ADHD prescribing has changed over the years – a new guide aims to bring doctors up to speed

Attention-deficit hyperactivity disorder (ADHD) is the most diagnosed childhood neurological disorder in Australia.

Over the years, it has been the subject of controversy about potential misdiagnosis and overdiagnosis. There has also been variation in levels of diagnosis and drug prescription, depending on where you live and your socioeconomic status.

To address these concerns and improve consistency in ADHD diagnosis and prescribing, the Australasian ADHD Professionals Association has released a new prescribing guide. This will help the health-care workforce to consistently get the right treatment to the right people, with the right mix of medical and non-medical supports.

Here’s how ADHD prescribing has changed over time and what the new guidelines mean.

What is ADHD and how is it treated?

Up to one in ten young Australians experience ADHD. It is diagnosed due to inattention, hyperactivity and impulsivity that has negative effects at home, school or work.

Psychostimulant medication is a central pillar of ADHD treatment.

However, the internationally recognised approach is to combine medicines with non-medical interventions in a multimodal approach. These non-medical interventions include cognitive behavioural therapy (CBT), occupational therapy, educational strategies and other supports.

Medication use has changed over time

In Australia, Ritalin (methylphenidate) was originally the most prescribed ADHD medication. This changed in the 1990s after the introduction of dexamphetamine, along with the subsequent availability of Vyvance (lisdexamfetamine).

Perhaps the most significant change has come with “slow release” versions of the above medications that can last more than eight hours (longer than a school day).

When following clinical guidelines, prescribing medication for ADHD is safe practice. Yet the use of amphetamines to treat young people with ADHD has caused public concern. This highlights the importance of consistent guidelines for prescribing professionals.

Medication for ADHD can be combined with other non-drug approaches.
Caleb Woods/Unsplash

Growth in diagnosis and prescribing

Starting from low levels, there was a dramatic rise in diagnosis and drug treatment in the 1990s. Much of this was overseen by a small number of psychiatrists and paediatricians in each state or territory. While this promised the potential of consistency in the early days, it also raised concerns about best practice.

This led to the development of the first ADHD clinical guidelines by the National Medical Health and Research Council in 1997.

It was followed by several refinements as prescription expanded due to changing diagnostic criteria (expanding to include a dual diagnosis with autism) and the need for best practice with the growing prescription by GPs. These guidelines enhanced the consistency of approaches nationally and reduced the likelihood of misdiagnosis or overdiagnosis.

However, a recent Senate inquiry found diagnosis and drug treatment continued to grow substantially in the five years to 2022. It emphasised the need for a more consistent approach to diagnosis and prescribing.

First the ingredients, then the recipe

The most recent clinical guidelines, released by the Australasian ADHD Professionals Association in 2022, outlined a roadmap for ADHD clinical practice, research and policy. They did so by drawing on the lived experience of those with ADHD. They also emphasised broader health questions, such as how to respond to ADHD as a holistic condition.

It remains difficult to predict individual responses to different medication. So the new prescribing guide offers practical advice about safe and responsible prescribing. This aims to reduce the potential for incorrect prescribing, dosing and adjusting of ADHD medication, across different age groups, settings and individuals.

To put this visually, the clinical guidelines describe what the ingredients of the cake should be, while the prescribing guidelines provide step-by-step recipes.

So what do they recommend?

An important principle in both these documents is that medication should not be the first and only treatment. Not every drug works the same way for every child. In some cases they do not work at all.

The possible side effects of medication vary and include poor appetite, sleep problems, headaches, stomach aches, moodiness and irritability. These guidelines assist in adapting medication to reduce these side effects.

Medication provides an important window of opportunity for many young people to gain maximum value from psychosocial and psychoeducational supports. These supports can, among others, include:

Support for ADHD can also include parent training. This is not to suggest parents cause ADHD. Rather, they can support more effective treatment, especially since the rigours of ADHD can be a challenge to even the “perfect” parent.

Getting the right diagnosis

There have been reports of people seeking to use TikTok to self-diagnose, as well as a rise in people using ADHD stimulants without a prescription.

However, the message from these new guidelines is that ADHD diagnosis is a complex process that takes a specialist at least three hours. Online sources might be useful to prompt people to seek help, but diagnosis should come from a qualified health-care professional.

Finally, while we have moved beyond unhelpful past debate about whether ADHD is real to consolidate best diagnostic and prescribing practice, there is some way to go in reducing stigma and changing negative community attitudes to ADHD.

Hopefully in future we’ll be better able to cherish diversity and difference, and not just see it as a deficit. Läs mer…

Curious Kids: What does the edge of the universe look like?

What does the edge of the universe look like?

Lily, age 7, Harcourt

What a great question! In fact, this is one of those questions humans will continue to ask until the end of time. That’s because we don’t actually know for sure.

But we can try and imagine what the edge of the universe might be, if there is one.

Looking back in time

Before we begin, we do need to go back in time. Our night sky has looked the same for all of human history. It’s been so reliable, humans from all around the world came up with patterns they saw in the stars as a way to navigate and explore.

