The aim of this study was to establish the characteristics of adults with type 1 diabetes who disengaged entirely from diabetes care provision. Those who were classified as disengaged had no recorded HbA1c value in either primary or secondary care during the preceding 15 months. A clinical database was used to identify patients with type 1 diabetes who were disengaged and to generate comparative data on those patients who had at least one HbA1c value recorded in the previous 15 months (classified as engaged). Of 2772 adults with type 1 diabetes in Grampian, there was no recorded HbA1c value for 229 (8.3%) in the previous 15 months. Those who were disengaged were significantly younger (p<0.001), more commonly experienced clinical levels of anxiety (Fisher's exact test, p=0.0442) and depression (Fisher's exact test, p=0.0474), and at their most recent diabetes appointment had higher recorded HbA1c values (p=0.007). Significantly more males than females were disengaged (9.2% versus 7.0%; Fisher's exact test, p=0.037), and those disengaged more frequently came from the two most deprived categories of the Scottish Index of Multiple Deprivation (24.8% versus 18.1%; Fisher's exact test, p=0.005). A proportion of those disengaged from diabetes care are markedly struggling to self‐manage their condition, and it is difficult to see how they will get the support they need. Innovative methods and systems are required to keep vulnerable adults with type 1 diabetes engaged in services and to re‐engage them if they drop out. Copyright © 2014 John Wiley & Sons.

Understanding impact of the coronavirus pandemic (COVID-19) on Adolescents and Young Adults (AYA) with cancer is important to inform care. Online survey of 16–24 year olds receiving cancer treatment at eight cancer centres in the UK. We measured: self-perceived increased anxiety since COVID-19, impact of COVID-19 on treatment, life and relationships, PHQ-8, GAD and the two-item Connor–Davidson Resilience Scale (CD-RISC). 112 AYA participated. 59.8% had previous mental health difficulties. 78.6% reported COVID-19 having a significant impact on life. 79% reported experiencing increased anxiety since COVID-19.43.4% had moderate-severe PHQ-8 scores and 37.1% GADS-7 scores. Impact on life was associated with moderate-severe PHQ-8 scores (OR 5.23, 95% CI 1.65–16.56, p < 0.01), impact on relationships with moderate-severe GADS-7 and PHQ-8 score (OR 2.89, 95% CI 1.11–7.54, p = 0,03; OR 3.54, 95% CI 2.32–15.17, p < 0.01; OR 2.42, 95% CI 1.11–5.25, p =0.03). Greater resilience was associated with lower mod-severe GADS-7and PHQ-8 scores (OR 0.58, 95% CI 0.41–0.81, p < 0.01; OR 0.55 95% CI 0.4–0.72, p < 0.01; OR 0.52, 95% CI 0.38–0.69, p < 0.01). We found high levels of psychological distress. Perceived impact of COVID-19 on relationships and life was predictive of poorer mental health, with resilience a protective factor.

AIM This study investigated the nature of coordination and control problems in children with developmental coordination disorder (DCD).METHOD Seven adults (two males, five females, age range 20-28y; mean 23y, SD 2y 8mo) and eight children with DCD (six males, two females, age range 7-9y; mean 8y, SD 8mo), and 10 without DCD (seven males, three females, age range 7-9y; mean 8y, SD 7mo) sat in a swivel chair and looked at or pointed to targets. Optoelectronic apparatus recorded head, torso, and hand movements, and the spatial and temporal characteristics of the movements were computed.RESULTS Head movement times were longer (p<0.05) in children with DCD than in the comparison group, even in the looking task, suggesting that these children experience problems at the lowest level of coordination (the coupling of synergistic muscle groups within a single degree of freedom). Increasing the task demands with the pointing condition affected the performance of children with DCD to a much greater extent than the other groups, most noticeably in key feedforward kinematic landmarks. Temporal coordination data indicated that all three groups attempted to produce similar movement patterns to each other, but that the children with DCD were much less successful than age-matched children in the comparison group.INTERPRETATION Children with DCD have difficulty coordinating and controlling single degree-offreedom movements; this problem makes more complex tasks disproportionately difficult for them. Quantitative analysis of kinematics provides key insights into the nature of the problems faced by children with DCD.

