“Best for everyone concerned” or “Only as a last resort”? Views of Australian doctors about sterilisation of men and women with intellectual disability

Background  Doctors have the potential to influence opportunities for normative life experiences in the area of sexuality for individuals with intellectual disability (ID). Method  In Study One, 106 doctors completed the Attitudes to Sexuality Questionnaire (Individuals with an Intellectual Disability). In Study Two, 97 doctors completed a modified form of the questionnaire that included additional questions designed to assess their views about sterilisation. Results  Attitudes were less positive about parenting than about other aspects of sexuality, and less sexual freedom was seen as desirable for adults with ID. A surprising number of doctors agreed that sterilisation was a desirable practice. Study Two provided data about the conditions under which sterilisation was endorsed. Most doctors reported they had not been approached to perform sterilisations. Only 12% believed medical practitioners receive sufficient training in the area of disability and sexuality. Conclusions  The findings have implications for training and professional development for doctors.

Processing, Annealing and Sterilisation of Poly-L-Lactide.

Poly--lactide (PLLA) is one of the most significant members of a group of polymers regarded as bioabsorbable. Degradation of PLLA proceeds through hydrolysis of the ester bonds in the polymer chains and is influenced significantly by the polymer's molecular weight and crystallinity. To evaluate the effects of processing and sterilisation on these properties, PLLA pellets were either compression moulded or extruded, subjected to annealing at 120°C for 4 h and sterilised by ethylene oxide (EtO) gas. Procedures were used to evaluate the mechanical properties, molecular weight and crystallinity. Upon processing, the crystallinity of the material fell from 61% for the PLLA pellets to 12% and 20% for the compressed and extruded components, respectively. After annealing, crystallinity increased to 43% for the compression-moulded material and 40% for the extruded material. Crystallinity further increased upon EtO sterilisation. A slight decrease in molecular weight was observed for the extruded material through processing, annealing and sterilisation. Young's modulus generally increased with increasing crystallinity, and extension at break and tensile strength decreased. The results from this investigation suggest that PLLA is sensitive to processing and sterilisation, altering properties critical to its degradation rate.

Microabrasion : A novel method to assess surface degradation of UHMWPE following sterilisation and ageing

The ageing behaviour of ultra-high molecular weight polyethylene (UHMWPE) has been studied following gamma irradiation (25 or 40 kGy) in air. Accelerated ageing procedures used elevated temperature (70°C) and/or pressurised oxygen (5 bar). Shelf-aged UHMWPE was also studied. The variation in surface density and mechanical properties were determined following the various sterilisation and ageing treatments. Microabrasive wear testing was also performed. Wear rates were found to correlate well with stress at break for sterilised and aged UHMWPE but not with elongation to failure. It is proposed that the wear mechanism is fracture dominated and occurs following some disentanglement of the polymer chains. Wear also depends upon embrittlement of the surface layer due to its processing and ageing. Elongation to failure in a tensile test is not a good measure of this embrittlement whereas the microabrasion test provides more surface sensitive information concerning this property.

Identification of a suitable sterilisation method for collagen derived from a marine Demosponge

Collagen is widely used as a biomedical material, and its importance is likely to grow as research and understanding progresses in this field. As a biomedical material, ensuring the sterility of collagen before use as, or incorporation into, a medical device is paramount. However, common sterilisation techniques can induce changes in the physical structure and protein chemistry of collagen, potentially affecting the performance. In this preliminary study, the influence of autoclaving, gamma irradiation and ethylene oxide gas sterilisation on the denaturation temperature and helical content of the collagen was evaluated using differential scanning calorimetry and Fourier transform infrared spectroscopy. Early results indicate that all sterilisation techniques affect collagen properties but suggest that the least damaging of the techniques investigated was y irradiation.

The impact of sterilisation on family relationships

The major objective of the researcher was to assess the gains or losses in relationship between spouses after sterilization of the wife. The second objective was to gauge the impact of sterilisation upon parent—child relationships. Factors that were responsible in motivating women to accept sterilization were subjected to enquiry with the conviction that the information would give insight into the inadequacies of the official Family Planning Programme, offering prospects for feasible and salutary changes. The report is arranged under six chapters. The first chapter, Introduction, has three parts. The global and natural dimension of the problem of population is considered in Part I; The Importance of the topic studied namely sterilisation is discussed in the second Part: and Part III explains the background and methodology %f the study. The second chapter is a description of tubecto~ mized women who were the respondents. Their personal and family data, economic, social, educational and demographic profilesform its contents. The direct and indirect influences that were-responsible to make women decide in favour of sterilization are dealt with in the Third chapter. The Fourth Chapter is an analysis of the interspouse relations pre and post—operatively and an assessment of gains and losses in the area subsequent to sterilisation. How children have benefitted physically and emotionally as a consequence of improved care/attention from parents post~operatively constitutes the analysis attempted in the Fifth chapter.

Effects of stabiliser addition and in-container sterilisation on selected properties of milk related to casein micelle stability

Different stabilising salts and calcium chloride were added to raw milk to evaluate changes in pH, ionic calcium, ethanol stability, casein micelle size and zeta potential. These milk samples were then sterilised at 121 °C for 15 min and stored for 6 months to determine how these properties changed. Addition of tri-sodium citrate (TSC) and di-sodium hydrogen phosphate (DSHP) to milk reduced ionic calcium, increased pH and increased ethanol stability in a concentration-dependent fashion. There was relatively little change in casein micelle size and a slight decrease in zeta potential. Sodium hexametaphosphate (SHMP) also reduced ionic calcium considerably, but its effect on pH was less noticeable. In contrast, sodium dihydrogen phosphate (SDHP) reduced pH but had little effect on ionic calcium. In-container sterilisation of these samples reduced pH, increased ethanol stability and increased casein micelle size, but had variable effects on ionic calcium; for DSHP and SDHP, ionic calcium decreased after sterilisation but, for SHMP, it remained little changed or increased. Milk containing 3.2 mM SHMP and more than 4.5 mM CaCl2 coagulated upon sterilisation. All other samples were stable but there were differences in browning, which increased in intensity as milk pH increased. Heat-induced sediment was not directly related to ionic calcium concentration, so reducing ionic calcium was not the only consideration in terms of improving heat stability. After 6 months of storage, the most acceptable product, in appearance, was that containing SDHP, as this minimised browning during sterilisation and further development of browning during storage.