231The West Australian Burden of Disease Study 2015: mental health in Aboriginal West Australians

Background Mental disorders represent a growing health problem: an estimated 45% of Australians experience a mental disorder in their lifetime. The Western Australian (WA) Burden of Disease study 2015 produced detailed data for sub-populations within the state to inform policy and planning. Using this, we describe the burden of mental, substance use disorders and self-inflicted injuries in the WA Aboriginal population. Methods The study generated estimates for over 200 diseases to create ranked disease-level estimates of burden in the WA Aboriginal population for the first time. Eleven individual conditions in the mental disorders disease group, and suicide and self-inflicted injuries were analysed. Results Mental disorders contributed 18% of Aboriginal male and 16% of Aboriginal female DALYs in WA. Among Aboriginal males, alcohol use disorders ranked 3rd among all diseases (ASR: 33.6 DALYs per 1,000 males). Among Aboriginal females, anxiety disorders ranked 3rd (ASR: 17.3 per 1,000 females). Suicide and self-inflicted injuries ranked 2nd among all diseases among Aboriginal males (ASR: 39.8 DALYs per 1,000 males) and 5th among Aboriginal females (ASR: 10.8 per 1,000 females). Conclusions The study highlighted the high burden of disease from mental disorders and self-inflicted injuries among Aboriginal West Australians: self-inflicted injuries, alcohol use disorders and anxiety disorders ranked in the top 10 of all diseases. Key messages Mental disorders contribute substantially to the disease burden in WA among the Aboriginal residents. The findings can inform health policy and planning around mental health in the Aboriginal population, as well as informing social and liquor licensing policy.

State Regulation of Fishing in Russia in the 19th – Early 20th Centurу

The article, mainly based on Siberian material, examines the problem of regulation of fishing in the Russian Empire in the late 19th – early 20th century, when serious consequences of predatory, unrestricted use of natural resources became apparent to the public and local officials. There is an awareness of the need for restrictive measures at the level of regional administration and the inattention of the general imperial power structures to this issue in relation to Asian Russia. Fishermen actively opposed any regulation of the time and methods of fishing in Siberia. Fishing in Asian Russia had no restrictions until the Soviet era. The officials found justification for this primarily in the rights of the foreign population to use traditional fishing grounds. All the lands of Siberia remained officially state-owned and during the XIX century, fishing grounds were gradually transferred to tax articles. Attempts to regulate the rental relations of the aboriginal population and fishermen, undertaken by local authorities, have not yielded great results. Somewhat more important were the measures to regulate the relations of fishermen and hired workers at capitalist fishing enterprises – strezhevye sands. The resolutions of the Tobolsk provincial administration obliged fishermen to give workers special clothes and shoes, improve nutrition, meat, fish, bread, porridge, butter, kvass and tea were to be included in the workers' diet. The working day was limited to 15 hours a day. The resolutions ordered to arrange separate rooms for workers to rest, imputed polite treatment of workers and an increase in wages to 30 rubles. per season. District police officers were appointed responsible for the execution of the resolution. This kind of control made the regulations practically useless. The fishing industry of Siberia remained throughout the 19th – early 20th century a field of spontaneous regulation based on the economic traditions of the Russian and aboriginal population.

ON THE PROCESS OF ISLAMIZATION AND TURKIFICATION OF THE UDMURTS IN THE MIDDLE OF THE XIX - EARLY XX CENTURIES

This article discusses conversion of pagan Udmurts to Islam in the XIX-XX centuries and their assimilation among the Kazan Tatars and partly among the Bashkirs. In the VII-VIII centuries AD, the Bulgars came to the Volga-Kama region, where the Udmurt tribes lived since ancient times, and they began active contacts with the local aboriginal population, whom they called "ar" (Chuv. ar, tat. Ir - “husband”, “man”) following the Khazars, and the Ar-Udmurts called them "biger". Linguistic, archaeological, anthropological, folklore data indicate active contacts of the Bulgars with the Ar-Udmurts. At the end of the VIII century, especially in the IX century, almost at the same time, when the Bulgars moved to the Volga, a large group of northern Udmurts, for reasons unknown to us, went to the Lower Kama region, to the Volga, where the state of Volga Bulgaria was creating. In the emerging state, mixing of cultural traditions of both groups, their leveling and the creating a new culture, which laid the foundation for the culture of the Volga Bulgaria, is observed. In some areas the Chepets-Ural population prevailed in number over the Bulgars. The process of Islamization and Turkification of the Udmurts was from the middle of the XIX century until the October Revolution of 1917.