To our eyes, the sky looks endless. With the invention of telescopes about 400 years ago, humans were able to see farther – more than just our eyes ever could. They continued to discover new things in the sky. They found more stars, and then eventually started to notice that there were a lot of strange-looking cosmic clouds.

This gigantic image of the Triangulum Galaxy — also known as Messier 33 — is put together from about 54 different pointings with Hubble’s Advanced Camera for Surveys. With a staggering size of 34,372 by 19,345 pixels, it is the second-largest image ever released by Hubble.
NASA, ESA, and M. Durbin, J. Dalcanton and B. F. Williams (University of Washington)

Astronomers gave them the name “nebula” from the Latin word for “mist” or “cloud”.

It was less than 100 years ago that we first confirmed these cosmic clouds or nebulas were actually galaxies. They are just like Milky Way, the galaxy our own planet is in, but very far away.

What is amazing is that in every direction we look in the universe, we see more and more galaxies. In this James Webb Space Telescope image, which is looking at a part of the sky no bigger than a grain of sand, you can see thousands of galaxies.

It’s hard to imagine there is an edge where all of this stops.

NASA’s James Webb Space Telescope has produced the deepest and sharpest image of the distant universe to date. Known as Webb’s First Deep Field, this image of galaxy cluster SMACS 0723 is overflowing with detail.
NASA, ESA, CSA, STScI

The edge of the universe

However, there is technically an edge to our universe. We call it our “observable” universe.

This is because we don’t actually know if our universe is infinite – meaning it continues forever and ever.

Unfortunately, we might never know because of one pesky thing: the speed of light.

We can only ever see light that’s had enough time to travel to us. Light travels at exactly 299,792,458 metres per second. Even at those speeds, it still takes a long time to cross our universe. Scientists estimate the size of the universe is at least 96 billion light years across, and likely even bigger.

You can learn a little more about that and our universe as a whole in this video below.

What would we see if there was an edge?

If we were to travel to the very, very edge of the universe we think exists, what would there actually be?

Many other scientists and I theorise that there would just be … more universe!

As I said, there is a theory that our universe doesn’t actually have an edge, and might continue on indefinitely.

But there are other theories, too. If our universe does have an edge, and you cross it, you might just end up in a completely different universe altogether. (That is best saved for science fiction for now.)

Even though there isn’t a straightforward answer to your question, it is precisely questions like these that help us continue to explore and discover the universe, and allow us to understand our place within it. You’re thinking like a true scientist. Läs mer…

NSW will remove 65,000 years of Aboriginal history from its syllabus. It’s a step backwards for education

The NSW Education Standards Authority has announced that teaching of the Aboriginal past prior to European arrival will be excluded from the Year 7–10 syllabus as of 2027.

Since 2012, the topic “Ancient Australia” has been taught nationally in Year 7 as part of the Australian Curriculum. In 2022, a new topic called the “deep time history of Australia” was introduced to provide a more detailed study of 65,000 years of First Nations’ occupation of the continent.

However, New South Wales has surprisingly dropped this topic from its new syllabus, which will be rolled out in 2027. Instead, students will only learn First Nations’ history following European colonisation in 1788.

This directly undermines the Alice Springs (Mparntwe) Education Declaration of 2020. This is a national agreement, signed by education ministers from all jurisdictions, which states:

We recognise the more than 60,000 years [sic] of continual connection by Aboriginal and Torres Strait Islander peoples as a key part of the nation’s history, present and future.

If the planned change to the syllabus goes through, the only Aboriginal history taught to NSW students would be that which reflects the destruction of traditional Aboriginal society. It also means Aboriginal students in NSW will be denied a chance to learn about their deep ancestral past.

The significance of Australia’s deep time past

Bruce Pascoe’s groundbreaking 2014 book Dark Emu (which sold more than 500,000 copies), and the associated documentary, have highlighted an enormous appetite for learning about Australia’s deep time past.

Hundreds of thousands of Australians engaged with Dark Emu. As anthropologist Paul Memmott notes, the book prompted a debate that encouraged a better understanding of Aboriginal society and its complexity.

It also generated research that investigated whether terms such as “hunter-gatherers” are appropriate for defining past Aboriginal society and economic systems.

An artists reconstruction of a Mithaka village, as documented in ethnohistoric accounts from 1871 and now being investigated by archaeologists.
G. Ginn (artist)/Author provided

Read more:
Farmers or foragers? Pre-colonial Aboriginal food production was hardly that simple

In schools, teachers have used Pascoe’s book Young Dark Emu to introduce students to sophisticated land and aquaculture systems used by First Peoples prior to colonisation.

The book raises an important question. If you lived in a country that invented bread and the edge-ground axe – a culture that independently developed early trade and social living – and did all of this without resorting to land war – wouldn’t you want your children to know about it?

