A Critical Review of Studies on Health Needs Assessment of Elderly in the World 2 2 Introduction: Health improvement, control of communicable diseases and increase in life expectancy among the elderly of developed and developing countries has greatly increased. Since the health care and social needs of older adults differ from that of other adults, it is necessary to identify the needs of the elderly in order to make proper plans that will promote their health. The aim of this paper is to critically review these researches. Methods: A comprehensive literature review on the needs assessment of elderly health was applied searching English and Persian databases in Pub Med, Science Direct, ProQuest, Elsevier, Magiran, ISC and using key words including, Health need, Assessment, Elderly, Aging, Older adults, Aged and Health care needs. Results: Initial search yielded 745 references, considering the inclusion criteria, 21 papers were reviewed. Results revealed that in conducting needs assessment, various methods and procedures in various health dimensions including physical health, mental health, emotional, care, social, cultural, economic, nutritional, service, security, legal and educational needs have been utilized. Some of the dimensions had been more explored and some rarely. Conclusion: Most of the conducted studies had mainly focused on the elderly physical health needs and had neglected to take in to account other needs such as social and health care needs. In order to comprehensively recognize the health needs of the elderly, identifying their health care and care services is also important. Furthermore, in addition to quantitative studies, discovering the older adults’ perceptions of their own health needs is also necessary. It seems that the challenge ahead of managers, experts and researchers on elderly health is trying to design comprehensive mechanisms of health need assessment and considering it as a reference for any future planning. 1 9 2017/01/11 1395/10/22 2017/03/2 1395/12/12 Sima Ghasemi Sima Ghasemi Department of Basic Sciences, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran Iran Nastaran Keshavarz Mohammadi Nastaran Keshavarz Mohammadi Department of Health Education and Health Promotion, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran Iran n_keshavars@yahoo.com Farahnaz Mohammadi Shahboulaghi Farahnaz Mohammadi Shahboulaghi Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran Iran Ali Ramezankhani Ali Ramezankhani Department of Health Education and Health Promotion, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran Iran Aged Needs Assessment Health Review Literature as Topic World Health Organization. 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[Accessed on 11 June 2016].## Florida Department of Elder Affairs. Assessing the needs of elder Floridians. Department of Elder Affairs State of Floridian, USA; 2012. Available from: http://elderaffairs.state.fl.us/doea/pubs/pubs/Asses sing_the_Needs_of_Elder_Floridians_Jan_2012.p df. [Accessed on 11 June 2015].## Manson-Siddle C, Johnson A, Cullum P, Akester H. Older people assessing health and social needs in north east Lincolnshire. Public Health Directorate: North East Lincolnshire Care Trust Plus. 2008.## McMillan M, Pulford A, McIntyre Z, Hamilton L, Watts M. An of the health and social care needs of older people. NHS, Ayrshire & Arran Council. 2013; 1-129.## Motlagh MA, TaheriTanjani P. Elderly health profile in Islamic republic of Iran. Tehran, Iran: Fojhan Publications; 2014.[Persian]## Afzali M, Baradaran Eftekhary M, Hejazi F, Khojasteh T, Tabrizi R, Faridi T. Social mobilization for health promotion in the elderly. Hakim Research Journal. 2007; 9(4): 1-6. 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Loneliness and Its Related Factors among Elderly People in Yazd 2 2 Introduction: Old people appear to be most prone to loneliness and depression perhaps because of decrease in their ability in daily livings, increase in morbidity, loss of close ties caused by loss of friends and spouses. This study was conducted for investigation of the loneliness and its related factors in elderly people in Yazd. Methods: In this cross sectional study, 200 old people (over 60 years old) from three zone; health centers, nursing home and retirement center by convenient sampling method. Data was collected by UCLA Loneliness Scale that was consisting of 20 items for loneliness measurement. Scores 41 and more defined as loneliness. Collected data was analyzed by proper statistical tests with SPSS software. Results: Results showed that 71 % of subjects had Not Feel Lonely, 24 % moderate and 5 % severe felling of loneliness. Factors such as level of education, marital status, numbers of daughter and sons, previous job, residence site, current job status, living in nursing home, insufficient income, place of praying, sleep quantity and quality of sleep and feeling of healthy were associated with loneliness status (p < 0.05). Conclusion: Our findings showed loneliness is common in elderly that support needs for more investigations and attention to loneliness related factors, educational courses conduction for family to take care of their elders, preparing of recreational measures and social support groups to decrease the loneliness in old people and so they spend this period by good and healthy sensation. 