Context: Organizational effectiveness and the continuity of patient care can be affected by certain levels of attrition. However, little is known about the retention and attrition of female certified athletic trainers (ATs) in certain settings.Objective: To gain insight and understanding into the factors and circumstances affecting female ATs' decisions to persist in or leave the National Collegiate Athletic Association Division I Football Bowl Subdivision (NCAA D-I FBS) setting.Design: Qualitative study. Setting: The 12 NCAA D-I FBS institutions within the Southeastern Conference.Patients or Other Participants: A total of 23 women who were current full-time ATs (n 5 12) or former full-time ATs (n 5 11) at Southeastern Conference institutions participated.Data Collection and Analysis: Data were collected via indepth, semistructured interviews, transcribed verbatim, and analyzed via a grounded theory approach. Peer review and member checking methods were performed to establish trustworthiness.Results: The decision to persist involved 4 main factors:(1) increased autonomy, (2) increased social support, (3) enjoyment of job/fitting the NCAA D-I mold, and (4) kinship responsibility. Two subfactors of persistence, the NCAA D-I atmosphere and positive athlete dynamics, emerged under the main factor of enjoyment of job/fitting the NCAA D-I mold. The decision to leave included 3 main factors: (1) life balance issues, (2) role conflict and role overload, and (3) kinship responsibility. Two subfactors of leaving, supervisory/coach conflict and decreased autonomy, emerged under the main factor of role conflict and role overload.Conclusions: A female AT's decision to persist in or leave the NCAA D-I FBS setting can involve several factors. In order to retain capable ATs long term in the NCAA D-I setting, an individual's attributes and obligations, the setting's cultural issues, and an organization's social support paradigm should be considered.Key Words: job satisfaction, turnover, qualitative research Key PointsN Although a certain amount of employee turnover is expected and necessary, high levels of turnover can negatively affect organizations.N A female athletic trainer's decision to persist in or leave the Division I Football Bowl Subdivision setting can involve a number of factors, including enjoyment of the atmosphere and student-athletes; ''fit'' with the job; social support and autonomy; responsibility to family members; life balance issues; and role conflict and role overload.N To promote the retention of qualified female athletic trainers in the Division I setting, an individual's attributes, personal obligations, and perceived life balance should be considered in conjunction with the organization's social support structure and cultural issues.

There is growing evidence that Aboriginal peoples often experience healthcare inequalities due to racism. However, research exploring the healthcare experiences of Aboriginal peoples who use illicit substances is limited, and research rarely accounts for how multiple accounts of stigma intersect and contribute to the experiences of marginalized populations. Our research aimed to explore the healthcare experiences of Aboriginal peoples who use illicit drugs and or illicit alcohol (APWUID/A) living in Vancouver’s inner city. Using Indigenous methodologies, a community research team comprised of APWUID/A led the study design, data collection and analysis. Peer-facilitated talking circles explored community members’ experiences accessing healthcare services and patient-provider encounters. Using an intersectionality framework, our research demonstrated how healthcare inequalities among Aboriginal peoples are perpetuated by systemic racism and discrimination. Stigmatizing racial stereotypes were perceived to negatively influence individual attitudes and clinical practice. Participants’ experiences of medical dismissal often resulted in disengagement from care or delay in care. The findings suggest healthcare providers must understand the structural and historical forces that influence racial disparities in healthcare and personal attitudes in clinical practice. Adequate clinical protocols for pain management within the context of illicit substance use are urgently needed. The valuation of Aboriginal peoples and cultures within healthcare is paramount to addressing the health gap between Aboriginal and non-Aboriginal Canadians.

The foundation for a successful work environment in the NCAA Division I clinical setting potentially can center on the management style of the supervisor, especially one who promotes teamwork among his or her staff members. Although a family-friendly work environment is necessary for work-life balance, each member of the athletic training staff must have personal strategies in place to fully achieve a balance.

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In Canada, Indigenous youth suicide represents one of several health disparities burdening Indigenous populations, and like many other of these disparities, can be understood as an expression of societal, historical, cultural and familial trauma. As the number of Indigenous youth who take their own lives every year in Canada continues to far exceed national averages, it appears that conventional suicide prevention efforts remain ineffective among this population. A growing body of research argues that conventional interventions, largely rooted in Western individual-level behavioural change frameworks, are culturally discordant with Indigenous paradigms. In response, some Indigenous communities are turning to cultural revitalization as a holistic community-driven response to suicide prevention and treatment. The following commentary explores the emerging evidence base for "culture as treatment" -a novel approach to suicide that emphasizes the significance of interconnectedness in healing, alongside the revitalization of traditional values to reclaim community wellness. In doing so, we seek to contribute to a changing discourse surrounding Indigenous youth suicide by acknowledging culture as strength against this national crisis.KEY WORDS: Suicide; health services; Indigenous; population groups; adolescent La traduction du résumé se trouve à la fin de l'article.