For many students, the history they learn at school is knowledge they carry into their adult lives – and knowledge is the strongest antidote to ignorance. Rather than abandoning the Aboriginal deep time story, schools should be encouraging students to engage with it.

If we ignore the ancient Aboriginal past, how can we be expect to build greater respect for Aboriginal culture among the next generation?
Dan Himbrechts/AP

Learning on Country

One of the strengths of the current NSW history syllabus is the requirement for students to undertake a “site study” in Years 8 and 9. Currently, NSW is the only jurisdiction that has made this mandatory.

Site studies are an excellent opportunity for students to learn on Country. Many teachers organise excursions to Aboriginal cultural sites where students can directly engage with local Traditional Owners and Elders.

New South Wales is brimming with sites of cultural significance to Aboriginal people. The map below highlightssome of these, ranging from megafauna sites, to extensive fish traps, to the enigmatic rock art galleries and ceremonial engravings (petroglyphs).

How students will miss out

The Ngambaa people and archaeologists from the University of Queensland are currently investigating one of the largest midden complexes in Australia. This complex, located at Clybucca and Stuart’s Point on the north coast, spans some 14 kilometres and dates back to around 9,000 years ago.

Middens, or “living sites”, are accumulations of shell that were built over time through thousands of discarded seafood meals. Since the shells help reduce the acidic chemistry of the soil, animal bones and plant remains are more likely to be preserved in middens.

For instance, the Clybucca-Stuarts Point midden complex contains remains from seals and dugongs. Both of these animals were once part of the local ecosystem, but no longer are.

The middens also extend back to before the arrival of dingoes, so studying them could help us understand how biodiversity changed once dingoes replaced thylacines and Tasmanian devils on the mainland.

UQ zooarchaeologist Tiina Manne and Ngamba Tradional Custodian Hannah Smith inspect animal ribs eroded out of one section of Clybucca-Stuarts Point midden complex.
Michael Westaway

Local school students, especially Aboriginal students, will be actively participating in this cutting-edge research alongside the Ngambaa people, archaeologists and teachers. Among other things, the students will learn how the Ngambaa people sustainably managed land and sea Country over thousand of years during periods of dramatic environmental change.

But innovative programs like this will no longer be as relevant if Australia’s deep time history is removed from the NSW syllabus.

An opportunity for leadership

The study of First Nations archaeological sites, history and cultures tells us a broader human story of continuity and adaptability over deep time. Indigenising the curriculum – wherein Aboriginal knowledge is braided with historical and archaeological inquiry – is a powerful way to reconcile different approaches to understanding the past.

The NSW Education Standards Authority’s proposed changes risk sending young people the message that Australia’s “history” before colonisation is not an important part of the country’s historic narrative.

But there is still time to show leadership – by reversing the decisions and by connecting teachers and students to powerful stories from Australia’s deep time past. Läs mer…

The hidden costs of building a home: what every family should know

Building a home can come with hidden costs. Unfortunately, many people don’t think about these costs until it’s too late.

Some buyers succumb to the tricks marketers use to attract them, with upgrades and add-ons blowing out the cost.

Other costs relate to risks of delay, changes in borrowing conditions, unexpected taxes and fees, insurance, compliance with local development standards and even exit fees in some cases.

So let’s explore the sales tactics buyers need to beware of, as well as the five hidden costs of building new homes.

How marketers persuade us to build a home

Marketers of home-building packages use various strategies to attract buyers.

Attractive pricing and promotions

Marketers often attract first-time home buyers and young families by advertising low prices and showing off modern designs.

They will then offer an upgrade or value package. The most common examples we see are deals with, for example, a $30,000 credit on upgrading, $45,000 cashback, or an amazingly cheap house and land package.

Our research found consumers are likely to feel more surprised by higher levels of discounts in the case of high-involvement products such as a buying a house.

The marketers make it seem like you’re getting a great deal, with options to customise the house just the way you like. What they don’t always tell you is the advertised prices usually apply to the most basic version of the home.

Any upgrades, such as granite countertops or hardwood floors, cost more. Often, the base price does not include essential features such as curtains, ceiling fans or air conditioning.

These upgrades quickly add up to more than that $30,000 credit for upgrading or that $45,000 cashback offer. Buyers can end up paying much more than they planned.

Keep in mind most home-building companies act as middlemen who buy and outsource products. They are likely to add charges for most upgrades or fixtures you order through them.

A $200 price tag for a kitchen light bought directly from a retailer such as Beacon Lighting can cost you $300 from the builder. Costs like this add up for a whole house.

What can you do? Note down the code or name of the item and buy it directly. See if the builders can install fittings for a lower cost if you supply them.

Social media and influencers

Influencers can make the process look easy and fun. Our research on influencer marketing and human influencers and virtual influencers shows trusting followers are more likely to follow influencers’ suggestions.

An influencer might, for example, share a video of their “perfect day” in their new home, focusing on the perks without mentioning the hidden costs.

Special deals and time-limited offers like cashbacks are used to make buyers feel they have to act fast, without taking the time to think about the financial commitment. This strategy exploits the fear of missing out, or FOMO.

