Nursing Practice Today
Volume:5 Issue: 3, Summer 2018

In an editorial published in the second issue of the fifth volume of the Nursing Practice Today, an issue was raised about an inconsistency between the registration information and the final report of a clinical trial published in the first issue of the fifth volume of the Journal. The publication entitled, “The effect of self-management education on the quality of life and severity of the disease in patients with severe psoriasis: a non-randomized clinical trial”. This trial had been registered in the Iranian Registry of Clinical Trials as a “randomized clinical trial”, while the title of its final report shows that it was “a non-randomized clinical trial”.
In the draft of that publication, there were ambiguities in the randomization of participants to the arms of the trial. Given the critical importance of randomization in clinical trials, the reviewers of the Journal asked the authors to clarify the ambiguities and clearly explain the randomization procedure. Then, based on the explanations and clarifications provided by the authors, the Editor of the Journal recommended the authors to revise the draft as a non-randomized clinical trial. However, despite the importance of congruence between the registration information and the final report of a trial, the authors provided no explanation about the inconsistency between the randomization techniques reported in the registration information and the final report of that study (1, 2). Thus, the present Editorial was written about the importance of clinical trial registration and its applications.
Around one thousand years ago, the famous Iranian physician, Ibn-e Sina (known as Avicenna in the west; 980–1037), wrote an article entitled the “Determination of temperaments of simple drugs through experiment”. That article—published as the second section of the second volume of his influential book, “The Canon of Medicine”—is considered as the first formal introduction of clinical trial. In that article, Ibn-e Sina introduced seven main requirements for drug experiments, the seventh of which holds that any judgment about the effects and the strengths of drugs should be made based on the results of studies on humans (3).
Currently, clinical trials are considered as the most reliable method of producing evidence for clinical practice (4) and a key strategy for the advancement of medical sciences. However, there have always been concerns over the credibility of the results of clinical trials. Therefore, several standard guidelines have been developed for registering, conducting, and reporting clinical trials (5, 6).
Studies show that the positive results of some clinical trials are frequently published in different formats, while their negative results are not published at all or are published with delay. Such selective outcome reporting has caused strong biases in using or not using a drug or a treatment protocol and has brought about destructive effects on human beings. Consequently, in 2004, the International Committee of Medical Journal Editors decided to publish only those trials which had been registered in formal registries before sampling onset (6). The aim of this policy shift was to oblige researchers to clearly and completely report all positive and negative results of their clinical trials and thereby, to prevent any kind of reporting biases and any misuses of the results (7–10). One month later, the health ministers who had participated in the annual meeting of the World Health Organization required this organization to develop a centralized network of authentic primary clinical trial registries in order to facilitate and organize the registration and the retrieval of clinical trials through a single platform. Accordingly, the International Clinical Trials Registry Platform was set up at the following address, www.who.int/ictrp. In its meeting in South Korea in October 2008, the World Medical Association also added the Principle 19 to the Declaration of Helsinki which holds that the registration of a clinical trial before its onset is mandatory (6, 11). Following these movements, the Iranian Registry of Clinical Trials (retrievable at www.irct.ir) was set up and connected to the International Clinical Trials Registry Platform in December 2008 as the ninth clinical trial registry center approved by the World Health Organization. After that, in December 2009, the Research Administration of the Iranian Ministry of Health and Medical Education required all Iranian research journals of medical sciences to consider only those clinical trials for publication which had been registered in the Iranian Registry of Clinical Trials (9, 10). The Iranian Society of Medical Science Journal Editors also strongly supported this requirement and encouraged researchers to register their clinical trials in this national registry and provide the registration number of their trials in the final reports of their works (10, 12).
Some of the main reasons for the essentiality of registering clinical trials are as the following:•Registration provides governments, academic institutions, and research centers with reliable information related to clinical trials and enables them to make wiser decisions about funding new researches instead of repetitive works. This will save limited research budget for new studies, particularly in developing countries.
•Registration helps the editors and the reviewers of journals more accurately evaluate completed clinical trials and provide them with information about similar publications and uncompleted works. Moreover, it provides them with the opportunity of comparing the final reports of clinical trials with their registration information in order to judge about the accuracy of the reports.
•Registration provides a valuable source of information for the public. People who are willing to participate in clinical trials can access registration information and decide whether to apply for participation in trials of their interest.
•Registration requires researchers to more strictly adhere to the principles of research ethics and helps protect patient rights.
•Registration promotes the credibility of the generated results (13–16).
Despite the importance of registration and the great emphasis on its application, studies on published clinical trials show inconsistencies between the registration information and the final reports of clinical trials respecting their designs, methodologies, and results. For instance, a systematic review reported the high prevalence of inconsistencies between the primary plans and the reported results (14). In the final reports of clinical trials, researchers need to report any inconsistencies between the registration information and the final reports and provide clear explanations about the reasons for such inconsistencies (4). Moreover, editors and reviewers of journals need to take registration information of clinical trials into account when considering their final reports for publication. The author guidelines of journals should also be revised to provide researchers and authors with detailed information about the principles and the processes of clinical trial registration as well as with standard guidelines and checklists for reporting clinical trials and other types of studies (15, 16).

