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Background: Globally, populations are aging, generating concerns about the sustainability of health and social care provision. In terms of the public provision of social care in particular, unpaid carers provide much of the support to people with disabilities and older people. In addition, there is an increased onus in many countries on digital transformation projects, in the hope that the digitalization of services can create efficiencies and savings in both costs and care labor. In England, the focus of this paper, the shift to digital services is also framed as a means to enhance choice and control for older unpaid carers, while being part of a broader offering that includes nondigital alternatives and support to mitigate digital exclusion., Objective: This study examines the impact of digitalization on older, unpaid carers-a group more likely to be both expected to engage digitally with services and at risk of digital exclusion-in England, focusing on their lived experiences in terms of caring and access to social care., Methods: We used a constructionist approach to thematic analysis, where data from 48 older unpaid carers collected through focus groups were analyzed using thematic analysis, resulting in 4 prevailing themes., Results: Our findings indicated that while unpaid carers largely acknowledge the benefits of digitalization, they also highlight several points of failure, whereby engagement with digital spaces is experienced as coercive and exacerbates feelings of exclusion. These are further worsened by government failures to address issues of connectivity, imposing additional financial burdens and complicating tasks such as benefit applications., Conclusions: In this study, we have highlighted the need for greater involvement in shaping both policy and technological solutions, which in turn will be more inclusive and aligned to the aspirations and circumstances of older carers., (©Anastasia Rousaki, Efpraxia D Zamani, Laura Sbaffi, Kate Hamblin, Rachael Black. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 24.10.2024.)

Time is a key organising principle in the formal provision of care to older people in their own homes. It is used when delivering homecare services, calculating fees and care staff's pay entitlement. Research in the UK highlights how the predominant service model of compartmentalising care into pre-defined tasks, delivered in strictly scheduled time-based units, offers poor quality jobs, characterised by low pay, insecure and tightly controlled work. Our case study research of 'new models' of homecare however, found variation in the way time measures were operationalised. Drawing from Thompson's (1967, Past & Present, 38, 56-97) conceptualisation of clock-time (where care work is controlled by external measures of time) and nature's time (where care work is performed through internal notions of time) as a lens, we examine how service delivery models and job quality are temporally connected through homecare work. Through our analysis, we exemplify how the use of strict time-based measures can limit care work according to nature's time. We also consider the potential of ambitemporality-the accommodation of clock and nature's time-in organising service delivery as a means of enriching job quality. Finally, we discuss the pertinent implications of conceiving job quality in homecare work through a temporal lens., (© 2023 The Authors. Sociology of Health & Illness published by John Wiley & Sons Ltd on behalf of Foundation for the Sociology of Health & Illness.)

Dating app facilitated sexual assault (DAppSA) is a concerning phenomenon with minimal published research. This retrospective study explored if DAppSAs were different than other sexual assaults (SAs) committed by acquaintances through a review of 3,413 sexual assault medical forensic examination (SAMFE) charts from 2017 to 2020 in a Mountain West state in the United States. Routine Activities Theory and Confluence Model of sexual aggression provided the theoretical framework for the study. Inclusion criteria for DAppSA cases included (1) victim was 14 years of age or older; (2) victim indicated meeting the perpetrator on a dating app; (3) SA occurred at initial in-person meeting; and (4) victim had a SAMFE with SA kit evidence collection. DAppSAs ( n  = 274) represented 8.02% of overall cases and 13.92% of acquaintance SAs ( n  = 1,968). DAppSA victims had unique characteristics including a higher percentage of male victims (7.5%), college students (22.2%), and victims with self-reported mental illness (MI) (59.6%). Victims were less likely to fight back during the assault with lower percentages of kicking (5.8%) and hitting (9%). DAppSA victims and perpetrators were less likely to use drugs or alcohol before or during the assault. DAppSAs were found to be more violent SAs with increased strangulation (32.4%); assaultive/penetrative acts; and victim injuries, especially anogenital and breast injuries. Unique and troubling differences were found in DAppSA cases than other SAs committed by acquaintances. Due to the increased violent nature of DAppSAs, the researchers propose that sexual predators use dating apps as hunting grounds for vulnerable victims. Recommendations to address dating app safety concerns, influence dating app usage policies, and improve care to survivors are discussed through systems-based and trauma-informed approaches.

This paper reports the findings of a thematic narrative review of peer-reviewed articles exploring innovation in UK independent homecare services published between January 2009-August 2021. Our analysis of 15 papers reveals four broad innovation types: personalised funding, operational models, workforce development and assistive technology. We conclude that research focused on innovation in independent homecare offers important insights into the positive and negative outcomes of different types of innovation for providers, care workers and people receiving care. There are, however, also areas which are neglected and need further elaboration, including more robust evidence of outcomes and clearer articulation of innovation processes., (© 2022 The Authors. Health and Social Care in the Community published by John Wiley & Sons Ltd.)

The anaerobic lifestyle of the intestinal parasite Blastocystis raises questions about the biochemistry and function of its mitochondria-like organelles. We have characterized the Blastocystis succinyl-CoA synthetase (SCS), a tricarboxylic acid cycle enzyme that conserves energy by substrate-level phosphorylation. We show that SCS localizes to the enigmatic Blastocystis organelles, indicating that these organelles might play a similar role in energy metabolism as classic mitochondria. Although analysis of residues inside the nucleotide-binding site suggests that Blastocystis SCS is GTP-specific, we demonstrate that it is ATP-specific. Homology modelling, followed by flexible docking and molecular dynamics simulations, indicates that while both ATP and GTP fit into the Blastocystis SCS active site, GTP is destabilized by electrostatic dipole interactions with Lys 42 and Lys 110, the side-chains of which lie outside the nucleotide-binding cavity. It has been proposed that residues in direct contact with the substrate determine nucleotide specificity in SCS. However, our results indicate that, in Blastocystis, an electrostatic gatekeeper controls which ligands can enter the binding site.

Blastocystis is a unicellular stramenopile of controversial pathogenicity in humans. Although it is a strict anaerobe, Blastocystis has mitochondrion-like organelles with cristae, a transmembrane potential and DNA. An apparent lack of several typical mitochondrial pathways has led some to suggest that these organelles might be hydrogenosomes, anaerobic organelles related to mitochondria. We generated 12,767 expressed sequence tags (ESTs) from Blastocystis and identified 115 clusters that encode putative mitochondrial and hydrogenosomal proteins. Among these is the canonical hydrogenosomal protein iron-only [FeFe] hydrogenase that we show localizes to the organelles. The organelles also have mitochondrial characteristics, including pathways for amino acid metabolism, iron-sulfur cluster biogenesis, and an incomplete tricarboxylic acid cycle as well as a mitochondrial genome. Although complexes I and II of the electron transport chain (ETC) are present, we found no evidence for complexes III and IV or F1Fo ATPases. The Blastocystis organelles have metabolic properties of aerobic and anaerobic mitochondria and of hydrogenosomes. They are convergently similar to organelles recently described in the unrelated ciliate Nyctotherus ovalis. These findings blur the boundaries between mitochondria, hydrogenosomes, and mitosomes, as currently defined, underscoring the disparate selective forces that shape these organelles in eukaryotes.