The goal is to get customers to quickly sign up with a $1,000–$5,000 deposit. That increases customer commitment and stops them backing out.

Carefully check the conditions of the deposit, as you can most likely back out with a full refund if you are not happy with the final price before the final contract is signed, or during a cooling-off period after signing.

What are the 5 hidden costs?

1. Changing interest rates over 30 years

Many home buyers think about interest rates when they get a mortgage, but they often do not consider how rates can change over the years. Even a small increase can mean paying thousands more over the life of the loan.

When buying a home, people hope for lower interest rates, though they cannot predict future economic conditions. The theory of optimism bias could explain why many of us have expectations about a future that’s more favourable to us.

Interest rates can change dramatically over a 30-year loan period.
RBA, CC BY

What should temper this optimism is the fact that even seemingly small interest rate changes make a big difference over time. For example, a $700,000 loan over 30 years at 3.5% interest has a monthly repayment of $3,143.31. At 4.5% interest, the repayment becomes $3,546.80. That’s an extra $4,841.88 a year.

Understanding this can help families budget for possible changes and avoid financial stress later on.

2. Delay costs

Delays can happen due to weather, problems getting materials, or other unexpected issues. Timber shortages have affected home building since 2020.

The costs of delay can include having to rent a place to live while waiting for the home to be finished. Renting for three months, for instance, at the national average of $600 a week will cost more than $7,000.

3. Unexpected costs

Apart from predictable costs, such as the down payment and tax or transfer (stamp) duty, other smaller, unexpected costs can add up.

These include bank fees, solicitor fees, building and pest inspections, moving costs, utility connections and home and contents insurance.

These are all essential to ensure the home is safe and secure. But the cost can easily top $5,000.

4. Standardised costs

Many new housing developments have rules about what owners can and cannot do with their property.

These rules might specify paint colours, fence types or landscaping choices, such as planting a set number of large trees.

A development might require home owners to use certain types of trees or materials for driveways, costing an extra $2,000.

More often than not, the land developer will require a refundable deposit of about $1,000–$5,000 when you buy the land for your home. It’s only refunded once the developer has confirmed you have met all the conditions. If you don’t, you won’t get your money back.

Before buying an apartment, first find out how much you have to pay in strata fees and other fixed or ongoing costs.

5. Exit costs

In rare cases, selling the property might attract exit fees. For example, if an owner sells their house within five years, they might face a $5,000 penalty fee for selling early.

This can be an unpleasant surprise and cause problems for families who need to move quickly due to a job change or other life events.

Make sure you read all the conditions of sale before signing.

A market in need of greater transparency

Knowing about these hidden costs of building a home helps avoid unexpected expenses and makes the process less stressful.

For policymakers and advocates, these costs highlight the need for fair marketing practices and rules that protect buyers from financial surprises.

Ensuring more transparency in this market can help make home ownership more affordable and accessible for everyone. Läs mer…

Daylight saving is about to start. But why do the days get longer?

The days are getting longer and in Australia, the switch to daylight saving time is almost upon us (for about 70% of the population, anyway).

But why do we have longer days in summer and shorter days in winter?

It’s all about the tilt

Earth goes around the Sun in an almost circular orbit. But not everything is lined up perfectly. Earth’s axis is tilted by 23.44 degrees relative to its orbit around the Sun.

Imagine Earth’s orbit as a flat frisbee with the Sun in the middle and Earth as a ball on a stick going around the edge.

Earth goes around the Sun in an almost circular orbit.
Angela Cini/Shutterstock

If Earth’s axis wasn’t tilted (if its tilt was zero degrees) the stick would be exactly perpendicular to the frisbee. If you grab that perpendicular stick and tip it 23.44 degrees sideways, that’s what Earth’s tilt looks like now.

As Earth orbits the Sun, the tilt of the stick does not rotate relative to the Sun. If you were in outer space looking at the Sun and you watched from the exact same position for a whole year, you would see Earth go around the Sun while the stick stayed tilted the same direction.

In other words, if the top of the stick was pointing to the right when you started watching Earth go around the Sun, it would stay pointing to the right the whole way around.

Diagram of Earth showing its rotational axis that it spins around once per day. The Northern Hemisphere is coloured blue and the Southern Hemisphere is coloured green.
Laura Driessen

This tilt gives us longer days in summer and shorter days in winter. Let’s set up the scenario so the Northern Hemisphere is the top of the planet and the Southern Hemisphere is the bottom of the planet.

When Earth is on one side of the Sun, the top of the stick is pointed towards the Sun. This is summer in the Northern Hemisphere and winter in the Southern Hemisphere. Six months later, when Earth is on the other side of the Sun, the bottom of the stick is pointed towards the Sun – and the seasons are reversed.

