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Aim: To explore the care experiences of Aboriginal and Torres Strait Islander Australians diagnosed with cirrhosis with a focus on support needed. Background: Cirrhosis disproportionately affects Indigenous Australians, and liver diseases contribute to the mortality gap between Indigenous and other Australian adults. Design: A qualitative study. Methods: Using yarning methods, Indigenous patients (n = 13) and support persons (n = 3) were interviewed by an Aboriginal researcher during April‐July, 2020. Thematic analysis was used to identify common themes using an inductive approach. Results: Six themes emerged. (1) Experience of diagnosis. This theme included stories of delays in the system, self‐awareness of signs and symptoms and relief of being diagnosed. (2) 'Shame, shame, shame'. Experiences of prejudices and discrimination from health professionals, the lack of understanding of cirrhosis among health professionals, and stories about alcohol cessation and counselling around alcohol cessation. (3) Health literacy. Participants' understanding of cirrhosis was variable. While the importance of knowledge was recognised, 'what works for someone might not work for others'. Several patients partnered with their support persons and clinicians to bridge the health literacy gap. (4) Sources of support included family and friends, transport facilities, health professionals and peers. (5) Positive and negative aspects of communication and patient consultation were discussed. (6) Psychosocial counselling to 'look after the caring side'. The need for more mental health care services was raised. Conclusion: Barriers related to poor health literacy, stigma and lack of practical and emotional support, and issues with communication and patient consultation, may lead to inequitable access to cirrhosis care and treatment for Indigenous Australians. Relevance to clinical practice: Gaining knowledge of the experiences of Indigenous Australians with cirrhosis is important for providing patient‐centred and culturally appropriate care. Liver specialist nurses have an important role in bridging the health literacy gap and in supporting Indigenous patients and families. [ABSTRACT FROM AUTHOR]

Background and Objectives Traditionally, Elders have held a unique social position within Indigenous Australian communities. This study aimed to identify the characteristics of Indigenous Elders that distinguish them from other people in their community. Research Design and Methods Using a community-based participatory research approach, the study was conducted in a regional Indigenous community in Southeast Queensland. The design and data collection methods were informed through a community forum, known as a "Yarning Circle." One-on-one semistructured interviews and focus groups with community members were carried out by Indigenous researchers. Data were analyzed in NVivo software, using thematic analysis (TA), with themes derived directly from data. Results Fifty individuals participated in the study. The participants' median age was 45 years (range 18–76 years) and 31 (62%) were female. TA identified 3 overarching themes related to Elders' attributes: (a) distinguishing characteristics of Elders (subthemes of respect, leadership, reciprocity, life experience, approachability, connection to traditional culture, and transmitting knowledge through generations); (b) how one becomes an Elder (earnt eldership, permanency of eldership, mentors and role models, age); and (c) threats to Elders' influence (intergenerational gap, community disconnect, and cultural trauma). Discussion and Implications Our results build a greater understanding of the contemporary role of Indigenous Australian Elders, which will inform the development of future interventions directed at strengthening Elders' role in their communities. [ABSTRACT FROM AUTHOR]

Background and Objectives Traditional Elders are integral to the social structure of Australian Indigenous communities. Due to progressive loss of traditional way of life, however, the role of Elders has been eroding. This study aims to develop a conceptual model of the role of Elders in an Australian Indigenous community, with the goal of attaining strategies to strengthen the role of Elders. Research Design and Methods The study, conducted in a regional Indigenous community in Australia, adopted a community-based participatory approach. Design and focus of the project were informed by a community forum (Yarning Circle). One-on-one semistructured interviews and focus groups with community members were conducted by Indigenous researchers. Group concept mapping (GCM) was applied to elicit major themes in qualitative data, from the point of view of community members, and to derive a conceptual model of the role of Elders. Results Fifty members of the Indigenous community took part in interviews and focus groups. The participants' median age was 45 years (range 18–76 years); 31 (62%) were female. An additional 24 Indigenous community members took part in the data sorting task of GCM. GCM identified seven major aspects of the role of Elders, including Community relations , Passing down the knowledge , Dealing with racism and oppression , Building a better resourced community , Intergenerational connectedness , Safeguarding our identity , and Caring for our youth. Discussion and Implications Elders fulfill many important roles in contemporary Indigenous communities. Our results can be used to assist the community to codesign a program to increase community wellbeing. [ABSTRACT FROM AUTHOR]

