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961.
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963.
Impacts from post‐Fordist and poststaples economic transition in the Canadian natural resource sector have resulted in dramatic challenges to the livelihoods of many rural residents and the viability of many rural communities. This study seeks to understand community response to economic transition through a lens of social ecological resilience. This article puts forward Archer's theory of cultural morphogenesis as an analogous model of social ecological change that focuses attention on cultural systems, cultural elaboration, and collective action within an adaptive cycle of resilience. With case material from focused ethnographies of two forest‐dependent communities, we identify distinctive interactions between culture and agency over time that condition community response to change, and we make an analytical distinction between the social system and cultural system. These insights point to catalysts for collective action and adaptation within a resilient cultural realm that extend beyond institutional factors such as economic dependency or political opportunity. By integrating culture, we also deepen the social theory contribution to social‐ecological resilience.  相似文献   
964.
Using data from Malawi, this study situates the discourse on migration, entrepreneurship, and development within the context of Africa's social realities. It examines self‐employment differences among three groups of migrants and corresponding group differences in agricultural and non‐agricultural self‐employment. International migrants are found to be more engaged in self‐employment than internal migrants. However, our results suggest that previous findings on the development‐related contributions of returning migrants from the West need to be appropriately contextualized. When returnees from the West invest in self‐employment, they typically shy away from Africa's largest economic sector – agriculture. In contrast, levels of self‐employment, especially in agricultural self‐employment, are highest among returning migrants and immigrants from other African countries, especially from those nearby. We also underscore the gendered dimensions of migrants’ contribution to African development by demonstrating that female migrants are more likely to be self‐employed in agriculture than male migrants. Furthermore, as human‐capital increases, migrants are more likely to concentrate their self‐employment activities in non‐agricultural activities and not in the agricultural sector. The study concludes using these findings to discuss key implications for policy and future research.  相似文献   
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966.
Abstract

“Should the Risk of Acquired Immunodeficiency Syndrome Deter Hepatitis B Vaccination? A Decision Analysis,” Henry S. Sacks, et al. The current epidemic of acquired immunodeficiency syndrome (AIDS) and fear that its causative agent contaminates the currently available hepatitis B vaccine may have deterred vaccine use. We formulated a decision-analytic model that compares the risk of death from hepatitis B and AIDS in those vaccinated with the risk of death from hepatitis B alone in those who wait two years for a synthetic vaccine. For individuals with 5% annual risk of hepatitis B, the best current estimate is that vaccination now would save 25 lives per 100,000. The best current estimate of the rate of vaccine-induced AIDS is zero, and one can be 95% confident that the rate is less than eight per 100,000. The rate would have to be considerably higher before postponement of vaccination would be rational for those for whom vaccination has been recommended. (Journal of the American Medical Association 1984;252:3375-3377.)

“Oral Candidiasis in High-risk Patients as the Initial Manifestation of the Acquired Immunodeficiency Syndrome,” Robert S. Klein, et al. We studied the frequency with which unexplained oral candidiasis led to unequivocal acquired immunodeficiency syndrome (AIDS) in patients at risk. Twenty-two previously healthy adults with unexplained oral candidiasis, of whom the 19 tested had a reversed T4/T8 ratio and 20 had generalized lympadenopathy, were compard with 20 similar patients with a reversed T4/T8 ratio and generalized lymphadenopathy who did not have oral candidiasis. All were intravenous-drug abusers, homosexual or bisexual men, or both. Thirteen of the 22 patients with oral candidiasis (59%) acquired a major opportunistic infection or Kaposi's sarcoma at a median of three months (range, 1 to 23) as compared with none of 20 patients with generalized lymphadenopathy and immunodeficiency but without candidiasis who were followed for a median of 12 months (range, 5 to 21) (P < 0.001). AIDS developed in 12 of 15 patients with candidiasis and T4/T8 ratios less than or equal to 0.51, as compared with none of four with ratios equal to or greater than 0.60 (P < 0.01). We conclude that in patients at high risk for AIDS, the presence of unexplained oral candidiasis predicts the development of serious opportunistic infections more than 50% of the time. Whether the remainder will have AIDS is not yet known. (New England Journal of Medicine 1984;311:354-8.)  相似文献   
967.
Abstract