The unsafe abortion complications may lead to mother mortality or morbidity, secondary infertility and other unwanted side effects. In some countries like ours, in many cases this kind of pregnancy termination is performed because in most cases the abortion is considered illegal by the government due to religious issues, while in some cases it may seem overly opposing the pregnancy termination. In this case report the mother was suffering from the severe psychosis symptoms, however she was not allowed to perform an abortion, and finally she decided to go to an illegal institute for abortion which results into secondary infertility. This case and similar cases bring up this question that to what extent the survival of the fetus is important in psychotic conditions of the mother.
Case Report: This study is a case report of a 32-year-old female at week 16 of pregnancy presented to the clinic with nausea and vomiting. Following to routine workup in a gynecology department she was referred to a neurologist. Therefore, after performing various imaging studies it was revealed that she had a mass in her brain and surgical resection of the mass was performed without any complication. After few days, she showed bizarre behavior and hallucination. Due to her pregnancy, the neurologists could not prescribe some medications like carbamazepine. Neurologists took the abortion into consideration, however it is illegal in our country to terminate the pregnancy after 4months.Finally, despite her doctor’s recommendation she performed abortion in an unapproved institute and returned to our clinic to follow up and continue the treatment. She is still on drugs and in the usual state.
Abortion within specific sort of diseases which might threaten the psychological condition of the mother and fetus should be legally permitted by the government. Therefore, by the availability of this opportunity for people who are suffering from psychological diseases like psychosis, they could easily approach to the well-known centers in order to terminate their pregnancy legally under appropriate observation. Useful studies must be done in this area to resolve the existing problem. This question should be answered by the government, health politicians, religious missionaries, clinical and social psychologists

Self- medication is defined as consuming nonprescription medicines to treat self-diagnosed disorders or symptoms. This study was carried out to examine prevalence of self-medication during three months ago and its correlates among the elderly population in Karaj-Iran by using the HBM model.
This cross sectional study was conducted on 189 elderlies who were covered by health care centers. The inclusion criteria were absent of cognitive disorders and being over the age of 60. The multistage sampling was used in this study. The data collection tools included: demographic characteristics and a questionnaire based on the HBM model, including knowledge, perceived susceptibility, perceived severity, perceived benefits, perceived barriers. Statistical analysis of the data was performed using chi-square tests, Student t-tests, ANOVAs and multiple logistic regressions. Analyses were done by SPSS 19.0.
The prevalence of self-medication was 26.5%. The most common medicine used for self-medication was Supplements (87.30%), cold drugs (40.2%), and pain killers (39.6). There was significant correlation between self-medication and health insurance coverage (P=0.01) and chronic diseases (P=0.001).There were two predictors of self -medication behavior in our study, which were having chronic disease and perceived susceptibility with OR were 1.46(95% CI:0.71-2.40) and 0.93(95%CI:0.76-1.13), respectively.
Due to the study results, it is suggested that an interventional program should be considered the promoting of the perceived susceptibility of the elderly population regarding self-medication and policy makers should be noted to elderly health insurance coverage.