The summer and winter solstices happen when Earth is on opposite sides of the Sun (six months apart). Earth’s axis tilt leans the same direction, to the right in this diagram, the whole way around the Sun. The Earth and Sun are not to scale in this diagram.
Laura Driessen

Solstices and equinoxes

Those two points, when the top of the stick is pointing directly towards the Sun or directly away from the Sun, are the solstices. They are the longest and shortest days of the year, depending on your hemisphere.

The shortest day of 2024 in Australia was June 21. Looking forward to sunnier times, the longest day of the year in 2024 will be December 21.

The equinox occurs when Earth is side-on to the Sun (not to scale). In this diagram, the Sun is very far behind Earth. Just like in the previous image, the tilt of Earth’s axis stays leaning in the same direction the whole way around the Sun. A second equinox happens when Earth is on the other side of the Sun too.
Laura Driessen

In between the summer and winter solstice, we have the equinoxes – when days and nights are almost exactly the same length. Those are the days when the stick through Earth is “side-on” to the Sun. The equinox is also the day when the Sun passes directly over Earth’s equator. In 2024 this happened on March 20 at 2:06pm AEDT and September 22 at 10:43pm AEST.

That means that since September 22, days have been getting longer than nights in the Southern Hemisphere.

What does daylight saving do?

Earth’s tilt means the Sun both rises earlier and sets later as we head towards summer. When the clocks (in some states) switch to daylight saving time, people in these states all get one hour less of sleep. However, the total length of the day doesn’t change just because we changed our clocks.

For me, daylight saving means I need an extra cup of coffee in the morning for about a week before I adjust to the daylight saving-lag (like jet lag, but without the fun of travel).

What it really gives us is more daylight in the evening, instead of more daylight in the morning. If you’re already a morning person, this isn’t the way to go. But if you prefer to have a long dinner in the summer sun it’s ideal.

Has it always been this way?

Earth’s axis hasn’t always been tilted at 23.44 degrees. It cycles from a minimum 22.1 degree tilt to a maximum 24.5 degree tilt and back again once every approximately 41,000 years.

Earth’s axis also “precesses”, where the stick through it draws a circle once every approximately 26,000 years. You can see this in the animation below.

Demonstration of the precession of Earth’s axis.
NASA/JPL-Caltech

The length of a day on Earth hasn’t always been the same, either.

At the moment, the length of a day is nearly exactly 24 hours. But it’s shifting all the time by tiny amounts. This is tracked very closely by a system of telescopes and satellites. These systems measure “Earth orientation parameters” that describe Earth’s exact orientation compared to the position of stars in the sky.

These are important to astronomers because the exact location of our telescopes is important for creating accurate maps of the sky. On top of all of this, the gravitational drag from the Moon causes days to become longer by around 2.3 milliseconds every 100 years. A few billion years ago, Earth’s day was a lot shorter – only 19 hours long.

Even though some of us are losing an hour of sleep this weekend, at least we get to enjoy 2.3 milliseconds longer every day than our great – and great-great – grandparents did. Läs mer…

Little kids, too little movement: Global study finds most children don’t meet guidelines for physical activity, screen time and sleep

Appropriate levels of physical activity, sedentary behaviour and sleep (collectively termed movement behaviours) are essential for the healthy growth and development of preschool-aged children.

This was the impetus for creating the Canadian 24-Hour Movement Guidelines for the Early Years (birth to four years). Likewise, this is why the World Health Organization adopted the Canadian guidelines when creating the global guidelines on physical activity, sedentary behaviour and sleep for children under five years of age.

Considering the extensive benefits of movement behaviours, it is very alarming that a recent study found that only 14 per cent of preschoolers around the world are meeting movement behaviour guideline recommendations.

A 24-hour day in the life of a preschooler meeting the guideline recommendations includes:

three or more hours of total physical activity (including at least one hour of energetic play or activities that make them slightly out of breath),
one hour or less of screen time, and
10 to 13 hours of good quality sleep

Importantly, preschoolers who meet these guidelines gain health benefits such as reduced risk of obesity, improved social and emotional skills, and proficient motor skills.

Global levels

Preschoolers with healthy movement behaviour habits meeting these guideline recommendations gain health benefits such as reduced risk of obesity, improved social and emotional skills, and proficient motor skills.
(Pixabay/Oleksandr Pidvalnyi)

A new global study shows most children around the world don’t meet these guidelines. The study included more than 7,000 preschoolers from 33 different countries, including Canada. The countries represented various World Bank income groups (e.g., high, middle and low income countries); and the geographical regions of Africa, Americas, Eastern Mediterranean, Europe, Southeast Asia and Western Pacific.

When looking at each movement behaviour individually for preschoolers around the world, 49 per cent met the physical activity recommendations, 42 per cent met the screen time recommendation, and 81 per cent met the sleep recommendation.

That most young children are not meeting each of these basic recommendations separately is cause for concern; that 86 per cent are not meeting all guideline recommendations combined is alarming and places preschoolers around the world at risk of sub-standard health and development.

