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Background: Despite medical advancements and treatment development, children with cancer experience a wide range of symptoms related to the disease and treatment side effects. Providing palliative care is essential to improve the quality of life for both the child and the family. Given limited available resources, cost-effective service packages can address this need. Objectives: This study aimed to develop an essential palliative care package for children with cancer in Iran. Methods: The study was under Health System Research and employed an exploratory mixed method design in three phases. The initial stage involved two sub-studies including a review of literature and a qualitative study. In the subsequent phases, the package draft was compiled and validated using the Delphi technique with input from 12 experts. Results: The essential palliative care package for children with cancer comprised two main components: INPUT, including dimensions related to medicine, human resources, equipment, and service delivery setting. INTERVENTION, encompasses physical, psychological, social, spiritual symptom management, and growth and development. Conclusions: Customized for Iran's social and cultural context, this essential service package provides safe, efficient, convenient, and affordable care. Physicians and nurses with primary training can integrate it into primary care including home care, emphasizing the importance of palliative care. [ABSTRACT FROM AUTHOR]

Context: The review of palliative care (PC) policies was introduced as one of the four main components of the WHO PC strategy. Considering that eastern Meditranian region countries (EMRCs) has made efforts to establish and develop PC in recent years, coordinated data collection provides a clearer picture of needs, challenges, and barriers at the regional level. Objective: The aim of this study was to analyze PC policies related to cancer in the EMRCs. Methods: A scoping review was conducted and reported following the PRISMA extension guidelines for scoping reviews (PRISMA-ScR). Scopus, Medline, Embase, ScienceDirect, PubMed, Web of Science, Google Scholar, and ProQuest were searched to identify relevant articles published in English and no limit time considered PC related policies in EMRCs. A Walt and Gilson model (context, content, process and actors) was used as a framework for analyzing and summarizing findings Results: Out of the 43 papers included in this study, 38 (8837%) were journal articles. The studies covered countries such as Egypt, Jordan, Saudi Arabia, Lebanon, Cyprus, Oman, United Arab Emirates, Palestine, and Iran. The extracted policies were classified into leadership and commitment of policy makers, affordable access (in context), providing integrated patient-family oriented services, improving the quality of care, creating the possibility of information-sharing (in content), Focus/invest in specialized training, capacity building in society (in process), and involve all stakeholders (in actors). Conclusions: The results of the present study provide a clear picture of how policies are made in the field of PC design and development in EMRCs. Before establishing such a system, it is essential to consider a wide range of economic, social, cultural, and political factors, mainly included in the four axes of Walt and Gilson's policy triangle. The results of this research can be used in policy making, design and formulation, as well as in decisions related to PC system programs. [ABSTRACT FROM AUTHOR]

Abstract Background Patient awareness plays an important role in integrating palliative care into the patient care process. Lack of awareness can create a negative attitude towards palliative care and affect patients' decisions during the treatment process. The present study was conducted to determine the level of knowledge about palliative care in Iranian patients with cancer. Methods The descriptive study was conducted with a convenience sample of 103 cancer patients admitted to an oncology center in Yazd, Iran, A three-part questionnaire including demographic information, sources of palliative care information and the Palliative Care Knowledge Scale (PaCKS) was used to collect data. All statistical analyses were performed using software SPSS 21. Results The mean age of patients was 36.2 ± 13.5 years. Of the total, 38.8% of patients received information about palliative care through the media and 36.9% from the treatment team. On a scale of 0 to 13, the mean PaCKS score was 6.7 ± 3.7. A ‘good’ level of knowledge was reported by 29.1% of participants; however 84.5% stated that they should leave other doctors at the time of receiving palliative care, 71.8% considered palliative care for patients in the last six months of life, 84.5% considered palliative care for patients with cancer, and 70.9% stated that palliative care encourages people to discontinue treatments aimed at treating their disease. Conclusion Our study found most cancer patients have a moderate to weak level of knowledge and considerable misinformation about palliative care, which highlights the importance of providing palliative care education. The development of training programs in this area could play an effective role in improving patients' knowledge of palliative care.

