Impact of the Friendly Schools whole-school intervention on transition to secondary school and adolescent bullying behaviour

Peer bullying increases in times of school transition, influenced by changing peer and friendship groups, new schooling environments and greater stress. Covert forms of bullying, including cyberbullying, become more common in secondary school and cause considerable distress and long-term harm. The period of transition to secondary school is therefore a critical window for intervening to manage and prevent bullying. A three-year cluster randomised control trial was conducted to develop, implement and evaluate the Friendly Schools Project intervention which aimed to reduce bullying and aggression among more than 3,000 students who had recently transitioned to secondary school. Intervention schools were provided with individualised training and resources to support students’ transition and reduce bullying using a multi-level comprehensive intervention addressing classroom curriculum, school policies and procedures, the social and physical environment, pastoral care approaches and school-home-community links. Although the observed effect sizes were small, the intervention had a consistently significant positive effect across a range of outcomes, including bullying perpetration, victimisation, depression, anxiety, stress, feelings of loneliness and perceptions of school safety at the end of the students’ first year in secondary school. However, none of these differences were sustained into the students’ second year of secondary school. These findings demonstrate the immediate value of whole-school interventions to reduce bullying behaviour and associated harms among students who have recently transitioned to secondary school, as well as the need to provide strategies that continue to support students as they progress through school, to sustain these effects.     

Tai Ji Quan as antihypertensive lifestyle therapy: A systematic review and meta-analysis

BackgroundProfessional health organizations are not currently recommending Tai Ji Quan alongside aerobic exercise to treat hypertension. We aimed to examine the efficacy of Tai Ji Quan as antihypertensive lifestyle therapy.MethodsTai Ji Quan interventions published in English and Chinese were included when they involved healthy adults, reported pre- and post-intervention blood pressure (BP), and had a non-exercise/non-diet control group. We systematically searched 11 electronic databases for studies published through July 31, 2018, yielding 31 qualifying controlled trials. We (1) evaluated the risk of bias and methodological study quality, (2) performed meta-regression analyses following random-effects assumptions, and (3) generated additive models representing the largest possible clinically relevant BP reductions.ResultsParticipants (n = 3223) were middle-aged (56.6 ± 15.1 years of age, mean ± SD) adults with prehypertension (systolic BP (SBP) = 136.9 ± 15.2 mmHg, diastolic BP (DBP) = 83.4 ± 8.7 mmHg). Tai Ji Quan was practiced 4.0 ± 1.4 sessions/week for 54.0 ± 10.6 min/session for 22.3 ± 20.2 weeks. Overall, Tai Ji Quan elicited significant reductions in SBP (–11.3 mmHg, 95%CI: –14.6 to –8.0; d₊ = –0.75) and DBP (–4.8 mmHg, 95%CI: –6.4 to –3.1; d₊ = –0.53) vs. control (p < 0.001). Controlling for publication bias among samples with hypertension, Tai Ji Quan trials published in English elicited SBP reductions of 10.4 mmHg and DBP reductions of 4.0 mmHg, which was half the magnitude of trials published in Chinese (SBP reductions of 18.6 mmHg and DBP reductions of 8.8 mmHg).ConclusionOur results indicate that Tai Ji Quan is a viable antihypertensive lifestyle therapy that produces clinically meaningful BP reductions (i.e., 10.4 mmHg and 4.0 mmHg of SBP and DBP reductions, respectively) among individuals with hypertension. Such magnitude of BP reductions can lower the incidence of cardiovascular disease by up to 40%.