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• Adverse childhood experiences (ACEs) screeners can be verbal or self-administered. • We used 2 contemporaneous surveys to compare prevalence of caregiver-reported ACEs. • The telephone survey had higher ACEs disclosure rates compared to paper/web survey. • Findings support the importance of verbal communication to identify ACEs exposure. Adverse childhood experiences (ACEs) are traumatic experiences that increase people's susceptibility to adverse physical health, mental health, and social consequences in adulthood. Screening for ACEs in primary care settings is complicated by a lack of consensus on appropriate methods for identifying exposure to ACEs. It is unclear whether self-report methods could increase disclosure of ACEs as compared to interview-based methods. This study compares data on the prevalence of ACEs from two publicly available surveys conducted on the same population of children's caregivers: the 2019 Ohio subsample of the web/mail-based National Survey of Children's Health and the telephone-based 2019 Ohio Medicaid Assessment Survey. We find higher disclosure of caregiver-reported child exposure to ACEs in the telephone interview survey, highlighting the importance of the role of verbal communication in developing a safe and trusting relationship in the disclosure of trauma. [ABSTRACT FROM AUTHOR]

• Recognition that carers' experience both affiliative and threat-based emotions in their relationships with birth parents; • Carers who share First Nations' cultural identities with parents find that these can provide a basis for affiliative emotional responses; • There is limited formal support for carers to manage the strong emotions, particularly threat-based emotions, that can complicate their relationships with birth parents; • We provide five recommendations for improving support for carers in building and sustaining relationships with birth parents and in realising their potential to support children's rights to family connections during the out-of-home care journey. Children in foster and kinship care have a right to relationships with their parents. The United Nations Convention on the Rights of the Child (UNCRC) asserts children's right to contact with their parents and families during periods of separation, except where this is proven not to be in the child's best interests. Foster and kinship carers can play a pivotal role in children's opportunities for, and experiences of, connection to parents and other family. Yet, the relationship between carers and parents is often characterised by ambivalence and tensions. Emerging research suggests that training and support to carers can help them to navigate their own and children's relationships with their families. However, such support is not routinely available, and the evidence-base for supporting carers to manage complex relationships with parents is not well-developed. In this paper, we report on a study with 113 foster and kinship carers in Queensland (Australia). We explore carers' perceptions of the emotional aspects of their relationships with parents. A novel feature of our study is our exploration of carers' perceptions of affiliative and threat-based emotions in their relationships with birth parents. We report that carers experience a wide spectrum of emotions in their relationships with parents, some of which strengthen these relationships while others create distance. We find also that carers receive little, if any, formal support in building relationships with parents and for supporting children's opportunities for, and experiences of family contact. Aboriginal and Torres Strait Islander carers report being unsupported in meeting their cultural obligations in developing relationships with children's parents and families. We discuss the implications for formal support to improve carers capacities to build and maintain their own, and children's, relationships with parents. [ABSTRACT FROM AUTHOR]

Many Latinx and Indigenous Mexican populations in the United States Southwest live in unincorporated communities in the US-Mexico borderlands called colonias. These environmental justice communities often lack basic infrastructure, including healthcare services, prompting many to seek services across the border. However, due to geopolitical factors more vulnerable caregivers are limited to utilize healthcare services in the US. This paper reports the experiences and healthcare decision-making of caregivers living in colonias in the US-Mexico border region who care for children with respiratory health conditions. This study was carried out from September to December 2020. Focus groups and interviews were conducted with Latinx and Indigenous Mexican caregivers of children with asthma or respiratory distress. Qualitative interviews elicited caregivers' perspectives on the environmental factors affecting children's chronic health conditions and use of healthcare services. The analysis employed the concept of structure vulnerability to theorize geography as a structural determinant of health for caregivers faced with making healthcare decisions for their suffering from respiratory health conditions. A survey was administered to collect basic sociodemographic information. A total of 36 caregivers participated in the study. Structural factors including unincorporated community status and government inaction intersected with social determinants of health to prompt caregivers to cross the US-Mexico border to access healthcare services in Mexico for their children. Yet, more vulnerable caregivers (i.e., those without documentation status in the US) and their children, accessing healthcare services in the US was not an option limiting caregivers' ability to meet their children's healthcare needs. In such cases, geography acts as a structural determinant of health. This study shows the importance of geography in health. Rural unincorporated colonias located in the borderlands are precariously located and lack basic critical infrastructure including healthcare access. Within such places, historically and socially marginalized populations become invisible, are subject to the health effects of environmental hazards, and are limited depending on their positionality and thus vulnerability to healthcare services. • Municipal unincorporation contributes to health disparities among Latinx families in US-Mexico borderlands. • Latinx children in colonias are disproportionately exposed to environmental toxins. • Geography acts as a structural determinant of health for Latinx families in colonias. • A binational approach to health services should be prioritized for families in the borderlands. [ABSTRACT FROM AUTHOR]

