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511.

Background

Continuity of midwifery care contributes to significant positive outcomes for women and babies. There is a perception that providing continuity of care may negatively impact on the wellbeing and professional lives of midwives.

Aim

To compare the emotional and professional wellbeing as well as satisfaction with time off and work-life balance of midwives providing continuity of care with midwives not providing continuity.

Method

Online survey. Measures included; Copenhagen Burnout Inventory (CBI); Depression, Anxiety and Stress Scale-21; and Perceptions of Empowerment in Midwifery Scale (PEMS-Revised). The sample (n = 862) was divided into two groups; midwives working in continuity (n = 214) and those not working in continuity (n = 648). Mann Whitney U tests were used to compare the groups.

Results

The continuity group had significantly lower scores on each of the burnout subscales (CBI Personal p = .002; CBI Work p < .001; CBI Client p < .001) and Anxiety (p = .007) and Depression (p = .004) sub-scales. Midwives providing continuity reported significantly higher scores on the PEMs Autonomy/Empowerment subscale (p < .001) and the Skills and Resources subscale (p = .002). There was no difference between the groups in terms of satisfaction with time off and work-life balance.

Conclusion

Our results indicate that providing continuity of midwifery care is also beneficial for midwives. Conversely, midwives working in shift-based models providing fragmented care are at greater risk of psychological distress. Maternity service managers should feel confident that re-orientating care to align with the evidence is likely to improve workforce wellbeing and is a sustainable way forward.  相似文献   
512.
513.
Lee  Jee Min  Tan  Jenny  Gill  Aman S.  McGuire  Krista L. 《Urban Ecosystems》2019,22(4):721-732

Due to extensive areas of impermeable surfaces, combined sewer overflow (CSO) is currently a major problem in urban areas across the United States. In CSO systems, sewage can travel through underground pipes to be decontaminated in treatment facilities, or it can combine with stormwater after a precipitation event and discharge into local waterways. Many cities are implementing green infrastructure installations, which use vegetation and bioactive soil microbial communities to enhance soil water-holding capacity, thereby minimizing CSO events. Understanding the factors that structure soil microbial communities in green infrastructure will facilitate more effective management of these engineered ecosystems; however, few studies to date have evaluated ecological patterns and processes of microbes in the urban environment. Nitrogen loading is known to be a major factor structuring fungi and bacteria in non-urban soils, and since cities also contain large populations of canines, N-rich urine deposition is a potential factor that could be important for structuring soil microbes in ground-level green infrastructure installations. Our study investigated the effects of canine urine on the urban soil microbial communities in a greenhouse experiment by treating Liriope muscari, a common plant found in New York City green infrastructure, with different concentrations of canine urine for 4 weeks in an experimental setting. We found that urine application significantly decreased total soil microbial biomass and microbial richness, and increased water runoff volume. These findings indicate that canine urine may have negative consequences for soil water-holding capacity and nutrient cycling in urban green infrastructure installations by directly decreasing the abundance and richness of soil microbial communities.

