Technological Change in the Retirement Transition and the Implications for Cybersecurity Vulnerability in Older Adults

Retirement is a major life transition, which leads to substantial changes across almost all aspects of day-to-day life. Although this transition has previously been seen as the normative marker for entry into older adulthood, its influence on later life has remained relatively unstudied in terms of technology use and cybersecurity behaviours. This is problematic as older adults are at particular risk of becoming victims of cyber-crime. This study aimed to investigate which factors associated with the retirement transition were likely to increase vulnerability to cyber-attack in a sample of 12 United Kingdom based older adults, all of whom had retired within the past 5 years. Semi-structured, one to one interviews were conducted and subsequently analysed using thematic analysis. Six themes were identified referring to areas of loss in: social interaction, finances, day-to-day routine, feelings of competence, sense of purpose, and technology support structures. We discuss the implications of these losses for building cyber-resilience in retirees, with suggestions for future research

Recognising diversity in older adults' cybersecurity needs

Older adults continue to be targeted by cybersecurity attacks: a trend which shows no signs of slowing, and one that has become even more problematic given that many older adults adopted new digital technologies during the Covid-19 lockdowns. Yet there remains a scarcity of solutions designed to help older adults protect themselves online. In part, this is due to a lack of understanding of the specific needs of older adults, who are the fastest growing, and arguably most technologically diverse population on the internet. This study draws upon recent qualitative research to identify key dimensions which are likely to influence older adult cybersecurity behaviour and subsequent vulnerability. We show how these dimensions can be used, for example, to develop a wide range of personas that help illustrate the range of abilities and attitudes in the older adult population. The dimensions outlined here can be used to help researchers, designers, and developers better understand the diverse needs of older adult users when developing digital or security solutions for this population

Surfactant Metabolism Dysfunction and Childhood Interstitial Lung Disease (chILD)

Surfactant deficiency and the resultant respiratory distress syndrome (RDS) seen in preterm infants is a major cause of respiratory morbidity in this population. Until recently, the contribution of surfactant to respiratory morbidity in infancy was limited to the neonatal period. It is now recognised that inborn errors of surfactant metabolism leading to surfactant dysfunction account for around 10% of childhood interstitial lung disease (chILD). These abnormalities can be detected by blood sampling for mutation analysis, thereby avoiding the need for lung biopsy in some children with chILD

How do Older Adults feel about engaging with Cyber-Security?

Older adults are increasingly a target for cyber-attacks; however, very little research has investigated how they feel about engaging in protective cyber-security behaviors. We developed and applied a novel card-sorting task to elicit how older adults feel about protective cyber-security behaviors and to identify the factors that impact their confidence in executing these behaviors. Nineteen task-assisted interviews were conducted with UK older adults. A thematic analysis revealed that older adults see protective online behaviors as important, but their reasons for disengagement fell into three categories: I do not want to (essentially, because the costs outweigh the benefits), I do not need to (e.g. because it is not my responsibility), and I am unable to (which includes heightened anxiety about doing something wrong). Underlying confidence around engagement with protective behaviors was a function of three factors: personal competence (related to good computer self-efficacy and relevant past experience), support (having a good network for information and advice), and demand (the effort of keeping up to date with the latest advice). Ultimately, we found that older adults are keen to protect themselves but are lacking appropriate support and we discuss implications for developers, researchers, and policy makers. This paper explores older adults' perceptions of common cyber-security behaviors. We introduce an effective card sorting methodology for security elicitation in older adults. We apply this to identify reasons as to why older adults may not engage in security behaviors as well as identifying a number of reasons why older adults actively avoid engaging in security behaviors

Training and Embedding Cybersecurity Guardians in Older Communities

Older adults can struggle to access relevant community expertise when faced with new situations. One such situation is the number of cyberattacks they may face when interacting online. This paper reports on an initiative which recruited, trained, and supported older adults to become community cybersecurity educators (CyberGuardians), tasked with promoting cybersecurity best practice within their communities to prevent older adults falling victim to opportunistic cyberattacks. This initiative utilised an embedded peer-to-peer information dissemination strategy, rather than expert-to-citizen, facilitating the inclusion of individuals who would ordinarily be unlikely to seek cybersecurity information and thus may be vulnerable to cyberattacks. We report on ways the CyberGuardians used informal methods to create more aware communities, served as role models for behaviour change and indirectly improved their personal wellbeing. We discuss considerations for supporting CyberGuardians, including implications for sustainability and for replicating this model in other digital contexts, e.g., recognising misinformation or improving mental health

