies showed adverse effects of prenatal IPV exposure on psychological, behavioral, physical health, and physiological outcomes, either directly or indirectly via mechanisms such as maternal behavioral health. Due to inconsistency in results and a lack of empirical evidence, however, social and cognitive outcomes were identified as needing further research to enhance our understanding of the global and domain-specific effects of prenatal IPV exposure. Prospective longitudinal studies, driven by theories of causal mechanisms, which adjust for empirically qualified confounders, will be critical to inform practice and policy to promote healthy development of prenatally IPV-exposed children. Incorporating strengths/asset-focused outcomes and examining contextual factors and sex/gender specific effects may advance the knowledge in this area.

Ontogenetic changes in bite force and gape in tufted capuchins.

Bite force and gape are two important performance metrics of the feeding system, and these metrics are inversely related for a given muscle size because of fundamental constraints in sarcomere length-tension relationships. How these competing performance metrics change in developing primates is largely unknown. Here, we quantified in vivo bite forces and gapes across ontogeny and examined these data in relation to body mass and cranial measurements in captive tufted capuchins, Sapajus spp. Bite force and gape were also compared across geometric and mechanical properties of mechanically challenging foods to investigate relationships between bite force, gape and food accessibility (defined here as the ability to breach shelled nuts). Bite forces at a range of gapes and feeding behavioral data were collected from a cross-sectional ontogenetic series of 20 captive and semi-wild tufted capuchins at the Núcleo de Procriação de Macacos-Prego Research Center in Araçatuba, Brazil. These data were paired with body mass, photogrammetric measures of jaw length and facial width, and food geometric and material properties. Tufted capuchins with larger body masses had absolutely higher in vivo bite forces and gapes, and animals with wider faces had absolutely higher bite forces. Bite forces and gapes were significantly smaller in juveniles compared with subadults and adults. These are the first primate data to empirically demonstrate the gapes at which maximum active bite force is generated and to demonstrate relationships to food accessibility. These data advance our understanding of how primates meet the changing performance demands of the feeding system during development.

Innovations in Trauma-Informed Care: Building the Nation's First System of Trauma-Informed Recreation Centers.

Exposure to adversity and traumatic events affects well-being across important domains of functioning, including mental, physical, social, emotional, spiritual, and neurobiological. Situated as a focal point throughout neighborhoods, recreation centers are a prime opportunity to cultivate spaces of safety and healing. However, current models of trauma-informed care largely do not map neatly onto the recreation organizational structure and functioning. This paper describes the efforts over the past five years to transform the City of Cleveland, Ohio's 22 recreation centers into trauma-informed Neighborhood Resource and Recreation Centers (NRRCs)--places where children, youth, and adults can readily acquire the support and services they need in an environment in which trauma-informed care principles are fully embedded in the fabric of the organization's culture. Phase 1 included transitioning the recreation centers to NRRCs, hiring of trained social workers and counselors to work within the recreation centers, and training all recreation staff about trauma. Phase 2 included development of NRRC trauma-informed standards, development of the Trauma-Informed Progress Tool to track change over time, development of Trauma-Informed Leadership Competencies for Center Managers, and ongoing training for the social workers and counselors. We discuss ideas for future work and lessons learned from each phase.

Impact of Seated Movement Incorporation on Middle School Classroom Physical Activity Levels and Academic Engagement.

Purpose: Physical inactivity is linked with several chronic diseases and poor academic outcomes. This study aimed to examine the effect an under-the-desk band would have on middle school students' physical activity level, and academic engagement. Methods: Two local middle school classrooms (n = 42, M = 20, F = 22) participated in the study, which was conducted over 14 weeks. Physical activity was measured with accelerometry, and academic engagement was assessed using momentary time sampling. Enrolled participants were provided an accelerometer to wear upon entering the classroom. The baseline period lasted for 36 days. During the intervention period, which lasted for the next 30 days, an under-the-desk band was provided to students to freely fidget at their desks. After the study, 13 participants (M = 5, F = 8) in Class A were included in final physical activity analysis, and the 6 participants (M = 3, F = 3) in Class B were included in the academic engagement analysis. Results: Class A had significant increases in percentage of sedentary time (MD = -12.91%, ES = .88) in addition to significant decreases in the percentage of light (MD = 8.82%, ES = .67), moderate (MD = 3.08%, ES = .84), and vigorous (MD = -.04%, ES = .63) physical activity time during the intervention period compared to the baseline period. No significant or meaningful changes occurred in academic engagement with the use of the under-the-desk band. Conclusions: This study high- lights the importance of finding appropriate methods to increase physical activity for adolescents.

