Cross sectional study design involves observation of variable/s at a particular point in time. It can be descriptive or analytical. Descriptive cross-sectional study design measures prevalence of disease/traits. Analytical cross-sectional study design evaluates associations between variables. However, it could not establish causality. Doing a cross-sectional study starts with identification of the purpose of the study. This is followed by development of the objectives that should follow the SMART criteria. A dummy table should also be constructed that is based on the objectives of the study so that needed data would not be missed. The next step is defining the population of the study followed by sample size computation which could be done using the Epiinfo™ program. Next, selection of sample population, ideally, using random sampling should be done. This is followed by the development of data collection methods. For cross-sectional studies, questionnaires are frequently used to collect data. 5A’s of questionnaire development should be kept in mind when formulating the questionnaire. In addition, the use of the following should be avoided: double-barreled item; negatively worded item; statements as questions; agreement response anchors; and too few or too many response anchors. Data collection and data analysis will be done next. Analysis of data could also be done using the Epi-info™ program. Descriptive statistics which includes frequency distributions, measures of central tendency and measures of variability provide a description and summary of participants data. Specific type of statistics is determined by the type of variable. For analytical type of crosssectional studies, measure of association could either be Prevalence Ratio (PR) or Odds Ratio (OR). Data independence and type of o utcomedata measured determine what statistical test to utilize in order to test the hypothesis. The STROBE statement should guide the writing of the final paper.

BACKGROUND AND OBJECTIVES

The Department of Clinical Epidemiology (DCE) of the University of the Philippines Manila is the only higher education institution in the Philippines offering graduate studies in clinical epidemiology. The Master of Science Epidemiology (Clinical Epidemiology) was first offered in 1992, while the Diploma in Epidemiology (Clinical Epidemiology) was offered in 1998. While the courses of the programs are continuously updated based on students’ feedback and advances on topics covered, the point of view of the students and alumni on the program as a whole has not been done. This study aimed to determine 1) self-reported current positions and affiliations, work areas where clinical epidemiology (CE) training is useful, and skills gained from CE training; 2) research studies completed and deemed by respondents to have considerable impact; and 3) strengths, weaknesses, and areas of improvement of the DCE graduate programs.

This is an online survey of students and alumni of the DCE graduate programs. We sent email invites to all 287 students and alumni. We collected data on their profession, institutional affiliations, positions, skills gained from their training, areas of clinical epidemiology applications, important research involvement, reasons for recommending or not recommending the programs, and how the graduate programs can be improved. Responses were summarized by frequencies and percentages. An analyst performed qualitative content analysis (QCA) to generate strengths and weaknesses of the program. We validated the results of the QCA through 1) presentation to the research team, 2) sending the survey report to study participants and other students and alumni for feedback, and 3) presentation to the DCE faculty and staff.

We received 159 responses (55.4% of the total study population)—145 (91.2%) were from the MSc program and 11 (6.9%) were from the Diploma program. Majority of the respondents were physicians (93.7%), had hospital affiliations (81.8%), and were affiliated with the academe (61%). Majority of the respondents used clinical epidemiology in their research endeavors (87.4%), clinical practice (85.5%), and teaching (78%). Majority (93.1%) would recommend the program they have taken. Eleven (6.9%) respondents were hesitant due to the possible mismatch with the students’ career path, challenging thesis work, and potential conflicting personal responsibilities. Several strengths of the programs were identified, including excellent and well-implemented programs, supportive faculty and staff, and relevant course work. While completing the course work had not been a problem in general, the main challenge encountered by students is the completion of their thesis, leading to a low graduation rate in the Master of Science program. Suggestions to improve the Master of Science and Diploma programs include 1) Improvement in program implementation, including thesis policies and support, smoother transition from Diploma to MSc Program and vice-versa, and implementation of a blended learning platform; 2) Curricular improvements such as wider choices for electives and tracking towards specialty areas; 3) Innovations in conduct of courses; and 4) Personnel and infrastructure development.

This survey reiterated the importance of clinical epidemiology graduate programs in research capacity building of health care professionals. Students and alumni occupied diverse positions in academic, research, clinical, and pharmaceutical setting, and majority accomplished research studies with considerable impact. A major challenge leading to a low graduation rate in the Master of Science program is the completion of thesis work. The survey identified several initiatives towards continuous quality improvement of clinical epidemiology programs, including improvement of thesis policies and support, updating the curriculum content and materials, increasing allotment of hours for hands-on activities, exploring possibilities of offering electives in partnership with other institutions, offering a blended learning platform, maintaining an efficient administrative support for students, and continuing education for alumni. Strong institutional support for personnel and infrastructure development is essential for these initiatives to succeed.