10 15 2017/01/112017/01/6 1395/10/17 2017/03/22017/04/23 1396/2/3 Mahmood Vakili Mahmood Vakili Monitoring of Health Research Center, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran Mohsen Mirzaei Mohsen Mirzaei Monitoring of Health Research Center, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran Drmmirzaei@yahoo.com Mojgan Modarresi Mojgan Modarresi Monitoring of Health Research Center, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran Loneliness Risk Factors Elderly Iran Hawkley LC, Hughes ME, Waite LJ, Masi CM, Thisted RA, Cacioppo JT. From social structural factors to perceptions of relationship quality and loneliness: the Chicago health, aging, and social relations study. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences. 2008; 63(6): S375-S84.##Victor CR, Scambler SJ, Marston L, Bond J, Bowling A. Older people's experiences ofloneliness in the UK: does gender matter?. Social Policy and Society. 2006; 5(01): 27-38.##Karnick PM. Feeling lonely: theoretical perspectives. Nursing Science Quarterly. 2005; 18(1): 7-12.##VanderWeele TJ, Hawkley LC, Cacioppo JT. On the reciprocal association between loneliness and subjective well-being. American Journal of Epidemiology. 2012; 176(9): 777 -84.##Park NS, Jang Y, Lee BS, Haley WE, Chiriboga DA. The mediating role of loneliness in the relation between social engagement and depressive symptoms among older Korean Americans: do men and women differ? The Journals of Gerontology Series B: Psychological Sciences and Social Sciences. 2013; 68(2): 193- 201.##Alpass FM, Neville S. Loneliness, health and depression in older males. Aging & Mental Health. 2003; 7(3): 212- 6.##Teh JKL, Tey NP, Ng ST. Family support and loneliness among older persons in multiethnic Malaysia. The Scientific World Journal. 2014; 2014. ##Lauder W, Sharkey S, Mummery K. A community survey of loneliness. Journal of Advanced Nursing. 2004; 46(1): 88-94.##Perissinotto CM, Cenzer IS, Covinsky KE. Loneliness in older persons: a predictor of functional decline and death. Archives of Internal Medicine. 2012; 172(14): 1078- 84.## Aartsen M, Jylhä M. Onset of loneliness in older adults: results of a 28 year prospective study. European Journal of Ageing. 2011; 8(1): 31- 8.##Hacihasanoğlu R, Yildirim A, Karakurt P. Loneliness in elderly individuals, level of dependence in activities of daily living (ADL) and influential factors. Archives of Gerontology and Geriatrics. 2012; 54(1): 61-6.## Alma MA, Van der Mei SF, Feitsma WN, Groothoff JW, Van Tilburg TG, Suurmeijer TP. Loneliness and self-management abilities in the visually impaired elderly. Journal of Aging and Health. 2011; 23(5): 843-61.## Savikko N, Routasalo P, Tilvis RS, Strandberg TE, Pitkälä KH. Predictors and subjective causes of loneliness in an aged population. Archives of Gerontology and Geriatrics. 2005; 41(3): 223-33.## Deindl C, Brandt M. Financial support and practical help between older parents and their middle-aged children in Europe. Ageing and Society. 2011; 31(04): 645-62.## Lai D, Thomson C. The impact of perceived adequacy of social support on caregiving burden of family caregivers. Families in Society: The Journal of Contemporary Social Services. 2011; 92(1): 99-106.## Hazer O, Boylu AA. The examination of the factors affecting the feeling of loneliness of the elderly. Procedia-Social and Behavioral Sciences. 2010; 9: 2083- 9.## Nzabona A, Ntozi J, Rutaremwa G. Loneliness among older persons in Uganda: examining social, economic and demographic risk factors. Ageing and Society. 2016; 36(04): 860-88.## Sheikholeslami F, Masouleh SR, Khodadadi N, Yazdani M. Loneliness and general health of elderly. Journal of Holistic Nursing and Midwifery. 2011; 21(66): 28-34. [Persian]## Sodani M, Shogaeyan M, Neysi A. The effect of group logo-therapy on loneliness in retired men. Research in Cognitive and Behavioral Sciences. 2012; 2(2): 43-54.##Arslantaş H, Adana F, Ergin FA, Kayar D, Acar G. Loneliness in elderly people, associated factors and its correlation with quality of life: A field study from Western Turkey. Iranian Journal of Public Health. 2015; 44(1): 43.## Khosravan S, Alaviani M, Alami A, Tavakolizadeh J. Epidemiology of loneliness in elderly women. Journal of Research & Health. 2014; 4: 871-7.## Jakobsson U, Hallberg IR. Loneliness, fear, and quality of life among elderly in Sweden. Aging Clinical Exprimental Research. 2005; 17(6): 494- 501.##Victor CR, Scambler SJ, Bowling A, Bond J. The prevalence of, and risk factors for, loneliness in later life: a survey of older people in Great Britain. Ageing and Society. 2005; 25(06): 357- 75.## Theeke LA. Predictors of loneliness in US adults over age sixty-five. Archives of Psychiatric Nursing. 2009; 23(5): 387-96.## Mushtaq R, Shoib S, Shah T, Mushtaq S. Relationship between loneliness, psychiatric disorders and physical health? A review on the psychological aspects of loneliness. Journal of Clinical and Diagnostic Research. 2014; 8(9): WE01.##Walters K, Breeze E, Wilkinson P, Price GM, Bulpitt CJ, Fletcher A. Local area deprivation and urban – rural differences in anxiety and depression among people older than 75 years in Britain. American Journal of Public Health. 2004; 94(10): 1768- 74.## Koochaki G, Hojjati H, Sanagoo A. 