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231.
Doctor's Expertise and Managing Discrepant Information from Other Sources in Genetic Counseling: A Conversation Analytic Perspective 总被引:1,自引:0,他引:1
The study examines a recurrent interactional pattern in genetic counseling. It describes clinical geneticists' responses in
situations in which clients have presented information from other sources that is potentially discrepant with information
given by the doctor. The data consists of 12 video-recorded sessions of genetic counseling in Finland, and the method is conversation
analysis. There are two primary ways the doctors respond: either they accept the client's information as such, but show that
it is not discrepant with the doctor's information, or they reject the client's information. In the latter case they mitigate
the ‘wrongness’ of the client's information. The clinical geneticists seem to be working with a dilemma: they need to find
a balance between ensuring correct understanding of the information and showing respect for the expertise of others. A particularly
complex case is also analyzed and reflected on. 相似文献
232.
One measure of the impact of genetic counseling and testing (GCT) is the extent to which it fosters behavioral change that is consistent with mutation status. We describe and illustrate how two different signal detection methods, receiver operating characteristic (ROC) analysis and recursive partitioning, can be used in this context to evaluate the impact of GCT. We analyzed real screening behavior data obtained in the 12 months following GCT for Hereditary Nonpolyposis Colon Cancer (HNPCC) using these two different signal detection approaches. Each approach demonstrated that GCT had an impact on behavioral outcomes, and was effective in fostering behavioral outcomes appropriate to mutation status. The ROC approach demonstrated that GCT was effective because mutation positive and mutation negative individuals could be distinguished on the basis of the number of recommended screening behaviors. The recursive partitioning approach demonstrated that GCT was effective because there were generally high rates of adherence to screening guidelines among subjects. The recursive partitioning technique also identified four subgroups of subjects, each with distinct characteristics, for which tailored interventions could be developed to increase rates of adherence to screening guidelines. Signal detection methods are easily implemented and are useful techniques for evaluating the impact of GCT. 相似文献
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235.
Dorothée?LegrandEmail author Franck?Grammont 《Phenomenology and the Cognitive Sciences》2005,4(3):249-257
We discuss the justification of Bickle's “ruthless” reductionism. Bickle intends to show that we know enough about neurons
to draw conclusions about the “whole” brain and about the mind. However, his reductionism does not take into account the complexity
of the nervous system and the fact that new properties emerge at each significant level of integration from the coupled functioning
of elementary components. From a methodological point of view, we argue that neuronal and cognitive models have to exert a
mutual constraint(MC) on each other. This approach would refuse to award any priority of cognitive approaches over neuroscience, and reciprocally,
to refuse any priority of neuroscience over cognitive approaches. MC thus argues against radicalreductionism at the methodological level. 相似文献
236.
The new correlated 8-factor measurement structure of the Child Behavior Checklist for ages 6-18 (CBCL/6-18; T. M. Achenbach & L. A. Rescorla, 2001) derived from an American sample was used as a benchmark to evaluate its generalizability to Turkish general population (N = 5,195) and clinical (N = 963) samples. Item-level confirmatory factor analysis (CFA) was used to evaluate the adequacy of the correlated 8-factor model across 3 sample conditions (general population, clinical, and combined sample whose Total Problems scores were above the Turkish national median). The results supported the generalizability of the overall measurement structure of the CBCL to the Turkish population. 相似文献
237.
Used linguistic analysis of written narratives of caregivers of hospitalized youth with chronic illness to identify emotional and cognitive processes related to physical and psychological health outcomes following writing. Measures were administered at baseline and 4 months. Experimental group (n = 29) wrote about traumas whereas the control group (n = 24) wrote about summer activities for 20 min on three different days. Compared groups on negative emotion- and cognition-related word use. Tested change in negative emotion- and cognition-related word use as predictors of outcomes in experimental group. Consistent with hypotheses, experimental group used more negative emotion words [F(1, 53) = 77.55, p < .001] and cognition-related words than control group [F(1, 53) = 19.09, p < .001] and an increase in cognition words predicted Physical Health Summary Score on SF-36 (standardized = .37, p < .05). A decrease in negative emotion words was related to Physical Health Summary Score on SF-36 only when entered into regression with change in cognition words (standardized = –.31, p < .05). A decrease in negative emotion together with an increase in cognitive processing facilitated by written emotional disclosure has beneficial effects on physical health-related quality of life. 相似文献
238.
Fisher WW DeLeon IG Rodriguez-Catter V Keeney KM 《Journal of applied behavior analysis》2004,37(2):171-184
Recent research has shown that the noncontingent delivery of competing stimuli can effectively reduce rates of destructive behavior maintained by social-positive reinforcement, even when the contingency for destructive behavior remains intact. It may be useful, therefore, to have a systematic means for predicting which reinforcers do and do not compete successfully with the reinforcer that is maintaining destructive behavior. In the present study, we conducted a brief competing stimulus assessment in which noncontingent access to a variety of tangible stimuli (one toy per trial) was superimposed on a fixed-ratio 1 schedule of attention for destructive behavior for individuals whose behavior was found to be reinforced by attention during a functional analysis. Tangible stimuli that resulted in the lowest rates of destructive behavior and highest percentages of engagement during the competing stimulus assessment were subsequently used in a noncontingent tangible items plus extinction treatment package and were compared to noncontingent attention plus extinction and extinction alone. Results indicated that both treatments resulted in greater reductions in the target behavior than did extinction alone and suggested that the competing stimulus assessment may be helpful in predicting stimuli that can enhance the effects of extinction when noncontingent attention is unavailable. DESCRIPTORS: Attention-maintained problem behavior, competing stimuli, extinction, functional analysis, noncontingent reinforcement 相似文献
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Rambo (1993) theorized that religious conversion consists of a process involving seven dimensions, labeled context, crisis, quest, encounter, interaction, commitment, and consequences. To test the Rambo model, a new measure, the 97-item Adult Religious Conversion Experiences Questionnaire (ARCEQ), was developed, revised on the basis of feedback from a focus group, and administered by mail to 110 adult volunteers who self-identified as having experienced conversion. Reliability analysis of the subscales of the ARCEQ resulted in five (crisis, quest, encounter, commitment, and consequences) meeting the criterion ( > .80). A sixth (interaction) achieved a reliability of .76 and was retained, but the seventh (context) was dropped. Principal components factor analysis with Varimax rotation produced factors labeled Redemptive Love, Zealous Dedication, Dysphoric Need, Openness to Uncertainty, Extrinsic Crisis, and Experiential Learning, which could readily be interpreted in relation to Rambo's model. Subsidiary analyses showed a number of significant correlations between demographic characteristics of the sample and differences in religious conversion experience. 相似文献