Preliminary assessment of various additives on the specific reactivity of anti- rHBsAg monoclonal antibodies

Background: Antibodies have a wide application in diagnosis and treatment. In order to maintain optimal stability of various functional parts of antibodies such as antigen binding sites, several approaches have been suggested. Using additives such as polysaccharides and polyols is one of the main methods in protecting antibodies against aggregation or degradation in the formulation. The aim of this study was to evaluate the protective effect of various additives on the specific reactivity of monoclonal antibodies (mAbs) against recombinant HBsAg (rHBsAg) epitopes. Methods: To estimate the protective effect of different additives on the stability of antibody against conformational epitopes (S3 antibody) and linear epitopes (S7 and S11 antibodies) of rHBsAg, heat shock at 37°C was performed in liquid and solid phases. Environmental factors were considered to be constant. The specific reactivity of antibodies was evaluated using ELISA method. The data were analyzed using SPSS software by Mann-Whitney nonparametric test with the confidence interval of 95%. Results: Our results showed that 0.25 M sucrose, 0.04 M trehalose and 0.5% BSA had the most protective effect on maintaining the reactivity of mAbs (S3) against conformational epitopes of rHBsAg. Results obtained from S7 and S11 mAbs against linear characteristics showed minor differences. The most efficient protective additives were 0.04 M trehalose and 1 M sucrose. Conclusion: Nowadays, application of appropriate additives is important for increasing the stability of antibodies. It was concluded that sucrose, trehalose and BSA have considerable effects on the specific reactivity of anti rHBsAg mAbs during long storage. © 2015, Avicenna Journal of Medical Biotechnology. All rights reserved

Relationship between moral distress and moral courage in nurses

In the nursing profession, moral distress is a challenge thatc an have different consequences. The nurses’ moral courage to make the right decision can play an important role in the prevention of moral distress, and thus promote moral comfort. The present study examined the relationship between moral distress and moral courage in nurses. In this study, 313 nurses from hospitals in southern Khorasan Province were selected through quota sampling, and Corley’s Moral Distress Scale and the Professional Moral Courage Scale by Sekerka, et al. were used for data collection. The collected data were analyzed by descriptive and analytical statistics. The findings showed a significant relationship between the intensity of moral distress and moral courage (P = 0.03, r = - 0.44). From a range of 0 - 5, the mean of moral distress was 3.7 ± 0.5 in terms of intensity, and 3.55 ± 0.86 in terms of frequency. The mean score of moral courage was calculated at 3.33 ± 0.46 from a range of 1 - 5. The significant correlation between moral distress and moral courage strongly suggests that high levels of moral courage in nurses can play an important role in controlling moral distress. Determining the factors that create moral courage and developing strategies and circumstances such as promoting an appropriate moral climate could play a major role in encouraging moral behavior and controlling moral distress

Moral distress and its relationship with professional stress in nurses

Moral distress is an important issue in the field of medical ethics that can have serious effects on nurses, patients and health organizations. One of the most common effects of this phenomenon is professional stress in nurses. Stressful situations in nurses’ job environment lead to burnout and dissatisfaction, and adversely affect the quality of care. This was a cross-sectional study aimed to determine the relationship between moral distress and professional stress in 220 nurses of educational hospitals in the city of Birjand. Data were collected using a 51-item questionnaire based on Corley’s Moral Distress Scale and Wolfgang’s Health Professions Stress Inventory. Reliability and validity of the questionnaire were assessed by the researchers, and its reliability was calculated using Cronbach’s alpha (93%). The results indicated a positive relationship between moral distress and professional stress (P<0/05, r = 0/8). Intensity and frequency of moral distress and professional stress were reported average. Moral distress and professional stress were reported at a frequency and severity of moderate size. Findings of this study can provide guidelines for educating nurses on this phenomenon and the conditions leading to it. They may also be used to develop management strategies and establish organizations to prevent and minimize the consequences of these phenomena in nurses