Objectives: To study (a) the prevalence of depressive symptoms and (b) the utilization of mental health treatment in an ethnoracially diverse sample consisting primarily of Asian Americans, European Americans, Native Hawaiians, and Pacific Islanders. Participants: Five hundred eighty-nine college students. Method: A questionnaire packet that included the Center for Epidemiological Studies Depression Scale (CES-D) was administered to students in introductory psychology courses. Results: (a) There were no differences among ethnoracial groups in levels of depressive symptoms as measured by the CES-D; (b) 71% of participants with high levels of depressive symptoms had not received any mental health treatment in the previous 12 months; and (c) European Americans were 3.7 times more likely to have received mental health treatment in the previous 12 months than other students. Conclusion: Outreach efforts designed to improve utilization of mental health treatment services by depressed college students, especially by members of ethnoracial minority groups, should be increased.  相似文献   
968.
Abstract

Objective: Reduce college student at-risk drinking (ARD) using a Web-based brief motivational alcohol prevention/intervention called Michigan Prevention and Alcohol Safety for Students (M-PASS). Participants: Participants included 1,137 randomly sampled first-year college students, including 59% female, 80% white, and averaged age 18.1 years. Methods: Intervention group participants (n = 616) attended 4 online M-PASS sessions, receiving feedback tailored to individual drinking patterns and concepts from 4 behavior change theories. Control group participants (n = 521) completed a mid-phase survey, and both groups were surveyed at baseline and posttest. Results: Evidence of M-PASS's efficacy was found. The intervention was associated with advanced stage of change, lower tolerance of drinking and drink/driving, fewer reasons to drink, and use of more strategies to avoid ARD. Preliminary evidence of behavioral change was also found. Efficacy was greater for women than men. Conclusions: Web-based programs may be useful in reducing alcohol-related risk among college students. Further evaluation is needed.  相似文献   
969.
Abstract

Objective: Tobacco-control policy proposals are usually met with opposition on college campuses. Research to understand students’ viewpoints about health-related policy proposals and messaging strategies, however, does not exist. This study investigated students’ perceptions about a smoke-free policy proposal to help understand their positions of support and opposition and to inform the development of effective messaging strategies. Participants: In January 2012, 1,266 undergraduate students from a midwestern university completed an online questionnaire about smoke-free campus policies. Methods: Responses were coded and analyzed using Linguistic Inquiry and Word Count software and chi-square, independent-samples t tests, and binary logistic models. Results: Most students who supported a smoke-free policy considered environmental or aesthetic conditions, whereas most opponents used personal freedom frames of thought. Supporters viewed smoking policies in personal terms, and opponents suggested means-ends policy reasoning. Conclusions: Taken together, points of reference and emotions about proposed policies provided insight about participants’ perspectives to help inform effective policy advocacy efforts.  相似文献   
970.
This study examines nursing home regulatory activity by the states, assesses interstate variations in the volume and severity of nursing home deficiencies, and explores state-level factors that may account for these differences. Nursing home deficiency citation data over a 5-year period (2000–2004) were obtained from the Centers for Medicare and Medicaid Services. We examined interstate variations in regulatory activity and identified predictors of deficiency volume and severity at the state level (demographics, elected officials, industry characteristics, etc.) using the linear mixed model. Deficiency volume remained stable across the 50 states from 2000 to 2004, while deficiency severity decreased significantly. California had the highest volume of deficiencies per nursing home; Wisconsin had the lowest. New Hampshire had the highest percentage of severe deficiencies; California had the lowest. Higher deficiency volume was found in states with lower median household income, a lower proportion of residents aged 85 and older, and a Democratic legislature. Higher deficiency severity was associated with higher median household income and a higher proportion of Medicaid nursing home residents in a state. In contrast, greater state agency funding, higher state standards for nursing home administrators, and a Democratic and more professional legislature predicted lower deficiency severity. Nursing home residents in the United States receive unequal protection from abuse and neglect, and this is partly due to their state of residence. Interstate variations in deficiency volume and severity are due to a complex set of factors beyond nursing home quality.  相似文献   
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