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151.
152.
This paper describes the present status of aquaculture activities in Dhaka City and its surrounding areas including the system of fish marketing and distribution and environmental and socioeconomic issues. Dhaka City contains over 10 million people and is expanding day by day. Demand of fish in the last 10 years has increased as a result of increases in population and income levels. The annual per capita consumption of fish is reported to drop by 0.5 kg since 1985. The reason for this decline is increased prices and decreased supply of fish. Fish supply to the city comes from catch in the rivers-estuaries and floodlands of Dhaka district, neighboring districts, imports from other areas and aquaculture in surrounding areas of the city. Considerable quantities of fish are imported from India, Myanmar and Thailand. Seasonal patterns are common both in supply and consumption of fish. Along with traditional rural household aquaculture, in recent years, urban and peri-urban aquaculture has also been popular. Three broad types of aquaculture activities are found in and around Dhaka City; these are polyculture of carp in ponds, monoculture of catfishs in ponds, and pen and cage aquaculture in open waters. The carp includes both Indian major carp and Chinese carp and some minor carp. The catfish group includes mainly Thai pangas (Pangasius sutchi). Tilapia (Oreochromis niloticus) is also widely popular among the farmers. The technology used for aquaculture is improved extensive to semi-intensive. Increasing demand for fish in the city markets has encouraged the expansion of peri-urban aquaculture with a corresponding increase in the proportion of farmed fish in the markets.  相似文献   
153.
Alcohol remains the drug of choice for many adolescents; however, the nature of the relationship between athletic involvement and alcohol misuse remains ambiguous. In this article, we used a longitudinal sample of over 600 Western New York adolescents and their families to explore the gender-specific and race-specific relationships between identification with the "jock" label and adolescent alcohol consumption, specifically problem drinking. Operationalization of problem drinking included frequency measures of heavy drinking, binge drinking, and social problems related to alcohol (e.g., trouble with family, friends, school officials over drinking). Self-identified adolescent "jocks" were more likely to engage in problem drinking than their non-jock counterparts, even after controlling for gender, age, race, socioeconomic status, physical maturity, social maturity, and frequency of athletic activity. Jock identity was strongly associated with higher binge drinking frequency in Black adolescent girls. This study underscores the need to distinguish between objective and subjective meanings of athletic involvement when assessing the relationship between sport and adolescent health-risk behavior.  相似文献   
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Progressive multi-state models provide a convenient framework for characterizing chronic disease processes where the states represent the degree of damage resulting from the disease. Incomplete data often arise in studies of such processes, and standard methods of analysis can lead to biased parameter estimates when observation of data is response-dependent. This paper describes a joint analysis useful for fitting progressive multi-state models to data arising in longitudinal studies in such settings. Likelihood based methods are described and parameters are shown to be identifiable. An EM algorithm is described for parameter estimation, and variance estimation is carried out using the Louis’ method. Simulation studies demonstrate that the proposed method works well in practice under a variety of settings. An application to data from a smoking prevention study illustrates the utility of the method.  相似文献   
156.
Journal of Population Research - This paper examines immigrant retention using a novel approach based on data contained in New Brunswick’s Medicare Registry database. To date, researchers...  相似文献   
157.

Background

Vaginal birth after caesarean can be a safe and satisfying option for many women who have had a previous caesarean, yet rates of vaginal birth after caesarean remain low in the majority of countries. Exploring women’s experiences of vaginal birth after caesarean can improve health practitioners’ understanding of the factors that facilitate or hinder women in the journey to have a vaginal birth after caesarean.

Methods

This paper reports on a meta-ethnographic review of 20 research papers exploring women’s experience of vaginal birth after caesarean in a variety of birth locations. Meta-ethnography utilises a seven-stage process to synthesise qualitative research.

Results

The overarching theme was ‘the journey from pain to power’. The theme ‘the hurt me’ describes the previous caesarean experience and resulting feelings. Women experience a journey of ‘peaks and troughs’ moving from their previous caesarean to their vaginal birth after caesarean. Achieving a vaginal birth after caesarean was seen in the theme ‘the powerful me,’ and the resultant benefits are described in the theme ‘the ongoing journey’.

Conclusion

Women undergo a journey from their previous caesarean with different positive and negative experiences as they move towards their goal of achieving a vaginal birth after caesarean. This ‘journey from pain to power’ is strongly influenced by both negative and positive support provided by health care practitioners. Positive support from a health care professional is more common in confident practitioners and continuity of care with a midwife.  相似文献   
158.
Informed by critical race theory (CRT), we examine how African-American and white college students, at a predominantly white, structurally diverse, Southern US university, understand their cross-racial experiences. Black–white interactions are understood within the context of the so-called ‘post-racial’ environment, against the backdrop of high-profile cases of racial injustice, and within the added context of the historical legacy of slavery and Jim Crow segregation in the rural Southern United States. Our study suggests that many students, regardless of race, recognized the persistence of racial segregation, especially in nightlife and campus Greek letter organizations (GLOs). African-American students were the most vocal and troubled by this division. Unexpectedly, however, students appeared to take for granted that in the American South, racism is persistent and indestructible. Building on Bell’s (1991) notion of racial realism and Bonilla-Silva’s (2013) notion of naturalization, we expand the view that racism is inherent or related to individual preference, to place and time, with a construct we term southern assumptions. Southern assumptions are the mechanisms in which participants connect collective historical racism in the south to the race problems of today.  相似文献   
159.
160.
Nonmedical factors and diagnostic certainty contribute to variation in clinical decision making, but the process by which this occurs remains unclear. We examine how physicians' interpretations of patient sex-gender affect diagnostic certainty and, in turn, decision making for coronary heart disease. Data are from a factorial experiment of 256 physicians who viewed 1 of 16 video vignettes with different patient-actors presenting the same symptoms of coronary heart disease. Physician participants completed a structured interview and provided a narrative about their decision-making processes. Quantitative analysis showed that diagnostic uncertainty reduces the likelihood that physicians will order tests and medications appropriate for an urgent cardiac condition in particular. Qualitative analysis revealed that a subset of physicians applied knowledge that women have "atypical symptoms" as a generalization, which engendered uncertainty for some. Findings are discussed in relation to social-psychological processes that underlie clinical decision making and the social framing of medical knowledge.  相似文献   
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