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91.
Dorothy E. Dean M.D. Jennifer M. Jamison M.A. B.S. Jason L. Lane M.D. 《Journal of forensic sciences》2014,59(4):1142-1145
Peritonitis secondary to spontaneous rupture/perforation of the gall bladder is a rare condition overall and is even less common in the forensic population. We report the case of a middle‐aged man who died from generalized peritonitis from gall bladder perforation due to acute acalculous cholecystitis. This condition usually occurs in critical patients with systemic illness, and although the exact pathogenesis remains unclear, the development of acalculous cholecystitis appears to be multifactorial. Antemortem diagnosis is reliant upon clinical presentation, laboratory data, and radiologic studies. Surgery and appropriate antibiotics are mainstays of treatment; however, there is an emerging role for minimally invasive procedures. Histopathologic features show significant overlap with the calculous type. Although increasing numbers of acalculous cholecystitis have been diagnosed in the critically ill, the fatal presentation of a perforated gall bladder following an undiagnosed case of acute acalculous cholecystitis is unusual in a nonhospitalized and ambulatory man. 相似文献
92.
基于收入差别的农村公共服务需求偏好与满意度研究 总被引:3,自引:0,他引:3
本文以收入差别为逻辑起点,对当前我国农村公共服务需求偏好进行研究发现:现阶段我国农村养老、子女教育和医疗保障服务的需求愿望较为强烈,且生活类公共服务需求愿望强于生产类公共服务需求;随着收入的增加,保障型公共服务需求递减,发展型公共服务需求递增;在农村公共服务满意度方面,高收入群体对公共服务的满意度总体上高于低收入群体。这一研究发现蕴涵三方面的公共政策取向:一是当前完善农村公共服务体系的重点是公众需求强烈的子女教育、医疗保障、养老等基本民生领域;二是在对农村公共服务供给结构组合中,优先保证公众生活类公共服务需求,同时尽力满足公众发展型公共服务需求;三是在农村公共服务供给项目选择上,优先保证低收入群体的公共服务需求。 相似文献
93.
Abstract Previous research suggests that delivering treatment for sexual offenders can have both positive and negative effects on therapists. We know less about the specific impact of conducting such work in different ways; for example, individually rather than in groups. This study aimed to explore the experiences of sexual offender therapists delivering a one-to-one programme with clients. Eleven therapists delivering an individual intervention with high-risk sexual offenders in English prisons took part in interviews and focus groups about the impact this work has had upon them. One participant also completed a diary charting their experiences while delivering the intervention. Content analysis identified that participants felt they experienced changes in how they viewed themselves, others and the therapeutic relationship, in both positive and negative ways. They also described experiencing intrusive thinking and feeling overly responsible for the outcome of treatment. However, positive effects were also identified. Findings suggest that the provision of structured supervisory support was particularly key in mitigating the impact of treatment delivery. 相似文献
94.
Education policy has recently focused on improving accountability and incentives of public providers for actual learning outcomes, often with school-based reward programmes for high performers. The Learning Guarantee Programme in Karnataka, India, is prominent among such efforts, providing cash transfers to government schools that achieve learning at specified high levels. This study examines whether schools that self-selected into the incentive programme are different than those that did not. The answer has important implications for how to evaluate the impact of such a programme. Although we find no significant differences in resources and characteristics, we do find significant and substantial differences in test scores prior to selection into the programme, with better performing schools more likely to opt-in. These findings also provide insight into how incentive-based programmes that focus on levels of (rather than changes in) achievement can exacerbate inequality in education. Failing schools, since they are more likely to opt-out of incentive programmes, are likely to require other targeted programmes in order to improve. In addition, our findings reinforce the value of randomised controlled trials to evaluate incentive programmes since evaluations that rely on matching schools based on resources (if, for instance, pre-programme test scores are unavailable) will be biased if resources poorly predict test scores. 相似文献
95.
This article investigates the impact of rising wheat prices on household food security in Afghanistan. Exploiting a unique nationally-representative household survey, we find evidence of large declines in the real value of per capita food consumption. Smaller price elasticities with respect to calories than with respect to food consumption suggest that households trade off quality for quantity as they move away from nutrient-rich foods such as meat and vegetables toward staple foods. Our work improves upon country-level simulation studies by providing estimates of actual household food security during a price shock in one of the world's poorest, most food-insecure countries. 相似文献
96.
97.
AbstractIn this article, we see the month-long graduate student and contract faculty strike at York University (Toronto, 2015) through a lens informed by Herbert Marcuse’s thought. In the context of widespread student protests across North America against neoliberal austerity, we draw on our picket line experiences to argue that Marcuse’s work provides insights into how students and faculty can engage in critical praxis within the neoliberal university. We argue that CUPE 3903, the union of TAs and contract faculty at York, is a kind of counter-institution that Marcuse argued was necessary for liberation. Marcuse strategically urged students to take advantage of gaps or cracks in a disintegrating system. Our analysis revolves around the complex experience of the graduate student picket lines – a “gap” – as a site of rupture for the liberation of aesthetic experience, “organized spontaneity,” open, democratic organization, as well as conflict. 相似文献
98.
Dean Curran 《Critical Criminology》2018,26(4):595-610
In an age of accelerating wealth at the very top and accelerating risks at the bottom, there is a clear disjunction between the flow of social benefits and social damages produced by different actors and their share of these respective benefits and damages. Yet, the specific processes that generate the dualization of tracks of accumulation of rewards or accumulation of risks and precarity are still up for debate. In tackling this dual process in a way that is attuned to the critical contribution of contemporary forms of the law to this uneven accumulation of wealth and of risks, this paper focuses on organized irresponsibility—where individuals can cumulatively contribute to risks, but avoid individual culpability—and how relations of organized irresponsibility provide extensive opportunities for risk arbitrage. Risk arbitrage is correspondingly a process where actors, whether it be individuals or larger organizations, can produce social risk, appropriate benefit from these risks, and disproportionately avoid the consequences of the risks so as to benefit from the overall “cycle of reward and risk”—even if society as a whole is worse off. The paper identifies organized irresponsibility as fundamentally undergirded by mismatches between existing configurations of law and the existing complexity of the processes of the production of social goods and risks. This paper proceeds to show how gaps in the law enable the organized irresponsibility principle—that given a level of risk production, the greater the number of actors involved and the greater complexity between causes and the risk’s impacts, the less overall culpability that tends to be assigned. It then shows how the organized irresponsibility principle enables relationships of risk arbitrage that intensify contemporary risk and inequality. 相似文献
99.
Malcolm Dean 《Criminal Justice Matters》2013,92(1):44-45
Five years ago after 46 years of daily deadlines – the last 38 on The Guardian – I retired to explore, with the help of Joseph Rowntree Foundation and Nuffield College Oxford fellowships, just how much influence was played by the media in the policy making process. The exercise was prompted by rising public concern over the ever widening power of the media. Onora O'Neill, the philosopher, in her Reith lectures in 2002 on trust in public institutions, noted with irony that the main champion of transparency and accountability – the media – were themselves the least transparent and accountable group in democracy. Anthony Sampson, a distinguished journalist, in his fourth edition of Anatomy of Britain in 2004, documented just how entrenched this perception was. 相似文献
100.