Communication with the patient is the basis for nursing practice in providing care for the patient. The aim of this study was to determine the barriers to nurse-patient communication from the viewpoint of nurses working in educational hospitals of Kurdistan University of Medical Sciences,
This descriptive cross-sectional study was performed on 151 of nursing staff in educational hospitals of Kurdistan University of Medical Sciences selected by convenience sampling method. Data gathering tool was a questionnaire including demographic characteristics and “barriers to nurse-patient communication” questionnaire with four-part: common barriers between nurses and patients, nurses’ barriers, patients’ barriers and environmental barriers. The data were analyzed by SPSS software ver 16. The demographic data and the barriers to nurse-patient communication were measured, using frequency, mean, and standard deviation.
Cultural difference between nurses and patients (2.62±1.06) was the most common barriers to the nurse-patient communication. The most important barriers related to the patient included the patient's companion’s interference (3.24±0.92). Among the environmental barriers, caring for a critical patient (3.27±0.98) was the most important barriers. The most important nurses’ barriers was lack of time (3.46±0.78).
Nurses and nursing managers should work to address and remove the barriers identified in relation to the nurse-patient communication. Providing care by native and same gender nurses, absence of patient's companion, creating a quiet environment and increasing the number of nursing staff could help to overcome these barriers

The majority of studies on the facilitators and barriers to functioning in spinal cord injury (SCI) focussed on physical and psychosocial barriers/facilitators, with little emphasis on barriers and facilitators related to the health care system. The purpose of the present study was to explore the barriers/facilitators in the health care system to the functioning of persons with SCI.
Methods & Materials: The present study was a qualitative descriptive design that was conducted at the Tamale Teaching Hospital in the Northern Region of Ghana. The study employed the purposive sampling technique with the Neurosurgical Unit of the Hospital as an outlet for the selection of the sample. Thirteen participants were interviewed using an interview guide. The sample was determined by saturation and the data was analysed using thematic analysis.
Treatment and management issues, health staff issues and health education issues respectively emerged as the main themes of the present study. Sub-themes such as long-term analgesic use, herbal treatment, lack of health education and high cost of treatment emerged as barriers to functioning of persons with SCI. While physiotherapy and health education were identified as facilitators to functioning, surgery emerged as both a barrier and a facilitator to functioning.
Addressing the barriers related to the health care system on the functioning of persons with SCI and improving on the few existing facilitators to functioning would help improve the general wellbeing of persons with SCI and also assist in their adjustment to the injury.

Regular physical activity is a major aspect of healthy lifestyle and control and prevention of many chronic diseases. Also, perceived barriers to physical activity among various populations are different. This study aimed to determine the status of regular physical activity and perceived barriers to performing it in adolescents who studying in the junior high school.
This cross-sectional study has used a stratified random sampling with proportional allocation on 280 subjects among the students at the city of Babol. For data collection, three questionnaires for demographic status, physical activity and perceived barriers to physical activity have been used. The data analyzed by using descriptive statistics and chi-square tests.
Theresults showed that most ofstudents(61/1 percent) didn’t have regularphysicalactivity, and only a few(38/9 percent) had regularphysicalactivity. The most common perceived barriers tophysicalactivityofstudents in this researchhas been listed as:lackofrelativessupports (53/6 percent), to being far from sports places(35 percent), And lack of enough self-confidence (33/2 percent).
Regardless of the importance of regular physical activity during adolescence, the results indicate that regular physical activity in the lifestyle of most young people is not present. Therefore, given the identified barriers, it is necessary to plan for the expansion of regular physical activity in this age group.

Labor pain is an unpleasant experience for most women and can affect their birth satisfaction. This study investigated the effects of ice pack application on pain intensity in the active phase of labor and on birth satisfaction among primiparous women.
Methods & Materials: This randomized controlled trial was conducted on ninety primiparous women. Participants were randomly allocated to either an intervention or a control group. In the intervention group, an ice pack was placed on the sacral area of each participant in the active phase of labor for ten minutes. This intervention was repeated every thirty minutes up to the beginning of the second stage of labor. In both groups, labor pain intensity was assessed before and every one hour after intervention onset and birth satisfaction was assessed 24 hours after delivery. Data were analyzed through the SPSS software (v. 22.0).
Groups did not significantly differ from each other respecting participants’ demographic and clinical characteristics. Throughout the study intervention, labor pain intensity increased in both groups; however, the increase in the control group was significantly greater than the intervention group (P Without any significant side effects, ice pack application can significantly reduce pain intensity during the active phase of labor. Thus, this intervention is recommended for labor pain alleviation.