Amanda D. Hutchinson

Sensory processing differences are highly prevalent among autistic adults, yet evidence for sensory rooms and similar environments remains mixed. One likely reason is that sensory processing varies widely between individuals and fluctuates within a person across time and context, which fixed environments cannot accommodate. We co-designed a customisable, nature-based virtual reality (VR) sensory application with autistic adults to provide a portable sensory experience that users can tailor to their own needs. This study reports an ecologically valid evaluation of that prototype. Seven autistic adults used the application at home over seven days on a standalone Meta Quest 3 headset, completing per-use and daily experience-sampling ratings of stress, mood, and sensory stress, followed by semi-structured exit interviews. We analysed rating data descriptively at the participant level and interview data using qualitative content analysis. Participants varied in perceived benefit, and we characterised this through three response profiles: consistent, partial or context-dependent, and minimal perceived benefit. Crucially, benefit also varied within individuals across occasions: participants reported the application as most valuable during sensory stress or overwhelm and least valuable near baseline. Qualitative analysis identified four factors shaping this variation: whether use met a genuine regulatory need, fit between a person's sensory profile and the content, the degree of control and customisation available, and the learning curve and cybersickness. These findings suggest that the value of VR sensory tools is dynamic and individual, and that controlled or fixed-use designs risk missing the conditions under which such tools help most.

Autistic adults often experience sensory processing differences that can affect their daily lives. Physical sensory rooms exist to provide respite but have limitations, such as cost, space requirements, and limited customisability - VR has the potential to overcome these limitations. This study co-designed a VR sensory application with autistic adults using an iterative participatory approach. Eight autistic co-designers attended three sessions over nine weeks, with each session allowing participants to test and provide feedback on the application. Usability and simulator sickness scores were also measured. Content analysis revealed that participants prioritised natural environments, customisation, and varied sources of interactive entertainment when co-designing the application. Feedback evolved across the sessions from predominantly feature requests to eventual validation, culminating in a vertical slice. Despite the large amount of content and features added throughout, usability scores trended upwards, crossing the threshold for "good" usability. Results also indicate the co-design process was a successful and enjoyable experience for the participants, which allowed them to feel listened to. In conclusion, iterative co-design is effective for developing VR sensory applications.

To understand how individuals with ovarian cancer interpret and identify with the term 'survivor' and if this impacts survivorship service uptake and whether individuals feel included or identify with these services following treatment within the Australian context. Semi-structured interviews were conducted with 18 individuals aged 40-72 (M = 57). Using a social identity theory lens, data were analysed using reflexive thematic analysis. Two themes were generated, 'But I live in hope': How social constructs of the term 'survivor' impact on its meaning and inclusion into self-identity' and 'Forgotten or excluded: The realities of care after treatment' with the subtheme 'Advocacy and growth: Subversion from exclusion'. Participants rejected the 'survivor' identity due to connotations of unachievable finality. This was reinforced by the absence of support services routinely offered or available following treatment. Through exclusion, participants created their own support groups and joined advocacy groups, thereby redefine/reinterpret their identities separate to the 'survivor' narrative and providing connection and purpose. Support services and strategies (such as social prescribing) should be routinely offered following treatment within Australia. Terminology should be informed by individuals with ovarian cancer, thereby supporting moving forward with life in ways that are tailored to specific needs and wants.