Globally, 81 per cent of preschoolers met sleep recommendations.
(Shutterstock)

Seventeen per cent of boys met all the guideline recommendations, compared to 13 per cent of girls. This slight difference was driven by more boys meeting the physical activity recommendation (56 per cent boys, 42 per cent girls), and protected from being even worse by more girls meeting the screen time (45 per cent girls, 38 per cent boys) and sleep (82 per cent girls, 79 per cent boys) recommendations.

The fact that boys had more screen time and less good quality sleep could be related, as previous research has found screen time overall and screen time in the evening is associated with less sleep and lower sleep quality.

Better screen time and sleep habits for girls protected their overall movement behaviour adherence from being even worse, showcasing the various paths to health through different movement behaviour combinations. However, the low number meeting all movement behaviour recommendations demonstrates the need for all preschoolers to routinely be more active, reduce screen time and accumulate good quality sleep in a day.

By income

Screen time in the evening is associated with less sleep and lower sleep quality.
(Shutterstock)

Low-income countries had the highest movement behaviour guideline adherence levels (17 per cent), compared to middle-income (12 per cent) and high-income (14 per cent) countries.

While children from high-income countries were more active and had more quality sleep, they also had the worst screen time behaviours compared to low- and middle-income countries. It is a double-edged sword that in higher-income countries, children have more access to physical activity opportunities and quality sleep environments, but also more access to screen time devices.

Likewise, middle-income countries with the lowest movement behaviour adherence rates could symbolize a region’s development transition where infrastructure in the homes and communities cannot yet support more physical activity and good quality sleep, but availability of cell phones, televisions and other screens leads to increased sedentary behaviours.

By region

The African and European regions had the highest movement behaviour adherence (24 per cent), while the Americas region had the lowest (eight per cent). With 17 per cent meeting the screen time recommendations and 68 per cent meeting the physical activity recommendations, the Americas region had the worst screen time and best physical activity.

The physical activity levels of the Americas region preschoolers are higher compared to the 39 per cent of older Canadian children and youth as reported in the ParticipACTION Report Card on Physical Activity for Children and Youth. But these older Canadian children and youth did have slightly better, albeit still poor, screen time behaviours with 27 per cent meeting the guidelines.

Sixty-eight per cent of preschool-aged children in the Americas were meeting the physical activity recommendations, compared to only 26 per cent of Southeast Asian children. However, it remains a concern that roughly half of all young children around the world are at risk of sub-optimal health and development from lack of physical activity.

Roughly half of all young children around the world are at risk of sub-optimal health and development from lack of physical activity.
(Shutterstock)

Guidance for improvements can be drawn from the World Health Organization’s Global Action Plan on Physical Activity, where the goal of a 15 per cent relative reduction in global physical inactivity rates by 2030 relies on capacity-building collaborations within research organizations and alliances to strengthen our global understanding of movement behaviours.

Along with the best movement behaviours overall, the African region had the best screen time levels with 63 per cent meeting the recommendations. This is potentially explained by limited access to screen time devices.

However, to better understand why screen time behaviours are better in Africa, initiatives like the Active Healthy Kids Global Alliance Global Matrix project should be used as a model. Within the Global Matrix, region-level differences are an opportunity to learn the strengths of other regions, while addressing regional weaknesses at home.

For instance, Canada could be a model for less active countries, while attempting to model the African region’s reduced screen time lifestyles. Further, projects such as the SUNRISE study — where researchers from more than 70 countries are collaborating to measure preschoolers’ movement behaviours, health and development — are excellent venues for this necessary capacity-building and global learning.

Take home

The WHO has Global Movement Guidelines for preschool children and a Global Action Plan to increase physical activity. Canada has similar guidelines and a similar plan.

However, health movement behaviour levels in Canada and across the globe are unsatisfactory and forecast further global health challenges, inequalities, and distancing from United Nations Sustainable Development Goals. It’s time to get our little ones a little more active. Läs mer…

From cheeky thrill to grande dame – the Moulin Rouge celebrates 135 years of scandal and success

When the Moulin Rouge first opened on October 6 1889, it drew audiences from across classes and countries.

The Moulin offered an array of fin-de-siècle (end-of-the-century) entertainments to Paris locals and visitors. Located in Montmartre, its name, the “red windmill”, alluded to Montmartre’s history as a rural idyll. The neighbourhood was also associated with artistic bohemia, crime, and revolutionary spirit. This setting added a certain thrill for bourgeois audiences.

From irreverent newcomer to a French institution, the Moulin Rouge has survived scandal, an inferno and found new ways to connect with audiences.

Read more:
How the Eiffel Tower became silent cinema’s icon

Red and electric

In 1889, the Moulin Rouge was not the only red landmark to open in Paris. The Eiffel Tower, built as part of the Universal Exhibition and originally painted red, had opened earlier that same year. What set them apart, however, was their popularity.

The Moulin Rouge was an instant hit, capitalising on the global popularity of a dance called the cancan. Dancers like Moulin Rouge headliner La Goulue (“The Glutton”, real name Louise Weber) were seen as more appropriate emblems for the city than the Tower, which many considered an eyesore.