High salt intake activates the hypothalamic-pituitary-adrenal axis, amplifies the stress response, and alters tissue glucocorticoid exposure in mice.

AIMS: High salt intake is common and contributes to poor cardiovascular health. Urinary sodium excretion correlates directly with glucocorticoid excretion in humans and experimental animals. We hypothesized that high salt intake activates the hypothalamic-pituitary-adrenal axis activation and leads to sustained glucocorticoid excess. METHODS AND RESULTS: In male C57BL/6 mice, high salt intake for 2-8 weeks caused an increase in diurnal peak levels of plasma corticosterone. After 2 weeks, high salt increased Crh and Pomc mRNA abundance in the hypothalamus and anterior pituitary, consistent with basal hypothalamic-pituitary-adrenal axis activation. Additionally, high salt intake amplified glucocorticoid response to restraint stress, indicative of enhanced axis sensitivity. The binding capacity of Corticosteroid-Binding Globulin was reduced and its encoding mRNA downregulated in the liver. In the hippocampus and anterior pituitary, Fkbp5 mRNA levels were increased, indicating increased glucocorticoid exposure. The mRNA expression of the glucocorticoid-regenerating enzyme, 11ß-hydroxysteroid dehydrogenase Type 1, was increased in these brain areas and in the liver. Sustained high salt intake activated a water conservation response by the kidney, increasing plasma levels of the vasopressin surrogate, copeptin. Increased mRNA abundance of Tonebp and Avpr1b in the anterior pituitary suggested that vasopressin signalling contributes to hypothalamic-pituitary-adrenal axis activation by high salt diet. CONCLUSION: Chronic high salt intake amplifies basal and stress-induced glucocorticoid levels and resets glucocorticoid biology centrally, peripherally and within cells.

School-based obesity prevention programs in rural communities: a scoping review.

OBJECTIVE: The objective of this review was to examine existing literature and conceptually map the evidence for school-based obesity prevention programs implemented in rural communities, as well as identify current gaps in the literature. INTRODUCTION: Pediatric obesity is a significant public health condition worldwide. Rural residency places children at increased risk of obesity. Schools have been identified as an avenue for obesity prevention in rural communities. INCLUSION CRITERIA: We considered citations focused on children (5 to 18 years of age) enrolled in a rural educational setting. We included obesity prevention programs delivered in rural schools that focused on nutrition or dietary changes, physical activity or exercise, decreasing screen time, or combined nutrition and physical activity that aimed to prevent childhood obesity. We included all quantitative, qualitative, and mixed methods research designs, as well as text and opinion data. METHODS: A search was conducted of published and unpublished studies in English from 1990 through April 2020 using PubMed, CINAHL Complete, ERIC, Embase, Scopus, Academic Search Premier, Cochrane Register of Controlled Trials, and ClinicalTrials.gov. Gray literature was also searched. After title and abstract review, potentially relevant citations were retrieved in full text. The full texts were assessed in detail against the inclusion criteria by 2 independent reviewers. Included citations were reviewed and data extracted by 2 independent reviewers and captured on a spreadsheet targeting the review objectives. RESULTS: Of the 105 studies selected for full-text review, 72 (68.6%) were included in the final study. Most of the studies (n = 50) were published between 2010 and 2019 and were conducted in the United States (n = 57). Most studies included children in rural elementary or middle schools (n = 57) and targeted obesity prevention (n = 67). Teachers implemented the programs in half of the studies (n = 36). Most studies included a combination of physical activity and nutrition components (n = 43). Other studies focused solely on nutrition (n = 9) or physical activity (n = 9), targeted obesity prevention policies (n = 9), or other components (n = 8). Programs ranged in length from weeks to years. Overall, weight-related, physical activity-specific, and nutrition-specific outcomes were most commonly examined in the included citations. CONCLUSIONS: Obesity prevention programs that focused on a combination of physical activity and nutrition were the most common. Multiple outcomes were examined, but most programs included weight-specific and health behavior-specific outcomes. The length and intensity of rural school-based obesity prevention programs varied. More research examining scientific rigor and specific outcomes of rural school-based obesity prevention programs is needed.

Differences between preemptive and non-preemptive physical activity among 'drunkorexia'-positive college students.

