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61.
Susan Randall Armel Jeanna McCuaig Amy Finch Rochelle Demsky Tony Panzarella Joan Murphy Barry Rosen 《Journal of genetic counseling》2009,18(4):366-378
The number of individuals receiving genetic counseling for hereditary breast and ovarian cancer syndrome has steadily risen.
To triage patients for genetic counseling and to help reduce the amount of time needed by a genetic counselor in direct patient
contact, many clinics have implemented the use of family history questionnaires. Although such questionnaires are widely used,
scant literature exists evaluating their effectiveness. This article explores the extent to which family history questionnaires
are being used in Ontario and addresses the utility of such questionnaires in one familial cancer clinic. By comparing the
pedigrees created from questionnaires to those updated during genetic counseling, the accuracy and effectiveness of the questionnaires
was explored. Of 121 families recruited into the study, 12% acquired changes to their pedigree that led to a revised probability
estimate for having a BRCA1 or BRCA2 mutation and 5% acquired changes that altered their eligibility for genetic testing.
No statistically significant difference existed between the eligibility for genetic testing prior to and post counseling.
This suggests that family history questionnaires can be effective at obtaining a family history and accurately assessing eligibility
for genetic testing. Based on the variables that were significantly associated with a change in probability estimate, we further
present recommendations for improving the clarity of such questionnaires and therefore the ease of use by patients. 相似文献
62.
In this paper, we present an integrated ethical framework that covers the different levels of ethical tasks inherent in forensic and correctional work. First, we briefly give an overview of the ethical framework and its component notion of human dignity. Second we analyze in depth the concept of dignity and its relationship to normative theories and ethical concepts that are particularly relevant for forensic practitioners. Third, we explore the capacity of the conceptions of human dignity and vulnerable agency to integrate principles typically contained in ethical codes and practice, such as beneficence, autonomy, and justice. Fourth, we discuss how conflict between ethical codes or duties of station adhered to by practitioners can be effectively addressed in light of the model of dignity and agency outlined earlier. Fifth, we explain how individuals' specific ethical judgments and actions should proceed in light of our framework model. 相似文献
63.
Correctional practitioners work within a context that is heavily influenced and constrained by punishment policies and practices. The overlap between the normative frameworks of punishment and offender rehabilitation creates a unique set of ethical challenges for program developers and therapists. In this paper we set out to briefly outline three major punishment theories and draw out their implications for correctional practitioners. First, we discuss the nature of punishment and the problems it poses for practitioners and all citizens in liberal democracies. Second, consequential, retributive, and communicative justifications of punishment are succinctly described and their clinical implications analyzed and some limitations noted. Finally we conclude with some suggestions for ethical practice in correctional settings. 相似文献
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65.
Tony Garry 《Journal of Consumer Behaviour》2007,6(6):383-397
- Evidence which demonstrates a link between the affective dimension and satisfaction in a tangible product based context is well documented. However, when placed in a credence service context the role of Affect becomes more complex. Previous research in this field has assumed consumer homogeneity when there is increasing evidence of consumer heterogeneity. This research attempts to address this by examining affective reactions to service encounters between two groups of respondents, one with the ability to make performance assessments about the service and one without. Findings suggest consumers of differing sophistication will vary in the way they form expectation and performance assessments about the technical, functional and affective components of credence services and that consumer sophistication may have a moderating influence on affective reactions evoked. This in turn has implications for the design and delivery of service offerings within such contexts.
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67.
Tony Latham 《Journal of Family Therapy》1986,8(2):125-137
Recognizing the influence of ideologies on approaches to violence in the family, the author has sought to set this violence in the context of a violent society. In this same society, however, there has also evolved in recent years a range of concepts related to non-violent problem-solving. Examining some of these concepts the author considers the possibility of applying them to family situations as a way of developing skills useful to the family but also relevant in other life conflicts. 相似文献
68.
This study examined several important family and therapist characteristics as they related to treatment success. A total of 434 families entering family therapy at a sliding-fee clinic in Dallas, Texas were rated (on the Beavers Interactional Competence and Style Scales), and completed several self-report family assessment instruments (Self-Report Family Inventory, FACES III) prior to beginning therapy. The therapists, trainees from various disciplines, had been trained in the Beavers Systems Model. Overall, 75% of the families showed at least some improvement. Those that fared best in therapy were more competent at the outset. While number of therapy sessions was associated with greater gains, there were some families that made great gains in fewer than six sessions. There were important demographic qualities that did not discriminate between greater- vs. lesser-gain families, including income level, ethnicity, therapist gender, and family size. A regression analysis indicated that functional rather than demographic variables were more important in predicting therapy outcome. 相似文献
69.
This study examined therapeutic outcome for a group of 175 clinic families divided into levels of family competence and style, and, later, into seven clinical groupings. The division into these groups was based on the level of rated Competence and Style determined by using the Beavers Systems Model. Therapists also rated their level of Openness/Sharing Strategy, Power Differential, and Partnership with the family at the third session. Results indicate that more competent families who fared well in therapy had therapists who formed a partnership, disclosed strategy, and employed a minimal power differential with the family. The most disturbed families, and those with a Centrifugal style, did better with therapists employing a high power differential and lower levels of openness and partnership. The study also presented the distribution of individual diagnoses by family groups. Implications for family therapists, including the value of family assessment, are provided. 相似文献
70.