目的:搜集国内外公开发表的应用离散选择实验方法(DCE)研究中国人群对基层医疗卫生服务选择偏好的研究,为医疗服务提供者和决策者了解居民对基层医疗服务的偏好提供信息。方法:以“离散选择实验”、“偏好”、“基层医疗卫生服务”、“d...目的:搜集国内外公开发表的应用离散选择实验方法(DCE)研究中国人群对基层医疗卫生服务选择偏好的研究,为医疗服务提供者和决策者了解居民对基层医疗服务的偏好提供信息。方法:以“离散选择实验”、“偏好”、“基层医疗卫生服务”、“discrete choice experiment”、“preference”、“primary healthcare services preferences of Chinese”等为关键词,计算机检索从建库至2019年12月在PubMed、Medline、Embase、Web of Science、中国知网、万方、维普数据库公开发表的利用DCE研究中国人群在基层医疗卫生服务选择偏好中的应用的中英文文献,主要对DCE研究中属性及其水平的确定及偏好结果进行梳理。结果:本研究共纳入7篇研究,6篇发文于2019年,研究对象包括疾病人群、一般人群和基层全科医生。基层医疗服务纳入频次较高的属性包括服务类型、自付费用、医生技术水平、距最近就诊机构的时间、服务方式、医疗药品和设备的丰富程度。就诊咨询和等待时间、距就诊机构时间、医疗设备和药品丰富度、距最近医疗机构时间、医生技术水平、供给层次、预期疗效是影响人群对基层医疗服务选择偏好的最重要属性。结论:我国对特殊人群及基层医疗服务提供者偏好研究较少,离散选择实验设计尚需进一步完善,建议关注特殊人群及基层医疗服务提供者偏好研究,同时可借鉴ISPOR报告提出的开展DCE研究的十项标准,以提高设计的严谨性、保证DCE研究结果的可信性。展开更多
Fluid inclusion analysis and testing were conducted to clarify the relationship between reservoir densification and hydrocarbon accumulation in the Paleogene Pinghu and Huagang formations in the Xihu Depression.The hy...Fluid inclusion analysis and testing were conducted to clarify the relationship between reservoir densification and hydrocarbon accumulation in the Paleogene Pinghu and Huagang formations in the Xihu Depression.The hydrocarbon accumulation stages of the reservoirs were studied in combination with the reconstruction results of burial and thermal evolution histories.Furthermore,the relationship between reservoir densification and accumulation charging was clarified in combination with the pore evolutionary history.In accordance with the time relation between reservoir densification and hydrocarbon charging,the reservoirs were classified into three types:pre-charging,syn-charging,and after-charging densification.Results indicated that large-scale hydrocarbon charging occurred in 11–0Myr.Reservoir densification was mainly caused by strong mechanical compaction and pore filling by well-developed siliceous and carbonate cements.Entering the middle diagenetic stage A1,the reservoir was under an acidic-diagenetic environment,resulting in the development of secondary dissolution pores.If large-scale hydrocarbon charging occurred during this period,then an after-charging densification reservoir,which is the most suitable type for hydrocarbon accumulation,might have developed.Entering the middle diagenetic stage A2,the reservoir was under an acidic-alkaline transitional diagenetic environment.During this stage,dissolution became weak,and compaction and cementation were enhanced,resulting in the continuous loss of pore space and reservoir densification.Entering the middle diagenetic period B,the reservoir was under an alkaline-diagenetic environment,and the reservoir had been largely densified.If large-scale hydrocarbon charging occurred during this period,a pre-charging densified reservoir,which is the worst reservoir type for hydrocarbon accumulation,might have developed.展开更多
目的探究安徽省老年人抑郁现状及相关影响因素的性别差异,为改善当地老年人抑郁发生状况提供政策建议。方法2019年7—8月,采取多阶段抽样的方式,抽取安徽省4个地级市≥60岁老年人,利用患者健康问卷抑郁量表(patient health questionnair...目的探究安徽省老年人抑郁现状及相关影响因素的性别差异,为改善当地老年人抑郁发生状况提供政策建议。方法2019年7—8月,采取多阶段抽样的方式,抽取安徽省4个地级市≥60岁老年人,利用患者健康问卷抑郁量表(patient health questionnaire-9,PHQ-9)和自编基本信息问卷进行调查,并使用χ^(2)检验和有序logistic回归模型对不同性别老年人抑郁的影响因素进行统计分析。结果纳入6083名老年人,表现出抑郁倾向1892名(31.10%)。女性抑郁发生率(36.92%),高于男性(24.15%),差异有统计学意义(χ^(2)=127.546,P<0.01)。回归结果显示,文化程度(OR=0.73,95%CI=0.65~0.81)、慢性病(OR=1.53,95%CI=1.24~1.88)、认知功能(OR=1.38,95%CI=1.13~1.69)、运动(OR=0.75,95%CI=0.62~0.91)、睡眠质量(OR=0.24,95%CI=0.20~0.30)是男性老年人发生抑郁的影响因素;城乡(OR=1.30,95%CI=1.10~1.54)、年收入(OR=0.82,95%CI=0.72~0.93)、文化程度(OR=0.88,95%CI=0.79~0.97)、慢性病(OR=1.67,95%CI=1.41~1.99)、意外伤害(OR=1.67,95%CI=1.27~2.20)、去年是否住院(OR=1.36,95%CI=1.14~1.61)、认知功能(OR=1.46,95%CI=1.25~1.70)、运动(OR=0.74,95%CI=0.63~0.86)和睡眠质量(OR=0.20,95%CI=0.17~0.23)是女性老年人发生抑郁症状的影响因素。结论安徽省老年人抑郁有明显的性别差异,不同性别老年人发生抑郁的共同因素主要在文化程度、健康状况和生活方式方面,女性需要更多关注,尤其是农村地区、经济状况不佳的女性群体。展开更多