Stroke incidence and subtypes in Aboriginal people in remote Australia: a healthcare network population-based study

ObjectivesWe aimed to compare the incidence, subtypes and aetiology of stroke, and in-hospital death due to stroke, between Aboriginal and non-Aboriginal people in Central Australia, a remote region of Australia where a high proportion Aboriginal people reside (40% of the population). We hypothesised that the rates of stroke, particularly in younger adults, would be greater in the Aboriginal population, compared with the non-Aboriginal population; we aimed to elucidate causes for any identified disparities.DesignA retrospective population-based study of patients hospitalised with stroke within a defined region from 1 January 2011 to 31 December 2014.SettingAlice Springs Hospital, the only neuroimaging-capable acute hospital in Central Australia, serving a network of 50 healthcare facilities covering 672 000 km2.Participants161 residents (63.4% Aboriginal) of the catchment area admitted to hospital with stroke.Primary and secondary outcome measuresRates of first-ever stroke, overall (all events) stroke and in-hospital death.ResultsOf 121 residents with first-ever stroke, 61% identified as Aboriginal. Median onset-age (54 years) was 17 years younger in Aboriginal patients (p<0.001), and age-standardised stroke incidence was threefold that of non-Aboriginal patients (153 vs 51 per 100 000, incidence rate ratio 3.0, 95% CI 2 to 4). The rate ratios for the overall rate of stroke (first-ever and recurrent) were similar. In Aboriginal patients aged <55 years, the incidence of ischaemic stroke was 14-fold greater (95% CI 4 to 45), and intracerebral haemorrhage 19-fold greater (95% CI 3 to 142) than in non-Aboriginal patients. Crude prevalence of diabetes mellitus (70.3% vs 34.0%, p<0.001) and hypercholesterolaemia (68.9% vs 51.1%, p=0.049) was greater, and age-standardised in-hospital deaths were fivefold greater (35 vs 7 per 100 000, 95% CI 2 to 11) in Aboriginal patients than in non-Aboriginal patients.ConclusionsStroke incidence (both subtypes) and in-hospital deaths for remote Aboriginal Australians are dramatically greater than in non-Aboriginal people, especially in patients aged <55 years.

Acute myocardial infarction incidence and survival in Aboriginal and non-Aboriginal populations: an observational study in the Northern Territory of Australia, 1992–2014

ObjectivesTo examine long-term trends in acute myocardial infarction (AMI) incidence and survival among Aboriginal and non-Aboriginal people.DesignRetrospective cohort study.Setting, participantsAll first AMI hospital cases and deaths due to ischaemic heart disease in the Northern Territory of Australia (NT), 1992–2014.Main outcome measuresAge standardised incidence, survival and mortality.ResultsThe upward trend in Aboriginal AMI incidence plateaued around 2007 for males and 2001 for females. AMI incidence decreased for non-Aboriginal population, consistent with the national trends. AMI incidence was higher and survival lower for males, for Aboriginal people and in older age groups. In 2014, the age standardised incidence was 881 and 579 per 100 000 for Aboriginal males and females, respectively, compared with 290 and 187 per 100 000 for non-Aboriginal counterparts. The incidence disparity between Aboriginal and non-Aboriginal population was much greater in younger than older age groups. Survival after an AMI improved over time, and more so for Aboriginal than non-Aboriginal patients, because of a decrease in prehospital deaths and improved survival of hospitalised cases.ConclusionsThere was an important breakpoint in increasing trends of Aboriginal AMI incidence between 2001 and 2007. The disparity in AMI survival between the NT Aboriginal and non-Aboriginal populations reduced over time as survival improved for both populations.

General Principles and Logic of the Legal Regulation of Genetic Research in Australia

The paper deals with the features of the legal regulation of genetic research in the Commonwealth of Australia with due regard to the state structure, national, ethical and other factors. The primary source of law in Australia is the common law articulated in judicial precedents (case law) that has recently been supplemented by acts of statutory regulation. The paper thoroughly investigates the processes of storage, access and protection of full-genome sequencing data. The authors analyze the peculiarities of functioning of the judicial system of Australia; the experience of normative consolidation of informed consent for genetic research, confidentiality of obtained information, strategic priorities in integration of the results of genetic research into Australia’s health system. The paper provides the analysis of the list of documents containing indications of cases in which medical organizations should not collect confidential information about a person. As a result of the study, the authors identify certain gaps in the normative legal regulation of genetic research and inconsistencies and contradictions of certain normative legal acts. The paper focuses on specifics of genetic research with the participation of the Aboriginal population of Australia, which, in turn, will help in the formation of the relevant legal framework in the Russian Federation.As a conclusion, the authors note that in the field of legal regulation of the processes of storage, access and protection of genetic information in Australia there is a tendency to use normative regulators. Particular attention is drawn to the normative consolidation of the priority of public interests over private interests and its reflection not only in numerous reservations and exceptions, but also in the framework of generally relevant strategic priorities. Presuming the development of the similar legal framework in the Russian Federation and taking into account the multiethnicity of the population, it should be highlighted that Australia’s experience in implementing the genetic research involving the Aboriginal population should be implemented.