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81.
Managing incidental findings in human subjects research: analysis and recommendations. 总被引:8,自引:8,他引:0
Susan M Wolf Frances P Lawrenz Charles A Nelson Jeffrey P Kahn Mildred K Cho Ellen Wright Clayton Joel G Fletcher Michael K Georgieff Dale Hammerschmidt Kathy Hudson Judy Illes Vivek Kapur Moira A Keane Barbara A Koenig Bonnie S Leroy Elizabeth G McFarland Jordan Paradise Lisa S Parker Sharon F Terry Brian Van Ness Benjamin S Wilfond 《The Journal of law, medicine & ethics》2008,36(2):219-48, 211
No consensus yet exists on how to handle incidental findings (IFs) in human subjects research. Yet empirical studies document IFs in a wide range of research studies, where IFs are findings beyond the aims of the study that are of potential health or reproductive importance to the individual research participant. This paper reports recommendations of a two-year project group funded by NIH to study how to manage IFs in genetic and genomic research, as well as imaging research. We conclude that researchers have an obligation to address the possibility of discovering IFs in their protocol and communications with the IRB, and in their consent forms and communications with research participants. Researchers should establish a pathway for handling IFs and communicate that to the IRB and research participants. We recommend a pathway and categorize IFs into those that must be disclosed to research participants, those that may be disclosed, and those that should not be disclosed. 相似文献
82.
Jean‐Louis Denis Lise Lamothe Ann Langley Mylaine Breton Julie Gervais Louise‐Hlne Trottier Damien Contandriopoulos Carl‐Ardy Dubois 《Canadian public administration. Administration publique du Canada》2009,52(2):225-248
Abstract: Drawing on a longitudinal study from the early years of implementation of health‐care networks in Quebec, this article describes how public‐sector managers deal with complex challenges when both organizational structures and organizational strategies are radically transformed simultaneously. The new organizations studied had to completely re‐shuffle roles and responsibilities of their management teams while making sense of their new mandate of developing a population‐focused approach to health problems – all the time maintaining day‐to‐day operations. The four health‐care networks studied proceeded somewhat differently to meet these reciprocal challenges. The study reveals the importance of balancing organizing initiatives (focused on structures) with “sense‐making” initiatives (focused on strategies), of developing capacities for sense‐making through the creation of key “sense‐maker/sense‐giver” positions whose occupants are able to ensure that conceptual activities engage people working at different levels, even as organizational structures are in flux, and of mobilizing external constraints and influences as opportunities and resources in sense‐making and organizing. Sommaire : Se fondant sur une étude longitudinale des premières années de la mise en œuvre des réseaux de soins de santé au Québec, cet article décrit la manière dont les gestionnaires du secteur public font face à des défis complexes, alors que les structures et les stratégies organisationnelles sont radicalement transformées simultanément. Les nouveaux organismes étudiés ont dû complètement remanier les rôles et les responsabilités de leurs équipes de gestion et comprendre leur nouveau mandat d'élaborer une approche axée sur la population pour ce qui est des problèmes de santé, tout en maintenant leurs activités au jour le jour. Les quatre réseaux de soins de santéétudiés ont travailléà relever ces défis réciproques d'une manière assez différente. L'étude révèle l'importance de trouver un équilibre entre les initiatives consistant à organiser (axées sur les structures) et les initiatives consistant à interpréter les faits (axées sur les stratégies) ; de perfectionner les capacités à interpréter les faits grâce à la création de postes clés d'«interpréteurs de faits», dont les titulaires veilleraient à ce que des activités conceptuelles fassent intervenir les gens travaillant à différents niveaux même lorsque les structures organisationnelles fluctuent continuellement; et enfin de tirer parti des contraintes et influences externes comme autant d'occasions et de ressources pour interpréter et organiser les faits. 相似文献
83.
Margaret O’Dougherty Wright Emily Crawford Katherine Sebastian 《Journal of family violence》2007,22(7):597-608
Resolution of the trauma of childhood sexual abuse (CSA), and the current adjustment of 60 adult female CSA survivors were
explored through qualitative and quantitative analyses of their coping strategies, perceived benefits, and meaning-making
attempts. While the majority of the women (87%) perceived at least some benefit resulting from coping with the CSA experience,
many (29%) found it impossible to make any meaning of their trauma. Specific benefits that were associated with various aspects
of positive adjustment (marital satisfaction, better physical health, less isolation) included improved relationships with
others, religious or spiritual growth, and improved parenting skills. Some perceived benefits were actually associated with
a negative outcome. Increased knowledge of sexual abuse was associated with more isolation and lower marital satisfaction.
