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121.

Problem

There is lack of data on the rate of episiotomy in Lebanon and the study’s hospital.

Background

Only a few studies have addressed episiotomy practice in Lebanon and the Middle East and they show varying rates.

Aim

To identify the rate, and change in rate, of episiotomy practice over the years at a teaching hospital in Lebanon and to assess whether maternal age, parity, fetal weight, woman’s hospital admission class, and physician’s gender were associated with episiotomy. We also tested the association between episiotomy and postpartum hemorrhage and/or high degree perineal tears.

Methods

A retrospective observational study was conducted on 1756 records for women having a normal vaginal birth at a single centre from January 2009 to January 2014.

Findings

The rate of episiotomy at the hospital was very high, with 97.4% of women receiving an episiotomy in 2009. A major decrease in the rate was identified with a decline from 97.4% in 2009 to 73.3% in January 2014. Episiotomy was found to be associated with parity, maternal age, and with high degree perineal tears.

Discussion

The episiotomy rate at this centre remains higher than the 10% rate recommended by the World Health Organization, although there has been a significant reduction after a call for restrictive rather than liberal use.

Conclusion

Raising awareness among providers appeared to play a significant role in reducing this rate, although more efforts remain warranted. Other strategies – such as raising awareness of women about potential risks of episiotomy – are also worth exploring.  相似文献   
122.
Green infrastructure is a strategic planning concept that is able to address environmental, social and even economic problems by supplying a variety of benefits for society. Especially in times of public financial crises and spatial transformation, it is important to ensure that those services are high quality to guarantee that they will provide the intended benefits by integrating stakeholders’ knowledge and experience into green infrastructure planning. Active stakeholder participation leads to legitimate and informed future planning that accounts for society’s needs. This paper investigates participation approaches of six green infrastructure investments in Belgium, the UK, Germany and the Netherlands. The major aim is to explore how and when participation should take place to optimize participation in green infrastructure planning. This is achieved by surveying the stakeholders involved and conducting stakeholder discussions to identify their views on the participation approaches employed and their integration into the planning process. We found that stakeholders were generally satisfied with how they were involved but desired a broader and more tailored mix of approaches. Furthermore, we found several Arnstein gaps, which lead us to conclude by suggesting recommendations that are helpful for successful participation in green infrastructure planning.  相似文献   
123.
We consider the online matching problem, where n server-vertices lie in a metric space and n request-vertices that arrive over time each must immediately be permanently assigned to a server-vertex. We focus on the egalitarian bottleneck objective, where the goal is to minimize the maximum distance between any request and its server. It has been shown that while there are effective algorithms for the utilitarian objective (minimizing total cost) in the resource augmentation setting where the offline adversary has half the resources, these are not effective for the egalitarian objective. Thus, we propose a new Serve-or-Skip (SoS) bicriteria analysis model, where the online algorithm may reject or skip up to a specified number of requests, and propose two greedy algorithms: GriNN(t) and \({{\textsc {Grin}}^*(t)}\). We show that the SoS model of resource augmentation analysis can essentially simulate the doubled-server-capacity model, and then examine the performance of GriNN(t) and \({\textsc {Grin}^*(t)}\).  相似文献   
124.
We examine the treatment of female characters in videocassette pornography. Using a systematic sample, we analyze 209 vignettes in 40 x- to xxx- rated videos commercially available from a national chain in the local market. We found that most videos had sexually violent or dehumanizing/degrading themes; however, a significant number also had a theme of intimacy. As expected, we found little evidence (one case) of extreme sexual deviance. Extreme sexual deviance was the kind of sexual violence the 1986 Commission on Pornography assumed was commonly available in pornography today. We also examined how the race of the actor shapes pornographic violence. As hypothesized, we found that black women experienced more violence from both white and black men than was the case for white women. White women, in fact, experienced least violence when paired with a black man. Our work replicates that of others in that we found few intimacy themes in material where black actors were present.  相似文献   
125.
126.

Background

Hospital birth is commonly thought to be a safer option than homebirth, despite many studies showing similar rates of safety for low risk mothers and babies when cared for by qualified midwives with systems of back-up in place. Recently in Australia, demand has led to the introduction of a small number of publicly-funded homebirth programs. Women's confidence in having a homebirth through a publicly-funded homebirth program in Australia has not yet been explored.

Aim

The aim of the study was to explore the reasons why multiparous women feel confident to have a homebirth within a publicly-funded model of care in Australia.

Methods

Ten multiparous English-speaking women who chose to have a homebirth with the St George Hospital Homebirth Program were interviewed in the postnatal period using semi-structured, open-ended questions. Interviews were transcribed, then a thematic analysis was undertaken.

Results

Women, having already experienced a normal birth, demonstrated a strong confidence in their ability to give birth at home and described a confidence in their bodies, their midwives, and the health system. Women weighed up the risks of homebirth through information they gathered and integration with their previous experience of birth, their family support and self-confidence.

Discussion

Women choosing publicly-funded homebirth display strong confidence in both themselves to give birth at home, and their belief in the health system's ability to cope with any complications that may arise.

Implications for practice

Many women may benefit from access to publicly-funded homebirth models of care. This should be further investigated.  相似文献   
127.
This analysis contributes to LGBT campus climate research on the quality of campus life in higher education in the United States. We argue that public education institutions in different states face divergent impediments to improving campus climate, and that more research is needed identifying structural factors affecting campus climate. Using a social systems analysis of policymaking at one university as a case study, we illustrate how partisan politics and state regulation make Virginia colleges and universities more vulnerable to political scrutiny and control. Finally, we propose a social justice-oriented policy agenda to address structural inequalities.  相似文献   
128.
129.
The forms of protest that women occasionally adopted express a social and political assertion. Generally, they borrowed forms in circulation: civil procedures for the grievances under the ancient regime, declarations of human rights during the French revolution. After the Revolution, the adoption by women of the right of petition to the constituted powers is a massive phenomenon remaining practically unknown and little studied. The petitions of women are ancient demonstrations which are not only related to modern history; they are comparable with the ‘voices’ described by Hirschman and Boltanski. By marking out the political history of the modern period, they have an explanatory significance for political events and also contribute to the formation of public opinion.  相似文献   
130.
We examine a set of academic and social outcomes in 9th grade, comparing middle school attendees with those who attended K‐8 schools. Previous research with these data has shown that there are few differences in 8th‐grade outcomes by school type. Here we extend these findings to determine whether school form influences student outcomes in the first year of high school. The results reveal several domains in which attendance at a middle school results in worse outcomes (e.g., greater rates of course failure); however, we find that a large portion of the difference by type of a student's 8th‐grade school is accounted for by differential rates of attendance at the district's magnet schools. That is, our results indicate that type of school attended during the middle grades is significantly and positively related to magnet school attendance and thereby on the academic outcomes in the 9th‐grade year.  相似文献   
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