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61.
1. Confusion and controversy continue to surround the definition and use of safety contracts. 2. A safety agreement based on Orlando's Nursing Theory may be a more practical, concise, and nurse-patient friendly means to promote patient safety. 3. The key ingredients in a safety agreement are identifying patients' immediate safety needs and decreasing patients' immediate distress related to safety through the nurse-patient relationship. 4. The value of a safety agreement lies not in the tool itself but in its promotion of a nurse-patient relationship that involves communication and collaboration.  相似文献   
62.

Background

Despite high-level evidence of the benefits of caseload midwifery for women and babies, little is known about specific practice arrangements, organisational barriers and facilitators, nor about workforce requirements of caseload. This paper explores how caseload models across Australia operate.

Methods

A national cross-sectional, online survey of maternity managers in public maternity hospitals with birthing services was undertaken. Only services with a caseload model are included in the analysis.

Findings

Of 253 eligible hospitals, 149 (63%) responded, of whom 44 (31%) had a caseload model. Operationalisation of caseload varied across the country. Most commonly, caseload midwives were required to work more than 0.5 EFT, have more than one year of experience and have the skills across the whole scope of practice. On average, midwives took a caseload of 35–40 women when full time, with reduced caseloads if caring for women at higher risk. Leave coverage was complex and often ad-hoc. Duration of home-based postnatal care varied and most commonly provided to six weeks. Women’s access to caseload care was impacted by many factors with geographical location and obstetric risk being most common.

Conclusion

Introducing, managing and operationalising caseload midwifery care is complex. Factors which may affect the expansion and availability of the model are multi-faceted and include staffing and model inclusion guidelines. Coverage of leave is a factor which appears particularly challenging and needs more focus.  相似文献   
63.
Future development in cities needs to manage increasing populations, climate‐related risks, and sustainable development objectives such as reducing greenhouse gas emissions. Planners therefore face a challenge of multidimensional, spatial optimization in order to balance potential tradeoffs and maximize synergies between risks and other objectives. To address this, a spatial optimization framework has been developed. This uses a spatially implemented genetic algorithm to generate a set of Pareto‐optimal results that provide planners with the best set of trade‐off spatial plans for six risk and sustainability objectives: (i) minimize heat risks, (ii) minimize flooding risks, (iii) minimize transport travel costs to minimize associated emissions, (iv) maximize brownfield development, (v) minimize urban sprawl, and (vi) prevent development of greenspace. The framework is applied to Greater London (U.K.) and shown to generate spatial development strategies that are optimal for specific objectives and differ significantly from the existing development strategies. In addition, the analysis reveals tradeoffs between different risks as well as between risk and sustainability objectives. While increases in heat or flood risk can be avoided, there are no strategies that do not increase at least one of these. Tradeoffs between risk and other sustainability objectives can be more severe, for example, minimizing heat risk is only possible if future development is allowed to sprawl significantly. The results highlight the importance of spatial structure in modulating risks and other sustainability objectives. However, not all planning objectives are suited to quantified optimization and so the results should form part of an evidence base to improve the delivery of risk and sustainability management in future urban development.  相似文献   
64.
This paper is a comparison of the views of Max Weber and Émile Durkheim on socialism; these two have yet to be compared on this topic. They offered shared critiques of socialism, but differed in assessment of its overall worth, with Durkheim being more welcoming. After considering possible explanations for this divergence I argue it reflects the contrasting methodologies adopted by both. Whilst Weber places questions of the “value” of socialism solely in the conscious of the individual, and therefore beyond sociology, Durkheim sees this as a social question and therefore part of the practical concerns of sociologists.  相似文献   
65.
ABSTRACT

