Development and Initial Validation of the Pathological Obsessive-Compulsive Personality Scale for Children (POPS-C).

Transitions at the completion of specialist treatment remain a recurrent weak point in health systems. Across long term conditions, poorly specified handovers between specialist and community services are linked to loss to follow up, delay in acting on test results, unplanned emergency use and avoidable anxiety. These are socio‑technical coordination problems as they depend on how information, authority and tasks are configured across services and records, rather than on any single clinician’s behaviour. Cancer survivorship illustrates this clearly. Worldwide, more than 50 million people are alive within five years of a cancer diagnosis, many with persistent late effects that require coordinated follow up across oncology, primary care and supportive services. Survivors frequently report chronic pain, fatigue, functional limitations and unmet supportive care needs that depend on reliable cross team action rather than single discipline care. For head and neck cancer, about half of survivors report at least one moderate or high unmet supportive care need and around one third live with persistent pain. International policy now mandates integrated survivorship care, often shifting activity towards primary care, digital health and patient initiated follow up (PIFU). In parallel, national standards emphasise high quality communication and parity for non-digital access routes. Yet the transition from treatment to survivorship remains a high risk interface. In many services, the next owner, action, due by date and closure rule are not stated in routine correspondence or records. Survivors and clinicians describe chasing results, appointments and responses across organisational boundaries, generating delay and patterned inequities rather than reliable planned follow up. Survivorship care studies show consistent reports of fragmented communication, unclear division of responsibility and difficulty navigating post treatment care despite the existence of survivorship guidelines. In health‑information‑technology terms, these failures reflect how ownership, timelines and closure are (or are not) encoded and surfaced in electronic patient records and routine correspondence . When routine systems do not show who owns the next step, survivors and staff both end up chasing appointments, results and responses to keep care moving. We use the term mirrored burden for this health-system mechanism: coordination work is displaced onto both groups because accountability signals are not visible in routine correspondence and records. This mechanism extends Burden of Treatment theory, which focuses on the balance between workload and patient capacity, and work on patient work, by specifying the shared pattern of unpaid coordination labour across survivors and staff. It also connects with the administrative burden literature by locating these shared costs in opaque coordination infrastructure rather than in individual behaviour. Mirrored burden is socially patterned: those with less time, less secure employment, more complex lives or fewer resources are less able to keep returning until someone acts.