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Background

Childbirth fear is the most common underlying reason for requesting a caesarean section without medical reason. The aim of this randomised controlled study was to investigate birth preferences in women undergoing treatment for childbirth fear, and to investigate birth experience and satisfaction with the allocated treatment.

Methods

Pregnant women classified with childbirth fear (≥60 on the Fear Of Birth Scale) (n = 258) were recruited at one university hospital and two regional hospitals over one year. The participants were randomised (1:1) to intervention (Internet-based Cognitive Behaviour Therapy (ICBT)) (n = 127) or standard care (face-to-face counselling) (n = 131). Data were collected by questionnaires in pregnancy week 20–25 (baseline), week 36 and two months after birth.

Results

Caesarean section preference decreased from 34% to 12% in the ICBT group and from 24% to 20% in the counselling group. Two months after birth, the preference for caesarean increased to 20% in the ICBT group and to 29% in the counselling group, and there was no statistically significant change over time. Women in the ICBT group were less satisfied with the treatment (OR 4.5). The treatment had no impact on or worsened their childbirth fear (OR 5.5). There were no differences between the groups regarding birth experience.

Conclusion

Women’s birth preferences fluctuated over the course of pregnancy and after birth regardless of treatment method. Women felt their fear was reduced and were more satisfied with face-to-face counselling compared to ICBT. A higher percentage were lost to follow-up in ICBT group suggesting a need for further research.  相似文献   
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In modelling a system structure it is often important to test the constancy of the structural parameters. If the hypothesis of constant parameters is rejected we wish to characterize the parameter variation. In this paper we examine the usefulness of the MOSUMSQ test statistics for locating and characterizing the parameter variation in linear regression models. The means and the variances of the test statistics are given for non-random parameter variation. The observed path of the MOSUMSQ test statistics provides valuable knowledge about the time of the onset of the parameter change and whether it is instantaneous or gradual.  相似文献   
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Dual-earner migration. Earnings gains, employment and self-selection   总被引:1,自引:1,他引:0  
This paper examines how spouses in dual-earner couples weigh each partner’s expected wage growth in the decision to migrate. Previous research suggests that husbands’ job prospects dominate the migration choice irrespective of their relative earnings potential. Based on British panel data, this paper employs an endogenous switching model and estimates wage differentials of migrating vs. staying for husbands and wives corrected for double selectivity of migration and employment. Dual-earner couples attach a positive weight to each partner’s expected wage gains when deciding to migrate. Moreover, migrant wives’ employment decreases temporarily, and there are significant selection effects in migration and employment amongst non-migrants.  相似文献   
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Using a questionnaire based upon the work of Geert Hofstede, we examined the effects of gender on the following three work‐related dimensions: the importance of work‐related goals, the preference for performance rewards and the preference for management styles. The study was conducted for a multinational corporation headquartered in Germany with branches in China, Japan and the USA. Even though some inter‐country differences in the importance of work‐related matters are identified and intra‐country gender differences exist in work goal evaluation, overall we find that men and women exhibit similar preferences concerning performance rewards and managerial styles. Finally, for the three dimensions studied, our data do not confirm the stereotypical work‐related gender differences often reported in the literature and popular press.  相似文献   
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Rationalizations generally have a negative effect on health and known risk factors for musculoskeletal disorders. These effects may be reduced by paying attention to modifiers as worker participation and a resonant management style. In this study a participatory approach was used in the food industry in order to improve ergonomics and productivity. The food industry shows a high prevalence of musculoskeletal disorders, and repetitive manual work occurs extensively. Prototypes of new packaging solutions were developed in three cases, and compared in a simulated production to the existing production system through direct measurements of working postures and muscle activity, ratings of physical load, and general productivity data. Measured and rated ergonomic exposures showed that workload was significantly lower for the prototypes, in all three cases. In two cases, the number of handling operations included in the packaging operations were greatly reduced with the prototype package, as were production costs. The impact on disorders of the obtained load reductions is difficult to assess, but we believe that in "critical" situations like this, even small improvements may have an effect. This study shows that workloads during manual handling of packages as well as production costs can be reduced by applying participative development of packages.  相似文献   
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Previous studies have shown a link between work-related stress and the morning level of the stress hormone cortisol. The level of cortisol in the circulation is regulated by the hypothalamic-pituitary-adrenocortical (HPA) axis, dysregulation of which plays an important role in a number of disorders including hypertension, immune deficiency and being overweight (the 'metabolic syndrome'). The aim of this study was to investigate the association between workload and morning cortisol in women. Saliva samples were obtained four times during the first 45 min after awakening (0, 15, 30 and 45 min) in the morning on a work-free day from more than 200 women in full-time work who were born in 1955 and representing a normal population of a small city in Sweden. The amount of paid and unpaid work was reported in a questionnaire. Significant positive correlations were found between the amount of overtime at work and each of the four measurements of morning salivary cortisol (varying from r = .29 to r = .38, p < .01). In addition, participants with excessive overtime (more than 10 h/week) had on average about twice as high ( p < .01) morning cortisol levels as women with moderate overtime (< 10 h/week) or normal working hours (35-40 h/week). The results are consistent with earlier findings and suggest that morning cortisol is a sensitive indicator of work overload in women. However, additional research is necessary in order to reveal the specific pathways linking work-related stress to elevated morning cortisol.  相似文献   
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