Reflecting on the shifting landscape of higher education, this discussion highlights how inequality is entrenched within the university, largely as a result of Western-inspired, commodified knowledge production processes. The article grapples with scholarship on cognitive justice and builds a case for transformative resistance that is simultaneously anti-colonial and anti-neoliberal, within, against and beyond the Westernised university. The discussion concentrates specifically on epistemic hegemonies and internationalisation, and argues that substantive decolonisation as a counterhegemonic project must entail an intellectual element that is aimed at transforming the knowledge structures that facilitate dehumanisation. The pursuit of more equitable, anti-racist futures must thus involve the identification and obliteration of deeply embedded epistemic hegemonies, which have been created through the dehumanising processes of capital expansion and colonisation. This article offers a hopeful approach that encourages the collaborative creation of a counter-university that actively pursues epistemic diversity as a pathway to alternative futures.  相似文献   
66.
BackgroundConsideration of the needs of pregnant women and their ability and willingness to attend maternal services and pay for them is central to the provision of accessible and acceptable maternal care. Women's satisfaction with maternal services is poorly understood in many developing countries, including Cambodia in South East Asia. The objective of this study was to investigate women's perceptions and experiences of private and public skilled birth attendants, including midwives, during childbirth in Cambodia.MethodsA qualitative design using a naturalistic inquiry approach was undertaken to seek sensitive personal issue. Thirty individual in-depth interviews were conducted with women who had recently given birth at private and public health facilities in one province in Cambodia. Data were analysed using a thematic approach.FindingsWomen's choice of health facility was influenced by their perceptions of safety and staff attitudes. Reported barriers to the effective utilisation of public maternity services were costs associated with the birth, staff attitudes and a lack of supportive care during labour and in the postpartum period. Although private health care is more expensive than public health care, some women reported a preference for private birth attendants as they perceived them to provide safer and more supportive care in labour.ConclusionWomen expect, but do not always receive humane, professional, supportive and respectful treatment from public skilled birth attendants. While the removal of unexpected costs and geographical barriers are important to increasing public maternity care and service utilisation, improvements in maternity services should focus on addressing provider attitudes and enhancing communication skills during labour, birth and the immediate postpartum period.  相似文献   
67.
Europe in recent years has witnessed an increase in the amount of cross‐border operations by retailers. The retail sector has undergone substantial structural change characterized by the emergence of a group of rapidly‐growing large retailers, a redefinition of the balance of internalized and externalized functions and a need to respond to the cultural variety present in Europe that becomes evident as retailers move out of their domestic markets. The over‐arching requirement for these large retailers is to grow and gain scale economies. Internationalization of operations has become a requirement for these large firms. It is argued that the established academic conceptualizations of internationalization are unsatisfactory in not addressing this overriding requirement for growth. There is great variety in the international activity in retailing, with the absence of pattern being one of the few generalities. It is proposed that consideration of opportunism may be a better way to gain understanding of retailer activity than trying to fit activity into deterministic strategic models. The experiences of five West European retailers entering and building retail networks in Poland is provided as evidence for this view. Suggestions are made for future work exploring this issue of opportunism as a process in international retailing.  相似文献   
68.
Recently, Black's theory of law has been criticized for failing to capture quasi and de facto governmental social control institutions. A restatement of this theory introduces the idea of "more or less governmental social control" that encompasses government endorsement of private forms of social control or government delegation of social control powers to private parties. Drawing from this, we assess the utility of Black's theory by examining sexual harassment cases handled by the Canadian Human Rights Commission , a quasi-governmental body that has been delegated social control powers. Previous tests of Black's theory have relied primarily on criminal processes that often involve identifiable increments in law. While a sexual harassment case may be settled or dismissed, paralleling the criminal justice process of conviction or acquittal, further increments in law are less identifiable within this quasi-governmental institution. Using over 200 sexual harassment cases in Canada, we test several concepts from Black's theory for explaining decision making within a quasi-governmental social control institution and, specifically, for predicting whether single or multiple remedies are used to resolve these types of cases. Our results show some support for Black's theory, but demonstrate that whether a case was sent to conciliation played a greater role in predicting the quantity of law than the social structural dimensions emphasized by Black or the offense seriousness variables highlighted by more traditional criminal justice research.  相似文献   
69.
This paper analyzes the impact of managerial social status on the normative evaluation of managerial acts in organizational contexts. We test several propositions on the relationship between social status and normative evaluation derived from Donald Black's theoretical framework on social control. The research design consists of a factorial survey of 200 managers. Each respondent evaluated the seriousness of a normatively questionable managerial act. In each vignette, the perpetrator's social status was systematically manipulated in either a high or a low condition. The results generally support the argument that the higher a manager's social status the less vulnerable that individual is to unfavorable normative evaluations, holding constant the act. The paper closes with discussion of our findings in light of social structural and rational choice perspectives on informal social control in organizations. Additionally, we discuss methodological issues related to experimental research on informal social control in organizations, the consistency of our findings with those from previous studies of social control across diverse settings, potential theoretical applications and extensions of Black's framework in organizational contexts, and practical implications for the implementation of corporate codes of conduct and corporate dispute resolution systems.  相似文献   
70.
IG Dambolena 《Omega》1983,11(4):355-364
The prediction of corporate failures has received widespread attention over the past 15 years. Numerous articles on the subject in accounting and financial journals attest to this fact, stating that the failure of a business organization often has significant economic effects for its owners, creditors and employees. Past efforts have been quite successful in classifying firms as bankrupt or non-bankrupt ex-post, but much remains to be done in terms of developing better predictive models. This paper is intended to review the literature and to focus on some problems where research seems likely to yield improved models. It starts with a comprehensive, though not exhaustive, guided tour of the bibliography. It then discusses some recent attempts to improve the effectiveness of these models. Finally it points to some promising areas for future research.  相似文献   
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