Hadjelia truncata is a spirurida nematode with an indirect life cycle that can infect the digestive system of birds. Different beetles can be intermediate hosts. Birds were infected by ingesting beetles containing infective larvae. The worms can be diagnosed by light microscope and molecular techniques. The disease manifestation among birds can range from asymptomatic to severe, leading to death. This report describes the infection of quails' gizzards with H. truncata in Iran. Twenty-five referred gastrointestinal tracts of naturally dead quails were inspected. Eighteen H. Truncata nematodes were removed from 6 gizzards (24%) of 25 gastrointestinal samples. All the removed worms were located between the submucosal and muscular layers of the infected gizzards. Because of postmortem alterations, the histopathological sections of infected gizzards could not be performed. This report is the first observation of H. truncata infection among quails. This worm has been previously reported among pigeons (Columba livia domestica) and hoopoes (Upupa epops). [ABSTRACT FROM AUTHOR]

Background: Despite advances in pediatric pain management, postoperative pain remains a significant concern. By recognizing the multifaceted nature of pain and its susceptibility to various factors, there is a growing need to identify risk factors for postoperative pain and effective pain coping strategies. Objectives: This study aimed to investigate the relationship between psychological variables and postoperative pain in children. Methods: A descriptive-correlational study was conducted with a sample of 171 children aged 6 - 13 years, conveniently selected from a children's hospital in Tehran, Iran, based on specific inclusion criteria. The data were collected through a demographic questionnaire, the Child Pain Anxiety Symptoms Scale (CPASS), Spielberger's State-Trait Anxiety Inventory (STAI), and the Coping Strategies Questionnaire (CSQ). Statistical analysis was performed using SPSS software (version 21). Results: The majority of the 171 participants were male (65.5%), with an average age of 9.58 years. Abdominal surgery was the most common procedure (53.2%), with an average duration of 134.29 minutes. Regression analysis revealed a statistically significant association between psychological variables and postoperative pain. Specifically, for each point increase in children's and parents' mean anxiety scores, postoperative pain increased by 0.31% and 0.30%, respectively. Conversely, for each point increase in children's mean coping score, postoperative pain decreased by 0.14%. Conclusions: Child and parental anxiety and coping strategies were linked to postoperative pain. Accordingly, higher levels of anxiety in children and their parents were associated with an increased likelihood of postoperative pain; nevertheless, better coping skills in children correlated with reduced postoperative pain. Therefore, implementing psychological interventions might prove effective in managing postoperative pain in children. [ABSTRACT FROM AUTHOR]

Background: Palliative care is one of the primary rights of children with cancer and their families. Identifying the unmet needs of palliative care for these children is important in providing high-quality care. Objectives: The present study aimed at explaining the perception of formal and informal caregivers about the unmet palliative care needs of children with cancer and their families. Methods: This qualitative study was conducted from October 1, 2020, to May 15, 2021, in one of the children's hospitals in Rasht (Northern Iran). This study enrolled 25 caregivers (nurses, doctors, grandmothers, sisters, aunts, neighbors, and parents of children with cancer) and 5 children with cancer, who met the inclusion criteria by purposeful sampling to participate in in-depth and semi-structured interviews. The interviews continued until data saturation. A directed content analysis was performed according to the Elo and Kyngas proposed approach and based on the National Consensus Project (NCP) framework. The findings were managed byMAXQDA2020 software. Gubaand Lincoln criteria were used to ensure the trustworthiness of the data. Results: The average age of the participants was 32.40 ± 1.4 years, and 1,450 codes were extracted. The extracted theme was "the need for holistic care", which included 7 main categories such as "the structure and process of care", "physical aspects of care", "psychological aspects of care", "social aspects of care", "cultural aspects of care", "care of the patient nearing the end of life", and "spiritual, religious, and existential aspects of care", and 23 subcategories. Conclusions: Children with cancer and their families have many physical, psychological, spiritual, and social needs. To meet these needs, it is suggested to provide the necessary infrastructure for palliative care, strive for justice in access to palliative care services for children with cancer and their families, empower caregivers, form an interdisciplinary team, and promote cultural awareness regarding cancer and end-of-life care. [ABSTRACT FROM AUTHOR]