Violence towards formal and informal caregivers is a frequently occurring and complex international hazard in healthcare that has a negative impact on the physical and psychological health states of caregivers. However, little is known about the prevalence and type of violence towards formal and informal caregivers by care recipients in the home care settings. The aim of this review is to obtain insight into the prevalence of violence by home care recipients against formal and informal caregivers in home care settings and the types and consequences of violence. A systematic review was conducted between March and May 2023 using the PubMed, EMBASE, CINAHL, and PsycINFO databases. A methodological quality appraisal was conducted using the Mixed Methods Appraisal Tool (MMAT). Data collection was performed until May 2023. Out of 1087 screened articles, a total of 10 full texts were included after the screening process. Findings demonstrate that workplace violence is an understudied area of research. The few studies found in this review showed high prevalence rates of violence with risk for physical and mental injuries for formal caregivers. No information at all on violence against informal caregivers was available. Strategies for prevention and intervention against violence in the home care setting must be developed. To develop strategies, it is important to have more insight in the prevalence and types of violence. It is also important to explore violence against informal caregivers in research. Violence towards formal caregivers in home care settings is a common risk that negatively impacts the health status of caregivers. What is already known about the topic? • Workplace violence has a negative impact on the physical and psychological health state of formal caregivers. • There is a lack of knowledge on care recipient violence towards formal and informal caregivers in the home care setting. What this paper adds • No study was found that studied violence against informal caregivers; this review demonstrates the importance of exploring this topic. • In home care settings, formal caregivers are exposed to types of workplace violence that have little or no presence in the hospital setting • Sexual harassment and sexual aggression towards formal caregivers in the home care setting are underreported in the literature. [ABSTRACT FROM AUTHOR]

While carers' vulnerability has often been neglected in the literature, the recent COVID-19 pandemic brought this issue to the fore. This article explores why it has been so often ignored and how could it be dealt with differently. It does so in the form of a philosophical and conceptual investigation illustrated by various examples and situations, related primarily, but not exclusively, to the COVID period. Criticising a property-based view, and based on examples of carers' vulnerability during the pandemic, our investigation suggests that carers' vulnerability is relationally constructed and played out on multiple interwoven dimensions that may contradict each other. Our examples also suggest that the relational construction of vulnerabilities is socially and organisationally mediated, calling for the development of social and organisational forms of mediation that may help carers deal with their vulnerabilities. Second, and rather counterintuitively with regard to the COVID-period, we question the negative valence usually associated with vulnerability and analyse how this affects ways of dealing with carers' vulnerabilities and the co-creation of care. Finally, following Gilson (2014), we propose an ambivalent, relational conception of vulnerability, considered as 'openness to affectation by' and offer some theoretical and practical implications. Theoretically, this conception also allows us to consider such openness as an ability that may nurture carers' 'response-ability'. It also allows us to develop specific relational ethics for and in care relationships. Practically, this re-conceptualisation may help carers better embrace and process their vulnerabilities, including responses to negative affectations following exposure to carees. It may also facilitate their 'reception' of carees, and help co-create and adapt responses to carees' calls, thus avoiding paternalistic responses. • COVID-19 brought to the fore carers' vulnerability. • The paper critically discusses conventional understandings of vulnerability. • It develops an ambivalent and relational conception of vulnerability. • It opens new ways of interpreting and dealing with carers' vulnerability. [ABSTRACT FROM AUTHOR]