The authors tested the generalizability of J. P. Meyer and N. J. 3-component model of organizational commitment to the domain of occupational commitment. Measures of affective, continuance, and normative commitment to occupation were developed and used to test hypotheses concerning their differential relations with antecedent and consequence variables. Confirmatory factor analyses conducted on data collected from samples of student and registered nurses revealed that the 3 component measures of occupational commitment were distinguishable from one another and from measures of the 3 components of organizational commitment. Results of correlation and regression analyses were generally consistent with predictions made on the basis of the 3-component model and demonstrated that occupational and organizational commitment contribute independently to the prediction of professional activity and work behavior.

This study was conducted to examine the mechanisms involved in observed relations between human resource management (HRM) practices and employee commitment. Employees (N = 281) from several organizations completed a survey that included measures of (a) the quality of HRM practices pertaining to performance appraisal, benefits, training, and career development used in their organizations, (b) procedural justice and organizational support, and (c) affective, continuance, and normative commitment to the organization. Structural equation modeling analyses revealed that relations between employees' evaluations of HRM practices and their affective and normative commitment were largely mediated by perceptions of organizational support and procedural justice. These findings support previous claims that, although HRM practices can be valuable tools in the establishment and maintenance of employee commitment, their effects are neither direct nor unconditional. Résumé Cette étude avait pour but d'examiner certains mécan‐ismes intervenant dans le lien entre les pratiques de ges‐tion des ressources humaines et l'engagement des employés. Des employés (N=281) de plusieurs organisations ont rempli un questionnaire incluant des mesures de: (a) qualité des pratiques de gestion des ressources humaines en matière d'évaluation du rendement, de compensation, deformation et de développement profes‐sionnel, (b) justice en matiere de procedure et soutien organisationnel, et (c) engagement organisationnel affectif, continuation, et normatif. Des analyses basées sur la modélisation d'équations structurelles ont révélé que les liens entre l'évaluation par les employés des pratiques de gestion des ressources humaines et leur engagement affectif et normatif étaient en grande partie médiatisés par leur perception du soutien organisationnel et de justice en matière de procedure. Ces résultats corroborent le fait que malgré l'importance des pratiques de gestion des ressources humaines dans l'étab‐lissement et le maintien de l'engagement des employés, leurs effets ne sont ni directs ni inconditionnels.

Background: Tuberous sclerosis complex (TSC) is an autosomal dominant genetic disease affecting multiple body systems with wide variability in presentation. In 2013, Pediatric Neurology published articles outlining updated diagnostic criteria and recommendations for surveillance and management of disease manifestations. Advances in knowledge and approvals of new therapies necessitated a revision of those criteria and recommendations. Methods: Chairs and working group cochairs from the 2012 International TSC Consensus Group were invited to meet face-to-face over two days at the 2018 World TSC Conference on July 25 and 26 in Dallas, TX, USA. Before the meeting, working group cochairs worked with group members via e-mail and telephone to (1) review TSC literature since the 2013 publication, (2) confirm or amend prior recommendations, and (3) provide new recommendations as required. Results: Only two changes were made to clinical diagnostic criteria reported in 2013: "multiple cortical tubers and/or radial migration lines" replaced the more general term "cortical dysplasias," and sclerotic bone lesions were reinstated as a minor criterion. Genetic diagnostic criteria were reaffirmed, including highlighting recent findings that some individuals with TSC are genetically mosaic for variants in TSC1 or TSC2. Changes to surveillance and management criteria largely reflected increased emphasis on early screening for electroencephalographic abnormalities, enhanced surveillance and management of TSCassociated neuropsychiatric disorders, and new medication approvals. Conclusions: Updated TSC diagnostic criteria and surveillance and management recommendations presented here should provide an improved framework for optimal care of those living with TSC and their families.

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Background: Tuberous Sclerosis Complex International (TSCi) is a consortium of organizations that supports individuals with tuberous sclerosis complex (TSC) around the world. To improve care for TSC on a global level, TSCi identified the need to expand understanding about existing resources available in other countries, what individuals and caregivers value in TSC care, key gaps between needs and reality in each country, and ways these gaps can be addressed by advocacy organizations around the world. Methods: An iterative, mixed methods approach (the Improving Care project) was adopted to incorporate views from diverse members of TSCi. Through idea generation, a collection of qualitative openended responses and concept elicitation, we were able to build consensus where shared experiences and opinions were identified.Results: The research performed as a part of the Improving Care project revealed a significant gap between the guidelines and what is actually available to people with TSC worldwide. Three key priority areas of action to improve this gap were identified: (1) implementation of the guidelines; (2) access to TSC expertise, and (3) coordinated and integrated health care. Conclusions: There are significant opportunities for key stakeholders, including organizations, clinicians, and researchers to improve care for individuals with TSC on both local and global levels. Working across stakeholder groups and utilizing TSC organizations are essential to ensure that the advances in TSC research benefit people living with TSC around the world.

Health benefits associated with exercise are only obtained when exercise is maintained. The purpose of this pilot study was to examine the effects of a cognitive behavioral therapy (CBT) intervention on exercise behavior and physical outcomes in older adults. All participants were taught progressive flexibility, strength, and endurance exercises. The control group received no additional treatment. The experimental group was taught to recognize negative thoughts related to exercise and to counter these thoughts with more positive ones. Subsequent exercise behavior and physical outcomes were measured in all participants. Cognitive behavioral therapy was moderately to largely effective in improving the majority of physical outcomes assessed. In addition, CBT was moderately effective in improving several components of self-reported exercise behavior and mildly effective in improving exercise behavior overall. Results suggest that nurses can train older adults to identify and modify thoughts that interfere with or reduce their exercise behavior and thus improve physical functioning.

International adoptees show more behavior problems than their nonadopted peers do during childhood and adolescence. Although conditions of deprivation experienced prior to adoption have been found to have a long-lasting impact on child psychosocial adjustment, the influence of adoptive families tends to increase over age. The aim of this study was to investigate the impact of parenting stress and parent–child conflict on international adoptees’ behavior problems in adolescence. Our sample consisted of 60 adolescents adopted during infancy and their mothers. Adolescents’ behavior problems were assessed using the Dominic Interactive Adolescent, a self-report measure, and the Child Behavior Checklist, completed by mothers. Parenting stress was assessed using the Stress Index for Parents of Adolescents. Adolescents and their mothers were also observed during a discussion to evaluate parent–child conflict. Structural equation modeling revealed that parent–child conflict mediated the association between parenting stress and externalizing symptoms.