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The Prevalence of Alzheimer’s disease Preventive Behaviors in Elderly People, Yazd, Iran 2 2 Introduction: Alzheimer’s disease (AD) is a chronic condition characterized by gradual decline of mental abilities and behavioral disorders, which decreases the quality of life in elderly people. The aim of this study was to evaluate behaviors that may prevent elderly people from AD in Yazd. Methods: This cross-sectional study was conducted on 220 people aged from 60 to 70 years in Yazd. Cluster random sampling method was used for selecting the participants. Data collection instrument was a researcher-made questionnaire that included demographic information and questions on AD preventive behaviors (physical activity, mental activity, nutrition, and social interaction). The score range of each part and the overall behavior score was from zero to 100. Data were analyzed by SPSS statistical software and application of descriptive and inferential statistical methods. Results: The mean score of preventive behaviors was 44.6. The highest mean score (56.48) was for nutrition while the lowest mean score (32.03) was for mental activity. Only 15 % of the studied elderly consumed fruit regularly in their diet, which was followed by consumption of vegetable, 11.4 % and fish 9.1 %. There was a significant positive correlation between education level and behavior score (p < 0.001). However, there was no statistically significant gender difference (p > 0.05) in mean scores of the overall behavior and scores of married older adults compared to those of divorced or single, had a statistically significant difference (p = 0.007). Conclusion: The overall AD preventive behaviors in elderly are undesirable, remarkably as noted in physical and mental domains. The majority of participants did not regularly have fruits, vegetables, and fish in their daily and weekly diets. Numerous socio-demographic factors affect these behaviors. More studies are required to identify barriers of healthy behaviors. 16 22 2017/01/112017/01/62016/11/29 1395/9/9 2017/03/22017/04/232017/02/8 1395/11/20 Mohammad Ali Morowatisharifabad Mohammad Ali Morowatisharifabad Elderly Health Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran Zahra Fallah Zahra Fallah Department of Health Education and Health Promotion, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran zfallah88@yahoo.com Reza Bidaki Reza Bidaki Department of Psychiatry, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran Zahra Hashemian Zahra Hashemian MD, Shahid Sadoughi Hospital Iran Hossein Fallahzadeh Hossein Fallahzadeh Department of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran Mohammad Rafatifard Mohammad Rafatifard Social Determinants of Health Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran Hamid Aghabagheri Hamid Aghabagheri International Campus, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran Elderly Alzheimer’s disease Prevention Behavior Morewitz SJ, Goldstein ML. 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Utilization of Emergency Medical Services among Older People: A Case Study in Iran 2 2 Introduction: The need for emergency medical services (EMS) is growing because of the rapidly aging population. This study aimed to assess the utilization of EMS among older people in Tabriz, Iran. Methods: This retrospective study used data from the missions carried out by EMS in 2014-15. All of EMS records were analyzed over a continuous 12-month period by choosing selected profiles from the middle month of each quarter. Results: Among all 10940 missions accomplished in four months, 4175 (38.16 %) calls were for patients aged 60 years and older. A significant association was found between service characteristics and gender/age groups. Women and older people aged 80 - 84 years were more likely to use emergency services. Moreover, the older people had a higher proportion of histories for cardiovascular disease, respiratory difficulties, cerebrovascular accident, fall-related injuries, poisoning, and suicide. Conclusion: Older people constituted a large proportion of EMS which mostly were transferred to emergency departments. As the older adult population grows, health systems should prepare appropriate services by making changes in training, operations, and equipment. 23 27 2017/01/112017/01/62016/11/292017/02/10 1395/11/22 2017/03/22017/04/232017/02/82017/05/2 1396/2/12 Akbar Azizi Zeinalhajlou Akbar Azizi Zeinalhajlou Health Services Management Research Center, Tabriz University of Medical Sciences, Tabriz, Iran Iran Rouzbeh Rajaei Ghafouri Rouzbeh Rajaei Ghafouri Department of Emergency Medicine, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran Iran Hossein Matlabi Hossein Matlabi Department of Health Education and Promotion, School of Health Sciences, Tabriz University of Medical Sciences, Tabriz, Iran Iran hm1349@gmail.com Aging Emergency Medical Services Emergency Department Iran World Health Organization. 10 Facts on ageingand the life course. Geneva, Switzerland: WHO; 2014 [cited 2014 Apr 8]. Available from: http://www.who.int/features/factfiles/ageing/age ing_facts/en/index2.html##Pison G. Population ageing will be faster in the South than in the North. Population & Societies. 2009(457): 1.##Kirchengast S, Haslinger B. Gender differences in health-related quality of life among healthy aged and old-aged austrians: cross-sectional analysis. Gender Medicine. 2008; 5(3): 270-8.##Platts-Mills TF, Leacock B, Cabanas JG, Shofer FS, McLean SA. Emergency medical services use by the elderly: analysis of a statewide database. Prehospital Emergency Care. 2010; 14 (3): 329-33.