Background: Indigenous Australians experience greater health disadvantage and have a higher prevalence of many chronic health conditions. Liver diseases leading to cirrhosis are among the most common contributor to the mortality gap between Indigenous and other Australian adults. However, no comparative data exist assessing differences in presentation and patient outcomes between Indigenous and non-Indigenous Australians hospitalised with cirrhosis. Methods: Using data from the Hospital Admitted Patient Data Collection and the Death Registry, this retrospective, population-based, cohort study including all people hospitalised for cirrhosis in the state of Queensland during 2008–2017 examined rate of readmission (Poisson regression), cumulative survival (Kaplan–Meier), and assessed the differences in survival (Multivariable Cox regression) by Indigenous status. Predictor variables included demographic, health service characteristics and clinical data. Results: We studied 779 Indigenous and 10,642 non-Indigenous patients with cirrhosis. A higher proportion of Indigenous patients were younger than 50 years (346 [44%] vs. 2063 [19%] non-Indigenous patients), lived in most disadvantaged areas (395 [51%) vs. 2728 [26%]), had alcohol-related cirrhosis (547 [70%] vs. 5041 [47%]), had ascites (314 [40%] vs. 3555 [33%), and presented to hospital via the Emergency Department (510 [68%] vs. 4790 [47%]). Indigenous patients had 3.04 times the rate of non-cirrhosis readmissions (95%CI 2.98–3.10), 1.35 times the rate of cirrhosis-related readmissions (95%CI 1.29–1.41), and lower overall survival (17% vs. 27%; unadjusted hazard ratio (HR) = 1.16 95%CI 1.06–1.27), compared to non-Indigenous patients. Most of the survival deficit was explained by Emergency Department presentation (adj-HR = 1.03 95%CI 0.93–1.13), and alcohol-related aetiology (adj-HR = 1.08 95%CI 0.99–1.19). The remaining survival deficit was influenced by the other clinico-demographic and health service factors (final adj-HR = 1.08 95%CI 0.96–1.20). Conclusions: There was evidence of differential presentation, higher rates of readmissions, and poorer survival for Indigenous Australians with cirrhosis, compared to other Australians. The increased prevalence of Emergency Department presentation among Indigenous patients suggests missed opportunities for early intervention to prevent progressive cirrhosis complications and hospital readmissions. [ABSTRACT FROM AUTHOR]

Suicide prevention training in Aboriginal and Torres Strait Islander communities is a national health priority in Australia. This paper describes a qualitative study to increase understanding of how a mobile application (app) could be used to support suicide prevention gatekeepers in Indigenous communities. We respectfully use the term Indigenous to refer to Australian peoples of Aboriginal and/or Torres Strait Islander descent. Two participatory design workshops were held with 12 participants who were either Indigenous health workers or community members. The workshops first explored what knowledge, skills, and support suicide prevention gatekeepers in Indigenous communities may require, as well as how technology, specifically mobile apps, could be used to support these needs. Qualitative analysis identified four themes related to perceptions of who gatekeepers are, their role requirements, technology and supporting resources, as well as broader community issues. Participants thought training programs should target key, accessible, and respected people from diverse, designated, and emergent groups in Indigenous communities to act as gatekeepers, but requested an alternative, more culturally appropriate term to 'gatekeeper' (e.g., responder). Training should prepare gatekeepers for multifaceted suicide prevention roles, including the identification and management of at-risk Indigenous persons, the provision of psychoeducation and ongoing support, as well as facilitate integrated care in collaboration with community services. A combination of multiple support resources was recommended, including multi-platform options in the technology (e.g., mobile applications, social media) and physical domains (e.g., wallet cards, regular meetings). Recommended app features included culturally appropriate refresher content on suicide intervention, training recall, integrated care, how to access gatekeeper peer support, and debriefing. Broader community concerns on gatekeeper support needs were also considered. • Qualitative study explores new suicide prevention tools for Indigenous Australians. • Multi-platform technology and physical gatekeeper support resources recommended. • Key app functions include suicide intervention, refresher training, and referral. • Gatekeeper/responder selection criteria and training recommendations are provided. [ABSTRACT FROM AUTHOR]

This article will report on the recommendations from a study that investigated what Aboriginal and Torres Strait Islander students said affected their social and emotional wellbeing. The study interviewed students from seven different universities and utilised thematic analysis to determine what the factors where. As a result, a number of strategies became apparent that could be implemented to optimise Aboriginal Torres Strait Islander students' social and emotional wellbeing whilst at university, and not only make the experience more positive but also facilitate their progression and completion. [ABSTRACT FROM AUTHOR]

Background: The oral health of a child not only impacts the physical well-being of the child, but can have quality of life implications for parents and families as they endeavour to provide care and support their child's oral health needs. Within Australia, Aboriginal and Torres Strait Islander children are thought to experience a disproportionate burden of poor oral heath compared to non-Indigenous children. Despite the prevalence of oral health challenges, there are limited qualitative studies investigating the oral health experiences of families. The objective of the study was to explore 'from the perspective of urban, Aboriginal and Torres Strait Islander parents and carers' the impact child oral health has on families. Methods: Yarning circles and face-to-face interviews were used to document the experiences of (N = 20) parents of urban, Aboriginal and Torres Strait Islander children. Participants were recruited from an Aboriginal-owned and operated primary health clinic in northern Brisbane, Australia and through word of mouth. Information collected was transcribed and analysed thematically. Codes and themes were confirmed by the researcher and two participants. Results: The findings indicate that oral health is an important issue for urban Indigenous families and maintaining oral health to a desired standard is having emotional, physical and financial impacts. Themes identified were financial concerns, worry about the future and juggling multiple priorities, all of which were inter-related and cyclical. Conclusions: Families in this study have demonstrated that with the current policy arrangements, oral health is impacting their quality of life, contributing to stress, financial challenges and at times affecting their physical health. To address these challenges, oral health education and promotion needs a multidisciplinary approach that reaches families before children are school-aged. [ABSTRACT FROM AUTHOR]