In an illustration from Le Courrier Français newspaper, a dancer modelled on a photograph of La Goulue holds her leg aloft, flashing her underwear with the caption “Greetings to the provinces and abroad!”.

Every aspect of the Moulin spoke to the zeitgeist, from its design to the performances, the use of electric lights that adorned its façade, and its advertising.

Its managers, the impresario team of Joseph Oller and Charles Harold Zidler, had a string of successful venues and businesses to their names. They recognised the importance of modern marketing, using print media, publicity photographs, and posters to spark public interest.

Among the most iconic images of the Moulin is Henri de Toulouse-Lautrec’s 1891 poster. At its centre is La Goulue, kicking her legs amid swirling petticoats.

Henri Toulouse-Lautrec’s 1891 poster.
Shutterstock

She certainly can cancan

Found primarily in working-class dance halls from as early as the 1820s, the cancan became a staple of popular entertainment the world over.

Part of the dance’s thrill lay in the dancers’ freedom of movement and titillation of spectators, as well as its anti-establishment energy. Women used the cancan to thumb their nose at authority via steps like the coup de cul (“arse flash”) or coup du chapeau (removing men’s hats with a high kick).

The cancan was not the only attraction at the Moulin. There were themed spaces, sideshows, and variety performances ranging from belly dancers and conjoined twins to Le Pétomane (“The Fartomaniac”) who was a flatulist and the highest-paid performer. People watching was equally popular.

Famous farter, Le Pétomane (Joseph Pujol).
Wikimedia Commons

Scandals, riots, and royalty

Over the years, the Moulin has been no stranger to controversy.

In its early years, it cultivated an air of misbehaviour and featured in pleasure guides for visiting sex tourists.

In 1893 it hosted the Bal des Quat’z’Arts (Four-Arts Ball) held by students from local studios. Accusations of public indecency were made against the models and dancers in attendance, and violent protests followed after the women were arrested.

In 1907 the writer Colette appeared onstage at the Moulin in an Egyptian-inspired pantomime with her then-lover, Missy, the Marquise de Belbeuf. When the act culminated in a passionate kiss, a riot broke out.

Historical footage shows the Moulin Rouge as it was.

Kicking on and on

Over time, the Moulin Rouge shows changed their format to keep pace with public taste, though the cancan remained. The venue hosted revues and operettas, and various stars including Edith Piaf, Ella Fitzgerald, Frank Sinatra and Liza Minnelli.

Famous guests have included British royalty: from Edward VII (while Prince of Wales) to his great-granddaughter, Queen Elizabeth II, and her son, Prince Edward.

Since its opening, the Moulin’s fortunes have waxed and waned.

In 1915 the Moulin Rouge burned down but was rebuilt in 1921. Its famous windmill sails fell off overnight earlier this year but were swiftly repaired.

In the 1930s, it survived the Depression and rise of cinema (also capturing the attention of several filmakers). It also survived the Nazi occupation of Paris in the 1940s.

By the early 1960s, Jacki Clerico was managing the Moulin’s show after his father had revamped the venue as a dinner theatre destination. The younger Clérico oversaw additions like a giant aquarium where dancers swam with snakes, and its now-famous “nude line” – a chorus of topless dancers – in its shows.

In 1963, the Moulin Rouge struck upon a winning formula: revues, all named by Clérico with titles beginning with the letter “F” – from Frou Frou to Fantastique and Formidable. Since 1999, the revue Féerie (“Fairy”, also a French genre of stage extravaganza) has been performed almost without interruption.

The Moulin Rouge or ‘red mill’ today, with its famous windmill.
Rafa Barcelos/Shutterstock

Ticket sales were boosted thanks to Baz Luhrmann’s 2001 film Moulin Rouge! and more recently Moulin Rouge! The Musical.

Since COVID, the Moulin Rouge management have diversified. The windmill’s interior has been rented out via AirBnB and the Moulin’s dance troupe has performed on France’s televised New Year’s Eve celebrations. This year, the Moulin Rouge and its dancers were part of the Paris Olympics celebrations, dancing in heavy rain.

Though people have come to appreciate the Eiffel Tower too, the Moulin Rouge can still argue its status as the pinnacle of live entertainment in the French capital: immediately recognisable, internationally visible, and quintessentially Parisian. Läs mer…

How we created a beautiful native wildflower meadow in the heart of the city using threatened grassland species

A city street may seem an unusual place to save species found in critically endangered grasslands. My new research, though, shows we can use plants from these ecosystems to create beautiful and biodiverse urban wildflower meadows. This means cities, too, can support nature repair.

Species-rich grassy ecosystems are some of the most threatened plant communities on the planet. Occupying easily developed flat land, grassy ecosystems are routinely sacrificed as our cities expand.

In south-east Australia, the volcanic plains that support Melbourne’s northern and western suburbs were once grasslands strewn with wildflowers, “resembling a nobleman’s park on a gigantic scale”, according to early explorer Thomas Mitchell. But these exceptionally diverse, critically endangered ecosystems have been reduced to less than 1% of their original area. The few remnants continue to be lost to urban development and weed invasion.