##Singal BM, Hedges JR, Rousseau EW, Sanders AB, Berstein E, McNamara RM, et al. Geriatric patient emergency visits part I: comparison of visits by geriatric and younger patients. Annals of Emergency Medicine. 1992; 21(7): 802-7.##Vogeli C, Shields AE, Lee TA, Gibson TB, Marder WD, Weiss KB, et al. Multiple chronic conditions: prevalence, health consequences, and implications for quality, care management, and costs. Journal of General Internal Medicine. 2007; 22 (3): 391 –5.##Lehnert T, Heider D, Leicht H, Heinrich S, Corrieri S, Luppa M, et al. Review: health care utilization and costs of elderly persons with multiple chronic conditions. Medical Care Research Review. 2011; 68(4): 387 – 420.##Huang CC, Chen Wl, Hsu CC, Lin HJ, Su SB, Guo HR, et al. Elderly and nonelderly use of a dedicated ambulance corps’ emergency medical services in Taiwan. BioMed Research International. 2016.##Farazmand A, Toloei M. Causes of patients’ hospitalization in Guilan university hospitals. Journal of Guilan University of Medical Sciences. 2002; 11(42): 28-32. [Persian] 10. Miri S, Soleimanizade L, Rajabi R, Soleimanizadeh F. Emergency care for the elderly of Iran. 2nd Iranian Congress on Emergency Medicine. 2007; Tehran, Iran.[Persian]## Gruneir A, Silver MJ, Rochon PA. Emergency department use by older adults: a literature review on trends, appropriateness, and##consequences of unmet health care needs. Medical Care Research Review. 2011; 68(2): 131-55.##Imani A, Dastgiri S, Azizi Zein alhajlou A. Population aging and bu rden of diseases. Depiction of Health. 2015; 6(2): 54-61. [Persian]## Mion LC, Palmer RM, Anetzberger GJ, MeldonSW. Establishing a case ‐ finding and referral system for at ‐ risk older individuals in the emergency department setting: The SIGNET model. Journal of the American Geriatrics Society. 2001; 49(10): 1379-86.## Samaras N, Chevalley T, Samaras D, Gold G. Older patients in the emergency department: a review. Annals of Emergency Medicine. 2010; 56(3): 261- 9.## Legramante JM, Morciano L, Lucaroni F, Gilardi F, Caredda E, Pesaresi A, et al. Frequent use of emergency departments by the elderly population when continuing care is not well established. Plos One. 2016; 11(12): 1-11.## Latham LP, Ackroyd-Stolarz S. Emergency department utilization by older adults: a descriptive study. Canadian Geriatrics Journal. 2014; 17(4): 118-25.## Keskinoglu P, Inan F. Analysis of emergency department visits by elderly patients in an urban public hospital in Turkey. Journal of Clinical Gerontology and Geriatrics. 2014; 5(4): 127-31.##Fayyaz J, Khursheed M, Mir MU, Khan U. Pattern of emergency department visits by elderly patients: study from a tertiary care hospital, Karachi. BMC Geriatrics. 2013; 13(1):83.## Wolinsky FD, Liu L, Miller TR, An H, Geweke JF, Kaskie B, et al. Emergency department utilization patterns among older adults. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences. 2008; 63(2): 204-9.## Kaskie B, Obrizan M, Jones MP, Bentler S, Weigel P, Hockenberry J, et al. Older adults who persistently present to the emergency department with severe, non-severe, and indeterminate episode patterns. 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Lived Experiences of Elderly Patients with Coronary Artery Disease: A Hermeneutic Phenomenological Study 2 2 Introduction: Coronary artery disease is the most common type of cardiovascular disease. Despite the increasing number of patients with coronary artery disease, the lived experiences of these patients have remained unknown. The purpose of the study was to understand the lived experiences of elderly patients with coronary artery disease. Methods: This qualitative research was conducted using an interpretive phenomenological approach. Participants included thirteen elderly patients (9 males and 4 females) with coronary artery disease selective of purposive sampling method from Coronary Care Unit of Shahid Beheshti Hospital in Qom, 2016. Data were collected through semi-structured interviews between 55 - 80 minutes. The interviews were recorded and transcribed. The Van Manen's proposed six steps was used to analyze the data. Results: The main theme of study was "living with ups and downs". It included sub-themes of 1) losing calmness,2) trying to achieve calmness through spirituality, 3) losing health, 4) trying to promote health through modification of lifestyle, 5) perceiving family support, 6) living in fear, 7) living with a damaged heart". Conclusion: Findings of the research indicated that the coronary artery disease led patients to experience ups and downs for the participations. After the disease, they were trying to achieve calmness through some strategies. Members of the treatment team, especially nurses should provide self-care education for to make them be have successfully in this field. 28 34 2017/01/112017/01/62016/11/292017/02/102017/03/5 1395/12/15 2017/03/22017/04/232017/02/82017/05/22017/05/13 1396/2/23 Majideh Heravi-Karimooi Majideh Heravi-Karimooi Elderly Care Research Center, School of Nursing and Midwifery, Shahed University, Tehran, Iran Iran Nahid Rejeh Nahid Rejeh Elderly Care Research Center, School of Nursing and Midwifery, Shahed University, Tehran, Iran Iran Mohammad Abbasi Mohammad Abbasi Department of Nursing, School of Nursing and Midwifery, Qom University of Medical Sciences, Qom, Iran Iran mohamad_abbasi55@yahoo.com Experience Coronary Artery Disease Qualitative Study American Diabetes Association. Cardiovascular disease and risk management. Diabetes Care. 2016; 39(Supplement 1): 60-71.