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1.

Problem

Research suggests that the skill and experience of the attendant significantly affect the outcomes of vaginal breech births, yet practitioner experience levels are minimal within many contemporary maternity care systems.

Background

Due to minimal experience and cultural resistance, few practitioners offer vaginal breech birth, and many practice guidelines and training programmes recommend delivery techniques requiring supine maternal position. Fewer practitioners have skills to support physiological breech birth, involving active maternal movement and choice of birthing position, including upright postures such as kneeling, standing, squatting, or on a birth stool. How professionals learn complex skills contrary to those taught in their local practice settings is unclear.

Question

How do professionals develop competence and expertise in physiological breech birth?

Methods

Nine midwives and five obstetricians with experience facilitating upright physiological breech births participated in semi-structured interviews. Data were analysed iteratively using constructivist grounded theory methods to develop an empirical theory of physiological breech skill acquisition.

Results

Among the participants in this research, the deliberate acquisition of competence in physiological breech birth included stages of affinity with physiological birth, critical awareness, intention, identity and responsibility. Expert practitioners operating across local and national boundaries guided less experienced practitioners.

Discussion

The results depict a specialist learning model which could be formalised in sympathetic training programmes, and evaluated. It may also be relevant to developing competence in other specialist/expert roles and innovative practices.

Conclusion

Deliberate development of local communities of practice may support professionals to acquire elusive breech skills in a sustainable way.  相似文献   
2.
Summary. This study investigates whether there was evidence of increasing risk of still-birth with increasing paternal exposure to ionizing radiation received during employment at the Sellafield nuclear installation before the child was conceived. A significant positive association is found between the total paternal preconceptional exposure to external ionizing radiation and the risk of still-birth (after adjustment for year of birth, social class, birth order and paternal age, odds ratio at 100 mSv 1.24 (95% confidence interval 1.04–1.45)). A summary of the principal scientific findings of this study has been published in the Lancet . This paper describes in detail the statistical methods that were used in the investigation and presents the results in full.  相似文献   
3.
The effects of sectoral shifts, measured by dispersion in the growth rates of employment or earning across industries or regions, on unemployment are tested in a specification controlling for the effects of other labor-market variables and shifts in the demographic composition of the labor force. Interindustry and geographical shifts in labor demand have significant unemployment effects, with adult males the group most strongly affected. The estimated equations imply that most of the fluctuation in unemployment over the period 1956-87 was been due to microeconomic causes rather than aggregate demand.  相似文献   
4.
In recent years sport-based interventions have been implemented as a mechanism via which to target marginalised youth in relation to the development of social inclusion. Much of the political rhetoric surrounding social inclusion programmes highlights engagement with education, employment, or training, as key metrics. This has led some scholars to observe that conceptualising social inclusion in this way can act to further marginalise young people who fail to engage with these metrics. In contrast, this paper seeks to employ an alternative understanding of social inclusion, which uses the concepts of recognition and acceptance, to infer how participation in sports-based programmes may enable marginalised youth to meet mainstream societal expectations and aid with social assimilation. Drawing upon findings from two small-scale studies of sport-based interventions located in three UK cities, this paper places participant accounts at the centre of the analysis to explore broader notions of pro-social development in relation to recognition and interpersonal acceptance. The paper concludes by suggesting that within contexts in which young people are able to generate strong interpersonal relationships with key personnel (such as coaches), and which are built upon trust, recognition and developing self-worth, there is clear potential for sport-based programmes to incubate social assimilation.  相似文献   
5.
In this note, it is shown that the finite-sample distributions of the Wald, likelihood ratio, and Lagrange multiplier statistics in the classical linear regression model are members of the generalized beta model introduced by McDonald and Xu (1995a McDonald, J.B., Xu, Y.J. (1995a). A generalization of the beta distribution with applications. J. Econom. 66:133152.[Crossref], [Web of Science ®] [Google Scholar]). This is useful for examining the properties of these test statistics. For example, this characterization makes it easy to find distribution, quantile, and density functions for each test statistic, makes it clear why Wald tests may overreject the null hypothesis using asymptotic critical values, and formalizes the fact that the Lagrange multiplier statistic follows a distribution with bounded support.  相似文献   
6.
Neighbourhood planning (NP) as enabled by the 2011 Localism Act in England has precipitated a considerable literature discussing its potential, limitations and likely shortcomings referenced against government rhetoric and the reporting of initial experiences of the process. This paper provides an overview of the current literature on neighbourhood planning and sets out how it has been received and practised across England drawing on empirical evidence. The extent of take-up and the experience of those involved in the first five years of neighbourhood planning is used to consider how community-led planning may be designed and used following operational principles of inclusivity, capacity-building and adding value.  相似文献   
7.
8.
Van Valen's Red Queen hypothesis states that within a homogeneous taxonomic group the age is statistically independent of the rate of extinction. The case of the Red Queen hypothesis being addressed here is when the homogeneous taxonomic group is a group of similar species. Since Van Valen's work, various statistical approaches have been used to address the relationship between taxon age and the rate of extinction. We propose a general class of test statistics that can be used to test for the effect of age on the rate of extinction. These test statistics allow for a varying background rate of extinction and attempt to remove the effects of other covariates when assessing the effect of age on extinction. No model is assumed for the covariate effects. Instead we control for covariate effects by pairing or grouping together similar species. Simulations are used to compare the power of the statistics. We apply the test statistics to data on Foram extinctions and find that age has a positive effect on the rate of extinction. A derivation of the null distribution of one of the test statistics is provided in the supplementary material.  相似文献   
9.
The current economic climate demands more innovative approaches to increasing labor market participation for people with disabilities. Social entrepreneurship (SE) offers one alternative employment pathway. However, little is known about the broader factors influencing SE for people with disabilities. Using empirical data from focus groups comprised of social entrepreneurs with disabilities and interviews with key stakeholders working in the fields of policy, disability, and business, this research frames its analysis in the intersection of disability studies and entrepreneurship to explore which factors influence the potential for SE to provide equal participation opportunities for people with disabilities in the labor market. Findings suggest that further consideration of political–economic and socio-cultural factors is needed if we are to better understand the potential of SE for people with disabilities.  相似文献   
10.
The Family Adaptability and Cohesion Scale (FACES) IV does not provide instructions about which family members respondents should think about while answering questions. This study examined which family members respondents thought about while completing the FACES IV, and if this changed measurement invariance and population heterogeneity of the measure. Using a sample of n = 511 individuals, a latent class analysis showed three distinct classes: Nuclear Family, Family of Origin, and All of the Above. The FACES IV demonstrated measurement invariance across classes on the majority of subscales; however, population heterogeneity tests suggested that the means and variances of the subscales varied across classes. The findings suggest further examination of how the measure functions with unique family constellations is warranted.  相似文献   
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