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231.
Luis Toharia  Antonio Ojeda 《LABOUR》1999,13(1):237-267
The paper presents the findings of a comparative and interdisciplinary legal and economic study on managing labour redundancies in seven EU member countries. It is structured for comparability between the systems examined. The introductory section contains an account of the evolution of the Spanish labour market, with special reference to redundancy trends, of the features of the programmes for managing redundancies, of the roles of forms and the ‘external environment’ in handling workforce adjustments. The second section presents a map of policies that work to prevent labour redundancies (preventive measures) such as flexibility, training etc. Next, the instruments for handling temporary labour redundancies (retentive measures) are examined (e.g. short-time working, temporary layoffs etc.) The following section is devoted to instruments and programmes involved in the management of permanent labour redundancies (expulsive measures), e.g. collective dismissals, severance pay etc. The final section provides and overall assessment of the Spanish system for managing labour redundancies, and briefly discusses the national debate on the prospects for reform, in light of the principles and policies of convergence set forth by the European Union.  相似文献   
232.
The accuracy of a binary diagnostic test is usually measured in terms of its sensitivity and its specificity. Other measures of the performance of a diagnostic test are the positive and negative likelihood ratios, which quantify the increase in knowledge about the presence of the disease through the application of a diagnostic test, and which depend on the sensitivity and specificity of the diagnostic test. In this article, we construct an asymptotic hypothesis test to simultaneously compare the positive and negative likelihood ratios of two or more diagnostic tests in unpaired designs. The hypothesis test is based on the logarithmic transformation of the likelihood ratios and on the chi-square distribution. Simulation experiments have been carried out to study the type I error and the power of the constructed hypothesis test when comparing two and three binary diagnostic tests. The method has been extended to the case of multiple multi-level diagnostic tests.  相似文献   
233.
This paper considers learning rules for environments in which little prior and feedback information is available to the decision maker. Two properties of such learning rules are studied: absolute expediency and monotonicity. Both require that some aspect of the decision maker's performance improves from the current period to the next. The paper provides some necessary, and some sufficient conditions for these properties. It turns out that there is a large variety of learning rules that have the properties. However, all learning rules that have these properties are related to the replicator dynamics of evolutionary game theory. For the case in which there are only two actions, it is shown that one of the absolutely expedient learning rules dominates all others.  相似文献   
234.
Gambling disorder (GD) is a prevalent condition for which no pharmacological treatment has yet been approved, although there is evidence that topiramate can reduce impulsivity in GD and craving in various addictive behaviors. The goal of this study was to investigate the effectiveness of topiramate combined with cognitive restructuring for GD in a two-center, randomized, double-blind clinical trial. Participants were individuals seeking outpatient treatment for GD (n = 30), treated with either topiramate or placebo combined with a brief cognitive intervention, over a 12-week period, the dose of topiramate being tapered up during the first 8 weeks. The main outcome measures were gambling craving, behavior, and cognitive distortions; impulsivity; depression and social adjustment. Topiramate proved superior to placebo in reducing gambling craving (P = 0.017); time and money spent gambling (P = 0.007 and P = 0.047, respectively); cognitive distortions related to gambling (P = 0.003); and social adjustment (P = 0.040). We found no significant effects on impulsivity or depression. These findings are in contrast with data from a previous clinical trial with topiramate for GD. In the current study, we found that topiramate affects features specifically related to gambling addiction and had no significant effect on associated phenomena such as impulsiveness and depression. We believe that this response could be due to synergistic interaction between topiramate and the cognitive intervention.  相似文献   
235.
BPH associated with LUTS and sexual dysfunction is common. We performed UroLift on 11 patients, average age 71?years (range 56–90). IPSS improved by an average of 9 points post-procedure. Pre-operatively their post-void residuals were 306.3?ml (range 120–499?ml SD [120.6]) and their QMAX was 7?ml/s (range 4–14 SD [2.8] ml/s). Post-procedure the post-void residual decreased by 35.4% at 4?months (mean difference – 106.3?ml). QMAX improved by an average of 1.7?ml/s, which was not statistically significant. No patients suffered any sexual dysfunction side effects and all patients were satisfied with their result. Hospital stay and theatre time were significantly reduced. Average length of stay was just 10.6 (6–18) hours and average theatre time just 18.7 (12–30) min. This is significantly faster than other surgery for LUTS. We therefore feel that there are significant benefits for both the patients, who are able to go home much faster, and also the hospital, who are able to perform far more surgeries for their patients. Patients also do not require an inpatient bed so patients should not be cancelled on the day of theatre.  相似文献   
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ABSTRACT

This paper presents a theoretical reflection on e-social work by considering a case study: an intervention programme with vulnerable people, included in the services catalogue of a non-governmental organization (NGO), Zaragoza Red Cross Assembly. This programme cares for older people with a home assistance system mediated by information and communication technologies (ICTs). The digital convergence of the Spanish Red Cross and the digitalization of internal processes were accelerated by the use of ICTs as a tool in the aftermath of the 2008 crisis: first, to manage bureaucratic matters; second, to coordinate professionals and third, to interact with users. The text is divided into five sections including an introduction and final remarks. The first section describes the intervention programme and its evolution from a traditional social work vision to an e-social work perspective. The second section describes and analyses the intervention programme and the incorporation of ICTs in this NGO, over more than two decades. The third section describes professional contributions to the implementation and adaptation of social work to new social and technological circumstances and users’ requirements based on these intervention experiences.  相似文献   
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240.

Background

Postpartum anaemia is a problem with high prevalence that significantly affects maternal recovery. Among the causal factors is perineal trauma. However, it is still not known what degree of perineal trauma produces a greater reduction of haemoglobin.

Aim

To assess the relationship between the degree of perineal trauma and change in haemoglobin concentration at vaginal birth.

Methods

An observational, analytical retrospective cohort study was performed at the Mancha-Centro Hospital (Spain) during the period 2010–2014. Data were collected regarding 3479 women who gave birth vaginally. The main outcome variable was the change in haemoglobin concentration. Multivariate analysis by means of multiple linear regression was performed to control possible confounding factors and to determine the net effect of each degree of perineal trauma on haemoglobin reduction.

Findings

Of the total sample, 20.1% of women (699) had an intact perineum, 41.6% (1446) experienced some form of perineal trauma, but not episiotomy, and the remaining 38.3% of women (1334) underwent an episiotomy. The average reduction of haemoglobin was 1.46 g/dL (Standard Deviation (SD) = 1.09 g/dL) for women without episiotomy with a second degree tear and 2.07 g/dL (SD = 1.24 g/dL) for women who had an episiotomy and no perineal tear. The greatest reduction occurred among women with episiotomy and a third or fourth degree tear with a decrease of 3.10 g/dL (SD = 1.32 g/dL).

Conclusion

Episiotomy is related to greater reduction of haemoglobin concentration in comparison with all degrees of spontaneous perineal trauma. The use of episiotomy should be strictly limited.  相似文献   
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