##McAloon CJ, Boylan LM, Hamborg T, Stallard N, Osman F, Lim PB, et al. The changing face of cardiovascular disease 2000 – 2012: An analysis of the world health organisation global health estimates data. International Journal of Cardiology. 2016; 224: 256- 64.##Abbasi M, Mohammadi N, Nikbakht Nasrabadi A, Sadegi T. Experiences of Living with Coronary Artery Bypass Graft: a Qualitative Study. Journal of Hayat. 2014; 19(4): 38-47. [Persian]##Heusch G, Libby P, Gersh B, Yellon D, Böhm M, Lopaschuk G, et al. Cardiovascular remodelling in coronary artery disease and heart failure. The Lancet. 2014; 383(9932): 1933-43. ##Momennasab M, Moattari M, Abbaszade A, Shamshiri B. Spiritual experience of heart attack patients: A qualitative study. Journal of Qualitative Research in Health Sciences. 2013; 1(4): 284-97. [Persian]##Shafipour V, Mohammadi E, Ahmadi F. Experience of open heart surgery patients from admission to discharge: a qualitative study. Iranian Journal of Critical Care Nursing. 2013; 6(1): 1-10. [Persian]##O’Keefe -McCarthy S, McGillion MH, Victor JC, Jones J, McFetridge-Durdle J. Prodromal symptoms associated with acute coronary syndrome acute symptom presentation. European Journal of Cardiovascular Nursing. 2016; 15(3): 52-9.##Mohammadi N, Abbasi M, Nasrabadi AN, Salehiomran A, Davaran S, Norouzadeh R. Passion for life: lived experiences of patients after coronary artery bypass graft. The Journal of Tehran University Heart Center. 2015; 10(3): 129. ##Arthur HM, Wright DM, Smith KM. Women and heart disease: the treatment may end but the suffering continues. Canadian Journal of Nursing Research Archive. 2016; 33(3): 17- 29.##Azizi F, Rahmani M, Emami H, Mirmiran P, Hajipour R, Madjid M, et al. Cardiovascular risk factors in an Iranian urban population: Tehran lipid and glucose study (phase 1). Sozial-und Präventivmedizin/Social and Preventive Medicine. 2002; 47(6): 408-26.## Moeini M, Naseri N, Zargham-Boroujeni A. Lived experiences of women with ischemic heart disease. Iranian Journal of Nursing and Midwifery Research. 2012; 17(2):137-42.##Van Manen M, editor. Writing in the dark: Phenomenological studies in interpretive inquiry. Left Coast Press; 2003.##Taheri ZS, Zandi MA, Ebadi A. The effect of spiritual care based on Ghalbe Salim Model on the sleep quality of the patients with coronary artery disease. Iranian Journal of Critical Care Nursing. 2014; 7(2): 92-101.##Zamanzadeh V, Rassouli M, Abbaszadeh A, Nikanfar A-R, Alavi-Majd H, Mirza-Ahmadi F, et al. Spirituality in cancer care: a qualitative study. Journal of Qualitative Research in Health Sciences. 2014; 2(4): 366-78.##Akhbardeh M. Role of spiritual beliefs and prayer in health promotion of chronic patients: a qualitative study. Quran and Medicine. 2011; 1(1): 5-9.## Abbasi M, Tasooji HR, Hasan M, Ahmari Tehran H, Sadeghi T, Dehghani F, et al. Exploring the hospitalized patients’ religious expectations of nurses; a qualitative study . Health, Spirituality and Medical Ethics. 2016; 3(3): 30-6. ##Abbasi M, Mohammadi N, Nikbakht nasrabadi A, Gaeeni M. Towards spirituality after coronary artery bypass grafting: A hermeneutic phenomenological study. Health, Spiritual and Medical Ethics. 2017; 4(1): 10- 15.##Cowlishaw S, Niele S, Teshuva K, Browning C, Kendig H. Older adults' spirituality and life satisfaction: a longitudinal test of social support and sense of coherence as mediating mechanisms. Ageing and Society. 2013; 33(07): 1243- 62.## Nourisaeed A, Salari A, Nourisaeed A, Rouhi Balasi L, Moaddab F, Akbari B. Comparison of religious attitudes in patients with coronary artery disease and healthy people. Iranian Journal of Nursing Research. 2015; 10(3): 18- 25. [Persian]## Falahi Khoshknab M, Hasani P, Afrasiabifar A, Yaghmaei F. Iranian elderly experiences with myocardial infarction. Iranian Journal of Ageing. 2008; 3(3): 66-74. [Persian]## Najafi Ghezeljeh T, Yadavar Nikravesh M, Emami A. Coronary heart disease patients transitioning to a normal life: Perspectives and stages identified through a grounded theory approach. Journal of Clinical Nursing. 2014; 23(3-4): 571-85.##Lisa W, Amanda T, Ma'en Aq, Amanda Ch. The role of the family in supporting the self ‐ management of chronic conditions: A qualitative systematic review. Journal of Clinical Nursing. 2017: 1- 9.## Fors A, Dudas K, Ekman I. Life is lived forwards and understood backwards – experiences of being affected by acute coronary syndrome: a narrative analysis. International Journal of Nursing Studies. 2014; 51(3): 430-7.## Xavier D, Gupta R, Kamath D, Sigamani A, Devereaux P, George N, et al. Community health worker-based intervention for adherence to drugs and lifestyle change after acute coronary syndrome: a multicentre, open, randomised controlled trial. The Lancet Diabetes & Endocrinology. 2016; 4(3): 244- 53.## Hildingh C, Fridlund B, Lidell E. Access to the world after myocardial infarction: experiences of the recovery process. Rehabilitation Nursing. 2006; 31(2): 63-8## ##