Objective: 'Drunkorexia' is characterized by compensating for alcohol-related calories using physical activity (PA). Drunkorexia is common on college campuses but little is known about the PA behaviors within the drunkorexia paradigm. Methods: First-year college students living on campus completed an online survey collecting drunkorexia, PA, and alcohol consumption data. A total of 127 participants reported engaging in drunkorexia behaviors. Results: Fifty-three participants were classified as preemptively physically active (e.g., PA and drink on Tuesday) compared to 74 as non-preemptively physically active. Preemptively physically active participants consumed more alcohol on Fridays and Saturdays than those non-preemptively physically active. Preemptively physically active participants engaged in significantly greater amounts PA. Females accounted for all significant differences between groups. Discussion: Among drunkorexia-positive participants, many made preemptive efforts to control their calories before consuming alcohol, which may predispose them to higher incidences of adverse outcomes such as alcohol poisoning, unwanted sexual advances, and death.

A preventable, life-altering case of fluoroquinolone-associated tendonitis.

ABSTRACT: Fluoroquinolones, such as ciprofloxacin and levofloxacin, are broad-spectrum antibacterial agents that have historically been widely used for urinary tract infections, pneumonia, and intra-abdominal infections but are associated with several serious adverse reactions, including tendinopathy and tendon rupture, peripheral neuropathy, and aortic aneurysm. These drugs should not be used for uncomplicated infections unless no other antimicrobial treatment is feasible. This article describes a patient who experienced life-altering disability from a fluoroquinolone, reviews the adverse reactions of this drug class, and discusses recommended treatment for acute uncomplicated cystitis and asymptomatic bacteriuria.

Compositional analysis of movement behaviors' association on high-sensitivity c-reactive protein: the Jackson heart study.

PURPOSE: Movement behaviors (i.e. physical activity [PA], sedentary behavior [SB], and sleep) are intrinsically codependent, an issue resolved using compositional data analysis (CoDA). High-sensitivity C-reactive protein (hs-CRP) is a nonspecific inflammatory marker positively associated with cardiovascular diseases and affected by movement behaviors. Examine the relation between movement behaviors using CoDA and how time reallocation between two movement behaviors was associated with hs-CRP concentration. METHODS: The Jackson Heart Study was designed to investigate cardiovascular disease risk factors among African American participants in the Jackson, MS area. PA and sleep were self-reported with SB calculated as the remaining time in the day. RESULTS: The median untransformed hs-CRP concentration was 0.28 mg·dL-1 (interquartile range; 0.11, 0.61). Reallocating 15 minutes of PA with SB, the hypothetical change in log hs-CRP concentration was 0.08 mg·dL-1 (95% CIs; 0.04, 0.11) greater than the average log hs-CRP concentration. Substituting 15 minutes of SB or sleep with PA was associated with a hypothetical change in log hs-CRP concentration difference of -0.05 mg·dL-1 (-0.08, -0.03) and -0.06 mg·dL-1 (-0.08, -0.03), respectively. Reallocations between SB and sleep were not associated with the hypothetical difference in log hs-CRP concentration. CONCLUSIONS: Modeling estimates suggest replacing 15 minutes of SB with PA is associated with lower inflammation.

Corticosteroid Receptors in Cardiac Health and Disease.

Nuclear receptors play a central role in both energy metabolism and cardiomyocyte death and survival in the heart. Recent evidence suggests they may also influence cardiomyocyte endowment. Although several members of the nuclear receptor family play key roles in heart maturation (including thyroid hormone receptors) and cardiac metabolism, here, the focus will be on the corticosteroid receptors, the glucocorticoid receptor (GR) and mineralocorticoid receptor (MR). The heart is an important target for the actions of corticosteroids, yet the homeostatic role of GR and MR in the healthy heart has been elusive. However, MR antagonists are important in the treatment of heart failure, a condition associated with mitochondrial dysfunction and energy failure in cardiomyocytes leading to mitochondria-initiated cardiomyocyte death (Ingwall and Weiss, Circ Res 95:135-145, 2014; Ingwall , Cardiovasc Res 81:412-419, 2009; Zhou and Tian , J Clin Invest 128:3716-3726, 2018). In contrast, animal studies suggest GR activation in cardiomyocytes has a cardioprotective role, including in heart failure.

Comparison of Leisure Time Physical Activities by Metabolic Syndrome Status among Adolescents.

