Progress towards Every Newborn Action Plan (ENAP) implementation in Iran: obstacles and bottlenecks

Background: Neonatal mortality accounts for more than 47 of deaths among children under five globally but proper care at and around the time of birth could prevent about two-thirds of these deaths. The Every Newborn Action Plan (ENAP) offers a plan and vision to improve and achieve equitable and high-quality care for mothers and newborns. We applied the bottleneck analysis tool offered by ENAP to identify obstacles and bottlenecks hindering the scale-up of newborn care across seven health system building blocks. Methods: We applied the every newborn bottleneck analysis tool to identify obstacles hindering the scale-up of newborn care across seven health system building blocks. We used qualitative methods to collect data from five medical universities and their corresponding hospitals in three provinces. We also interviewed other national experts, key informants, and stakeholders in neonatal care. In addition, we reviewed and qualitatively analyzed the performance report of neonatal care and services from 16 medical universities around the country. Results: We identified many challenges and bottlenecks in the scale-up of newborn care in Iran. The major obstacles included but were not limited to the lack of a single leading and governing entity for newborn care, insufficient financial resources for neonatal care services, insufficient number of skilled health professionals, and inadequate patient transfer. Conclusions: To address identified bottlenecks in neonatal health care in Iran, some of our recommendations were as follows: establishing a single national authorizing and leading entity, allocating specific budget to newborn care, matching high-quality neonatal health care providers to the needs of all urban and rural areas, maintaining clear policies on the distribution of NICUs to minimize the need for patient transfer, and using the available and reliable private sector NICU ambulances for safe patient transfer. © 2021, The Author(s)

Mapping interactions with the chaperone network reveals factors that protect against tau aggregation.

A network of molecular chaperones is known to bind proteins ('clients') and balance their folding, function and turnover. However, it is often unclear which chaperones are critical for selective recognition of individual clients. It is also not clear why these key chaperones might fail in protein-aggregation diseases. Here, we utilized human microtubule-associated protein tau (MAPT or tau) as a model client to survey interactions between ~30 purified chaperones and ~20 disease-associated tau variants (~600 combinations). From this large-scale analysis, we identified human DnaJA2 as an unexpected, but potent, inhibitor of tau aggregation. DnaJA2 levels were correlated with tau pathology in human brains, supporting the idea that it is an important regulator of tau homeostasis. Of note, we found that some disease-associated tau variants were relatively immune to interactions with chaperones, suggesting a model in which avoiding physical recognition by chaperone networks may contribute to disease

Monitoring Social Well-Being in Iran

The main aim of this study was to design a system for measuring and monitoring social well-being in Iran, utilizing a conceptual model and choosing contextually specific domains and indicators. A number of different approaches in defining and measuring social well-being exist. Some of these measuring systems use a descriptive approach and employ sets of indicators, which cover topics of concern but lack any explicit theoretical basis. To better capture the specific societal context of social well-being within Iran, we constructed a compound model from multiple pre-existing conceptual models, allowing us to group indicators and show relationships among contextually relevant areas and domains. Our framework proposes that there are societal and individual-level determinants that affect social health in a society and that social health has outcomes and impacts. To measure social health, variables of social integration, social contribution, social coherence, social actualization, social acceptance, social support, and social functioning are considered. The outcomes and impacts are to be measured and monitored by 37 variables. In many countries, social well-being measurements have been conducted on a regular basis for decades. Some of these systems of social health focus on individual (micro) measures, some on societal (macro) measures, and many on both. In this research, both individual level and societal level well-being measures were selected after being deemed contextually important for Iran. This system of social well-being measurement is to be used as a descriptive and monitoring tool but could potentially be utilized in goal setting, outcome-based accountability, and evaluations in order to promote social well-being and social policy research in Iran. © 2015, Springer Science+Business Media Dordrecht