The Effect of Resistance Training on Levels of Interlukine-6 and High-Sensitivity C - reactive protein in Older-Aged Women 2 2 Introduction: Aging is associated with elevated levels of some proinflammatory factors and exercise is a non-invasive intervention to improve immune function among older adults .The aim of the study was to compare resistance training effects on interlukine-6 (IL-6) and high-sensitivity C-reactive protein (hs-CRP) levels in older-aged women. Methods: The study was quasi-experimental and forty healthy females were selected and randomly assigned to one of four groups: strength after endurance training (endurance + strength (E + S), n = 9), strength prior to endurance training (strength + endurance (S + E), n = 10), interval resistance-endurance training (Int, n = 12), and control (n = 9) groups. The training program was performed for eight weeks, three times per week. Human TNF-α and IL-6 sandwich ELISA Kit were used. Within-group differences were analyzed using a paired samples t-test and between-group differences were analyzed using one-way analysis of variance. Results: The intra-session order had not significantly influence on the adaptive response of waist-to-hip ratio (p = 0.55), IL-6 (p = 0.55) and hs-CRP (p = 0.55) throughout the study. However, significant differences were shown following combined training between the S + E, E + S and Int groups for Vo2 max (p = 0.029), body mass (p = 0.016) and BMI (p = 0.023) when comparing pre and posttests. Conclusion: This study confirmed that adaptations to a combination of endurance and resistance training appear to be independent of whether resistance training occurs prior to or following endurance training. 35 41 2017/01/112017/01/62016/11/292017/02/102017/03/52017/01/1 1395/10/12 2017/03/22017/04/232017/02/82017/05/22017/05/132017/03/9 1395/12/19 Zahra Mardanpour Shahrekordi Zahra Mardanpour Shahrekordi Department of Sport Sciences, School of Human Sciences, University of Shahrekord, Shahrekord, Iran Iran Ebrahim Banitalebi Ebrahim Banitalebi Department of Sport Sciences, School of Human Sciences, University of Shahrekord, Shahrekord, Iran Iran banitalebi@lit.sku.ac.ir Mohammad Faramarzi Mohammad Faramarzi Department of Sport Sciences, School of Human Sciences, University of Shahrekord, Shahrekord, Iran Iran Exercise Inflammation IL-6 hs-CRP Aging Noroozian M. The elderly population in Iran: an ever growing concern in the health system. Iranian Journal of Psychiatry and Behavioral Sciences. 2012; 6(2): 1- 6.##Stout MB, Justice JN, Nicklas BJ, Kirkland JL. Physiological aging: Links among adipose tissue dysfunction, diabetes, and frailty. Physiology. 2017; 32 (1): 9-19.##Jin K. Modern biological theories of aging. Aging Diseases. 2010; 1(2): 72 –4.## Castelo-Branco C, Soveral I. The immune system and aging: A review. Gynecological Endocrinology. 2014; 30(1): 16-22.##Ponnappan S, Ponnappan U. Aging and immune function: molecular mechanisms to interventions. Antioxidants& Redox Signaling. 2011; 14(8):1551–85.##Vasto S, Candore G, Balistreri CR, Caruso M, Colonna-Romano G, Grimaldi MP, et al. Inflammatory networks in ageing, age-related diseases and longevity. Mechanisms of Ageing and Development. 2007; 128(1): 83-91.##Brinkley TE, Leng X, Miller ME, Kitzman DW, Pahor M, Berry MJ, et al. Chronic inflammation is associated with low physical function in older adults across multiple comorbidities. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences. 2009: gln038.##Maggio M, Guralnik JM, Longo DL, Ferrucci L. Interleukin-6 in aging and chronic disease: a magnificent pathway. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences. 2006; 61(6): 575-84.##Solana R, Tarazona R, Gayoso I, Lesur O, Dupuis G, Fulop T. Innate immunosenescence: effect of aging on cells and receptors of the innate immune system in humans. In Seminar Immunology. 2012; 24(5): 331-41.##Pera A, Campos C, López N, Hassouneh F, Alonso C, Tarazona R, et al. Immunosenescence: Implications for response to infection and vaccination in older people. Maturitas. 2015; 82(1): 50-5.##Cook MD, Allen JM, Pence BD, Wallig MA, Gaskins HR, White BA, et al. Exercise and gut immune function: evidence of alterations in colon immune cell homeostasis and microbiome characteristics with exercise training. Immunologyand Cell Biology. 2016; 94(2): 158-63.##Passos GS, Poyares D, Santana MG, Teixeira AA, Lira FS, Youngstedt SD, et al. Exercise improves immune function, antidepressive response, and sleep quality in patients with chronic primary insomnia. Biomed Research International. 2014.##Ho TP, Zhao X, Courville AB, Linderman JD, Smith S, Sebring N, et al. Effects of a 12month moderate weight loss intervention on insulin sensitivity and inflammationstatus in nondiabetic overweight and obese subjects. Hormone and Metabolic Research. 2015; 47(4): 289-96.## Hammonds TL, Gathright EC, Goldstein CM,Penn MS, Hughes JW. Effects of exercise on C -reactive protein in healthy patients and in patients with heart disease: A meta-analysis. Heart and Lung: The Journal of Acute and Critical Care.2016; 45(3): 273-82.## Saijo Y, Kiyota N, Kawasaki Y, Miyazaki Y, Kashimura J, Fukuda M, et al. Relationship between C‐reactive protein and visceral adipose tissue in healthy Japanese subjects. Diabetes, Obesity and Metabolism. 2004; 6(4): 249-58.##Wanderley FA, Moreira A, Sokhatska O, Palmares C, Moreira P, Sandercock G, et al. Differential responses of adiposity, inflammation and autonomic function to aerobic versus resistance training in older adults. Exprimental Gerontology. 2013; 48(3): 326-33.