Moral distress in students: A cross- sectional study in educational environment

Moral distress in educational environments can be associated with multiple effects. Students who faced with this ethical challenge feel insecurity and dissatisfaction and so school dropout and failure will be increased in them. Low quality of teaching in these conditions could potentially cause a lack of scientific and clinical sufficiency and thus the performance of health systems to achieve the health goals will be at risk. This study aimed to assess the students' moral distress in Birjand paramedical school students. The Cross - Sectional study took on 600 students of paramedical school who were selected by census. To collect data, it was used a questionnaire of 20 questions. The validity and reliability of this questionnaire was evaluated and Cronbach's Alfa was calculated 81 percent. Data were collected by Spss16 software and were analyzed with descriptive and inferential statistics. The findings showed that the average of moral distress from total score was 0-5, (3/12±0/88) in the intensity and (3/5±1/2) in the frequency. There was a significant relationship between moral distress with years of educations and sex (P>0/05). Moderate level of moral distress in students requires the planning and some actions as students’ awareness to this phenomenon. Identification and control of this phenomenon in educational environments and investigating its reasons may play an important role in the control of this phenomenon and the prevention of its adverse effects in future

Moral reckoning in critical care units nurses

Introduction: The nurses especially in in critical care unitsfacing whit different moral challenges in the health system. ThatIf this situation is not resolved, will be leading to serious consequences for nurses, patients and health systems. In the process of these challenges the moral reckoning phenomenon can play a central role in the stability of personal values nurses. Thus, this study has been conducted with the aim of determining moral reckoning in the nurses. Methods and Materials: Cross sectional-analytical study on 211 intensive care unit nurses of Southern Khorasan hospitals in 2014. Samples were selected by accessible method and was used the 36-item instrument developed by the researcher. The data collected were analyzed by the software Spss16 and analyzed using descriptive (mean, standard deviation, frequency and relative frequency) and analytical methods (t-test, ANOVA and Pearson correlation coefficient). Results: The results showed that the mean score of moral reckoningin nurses was (3.27±0.5). There was a significant relationship among the mean score of moral reckoning and age, number of service years (P<0.05). Conclusion: The results showed that people with more experience successfully spent moral reckoning levels in the workplace and perhaps they will be able to support role to other people, especially those less experienced in healthcare team

Moral Sensitivity and Moral Distress in Critical Care Unit Nurses

Background and Aim: The present study was carried out aiming to determine the relationship between moral distress and moral sensitivity among nurses. Materials and Methods: This descriptive analytical study was conducted on 257 nurses employed in teaching hospitals affiliated to Birjand University of Medical Sciences (South Khorasan) in 2015. Available sampling was done among the nurses working in intensive care units (ICU, CCU, NICU and dialysis) in the whole province meeting the inclusion criteria. The data collection tool was a three-part questionnaire consisting of the demographic information questionnaire, Corly moral distress questionnaire, and the Korean version of the Hun moral sensitivity questionnaire. The collected data were analyzed running SPSS statistical software version 16. Ethical Considerations: Written consent was obtained from all participants. Additionally, all of them were assured of anonymity of the questionnaires and confidentiality of the information. Findings: There was no significant relationship between moral distress and the nurses’ moral sensitivity (P=0.2). The mean scores (out of 5) were 3.5±0.66 for the total moral distress, 3.5±0.75 for the intensity of moral distress, and 3.54±0.66 for the frequency of moral distress, respectively. The mean for moral sensitivity (out of 4) was 3.1±0.45. There was a statistically significant relationship between moral sensitivity and moral distress with age and years of work experience, and also between moral distress and the type of the ward (P<0.05). Conclusion: The findings indicates that nurses who do not have sufficient executive power for moral performance will experience moral distress, despite their high and low levels of moral sensitivity. Thus, it is necessary hospital administrators to take some specific measures to carry out periodic evaluation of this phenomenon, and hold some codified trainings in this regar