A mix of the seeds used to create the meadow.
Hui-Anne Tan, CC BY-NC

Unfortunately, efforts to restore the grasslands around Melbourne have had mixed results. In 2020 the City of Melbourne took matters into its own hands. Recognising it is possible to enrich the diversity of birds, bats and insects by providing low-growing native plants, the council set a goal to increase understorey plants by 20% on the land it manages.

Creating a large native grassland in inner-city Royal Park would help achieve this goal. Adopting a technique used by wildflower meadow designers, we sowed a million seeds of more than two dozen species from endangered grasslands around Melbourne. All but one of these species established in the resulting native wildflower meadow.

The recreated native wildflower meadow is close to an inner-city road.
Matthew Stanton, CC BY-NC

What were the challenges at this site?

Existing restoration techniques remove nutrient-enriched topsoils full of weed seeds before sowing native seeds. The target plant community can then establish with less competition from nutrient-hungry weeds.

However, this approach could not be used at the Royal Park site. Topsoil removal cannot be used on many urban sites where soils are contaminated or there are underground services. Alternative approaches are needed to reduce weed competition while minimising soil disturbance.

I saw a possible answer in the horticultural approaches used to create designed wildflower meadows.

Preparing the selected site in Royal Park by raking away mulch.
Hui-Anne Tan, CC BY-NC

While still rare in Australia, designed wildflower meadows can increase the amenity and biodiversity of urban environments. They also reduce the costs of managing and mowing turf grass. These meadows are designed to be infrequently mown or burnt.

Wildflower meadow designers typically use an international suite of species that can be established from seed and persist without fertiliser or regular irrigation. An abundance of flowers makes people more accepting of “messy” vegetation. Recognising this, designers select a mix of species that will flower for as much of the year as possible.

Seed being spread by hand across the prepared area in April 2020.
Hui-Anne Tan, CC BY-NC

To reduce competition from weeds, these meadows are often created on a layer of sand that covers the original site soils. The low-nutrient sand buries weed seeds and creates a sowing surface that resists weed invasion from the surrounding landscape.

However, the grasslands around Melbourne grow on clay soils, not sand. Would these techniques work for plants from these ecosystems?

A deep sand layer controls weeds and slugs

To find out we sowed more than a million seeds on sites with two depths of sand (10mm and 80mm) and one without a sand layer in Royal Park. Within one year, 26 of the 27 species sown had established to form a dense, flowering meadow across all sand depths. These plants included three threatened species.

The hoary sunray, Leucochrysum albicans subsp. tricolor, is one of the endangered species in the native wildflower meadow.
Marc Freestone/Royal Botanic Gardens Victoria, CC BY-NC-SA

Crucially, the deepest sand layer reduced weed numbers and therefore time spent weeding.

Interestingly, slugs played a role in determining the diversity of the native meadow. South-east Australia’s grasslands have largely evolved without slugs. As a result, seedlings lack chemical or physical defences against grazing by slugs, which can greatly reduce species diversity in native meadows.

Again, sand provided a real benefit. Fewer slugs occurred on the deepest sand layer compared to bare soil. The suggestion that sand can deter slugs is consistent with meadow research in Europe.

By September 2020, seedlings are growing on the prepared plots. The roof tile in the foreground is for monitoring slug numbers.
Hui-Anne Tan, CC BY-NC

Now to repair nature in all our cities

Our research gives us another technique to reinstate critically endangered plant communities. We can use it to bring nature back to city parks and streets.

Working in urban contexts also unlocks other advantages. There’s ready access to irrigation while the meadow gets established and to communities keen to care for natural landscapes. Creating native wildflower meadows in cities also helps native animals survive, including threatened species that call our cities home.

People will be able to engage with beautiful native plants that are now rare in cities. Enriching our experience of nature can enhance our health and wellbeing.

The meadow’s plant community was established by November 2020, six months after sowing.
David Hannah, CC BY-NC

My colleagues and I trialled these approaches with the support of the City of Melbourne. We are continuing our research to improve the scale and sustainability of native wildflower meadows in other municipalities.

Native wildflower meadows and grassland restoration projects could genuinely help Australia meet its commitment to restore 30% of degraded landscapes. But first we need to invest much more in seed production. Reinstating native species on degraded land requires a lot of seed.

Once seed supply is more certain, we will be able to bring back native biodiversity and beauty to streets, parks and reserves across the country.

I would like to acknowledge the Traditional Custodians of the land on which the project took place, the Wurundjeri and Bunurong people of the Kulin Nations, and we pay our respects to their Elders, past, present and emerging. I also acknowledge my colleagues listed as co-authors on the research paper that formed the basis of this article: urban ecologists Nicholas S.G. Williams and Stephen Livesley, and seed ecologists Megan Hirst and John Delpratt. Läs mer…