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Background: There is no published study evaluating the performance of cumulative sum (CUSUM) algorithm on meningitis data with limited baseline period. This study aimed to evaluate the CUSUM performance in timely detection of 707 semi-synthetic outbreak days. Methods: Simulated outbreaks were generated using syndromic data on fever and neurological symptoms from Mar 2010 to Mar 2013 in Hamadan Province, the west of Iran. The performance of CUSUM algorithms, numbered from 1 to 11, in timely detection of outbreaks was measured using sensitivity, specificity, false alarm rate, likelihood ratios and area under the receiver operating characteristics (ROC) curve. Results: The highest amount of sensitivity was related to algorithm11 (CUSUM (3-9 D 11)) and it was 52% (95% CI: 49%, 56%). Minimum amount of false alarm rate was related to CUSUM (1-7 D 5) algorithm equal to 8% (95% CI: 5, 10) and the best amount of positive likelihood ratio was related to CUSUM (1-7 D 4) equal to 4.97. CUSUM (1-7 D 1) has the best performance with AUC curve equal to 73% (95 CI%: 70%, 76%), as well. Conclusion: The used approach in this study can be the basis for applying CUSUM algorithm in conditions that there is no access to recorded baseline data about under surveillance diseases or health events.

Background: The occurrence and the mortality related to breast cancer (BC) in Iranian female population has increased over time. Although there are many studies on BC and related risk factors, however, the epidemiological aspects of this melanoma in Iranian females are uncertain. Therefore, the aim of this study was to determine the relationship between demographical and clinical factors on the shape of overall survival (OS) distribution in patients with BC. Methods: This historical cohort study was carried out using data from 522 participants with BC. Data were gathered from medical records of these patients admitted to Mahdieh Oncology Center of Hamadan Province, western Iran, from January 2000 to August 2011. Kaplan-Meier estimator was used to estimate the survival rates and, censored quantile regression (CQR) to provide in-depth insight in the multivariable association between prognosis factors and survival rates. Results: Patients' follow-up ranged from around 3 to 197 months. One-, three-, and five-year survival rates were 90%, 73% and 62.5%, respectively. Results of CQR model showed that change in the age at diagnosis, number of involved lymph nodes and tumor size could significantly change the median and some other quantiles of OS. Conclusions: This study, confirm the importance of early detection of BC and usefulness of CQR because of possible changes in distribution family of survival time.

Objective: Colorectal cancer is the third most common cancer among adults in Iran. Colorectal cancer screening is the effective way in reducing deaths from this cancer. However, the screening rate of colorectal cancer is very low among Iranian adults. This study investigated predictors of Iranian average-risk adults ' intention to take up colorectal cancer screening with fecal occult blood test using a mediator model. Methods: Participants of this cross-sectional study were comprised of 478 average-risk adults who were selected using a national sampling frame in Hamadan city, west of Iran. The data gathering instrument was a questionnaire based on the preventive health model constructs. Structural equation modeling (SEM) was employed to test the relationship using Smart PLS 2.0 software Results: All measures were robust in terms of its reliability and validity. Benefit (b= 0.12, p, Journal of Preventive Medicine and Hygiene, Vol 59, No 2 (2018): 2018592

Objective: Mental health is one of the evaluating factors of community indicators, and physical activity is considered an important tool for the importance of public health. Previous studies have demonstrated associations between physical activity and mental health, but these studies did not include those populations in which training children have some traditional and religious aspects. Methods: Multiple logistic regression analyses were used to compare the prevalence of mental health among those who had inactive, minimally and HEPA activity in a representative sample of adolescents aged 15-19 in South of Iran using data from the Mental Health Survey (n = 2584). The GHQ-28 and IPAQ-short forms were used to evaluate the mental health and physical activity, respectively . Results: A total of 2584 adolescents (1401 male and 1178 female) participated in the study. The observed odds of psychological symptoms in boys compared to girls is 1.2 times (p=0.018). We observed that HEPAactivity decreases odds of somatic istress and social dysfunction compared with inactivity (p=0.031 and 0.001, respectively); minimally activity decreases odds of anxiety compared with inactivity (p=0.038); but physical activity rate was not affected on odds of adolescents' depression (p>0.05). Conclusion: Physical activity decreases mental health subscales except for depression among adolescents in Boushehr, southern city of Iran.

Objectives: It has been claimed that periodontal dressing reduces the risk of wound infection, bleeding and granulation tissue formation and improves tissue healing. This study sought to assess the effect of periodontal dressing on wound healing and patient satisfaction following periodontal flap surgery. Materials and Methods: This clinical trial was conducted on 33 patients presenting to Hamadan University, School of Dentistry in 2012 whose treatment plan included two periodontal surgical procedures on both quadrants of the maxilla or mandible. The variables evaluated were severity of pain, bleeding, facial swelling and ease of nutrition experienced by patient during the first 3 days after surgery and inflammation, granulation tissue formation and gingival color at 7 and 14 days. Obtained data were analyzed using SPSS version 16.0 and R software and chi-square and t-tests. Results: The mean (±SD) pain score was 1.73±1.153 and 2.79±1.933 in surgical sites with and without periodontal dressing, respectively and this difference was statistically significant (P=0.005). No significant difference was noted between sites with and without periodontal dressing in terms of swelling, bleeding, gingival consistency, granulation tissue formation, gingival color and ease of nutrition (P>0.05). Conclusion: According to the results of the present study, patients did not experience more bleeding, facial swelling or nutritional problems without periodontal dressing; however, the level of pain experienced was lower after surgeries with the use of periodontal dressing.

Objective: The aim of this study was to identify prognosis factors associated with recurrence in patients ‎with bipolar disorder.‎‎ Method: This retrospective cohort study was conducted in Hamadan Province, the west of Iran. All ‎patients (n = 400) with bipolar disorder who were hospitalized for the second time or more ‎during April 2008 to September 2014 were included in this study. Ordinal logistic regression ‎analysis was employed to determine the effective factors in each recurrence, and odds ratio (OR) and 95% confidence intervals (CI) were obtained.‎ Results: The mean (SD) age of the participants at the entrance to the study was 34.62 (11.68) years. ‎There was an association between recurrence and type of bipolar disorder (P = 0.033). The ‎OR of recurrence was 0.28 (95% CI: 0.09, 0.90) for bipolar disorder II; 0.35 (95% CI: 0.13, ‎‎0.92) for the patients‎‏ ‏with college education; 0.39 (95% CI: 0.25, 0.60) for employed ‎patients; 0.55 (95% CI: 0.35, 0.87) for patients who received both drugs and ‎electroconvulsive therapy, and 1.89 (95% CI: 1.23, 2.92) for patients who stopped using ‎drugs. In addition, a non-significant association was found between recurrence and age, sex, ‎marital status, place of residence, season, mood classification and family history of mood ‎disorder.‎ Conclusion: Type of bipolar disorder and cessation of medication were the leading causes of an increase in ‎the relapse of the disease. Furthermore, patients who received both drugs and ‎electroconvulsive therapy had a fewer risk of recurrence.‎