Background: Bibliotherapy, or reading for therapy, has been shown to help with a variety of mental health conditions, yet reading can be difficult for those undergoing treatment due to cancer-related cognitive impairment (CRCI). Listening is likely to be easier than reading when experiencing CRCI and fatigue. Currently, no studies examine the potential impact of read-aloud programs on the emotional wellbeing of people undergoing cancer treatment. Methods: To explore a way to introduce or reinstate reading and the benefits it can bring, a new bibliotherapy model was developed and delivered to 38 people who were undergoing or had recently completed treatment. Most participants (97%) were older than 45 years, 34% were palliative, and 13% had incurable but treatable cancer, while 95% self-reported symptoms of CRCI. The bibliotherapy model was personalized in its approach to book selection and delivery (one-on-one in-person or via Zoom). Using a pragmatic, mixed-methods framework, participant wellbeing was measured preintervention to postintervention and qualitative interviews were conducted to explore psychosocial effects from participants' (n = 35) and family members' (n = 17) perspectives and were analyzed using reflexive thematic analysis. Results: Stress, anxiety, and depression decreased (as measured by DASS-21, P = .004, P = .000 and P = .015, respectively), and wellbeing increased (as measured by Warwick-Edinburgh Mental Wellbeing Scale [WEMWBS], P = .001) preintervention to postintervention. Qualitative analyses highlighted the aspects of the program participants valued: relaxation, mood lift, increased self-efficacy, time out, and feelings of warmth/nurturing. Distraction/escapism was viewed by participants as having benefits to their mood, pain, and nausea. Human interaction was also highly valued: the sense of connection with the reader was important. Family members expressed feelings of comfort and respite. Conclusions: Findings suggest a tailored bibliotherapy program may be associated with increases in the emotional wellbeing of people undergoing or recently completed cancer treatment, and comfort and respite for their family members. While further research using a randomized controlled trial design is needed, these findings suggest this model is eminently suitable as an offering in integrative cancer centers and palliative settings, with no negative unintended consequences being observed.

Objective: To assess the impact of ejaculatory dysfunction (EjD; failure of emission or retrograde ejaculation) on health‐related quality of life (HRQoL) after retroperitoneal lymph node dissection (RPLND) for testicular cancer and explore the efficacy of pseudoephedrine hydrochloride as treatment. Patients and Methods: In a single arm, phase II trial, patients at ≥6 months after RPLND were invited to complete patient‐reported outcome measures (European Organisation for Research and Treatment of Cancer [EORTC] quality of life questionnaire [QLQ]‐30‐item core, EORTC QLQ‐testicular cancer‐26, and Brief Male Sexual Function Inventory) evaluating HRQoL and sexual function in follow‐up (ACTRN12622000537752/12622000542796). If EjD was reported, post‐ejaculatory urine ± semen analysis was undertaken. In eligible patients, pseudoephedrine hydrochloride 60 mg was administered orally every 6 h for six doses. The primary endpoint was sperm count >39 million sperm/ejaculate (>5th centile) following treatment. The trial was powered to detect a clinically relevant 36% achieving sperm count of >39 million sperm/ejaculate. Secondary endpoints included semen volume >1.5 mL, total motile sperm count, safety, and HRQoL impacts. Results: Of the 58 patients enrolled, the median (interquartile range [IQR]) age was 35 (29–41) years, with a median (IQR) of 37 (18–60) months from RPLND. EjD was reported in 33 (57%), including 27/52 (52%) receiving follow‐up at our centre. There were no differences in global HRQoL; however, role functioning ( P = 0.045), sexual problems ( P < 0.005), and sexual enjoyment ( P = 0.005) was poorer if EjD was present. In all, 24/33 (73%) patients with EjD consented to pseudoephedrine treatment. Of 22 evaluable patients, four (18%) achieved a sperm count of >39 million/ejaculate ( P = 0.20), and four (18%) had a semen volume of >1.5 mL ( P = 0.20). There was a mean increase of 105 million sperm/ejaculate ( P = 0.051) and 1.47 mL increase in semen volume ( P = 0.01). No safety concerns arose. Conclusion: Ejaculatory dysfunction is common after RPLND but did not impact global HRQoL in our cohort. Pseudoephedrine improved EjD for some; however, its efficacy was lower than expected. Pseudoephedrine may be considered on an individualised basis.