文摘目的:搜集国内外公开发表的应用离散选择实验方法(DCE)研究中国人群对基层医疗卫生服务选择偏好的研究,为医疗服务提供者和决策者了解居民对基层医疗服务的偏好提供信息。方法:以“离散选择实验”、“偏好”、“基层医疗卫生服务”、“discrete choice experiment”、“preference”、“primary healthcare services preferences of Chinese”等为关键词,计算机检索从建库至2019年12月在PubMed、Medline、Embase、Web of Science、中国知网、万方、维普数据库公开发表的利用DCE研究中国人群在基层医疗卫生服务选择偏好中的应用的中英文文献,主要对DCE研究中属性及其水平的确定及偏好结果进行梳理。结果:本研究共纳入7篇研究,6篇发文于2019年,研究对象包括疾病人群、一般人群和基层全科医生。基层医疗服务纳入频次较高的属性包括服务类型、自付费用、医生技术水平、距最近就诊机构的时间、服务方式、医疗药品和设备的丰富程度。就诊咨询和等待时间、距就诊机构时间、医疗设备和药品丰富度、距最近医疗机构时间、医生技术水平、供给层次、预期疗效是影响人群对基层医疗服务选择偏好的最重要属性。结论:我国对特殊人群及基层医疗服务提供者偏好研究较少,离散选择实验设计尚需进一步完善,建议关注特殊人群及基层医疗服务提供者偏好研究,同时可借鉴ISPOR报告提出的开展DCE研究的十项标准,以提高设计的严谨性、保证DCE研究结果的可信性。
基金This study was supported by the National Science and Technology Major Projects(No.2016ZX05027-002-006)the Research on the Key Technologies of Exploration and Development in the West of Xihu Depression(No.CNOOC-KJ135ZDXM39SH01).
文摘Fluid inclusion analysis and testing were conducted to clarify the relationship between reservoir densification and hydrocarbon accumulation in the Paleogene Pinghu and Huagang formations in the Xihu Depression.The hydrocarbon accumulation stages of the reservoirs were studied in combination with the reconstruction results of burial and thermal evolution histories.Furthermore,the relationship between reservoir densification and accumulation charging was clarified in combination with the pore evolutionary history.In accordance with the time relation between reservoir densification and hydrocarbon charging,the reservoirs were classified into three types:pre-charging,syn-charging,and after-charging densification.Results indicated that large-scale hydrocarbon charging occurred in 11–0Myr.Reservoir densification was mainly caused by strong mechanical compaction and pore filling by well-developed siliceous and carbonate cements.Entering the middle diagenetic stage A1,the reservoir was under an acidic-diagenetic environment,resulting in the development of secondary dissolution pores.If large-scale hydrocarbon charging occurred during this period,then an after-charging densification reservoir,which is the most suitable type for hydrocarbon accumulation,might have developed.Entering the middle diagenetic stage A2,the reservoir was under an acidic-alkaline transitional diagenetic environment.During this stage,dissolution became weak,and compaction and cementation were enhanced,resulting in the continuous loss of pore space and reservoir densification.Entering the middle diagenetic period B,the reservoir was under an alkaline-diagenetic environment,and the reservoir had been largely densified.If large-scale hydrocarbon charging occurred during this period,a pre-charging densified reservoir,which is the worst reservoir type for hydrocarbon accumulation,might have developed.
文摘目的探究安徽省老年人抑郁现状及相关影响因素的性别差异,为改善当地老年人抑郁发生状况提供政策建议。方法2019年7—8月,采取多阶段抽样的方式,抽取安徽省4个地级市≥60岁老年人,利用患者健康问卷抑郁量表(patient health questionnaire-9,PHQ-9)和自编基本信息问卷进行调查,并使用χ^(2)检验和有序logistic回归模型对不同性别老年人抑郁的影响因素进行统计分析。结果纳入6083名老年人,表现出抑郁倾向1892名(31.10%)。女性抑郁发生率(36.92%),高于男性(24.15%),差异有统计学意义(χ^(2)=127.546,P<0.01)。回归结果显示,文化程度(OR=0.73,95%CI=0.65~0.81)、慢性病(OR=1.53,95%CI=1.24~1.88)、认知功能(OR=1.38,95%CI=1.13~1.69)、运动(OR=0.75,95%CI=0.62~0.91)、睡眠质量(OR=0.24,95%CI=0.20~0.30)是男性老年人发生抑郁的影响因素;城乡(OR=1.30,95%CI=1.10~1.54)、年收入(OR=0.82,95%CI=0.72~0.93)、文化程度(OR=0.88,95%CI=0.79~0.97)、慢性病(OR=1.67,95%CI=1.41~1.99)、意外伤害(OR=1.67,95%CI=1.27~2.20)、去年是否住院(OR=1.36,95%CI=1.14~1.61)、认知功能(OR=1.46,95%CI=1.25~1.70)、运动(OR=0.74,95%CI=0.63~0.86)和睡眠质量(OR=0.20,95%CI=0.17~0.23)是女性老年人发生抑郁症状的影响因素。结论安徽省老年人抑郁有明显的性别差异,不同性别老年人发生抑郁的共同因素主要在文化程度、健康状况和生活方式方面,女性需要更多关注,尤其是农村地区、经济状况不佳的女性群体。