## Myers J, McAuley P, Lavie CJ, Despres JP, Arena R, Kokkinos P. Physical activity and cardiorespiratory fitness as major markers of cardiovascular risk: their independent and interwoven importance to health status. Progress Cardiovascular Diseases. 2015; 57(4): 306-14.## Harris BA. The influence of endurance and resistance exercise on muscle capillarization in the elderly: a review. Acta Physiologica Scandinavica. 2005; 185(2): 89-97.## Drela N, Kozdron E, Szczypiorski P. Moderate exercise may attenuate some aspects of immunosenescence. BMC Geriatrics. 2004; 4(1): 8.## Riedl I, Yoshioka M, Nishida Y, Tobina T, Paradis R, Shono N, et al. Regulation of skeletal muscle transcriptome in elderly men after 6 weeks of endurance training at lactate threshold intensity. Experimental Gerontology. 2010; 45(11): 896-903.## Conraads V, Beckers P, Bosmans J, De Clerck L, Stevens W, Vrints C, et al. Combined endurance/resistance training reduces plasma TNF- α receptor levels in patients with chronic heart failure and coronary artery disease. European Heart Journal. 2002; 23(23): 1854- 60.##Libardi CA, Souza GV, GÁspari AF, Santos CFD, Leite ST, Dias R, et al. Effects of concurrent training on interleukin-6, tumour necrosis factor- alpha and C-reactive protein in middle-aged men. Journal of Sports Sciences. 2011; 29(14): 1573-81.##Ogawa K, Sanada K, Machida S, Okutsu M, Suzuki K. Resistance exercise training-induced muscle hypertrophy was associated with reduction of inflammatory markers in elderly women. Mediators of Inflammation. 2010.## Stefanov T, Vekova A, Bonova I, Tzvetkov S, Kurktschiev D, Blüher M, et al. Effects of supervised vs non-supervised combined aerobic and resistance exercise programme on cardiometabolic risk factors. Central European Journal of Public Health. 2013; 21(1): 239-43.##Jorge ML, de Oliveira VN, Resende NM, Paraiso LF, Calixto A, Diniz AL, et al. The effects of aerobic, resistance, and combined exercise on metabolic control, inflammatory markers, adipocytokines, and muscle insulin signaling in patients with type 2 diabetes mellitus. Metabolism. 2011; 60(9): 1244-52.## Alkan BM. The effects of the aerobics exercise program on the cardiopulmoner capacity and disease symptoms of the patients with primary fibromialgia syndrome. Open Journal of Rheumatology and Autoimmune Diseases. 2013.## Shields N, Taylor NF. A student-led progressive resistance training program increases lower limb muscle strength in adolescents with Down syndrome: a randomised controlled trial. Journal of Physiotherapy. 2010; 56(3): 187 -93.##Mayhew JL, Brechue WF, Smith AE, Kemmler W, Lauber D, Koch AJ. Impact of testing strategy on expression of upper-body work capacity and one-repetition maximum prediction after resistance training in college-aged men and women. The Journal of Strength & Conditioning Research. 2011; 25(10): 2796-807. ##Izquierdo M, Ibanez JK, Hakkinen K, Kraemer WJ, Larrion JL, Gorostiaga EM. Once weekly combined resistance and cardiovascular training in healthy older men. Medicine and Science in Sports and Exercise. 2004; 36(3): 435- 43.## Holviala J, Kraemer WJ, Sillanpaa E, Karppinen H, Avela J, Kauhanen A, et al. Effects of strength, endurance and combined training on muscle strength, walking speed and dynamic balance in aging men. European Journal of Applied Physiology. 2012; 112(4): 1335- 47.## Wood RH, Reyes R, Welsch MA, Favaloro- Sabatier JE, Sabatier MA, Lee CM, et al. Concurrent cardiovascular and resistance training in healthy older adults. Medicine and Science in Sports and Exercise. 2001; 33(10): 1751- 8.## Cadore EL, Pinto RS, Lhullier FL, Correa CS, Alberton CL, Pinto SS, et al. Physiological effects of concurrent training in elderly men. International Journal of Sports Medicine. 2010; 31(10): 689-97.## Antunes BD, Monteiro PA, Silveira LS, Cayres SU, Silva CB, Junior F, et al. Effect of concurrent training on risk factors and hepatic steatosis in obese adolescents. Revista Paulista de Pediatria. 2013; 31(3): 3 71-6.## Campos AL, Del Ponte LD, Cavalli AS, Afonso MD, Schild JF, Reichert FF. Effects of concurrent training on health aspects of elderly women. Revista Brasileira de Cineantropometria & Desempenho Humano. 2013; 15(4): 437-47.## Sillanpaa E, Laaksonen DE, Haakkinen A, Karavirta L, Jensen B, Kraemer WJ, et al. Body composition, fitness, and metabolic health during strength and endurance training and their combination in middle-aged and older women.European Journal of Applied Physiology. 2009;106(2): 285-96.## Akuthota V, Ferreiro A, Moore T, Fredericson M.Core stability exercise principles. Current Sports Medicine Reports. 2008; 7(1): 39-44.## Ghahramanloo E, Midgley AW, Bentley DJ. The effect of concurrent training on blood lipid profile and anthropometrical characteristics of previously untrained men. Journal of Physical Activity and Health. 2009; 6(6): 760.##Cadore EL, Izquierdo M, Alberton CL, Pinto RS,Conceiaao M, Cunha G, et al. Strength prior toendurance intra-session exercise sequence optimizes neuromuscular and cardiovascular gains in elderly men. Experimental gerontology. Exprimental Gerontology. 2012; 47(2): 164-9. ## Kuusmaa M. Effects of 24 weeks of single session combined strength and endurance training on body composition and fitness: examination of order effect [MSC thesis]. 