Mean vigorous physical activity across tertiles of cardiorespiratory fitness.

<p>*Significantly different to “Middle” fitness group, p<0.05.</p

Characteristics of participants (n = 55).

<p>zSBP, z-scores for systolic blood pressure; zDBP, z-scores for diastolic blood pressure; GMFCS, Gross Motor Function Classification System</p><p>Characteristics of participants (n = 55).</p

Mean waist-height ratio across tertiles of cardiorespiratory fitness.

<p>*Significantly different to “Middle” and “High” fitness groups, p<0.001.</p

Mean BMI grade across tertiles of cardiorespiratory fitness.

<p>**Significantly different to “Middle” and “High” fitness group, p<0.01. *Significantly different to “”High” fitness groups, p<0.05.</p

Relationship between cardiorespiratory fitness, systolic blood pressure, body mass index, waist circumference and waist-height ratio.

<p>^aadjusted for age, sex and GMFCS level</p><p>^badjusted for age, sex, GMFCS level and BMI grade; zSBP, z-scores for systolic blood pressure</p><p>Relationship between cardiorespiratory fitness, systolic blood pressure, body mass index, waist circumference and waist-height ratio.</p

Transition from child to adult services for young people with cerebral palsy in Ireland: influencing factors at multiple ecological levels

Aim: To explore the factors that influence the process of transitioning from child to adult services in Ireland among young people with cerebral palsy, their parents, and service providers. Method: This study followed a qualitative descriptive approach. Semi-structured interviews were conducted with 54 participants, including young people with cerebral palsy aged 16 to 22 years (n = 13), their parents (n = 14), and service providers (n = 27). Data were analysed using the Framework Method. Findings were categorized using an ecological model across four levels: individual, microsystem, mesosystem, and exosystem. Results: Limited awareness, preparation, and access to information hindered successful transition. Microsystem factors such as family knowledge, readiness, resilience, and health professional expertise influenced transition experience. Mesosystem factors encompassed provider-family interaction, interprofessional partnerships, and interagency collaboration between child and adult services. Exosystem factors included inadequate availability and distribution of adult services, limited referral options, coordination challenges, absence of transition policies, staffing issues, and funding allocation challenges. Interpretation: Transition is influenced by diverse factors at multiple ecological levels, including interactions within families, between health professionals, and larger systemic factors. Given the complexity of transition, a comprehensive multi-level response is required, taking into account the interactions among individuals, services, and systems.</p

Transition from child to adult health services for young people with cerebral palsy in Ireland: a mixed-methods study protocol

Introduction: The transition from child to adult health services is a challenging and complex process for young people with cerebral palsy (CP). Poorly managed transition is associated with deterioration in health, increased hospitalisations and reduced quality of life. While international research identifies key practices that can improve the experience and outcomes of transition, there is a paucity of data in the Irish context. This research study aims to gain an insight into the experience of transition for young people with CP in Ireland. Methods and analysis: A convergent parallel mixed-methods design will be used to collect, analyse and interpret quantitative and qualitative data. Participants will be young people aged 16-22 years with CP, their parent(s)/carer(s) and service providers. Quantitative and qualitative data will be collected through questionnaires and interviews, respectively. Quantitative data will be reported using descriptive statistics. Where sufficient data are collected, we will examine associations between the experience of transition practices and sociodemographic and CP-related factors, respectively, using appropriate regression models. Associations between service provider characteristics and provision of key transition practices may also be explored using appropriate regression models. Qualitative data will be analysed using the Framework Method. A coding matrix based on key transitional practices identified from the literature will be used to identify convergence and divergence across study components at the integration stage. Ethics and dissemination: The study has been approved by the RCSI University of Medicine and Health Sciences Research Ethics Committee (REC201911010). Results will be presented to non-academic stakeholders through a variety of knowledge translation activities. Results will be published in open access, peer-reviewed journals and presented at national and international scientific conferences.</p