Background: Metabolic syndrome (MetS) increases the risk of premature morbidity and mortality. Physical activity (PA) beneficially affects MetS; however, it is unclear if PA types differ among adolescents 12-15 years old, according to their MetS status. This study compared self-reported PA types by MetS status. Methods: Using the 2015-2016 National Health and Nutritional Examination Survey (NHANES) data, 664 adolescents self-reported PA in the past seven days. MetS status was assessed using Ford's pediatric adaptation of the ATP-III adult criteria. Pearson chi-square and t-tests were conducted to determine self-reported PA differences. Results: The adolescents' mean age was 13.47 years (95% CIs; 13.04, 14.38) and 52.69% were male (352). Twenty-seven (4.07%) adolescents were MetS positive. The prevalence of PA engagement in the past seven days was similar for MetS-positive and -negative adolescents (77.67% and 70.51%, respectively; p > 0.05). No significant differences were observed for PA type by MetS status. MetS-positive adolescents reported higher sedentary time (565.77 [438.99, 692.56] vs. 490.59 [377.86, 603.33] minutes per day, respectively; p = 0239). Conclusions: Engagement in specific PA types does not appear to differ by MetS status, but MetS-positive adolescents have significantly higher sedentary time. PA promotion should target a variety of activities to maximize the effectiveness of public health programs and interventions should target reducing sedentary time.

Barriers to Healthy Eating and Physical Activity in the Mississippi Delta.

Rural regions in the United States are home to approximately 15-20% of the country's population. These regions are often characterized by low access to medical care and high rates of disease and death. The literature has detailed the heterogeneous nature of rural health disparities, calling for research detailing regional factors that influence individual-level risk factors such as diet and physical activity. Approximately 54% of Mississippi residents live in rural areas. The Mississippi Delta population is largely characterized by high obesity rates, poor diet, and low levels of physical activity. This study presents detailed observations of the community-level barriers and facilitators to healthy eating and physical activity within Mississippi Delta communities, contextualizing the findings of a survey of 352 individuals across 25 communities to provide implications and direction for future activities aimed at reducing obesity in the Mississippi Delta. Study participants reported a high prevalence of overweight (22.9%) and obese (62.1%) body mass index classifications. Chi-square analyses revealed significant relationships between body mass index, age, and health conditions. Community food and physical activity environments and rural characteristics were largely implicated as barriers to fruit and vegetable consumption and physical activity. Next steps involve using qualitative research techniques to guide the development of programmatic strategies for reducing obesity through diet and physical activity in these communities and other rural regions in the United States.

The influence of jaw-muscle fibre-type phenotypes on estimating maximum muscle and bite forces in primates.

Numerous anthropological studies have been aimed at estimating jaw-adductor muscle forces, which, in turn, are used to estimate bite force. While primate jaw adductors show considerable intra- and intermuscular heterogeneity in fibre types, studies generally model jaw-muscle forces by treating the jaw adductors as either homogeneously slow or homogeneously fast muscles. Here, we provide a novel extension of such studies by integrating fibre architecture, fibre types and fibre-specific tensions to estimate maximum muscle forces in the masseter and temporalis of five anthropoid primates: Sapajus apella (N = 3), Cercocebus atys (N = 4), Macaca fascicularis (N = 3), Gorilla gorilla (N = 1) and Pan troglodytes (N = 2). We calculated maximum muscle forces by proportionally adjusting muscle physiological cross-sectional areas by their fibre types and associated specific tensions. Our results show that the jaw adductors of our sample ubiquitously express MHC α-cardiac, which has low specific tension, and hybrid fibres. We find that treating the jaw adductors as either homogeneously slow or fast muscles potentially overestimates average maximum muscle forces by as much as approximately 44%. Including fibre types and their specific tensions is thus likely to improve jaw-muscle and bite force estimates in primates.

Altered hypothalamic DNA methylation and stress-induced hyperactivity following early life stress.