‘Function First’: how to promote physical activity and physical function in people with long-term conditions managed in primary care? A study combining realist and co-design methods

Objectives To develop a taxonomy of interventions and a programme theory explaining how interventions improve physical activity and function in people with long-term conditions managed in primary care. To co-design a prototype intervention informed by the programme theory. Design Realist synthesis combining evidence from a wide range of rich and relevant literature with stakeholder views. Resulting context, mechanism and outcome statements informed co-design and knowledge mobilisation workshops with stakeholders to develop a primary care service innovation. Results A taxonomy was produced, including 13 categories of physical activity interventions for people with long-term conditions. Abridged realist programme theory Routinely addressing physical activity within consultations is dependent on a reinforcing practice culture, and targeted resources, with better coordination, will generate more opportunities to address low physical activity. The adaptation of physical activity promotion to individual needs and preferences of people with long-term conditions helps affect positive patient behaviour change. Training can improve knowledge, confidence and capability of practice staff to better promote physical activity. Engagement in any physical activity promotion programme will depend on the degree to which it makes sense to patients and professions, and is seen as trustworthy. Co-design The programme theory informed the co-design of a prototype intervention to: improve physical literacy among practice staff; describe/develop the role of a physical activity advisor who can encourage the use of local opportunities to be more active; and provide materials to support behaviour change. Conclusions Previous physical activity interventions in primary care have had limited effect. This may be because they have only partially addressed factors emerging in our programme theory. The co-designed prototype intervention aims to address all elements of this emergent theory, but needs further development and consideration alongside current schemes and contexts (including implications relevant to COVID-19), and testing in a future study. The integration of realist and co-design methods strengthened this study

Impaired self awareness after traumatic brain injury: inter-rater reliability and factor structure of the dysexecutive questionnairre (DEX) in patients, significant others and clinicians

Aims: This study sought to address two questions: (1) what is the inter-rater reliability of the Dysexecutive Questionnaire (DEX) when completed by patients, their significant others, and clinicians; and (2) does the factor structure of the DEX vary for these three groups? Methods: We obtained DEX ratings for 113 patients with an acquired brain injury from two brain injury services in the UK and two services in Ireland. We gathered data from two groups of raters—”significant others” (DEX-SO) such as partners and close family members and “clinicians” (DEX-C), who were psychologists or rehabilitation physicians working closely with the patient and who were able to provide an opinion about the patient’s level of everyday executive functioning. Intra-class correlation coefficients and their 95% confidence intervals were calculated between each of the three groups (self, significant other, clinician). Principal axis factor (PAF) analyses were also conducted for each of the three groups. Results: The factor analysis revealed a consistent one-factor model for each of the three groups of raters. However, the inter-rater reliability analyses showed a low level of agreement between the self-ratings and the ratings of the two groups of independent raters. We also found low agreement between the significant others and the clinicians. Conclusion: Although there was a consistent finding of a single factor solution for each of the three groups, the low level of agreement between significant others and clinicians raises a question about the reliability of the DEX.</p

Impaired self awareness after traumatic brain injury: inter-rater reliability and factor structure of the dysexecutive questionnairre (DEX) in patients, significant others and clinicians

Aims: This study sought to address two questions: (1) what is the inter-rater reliability of the Dysexecutive Questionnaire (DEX) when completed by patients, their significant others, and clinicians; and (2) does the factor structure of the DEX vary for these three groups? Methods: We obtained DEX ratings for 113 patients with an acquired brain injury from two brain injury services in the UK and two services in Ireland. We gathered data from two groups of raters—”significant others” (DEX-SO) such as partners and close family members and “clinicians” (DEX-C), who were psychologists or rehabilitation physicians working closely with the patient and who were able to provide an opinion about the patient’s level of everyday executive functioning. Intra-class correlation coefficients and their 95% confidence intervals were calculated between each of the three groups (self, significant other, clinician). Principal axis factor (PAF) analyses were also conducted for each of the three groups. Results: The factor analysis revealed a consistent one-factor model for each of the three groups of raters. However, the inter-rater reliability analyses showed a low level of agreement between the self-ratings and the ratings of the two groups of independent raters. We also found low agreement between the significant others and the clinicians. Conclusion: Although there was a consistent finding of a single factor solution for each of the three groups, the low level of agreement between significant others and clinicians raises a question about the reliability of the DEX.</p