  相似文献   
514.
The theory of Birth Territory describes, explains and predicts the relationships between the environment of the individual birth room, issues of power and control, and the way the woman experiences labour physiologically and emotionally. The theory was synthesised inductively from empirical data generated by the authors in their roles as midwives and researchers. It takes a critical post-structural feminist perspective and expands on some of the ideas of Michel Foucault. Theory synthesis was also informed by current research about the embodied self and the authors' scholarship in the fields of midwifery, human biology, sociology and psychology. In order to demonstrate the significance of the theory, it is applied to two clinical stories that both occur in hospital but are otherwise different. This analysis supports the central proposition that when midwives use 'midwifery guardianship' to create and maintain the ideal Birth Territory then the woman is most likely to give birth naturally, be satisfied with the experience and adapt with ease in the post-birth period. These benefits together with the reduction in medical interventions also benefit the baby. In addition, a positive Birth Territory is posited to have a broader impact on the woman's partner, family and society in general.  相似文献   
515.
What are the risks associated with child sexual abuse? Who is at risk? From whom? For professionals working in the field of child abuse, the main answers to such questions are straightforward. There is a broad consensus that children are at risk from adults (and young people), often from men (and sometimes women) that they know. Fathers, step-fathers, uncles and brothers are often implicated. This is not, however, the focus of news coverage. Abductions, paedophile rings and abuse in children's homes attract intermittent but occasionally intense media attention. In contrast, sexual abuse of children within their own families is rarely front page news—except, that is, where the accusations are contested. Almost as soon as the existence of widespread abuse within ‘ordinary’ homes became public knowledge, this was over-shadowed by a series of high-profiled ‘scandals’, such as Cleveland, Rochdale and Orkney. The focus turned to questions of misdiagnosis, inappropriate intervention and the supposed coaching of children to make false accusations. More recently ‘false memory syndrome’ has hit the headlines suggesting that some adults' accounts of abuse can also be discredited. The news coverage often gives the impression that the main risks are not tochildren, but to parents, particularly fathers. How has this come to be the focus of public debate? Why is it that these risks have proved so much more ‘newsworthy’? This paper examines the media profile of the risks associated with sexual abuse and draws on interviews with journalists to seek to explain the shape of the coverage.  相似文献   
516.
Caregivers in informal kinship care encounter numerous difficulties when lacking a legal relationship with the children in their care. The de facto custodian guardianship, a concept that is relatively unknown in social work, provides an additional legal option to caregivers by allowing them to present their caregiving history during custody hearings. This article introduces the significance of the de facto concept and provides detailed information on its components and limitations. Recommendations are forwarded for social education and practice.  相似文献   
517.
This article examines the strategies used by some third sector organizations in Australia to advocate. The purpose of this article is to identify the kinds of activities that organizations in New South Wales and Queensland use to promote advocacy, the kinds of language that is used to describe these activities, and the reasons given for the particular strategies adopted. The extent to which the organizations adopt “softer” (that is more institutional forms of advocacy) rather than more openly challenging forms of activism is examined, particularly in light of a neo-liberal political and economic environment. In this analysis emergent strategies are identified that are not easily categorized as either “institutional” or “radical” advocacy. The article presents an exploratory analysis of some of the implications of the strategies adopted, in terms of their democratic effects and potential to strengthen the capacity of third sector organizations. The article is informed by the findings of a qualitative research project involving interviews with 24 organizations in the community services and environmental fields.  相似文献   
518.
519.
This paper will give an overview of Murray Bowen's theory of family systems. It will describe the model's development and outline its core clinical components. The practice of therapy will be described as well as recent developments within the model. Some key criticisms will be raised, followed by a case example which highlights the therapeutic focus of Bowen's approach.  相似文献   
520.
This paper examines the media coverage of preventing child sexual abuse. It draws on a content analysis of all press and TV news coverage about child sexual abuse that appeared in the UK during a complete 12-month period. The findings demonstrate that the bulk of the coverage was case-based, for example focusing on the Orkney case. There was very little opportunity for broader discussion of general issues of concern, including how sexual assaults against children might be prevented. The coverage of ‘prevention’ which did exist drew on a very narrow range of debates and was disproportionately concerned with abuse outside the home (abductions by strangers, or abuse within institutions such as schools or children's homes). Discussions about prevention were dominated by reactive news stories generated by particular ‘scandals’. The coverage was also largely drawn from a small constituency of official source agencies (such as government officials, court proceedings and police statements). There were few attempts to address the broader social conditions which might facilitate or inhibit sexual violence or to examine explicitly political analyses of the problem. The paper argues for a more diverse discussion about ways of preventing sexual violence against children, especially assaults by fathers, uncles, brothers and friends of the family. This demands close attention to the ways in which the mass media operate, as well as the priorities of source agencies. The paper points to factors within news production practices which both obstruct and facilitate debate about prevention and concludes by suggesting strategies to promote this issue as a vital part of the public agenda.  相似文献   
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