Exposure to early life stress (ELS) during childhood or prenatally increases the risk of future psychiatric disorders. The effect of stress exposure during the neonatal period is less well understood. In preterm infants, exposure to invasive procedures is associated with altered brain development and future stress responses suggesting that the neonatal period could be a key time for the programming of mental health. Previous studies suggest that ELS affects the hypothalamic epigenome, making it a good candidate to mediate these effects. In this study, we used a mouse model of early life stress (modified maternal separation; MMS). We hypothesised MMS would affect the hypothalamic transcriptome and DNA methylome, and impact on adult behaviour. MMS involved repeated stimulation of pups for 1.5 h/day, whilst separated from their mother, from postnatal day (P) 4-6. 3'mRNA sequencing and DNA methylation immunoprecipitation (meDIP) sequencing were performed on hypothalamic tissue at P6. Behaviour was assessed with the elevated plus, open field mazes and in-cage monitoring at 3-4 months of age. MMS was only associated with subtle changes in gene expression, but there were widespread alterations in DNA methylation. Notably, differentially methylated regions were enriched for synapse-associated loci. MMS resulted in hyperactivity in the elevated plus and open field mazes, but in-cage monitoring revealed that this was not representative of habitual hyperactivity. ELS has marked effects on DNA methylation in the hypothalamus in early life and results in stress-specific hyperactivity in young adulthood. These results have implications for the understanding of ELS-mediated effects on brain development.

Vortioxetine ameliorates anhedonic-like behaviour and promotes strategic cognitive performance in a rodent touchscreen task.

Depression-associated cognitive impairments are among the most prevalent and persistent symptoms during remission from a depressive episode and a major risk factor for relapse. Consequently, development of antidepressant drugs, which also alleviate cognitive impairments, is vital. One such potential antidepressant is vortioxetine that has been postulated to exhibit both antidepressant and pro-cognitive effects. Hence, we tested vortioxetine for combined antidepressant and pro-cognitive effects in male Long-Evans rats exposed to the chronic mild stress (CMS) paradigm. This well-established CMS paradigm evokes cognitive deficits in addition to anhedonia, a core symptom of depression. Learning and memory performance was assessed in the translational touchscreen version of the paired-associates learning task. To identify the mechanistic underpinning of the neurobehavioural results, transcriptional profiling of genes involved in the stress response, neuronal plasticity and genes of broad relevance in neuropsychiatric pathologies were assessed. Vortioxetine substantially relieved the anhedonic-like state in the CMS rats and promoted acquisition of the cognitive test independent of hedonic phenotype, potentially due to an altered cognitive strategy. Minor alterations in gene expression profiling in prefrontal cortex and hippocampus were found. In summary, our findings suggest that vortioxetine exhibits an antidepressant effect as well as behavioural changes in a translational learning task.

Impact of COVID-19 Pandemic on Posttraumatic Stress, Grief, Burnout, and Secondary Trauma of Social Workers in the United States.

The purpose of this study is to measure posttraumatic stress, grief, burnout, and secondary trauma experienced by employed social workers in the United States and to describe organizational support provided to social workers during the novel coronavirus disease 2019 (COVID-19) pandemic. This study used data from the first wave of the COVID-19 Pandemic and Emotional Well-Being Study, a prospective panel study examining the psychological impact of the COVID-19 pandemic, and includes a sample of 181 social workers. We conducted univariate analyses. Over a quarter (26.21%) of social workers met the diagnostic criteria for PTSD and 16.22% reported severe grief symptoms. While 99.19% of the sample reported average to high compassion satisfaction, 63.71% reported average burnout and 49.59% reported average secondary trauma. Findings indicate that social workers are reporting higher than national estimates of PTSD, indicating a greater need for more emotional support during the COVID-19 pandemic. Given the significance and severity of the pandemic, it is essential that organizations provide resources for both immediate and ongoing support for the emotional well-being of their employees.

"Making Sure We Are All Okay": Healthcare Workers' Strategies for Emotional Connectedness During the COVID-19 Pandemic.

Healthcare workers have been on the front lines throughout the COVID-19 pandemic, treating affected patients and navigating overwhelmed healthcare systems. Emotional connection has been associated with resilient outcomes following collective trauma. This qualitative study examined how healthcare workers define emotional connectedness during the COVID-19 pandemic and their adaptive emotional connection strategies. Data were gathered through the first wave of the online COVID-19 Pandemic and Emotional Well-Being study, a prospective panel study of the psychological impact of COVID-19 on frontline workers and the general public. This study focused on three extended-response questions about definitions of and strategies for emotional connectedness. Data were analyzed using reflexive thematic analysis. Participants conceptualize emotional connectedness as having empathy and value, help and support, presence, and vulnerability. They also describe emotionally connected relationships as being characterized by mutuality and frequent contact. Participants identify current behavioral strategies for cultivating emotional connectedness, such as using technology, providing instrumental help or sending gifts via mail, and building quality time within their households. They also report challenges in maintaining these connections. Future research must contribute knowledge about effective interventions for essential healthcare workers in the aftermath of COVID-19. Specific recommendations for social work practitioners are also discussed.