BACKGROUND: Adolescents and young people (AYA) with cancer are at greater risk of psychological distress which can impact treatment. COVID-19 has resulted in changes to cancer care delivery and AYA have been disproportionately affected by economic and educational effects of COVID-19, potentially impacting on mental health. Understanding the impact of COVID-19 on AYA with cancer is important to inform care. METHODS: Online survey of 16-24 year olds receiving cancer treatment at 8 cancer centres in the UK in December 2020. We measured: self-perceived increased anxiety since COVID-19, impact of COVID-19 on treatment, life and relationships and used the 8-item Patient Health Questionnaire(PHQ-8), 7-item Generalised Anxiety Disorder Scale(GAD) and the 2-item Connor-Davidson Resilience Scale(CD-RISC). RESULTS: 112 AYA participated (17.8% of total eligible). 62.8% were female, 67.3% were 21-24 years. 83% were white. 59.8% had previously experienced mental health difficulties. 67.9% received cancer treatment during the pandemic and 33.9% were diagnosed during the pandemic. 78.6% reported COVID-19 having a significant impact on their life, 55.4% on their key relationship and 39.3% on their treatment. 79% reported experiencing some degree of increased anxiety since COVID-19.43.4% had moderate-severe PHQ-8 scores and 37.1% for GADS-7. Self-report of impact on life was associated with greater anxiety during COVID-19 and moderate-severe PHQ-8 score (OR 3.64, 95% CI 2.52 to 19.40, p <0.01; OR 5.23, 95%CI 1.65 to 16.56, p < 0.01). Impact on relationships was associated with greater anxiety and moderate-severe GADS-7and PHQ-8 score (OR 2.89, 95% CI 1.11 to 7.54, p = 0,03; OR 3.54, 95% CI 2.32 to 15.17, p<0.01; OR 2.42, 95% CI 1.11 to 5.25, p =0.03). Greater CD-RISC score was associated with lower risk of anxiety and mod-severe GADS-7and PHQ-8 scores (OR 0.58, 95%CI 0.41 to 0.81, p <0.01; OR 0.55 95% CI 0.4 to 0.72, p <0.01; OR 0.52, 95% CI 0.38 to 0.69, p <0.01) CONCLUSIONS: We found high levels of psychological distress in AYA with cancer, which is important knowledge for clinical teams working with this age group. Perceived impact of COVID-19 on relationships and life was predictive of poorer mental health, with resilience a potential protective factor.

BACKGROUND: Adolescents and young people (AYA) with cancer are at greater risk of psychological distress which can impact treatment. COVID-19 has resulted in changes to cancer care delivery and AYA have been disproportionately affected by economic and educational effects of COVID-19, potentially impacting on mental health. Understanding the impact of COVID-19 on AYA with cancer is important to inform care. METHODS: Online survey of 16-24 year olds receiving cancer treatment at 8 cancer centres in the UK in December 2020. We measured: self-perceived increased anxiety since COVID-19, impact of COVID-19 on treatment, life and relationships and used the 8-item Patient Health Questionnaire(PHQ-8), 7-item Generalised Anxiety Disorder Scale(GAD) and the 2-item Connor-Davidson Resilience Scale(CD-RISC). RESULTS: 112 AYA participated (17.8% of total eligible). 62.8% were female, 67.3% were 21-24 years. 83% were white. 59.8% had previously experienced mental health difficulties. 67.9% received cancer treatment during the pandemic and 33.9% were diagnosed during the pandemic. 78.6% reported COVID-19 having a significant impact on their life, 55.4% on their key relationship and 39.3% on their treatment. 79% reported experiencing some degree of increased anxiety since COVID-19.43.4% had moderate-severe PHQ-8 scores and 37.1% for GADS-7. Self-report of impact on life was associated with greater anxiety during COVID-19 and moderate-severe PHQ-8 score (OR 3.64, 95% CI 2.52 to 19.40, p <0.01; OR 5.23, 95%CI 1.65 to 16.56, p < 0.01). Impact on relationships was associated with greater anxiety and moderate-severe GADS-7and PHQ-8 score (OR 2.89, 95% CI 1.11 to 7.54, p = 0,03; OR 3.54, 95% CI 2.32 to 15.17, p<0.01; OR 2.42, 95% CI 1.11 to 5.25, p =0.03). Greater CD-RISC score was associated with lower risk of anxiety and mod-severe GADS-7and PHQ-8 scores (OR 0.58, 95%CI 0.41 to 0.81, p <0.01; OR 0.55 95% CI 0.4 to 0.72, p <0.01; OR 0.52, 95% CI 0.38 to 0.69, p <0.01) CONCLUSIONS: We found high levels of psychological distress in AYA with cancer, which is important knowledge for clinical teams working with this age group. Perceived impact of COVID-19 on relationships and life was predictive of poorer mental health, with resilience a potential protective factor.