OBJECTIVES: We wanted to investigate the relationship of shift work to the cardiovascular and gastrointestinal symptoms of Korean female workers. METHODS: The data was analyzed from a cross-sectional survey of 1,875 Korean female workers. Information was obtained about the shift work, the cardiovascular and gastrointestinal symptoms and the background characteristics. Multiple regression analysis was used to test for the relationship between the cardiovascular and gastrointestinal symptoms and the shift work variables, while controlling for the covariates. RESULTS: Shift work was more common for blue-collar workers than for office workers. A higher proportion of current smokers and drinkers was observed for shift workers than for day workers. A full-time job was more popular for shift workers than for day workers, while more day workers worked over 8 hours per day than did the shift workers. The mean scores of the cardiovascular and gastrointestinal symptoms were significantly higher for shift workers than for day workers. Shift work was associated with 0.54 more cardiovascular symptoms and with 0.38 more gastrointestinal symptoms on a multiple regression analysis (p=0.001; p=0.020, respectively). CONCLUSIONS: Our findings suggest that shift work may increase the risks for cardiovascular and gastrointestinal disturbances. Therefore, preventive strategies are needed to control the negative effects of shift work in the workplace.
Cross-Sectional Studies ; Female ; Humans

BACKGROUND: The Occupational Safety and Health Monitoring and Assessment Tool (OSH-MAT) is a practical instrument that is currently used in the German woodworking and metalworking industries to monitor safety conditions at workplaces. The 12-item scoring system has three subscales rating technical, organizational, and personnel-related conditions in a company. Each item has a rating value ranging from 1 to 9, with higher values indicating higher standard of safety conditions. METHODS: The reliability of this instrument was evaluated in a cross-sectional survey among 128 companies and its validity among 30,514 companies. The inter-rater reliability of the instrument was examined independently and simultaneously by two well-trained safety engineers. Agreement between the double ratings was quantified by the intraclass correlation coefficient and absolute agreement of the rating values. The content validity of the OSH-MAT was evaluated by quantifying the association between OSH-MAT values and 5-year average injury rates by Poisson regression analysis adjusted for the size of the companies and industrial sectors. The construct validity of OSH-MAT was examined by principle component factor analysis. RESULTS: Our analysis indicated good to very good inter-rater reliability (intraclass correlation coefficient = 0.64–0.74) of OSH-MAT values with an absolute agreement of between 72% and 81%. Factor analysis identified three component subscales that met exactly the structure theory of this instrument. The Poisson regression analysis demonstrated a statistically significant exposure–response relationship between OSH-MAT values and the 5-year average injury rates. CONCLUSION: These analyses indicate that OSH-MAT is a valid and reliable instrument that can be used effectively to monitor safety conditions at workplaces.
Cross-Sectional Studies ; Occupational Health*

PURPOSE: The purpose of this study was to identify the influencing factors on burnout after analyzing the relationship among clinical nurses' various perfectionism and coping styles. METHODS: A descriptive, cross-sectional study was conducted with 200 clinical nurses who had six months or more years of clinical experiences from two general hospitals located in D city. The data were analyzed by t-test, one-way ANOVA, Pearson's correlation coefficients, and stepwise regression analysis using IBM SPSS statistics 23.0 program. RESULTS: The burnout of clinical nurses was positively correlated with socially prescribed perfectionism and negatively correlated with active coping style. Socially prescribed perfectionism was positively correlated with active coping style and passive coping style. Influencing factors on the burnout of clinical nurses were socially prescribed perfectionism (β=.37), satisfied work unit (β=−.64) and neutral satisfaction of work unit (β=−.27), over 40 years of age (β=−.21), and active coping style (β=−.14). The model consisting of these variables explained 42% of variance of burnout in clinical nurses. CONCLUSION: Based on the findings of this study developing intervention programs that consider influencing factors such as perfectionism and coping styles is needed to reduce the level of burnout of clinical nurses.
Cross-Sectional Studies ; Hospitals, General