Background: Sensory rooms provide a therapeutic environment designed to stimulate and balance an individual’s sensory experiences. Equipped with a variety of sensory-engaging equipment and materials, these rooms aim to facilitate relaxation, emotional regulation, and sensory integration. However, the specific relaxation techniques and essential elements required to create effective, calming spaces for autistic adults remain poorly understood. This study seeks to bridge this gap by investigating the unique sensory preferences and needs of autistic adults, with the objective of informing sensory room designs to better accommodate their specific requirements. Methods: An online mixed-methods survey, divided into three parts, was conducted. Part One utilised the Autism Spectrum Quotient (AQ-50) to screen for autistic traits and participants scoring above the threshold of 25 were invited for further studies. Part Two 1comprised a survey incorporating open-ended and closed questions to assess participants' sensory and relaxation preferences. Part Three also used an online survey and targeted individuals with prior sensory room exposure to assess their experiences. Qualitative results were analysed using thematic analysis. Results: Of the 150 participants screened in Part One, 96 and 13 participants completed Part Two and Three, respectively. Results of the study found that whilst general themes can be identified, autistic adults use a diverse range of methods and sensory modulation techniques to facilitate relaxation. When asked about preferred relaxation activities, themes such as the use of active or passive media arose, as did spending time outdoors, in solitude, or engaging in creative activities. However, there was a considerable amount of diversity between participants regarding how they chose to interact with the items that comprise each theme. In terms of specific sensory modalities, visual, auditory, and somatosensory were identified as the primary senses that can affect relaxation, particularly through customised lighting or sounds, however, these preferences were highly person specific. Conclusions: Our findings emphasise the importance of taking an individualized approach when designing calming spaces for this demographic. The study reveals a wide range of methods autistic adults use to self-regulate, spanning customized environmental changes, sensory stimulation, nature, media engagement, and internal coping strategies. Additionally, suggestions for improving existing spaces focus on increasing personalization and control to better meet individual sensory needs.

Post-traumatic stress disorder (PTSD) is a pervasive disorder among both current and ex-serving Australian Defence Force (ADF) members. Studies have shown current psychological and pharmacological treatments for PTSD are suboptimal in veterans, with high dropout rates and poor adherence to treatment protocols. Therefore, evaluating complementary interventions, such as assistance dogs, is needed for veterans who may not receive the ultimate benefit from traditional therapies. The present longitudinal mixed-method study examined the effectiveness of Operation K9 assistance dogs among sixteen veterans with PTSD, specifically, their effects on suicidality, PTSD, depression, and anxiety from baseline to 12 months post-matching. Self-reported measures were completed prior to receiving their dog (baseline) and at three time points (3, 6, and 12 months) following matching. The Clinician-Administered PTSD Scale for DSM-5 was used to assess the severity of every PTSD case. Veterans participated in a semi-structured interview 3 months post-matching. Whilst there was a reduction in the proportion of veterans reporting any suicidality, there was no significant change in the probability of veterans reporting suicidality between time points. There was a significant effect of time on PTSD, depression, and anxiety symptoms. Three major themes emerged from qualitative data analysis: life changer, constant companion, and social engagement. Qualitative data suggest assistance dogs can have a positive impact on important areas of daily life and support veterans in achieving some of the prerequisites for health, including access to services, transport, education, employment, and development of new and diverse social and community connections. Connections were key in improving health and wellbeing. This study exemplifies the power of human–animal relationships and adds emphasis to the need to take these seriously and create supportive healthy environments for veterans with PTSD. Our findings could be used to inform public health policy and service delivery, in line with the Ottawa Charter action areas and indicate that for veterans with PTSD, assistance dogs may be a feasible adjunct intervention.

Gynecological cancers make up nearly 10% of all cancers diagnosed in Australian women. Despite this, increased survival rates have seen many women facing changes to self-identity post diagnosis alone. This study investigated the factors influencing a woman’s self-identity following gynecological cancer treatment by interviewing 11 women aged 30–61, with various gynecological cancer types. Semi-structured interviews were conducted, and reflexive thematic analysis was utilized. Two overarching themes were identified, changes in self-identity and the influence of stigma, with four subthemes: the cancer identity, the real meaning of survivorship, understanding womanhood, and the socially changed body. Outcomes show that social norms play a major role in the way women see themselves following treatment and that a reevaluation of blanket terms (e.g., survivor) is required within this space. This knowledge can be used to inform health-care professionals working with women following treatment in order to improve psychological well-being and self-acceptance.