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131.
OBJECTIVE: This study compares abnormal genital examination findings made by pediatric emergency medicine (PEM) physicians to examinations by physicians with training in child sexual abuse in the evaluation of prepubertal girls for suspected sexual abuse. METHOD: A prospective study was performed following the genital examination by a PEM physician of prepubertal girls suspected of being sexually abused. A physician with training in child sexual abuse re-examined those girls whose examinations were interpreted as abnormal by the PEM physicians. The findings and interpretations of the PEM physician were then compared to those by the physicians with training in child abuse. RESULTS: Between October 1994 and October 1998, 46 patients diagnosed by PEM physicians with nonacute genital findings indicative of sexual abuse were re-examined by a physician with training in child abuse. The follow-up examinations were done 2 days-16 weeks (mean 2.1 weeks) after the emergency department visit. The physicians with training in child abuse concluded that only eight of these children (17%) showed clear evidence of abuse. Normal findings were noted in 32 children (70%), nonspecific changes were noted in 4 children (9%), and 2 children (4%) had findings that are more commonly seen in abused children than nonabused children but are not diagnostic for abuse (concerning for abuse). CONCLUSIONS: There was poor agreement between the pediatric emergency medicine physicians and the physicians with training in child sexual abuse. This study suggests that emergency medicine physicians should consider additional training in this area. In addition, all children with abnormal ED examinations should have follow-up examinations by a child abuse trained physician.  相似文献   
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This essay emerged from the authors’ presentation at an invited session of the 15th Annual Conference on Interdisciplinary Qualitative Studies (QUIG) at the University of Georgia, Athens, 3–5 January 2002. They presented on the conference theme, ‘Vision, Voice & Virtuality: (Re)Conceptualizing Qualitative Representation.’ Their work here encompasses their response to the conference organizers’ invitation to grapple with (re)conceptualizing qualitative representation. Their goal is to explore the (re)presentation of voices and subjectivities that are engaged in Queer processes for social change. First they question whether Queer can be adequately articulated. They then posit that emerging Queer theory and the actions it invigorates are significant, galvanizing contemporary intellectual and political forces that power social change. Blurring the lines of bounded, intact, stable and essential identity categories—such as straight, lesbian, and gay—they give examples from their qualitative research, including autoethnographic accounts that indicate that the Queer movement has shifting, multiple and overlapping sites of education and resistance. These sites textualize everyday life; contest hetero‐hegemony; resist readings that exclude or defame Queers and non‐normative identities; allow the development of oppositional practices; and make commitment to social change in an environment of hope and possibility. Finally, they explore some characteristics of Queer qualitative research, and suggest future directions for infusing theory with ‘justice to come.’  相似文献   
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This exploratory study examined the extent to which the effectiveness of instructional interactions varies among classroom social settings (i.e., large group, free choice, meals, and routines), learning activities (i.e., shared reading, literacy, math, science, social studies, and esthetics), or their combination. Participants were 314 preschool teachers primarily serving children from low-income backgrounds. Instructional interactions were measured in multiple cycles across one day of classroom observation as teachers engaged in a variety of settings and learning activities. Linear mixed models indicated that the effectiveness of teachers’ instructional interactions was generally higher in the large group setting than in free choice, meals, and routine settings. When considering settings and learning activities in combination, teachers displayed the most effective global instructional interactions when leading science activities in large group or free choice settings, and the most effective literacy-focused interactions during large group literacy activities.  相似文献   
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Academic work is changing fast, as is the work of other professionals, because of challenges such as accountability and regulations frameworks and globalised academic markets. Such changes also have consequences for everyday academic practice and learning. This paper seeks to explore some of the ways in which academic work is changing by opening the ‘black-box’ of everyday academic work and examining the enactment of academics’ everyday learning. The paper draws on a study of everyday academic practice in the social sciences with respect to the institution, the department and the discipline. Assuming a sociomaterial sensibility, the study also sought to understand how academics’ learning is enacted in everyday work. Within three universities, fourteen academics were work-shadowed; social, material, technological, pedagogic and symbolic actors were observed and, where possible, connections and interactions were traced. The paper illuminates through two stories from the study how specific practices and meanings of disciplinary academic work are negotiated, configured and reconfigured within and beyond the department or meso-level, attending to resistance and rejection as well as accommodation and negotiation. The paper responds to educational concerns of professional (here, academic) learning by foregrounding both the assembling and reassembling of academic work and the enactment of learning.  相似文献   
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Biological maturation can be defined as the timing and tempo of progress to achieving a mature state. The estimation of age of peak height velocity (PHV) or percentage of final estimated adult stature attainment (%EASA) is typically used to inform the training process in young athletes. In youth soccer, maturity-related changes in anthropometric and physical fitness characteristics are diverse among individuals, particularly around PHV. During this time, players are also at an increased risk of sustaining an overuse or growth-related injury. As a result, the implementation of training interventions can be challenging. The purpose of this review was to (1) highlight and discuss many of the methods that can be used to estimate maturation in the applied setting and (2) discuss the implications of manipulating training load around PHV on physical development and injury risk. We have provided key stakeholders with a practical online tool for estimating player maturation status (Supplementary Maturity Estimation Tools). Whilst estimating maturity using predictive equations is useful in guiding the training process, practitioners should be aware of its limitations. To increase the accuracy and usefulness of data, it is also vital that sports scientists implement reliable testing protocols at predetermined time-points.  相似文献   
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Teacher referrals for consultation resulted in two independent teams collecting evidence that allowed for a treatment component evaluation of color wheel (CW) procedures and/or interdependent group‐oriented reward (IGOR) procedures on inappropriate vocalizations in one third‐ and one first‐grade classroom. Both studies involved the application of B‐C‐D‐C designs, with the initial B phase involving the application of independent group‐oriented punishment (IGOP) procedures that were applied in all classrooms at the respective schools and maintained across all phases of the studies. In Study I, the C phase involved that application of IGOP, IGOR, and CW; CW was withdrawn in the D phase and reinstated in the subsequent C phase. In Study II, IGOP procedures were supplemented with CW procedures (first C phase), then IGOR procedures were added (D phase) and withdrawn (second C phase). Results from the two studies converge and provide evidence that CW procedures are effective when applied with IGOP procedures and that supplementing them with IGOR procedures may have little classwide impact on inappropriate vocalizations. © 2010 Wiley Periodicals, Inc.  相似文献   
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Jamie 《英语辅导》2003,(6):29-29
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