BACKGROUND: This cross-sectional study assessed the sleep quality using the ActiGraph and investigated the relationship between the parameters of sleep assessment and the type of shift work in Korean firefighters. METHODS: The participants were 359 firefighters: 65 day workers (control group) and 294 shift workers (shift work group: 77 firefighters with 3-day shift, 72 firefighters with 6-day shift, 65 firefighters with 9-day shift, and 80 firefighters with 21-day shift). Sleep assessments were performed using the ActiGraph (wGT3X-BT) for 24 hours during day shift (control and shift work group) and night shift and rest day (shift work group). The participants recorded bed time and sleep hours during the measurement period. RESULTS: Sleep efficiency, total sleep time, and percentage of wake after sleep onset during night work were lower in the shift work group than control group (p < 0.05). Sleep efficiency decreased in night shift and increased in rest day, whereas wake after sleep onset increased in night shift and decreased in rest day (p < 0.05). Among shift work groups, sleep efficiency of 6-day shift was higher in day shift, and sleep efficiency of 21-day shift was lower in night shift than other shift groups (p < 0.05). CONCLUSION: We found that the sleep quality in night shift of the shift work group was poorer than the control group. As to the type of shift work, sleep quality was good in 6-day shift and poor in 21-day shift. Thus, fast rotating shift such as 6-day shift may be recommended to improve the sleep quality of the firefighters.
Cross-Sectional Studies ; Firefighters ; Humans

Cross-Sectional Studies ; Urodynamics ; China

Introduction: In the Philippines, essential eye care services are not easily accessible especially for those in lower income groups, putting public elementary school students at risk for underdiagnosis of problems in visual acuity. The objective of this investigation was to determine prevalence of undetected refractive errors among public elementary students using the Welch Allyn Spot™ Vision Screener. Methods : A cross-sectional design was used in this investigation to estimate the prevalence of uncorrected refractive errors in the first grade students in San Perfecto Elementary School using Welch Allyn Spot™ Vision Screener (Photoscreener). Eligible students who gave informed consent and assent answered a questionnaire and underwent an eye examination. The prevalence of undetected errors of refraction were computed for the sample population and for selected demographic variables. Results : Approximately one out of four students (24.53%) had errors of refraction, with the most common type being astigmatism (22.64%), followed by myopia (3.77%) and hyperopia (2.83%). Conclusion This study revealed a high prevalence of undetected refractive errors among school-age children, higher than current published data (5%) in the Philippines.
Cross-Sectional Studies ; Refractive Errors

OBJECTIVES: To evaluate whether a relation between blood lead and zinc proto porphyrin(ZPP) was modified by gender in Korean lead workers. METHODS: A cross-sectional study was conducted with 1,304 male and 101 female subjects in 1997. The relation between blood lead and ZPP were evaluated with linear, exponential, and quadratic models. Then, the different effect of gender on the relation was examined by adding the interaction terms in the each model. RESULTS: Mean+/-SD of blood lead and ZPP level was different between male(27.7+/-10 microgram /dl and 51.3+/-23.4 microgram/dl) and female subjects(22.5+/-9.2 microgram/dl and 78.7+/-38.6 microgram/dl). After adjusting for possible confounders, the effect modification by gender was significant in linear(beta=1.119, p<0.001), exponential(beta=Exp(0.008), p<0.05), and quadratic model(beta= 1.388, p<0.001). In separate analysis, a quadratic relation between blood lead and ZPP was shown in male lead workers(beta=0.036, p<0.001), but an exponential relation in female lead workers(n=Exp(0.029), p<0.001). CONCLUSION: Our data showed that the increasing rate of ZPP in female were always higher than in male lead workers, suggesting that females were more susceptible to occupational lead exposure than males.
Cross-Sectional Studies ; Female ; Humans ; Male ; Zinc*

PURPOSE: The purpose of this cross-sectional study was to assess the nutritional states and investigate the energy intake of tube-fed patients with severe neurodevelopmental disability. METHODS: Eighty six tube-fed patients with severe neurodevelopmental disability were studied. Heights were measured by flexible scale segmentally. Nutritional parameters of weight, triceps skin- fold thickness and mid-arm circumference were also measured. Total caloric intakes through the tube were calculated. RESULTS: The anthropometric results showed that nutritional states of tube-fed patients with severe neurodevelopmental disability were poor. The mean daily caloric intake was much less than daily energy requirement (mean=45.2% of requirement). The caloric intake was 7.2 kcal/height (cm), 57.0 kcal/weight (kg). Height was more related with caloric intake (r=0.476) than weight (r=0.263). CONCLUSION: These results provide that tube-fed patients with severe neurodevelopmental disability were growth retarded and their energy intakes were much less than daily energy requirements. The preliminary evidence was that they need adequate nutritional supply.
Anthropometry ; Cross-Sectional Studies ; Energy Intake ; Humans