When positive meaning could be derived from the coping process, the women reported less isolation. Avoidant coping was strongly
associated with more depressive symptoms and poorer resolution of abuse issues. Results highlight the importance of considering
coping strategies and cognitive restructuring efforts in designing therapeutic interventions with this population.
Portions of this paper were presented at the annual meeting of the Midwest Psychological Association, May 2004, Chicago, IL. 相似文献
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85.
Carl Baar 《Canadian public administration. Administration publique du Canada》1977,20(2):242-274
Abstract. This paper argues that patterns of court administration and the strategies pursued by judiciaries in Canada and the United States are quite different as a result of contrasting constitutional principles. Parliamentary supremacy in Canada has led to executive department administration of the courts, while the American separation of powers doctrine has encouraged judicial branch administration of the courts. Constitutional differences have also promoted more unified systems of court administration in Canada than in the United States. As a result of these differences, Canadian judiciaries have pursued an encapsulation strategy and have depended on the legal community to serve as their patron. On the other hand, American judiciaries have promoted organizational growth and sought empowerment — the development of a separate power base — rather than relying on powerful allies. Sommaire. D'après l'auteur de cet article, les scénarios de l'administration des tribunaux et les stratégies adoptés par les fonctionnaires judiciaires sont très différents au Canada et aux Etats-Unis, par suite de la divergence de leurs principes constitutionnels. La suprématie du parlement, au Canada, a conduit à l'exercice d'un contrǒle par l'exécutif sur l'administration des tribunaux alors que la doctrine américaine de la séparation des pouvoirs a encouragé l'exercice de ce contrǒle par le pouvoir judiciaire lui měme. Les différences constitution-nelles ont aussi contribuéà promouvoir des systèmes d'administration des tribunaux plus unifiés au Canada qu'aux Etats-Unis. A cause de ces différences, les fonctionnaires judiciaires canadiens ont adopté une stratégie de retranchement, comptant sur la communauté des juristes pour leur servir de protecteurs. Leurs homologues américains, par contre, ont cherché ce promouvoir la crois-sance de leur organisation et de ses pouvoirs en fait le devéloppement d'un pouvoir siparé-au lieu de se fies à des allies puissants extérieurs. 相似文献
86.
Barry Wright 《Journal of law and society》1998,25(2):213-236
The systematic study of political trials and national security measures tends to be associated with the old-fashioned genre of ‘state trials’. Although whiggish or critical reductionism has since tended to prevail, recent social historical work on protest movements, ideology, and rights struggles opens up fresh approaches. The current scholarly shift of attention away from the repressive powers of the state to plural sites of power, while representing an advance, also threatens to relegate the area to neglect. The modern renewal of national security measures can in fact be seen as part of a more complex deployment of law and linked to current debates around state formation, governmentality, and citizenship. As the late modern state is eroded from above by globalization, and from below by demands of identity politics and differentiated citizenship, will such repressive measures be revealed as an anachronism or continue as a final resource of the state in crisis? 相似文献
87.
Ronald Wright 《Law & policy》1998,20(4):429-464
Between 1993 and 1997, state legislatures across the country passed legislation popularly known as "three strikes and you're out" laws. These laws appeared at a time when sentencing commissions existed in many states, and the commissions were involved in the legislative debates leading to the votes on three strikes laws. Thus, the passage of three strikes laws can shed light on one type of interaction between sentencing commissions and legislatures. This article posits a variety of objectives for sentencing commissions during three strikes debates, each a response to the recurring "pathologies" that appear when legislative, judicial, and executive branch officials create sentencing policy. A survey of states that have passed three strikes laws indicates that sentencing commissions have not made any systematic difference in the legislative debates on these statutes. Commissions have little reason to oppose these laws absolutely, and could lose political credibility by doing so. Commissions have incentives instead to argue for limiting the scope of these statutes. Where commissions have been involved in the debates about habitual felon legislation, they have emphasized limits on judicial discretion, focused on the quality of legislative deliberations rather than on legislative outcomes, and devoted little attention to prosecutorial charging decisions. 相似文献
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