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Fear of Falling and Social Participation in the Elderlies in Mobarakeh, Isfahan Province, Iran 2 2 Introduction: Due to the Increasing elderly population and the high prevalence of psychological, social and physical problems among them, this study was conducted to determine fear of falling and social participation status among elderly people in Mobarakeh city, Isfahan province, Iran in 2016. Methods: This was a cross-sectional study in which 300 elderly residents of Mobarakeh city were randomly recruited by cluster sampling. Data collection tools were demographic questionnaire, Falls Efficacy Scale-International form and social participation scale of Canadian Community Health Survey. Mini Mental State Examination also was used to diagnose cognitive disorders. Data were analyzed with SPSS software using t-test, ANOVA and Pearson correlation coefficient. Results: The mean age of participants was 70.83 ± 8.68 years and the mean score of fear of falling was 33.25 ± 16.37 (16-64). Regarding the fear level, 22.3 % had no fear, 34.3 % low fear, 20 % moderate fear, and 23% a high fear of falling. Mean score of social participation was 16 ± 4.63 (8-40). The most frequently reported social participation activity was attending religious ceremonies (99.7 %) while the least was attending professional and social forums (79.3 %). There was an inverse significant correlation between fear of falling and social participation (r = -0.421, p < 0.01). Conclusion: Level of fear of falling in the elderlies was moderate while social participation was low. By using preventive measures, effective education, psychological and social interventions, disease-control programs and removing the existing obstacles, the fear of falling could be reduced and social participation could be promoted among the elderlies. 42 49 2017/01/112017/01/62016/11/292017/02/102017/03/52017/01/12017/02/6 1395/11/18 2017/03/22017/04/232017/02/82017/05/22017/05/132017/03/92017/04/2 1396/1/13 Mohammad Ali Morowatisharifabad Mohammad Ali Morowatisharifabad Department of Aging Health, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran Tahereh Shakeri-Mobarakeh Tahereh Shakeri-Mobarakeh Department of Aging Health, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran shakeri.1054@yahoo.com Ali Akbar Vaezi Sharifabad Ali Akbar Vaezi Sharifabad Department of Nursing, School of Nursing and Midwifery, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran Reza Bidaki Reza Bidaki Department of Psychiatry, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran Mohsen Asgari-Shahi Mohsen Asgari-Shahi Department of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran Hassan Rezaeipandari Hassan Rezaeipandari Elderly Health Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran Elderly Fear of Falling Social Participation Filiatrault J, Gauvin L, Richard L, Robitaille Y, Laforest S, Fournier M, et al. 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Effects of Different Coumarin- 3-Carboxamide Agents on Scopolamine Induced Learning and Memory Deficit in Mice 2 2 Introduction: It has been shown that three new synthetic coumarins-3-carboxamides including 3-fluorobenzilchloride, 4-fluorobenzilchloride and 2-hidroxy-3 metoxybenzaldehyde, have acetylcholinesterase inhibitory activity. This study was performed to estimate ameliorating effect of these new coumarin-3-carboxamides on memory impairments induced by scopolamine (1 mg/kg, induced prolongation) in mice. Methods: 30 male mice were divided into five groups, 6 mice in each group. Three experiment groups received coumarins-3- carboxamides (10 mg/kg body weight) 30 min before scopalamin injection and two other groups considered as normal (saline-treated) groups and finally one negative control (scopalamin only) group. The experiment groups were treated with coumarins of 3-fluorobenzilchloride, 4-fluorobenzilchloride and 2-hidroxy-3 metoxybenzaldehyde. The passive avoidance test was performed in an automatic conventional shuttle box set-up. The stepped down latency and number of errors was recorded. Results: With reference to saline-treated group, scopolamine-treated mice demonstrated impairment of learning and memory as a reduction of latency and an increased numbers of errors in step-down test)p < 0.01). Treated mice receiving these coumarins at the dose of 10 mg/kg showed an increase in the number of avoidances on the memory tests compared to the scopolamine group (p < 0.01). Conclusion: The study has demonstrated some therapeutic effects of coumarin-3-carboxamides on learning and memory deficit induced by scopolamine. Further investigation is needed to explore whether coumarin-3-carboxamides could be beneficial for memory impairment in Alzheimer’s disease in which cholinergic deficit is one of the hallmarks. 50 54 2017/01/112017/01/62016/11/292017/02/102017/03/52017/01/12017/02/62017/04/19 1396/1/30 2017/03/22017/04/232017/02/82017/05/22017/05/132017/03/92017/04/22017/06/2 1396/3/12 Samaneh Ghanei Nasab Samaneh Ghanei Nasab Department of Chemistry, Arak Branch, Islamic Azad University, Arak, Iran Iran s_ghaneinasab_chem@yahoo.com Farzin Hadizadeh Farzin Hadizadeh Biotechnology Research Center, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran Iran Azam Marjani Azam Marjani Department of Chemistry, Arak Branch, Islamic Azad University, Arak, Iran Iran Coumarins Scopolamine Passive Avoidance 3-fluorobenzilchloride 4-fluorobenzilchloride 2-hidroxy-3 metoxybenzaldehyde Rodriguez JJ, Ferri CP, Acosta D, Guerra M, Huang Y, Jacob KS, et al. 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