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IntroductionThere is sub optimal documentation of neurological exam findings in patient’s hospital records. Documented Neurological findings are often incomplete, omitted or scattered in various places in the clinical notes. This is important in the setting of acute neurological emergencies, where accurate documentation is vital in gauging potential deterioration/improvement in a patient’s condition.MethodA chart review was performed on 80 patients referred to the Neurology consult service in St James’s Hospital between January-February 2018. All aspects of the Neurological exam findings documented in these charts were noted. A gold standard template for accurate recording of Neurological exam findings was then created and circulated to all Hospital NCHD’s. A repeat chart review was performed on 80 patients referred to Neurology Consults between March-May 2018 (following the circulation of this template) and results were compared.DiscussionRecord keeping varied according to different clinical parameters, being lowest for speech at just over 20% and highest for muscle power at over 70%. Globally there was a small but significant improvement (P Value<0.001) in the documentation rates of neurological exam parameters following circulation of the template. We plan to apply this template to all acute medical admissions in St James’s Hospital.

Purpose There is an absence of research examining job embeddedness in SMEs. Results of job embeddedness studies may not apply to SMEs, because the process of managing a SME differs from that of the large firm. The purpose of this paper is to examine relationships between on-the-job embeddedness, as well as each of its sub-dimensions, and turnover intentions; and group cohesion, on-the-job embeddedness and turnover intentions. Design/methodology/approach Data were collected from 147 employees in SMEs located in Perth, Western Australia and 350 employees from SMEs operating in four business centres in South Africa. After invariance testing, data from the two countries were combined to increase statistical power of the analysis. Findings On-the-job embeddedness and each sub-dimension were negatively related to turnover intentions. Group cohesion was positively related to composite on-the-job embeddedness. Findings suggest that while group cohesion on its own does not reduce turnover intentions, it does contribute to development of on-the-job embeddedness that, in turn, reduces turnover intentions. Research limitations/implications Future research should control for the effects of external influences on turnover intentions. Findings imply that managerial actions related to antecedents of group cohesion could foster the on-the-job embeddedness of employees. Originality/value This study is perhaps the first that tests the operation of on-the-job embeddedness in SMEs located in two countries. The conceptual arguments for links between each of the sub-dimensions of on-the-job embeddedness and turnover intentions are based on distinctive characteristics of SMEs and can serve as a theoretical foundation for future research on embeddedness in SMEs.

Background: Headaches represent a significant proportion of referrals to any neurology consult service, of which many are migrainous. Regular use of opioids can lead to medication overuse headache in these patients and in some cases, dependence. The epidemic of opioid abuse represents a serious public health concern, with long term use of opioids associated with risk of misuse, abuse, addiction and even overdose. Methods: We audited headache referrals to the neurology consult service in an acute tertiary hospital over three 6-month periods between 2012 and 2019. Appropriateness of referrals with respect to NICE guidelines and initial treatments strategies were assessed. Results: The majority of headache disorders seen were migrainous and we found an alarming and repeated trend of early opioid prescribing in the initial acute setting (up to 56%). Conclusions: Further education of healthcare professionals and patients is urgently required to prevent this group becoming victims of the growing global opioid epidemic.

Autosomal dominant optic atrophy plus syndrome is a rare cause of blindness and sensorineural deafness, usually presenting with insidious onset in childhood. Other clinical manifestations are variable but include, peripheral neuropathy, myopathy, opthalmoplegia, ataxia and spastic paraparesis.We present a 50-year-old gentleman brought to clinic with a history of a slowly progressive gait difficulty. He was blind and deaf since childhood but no diagnosis had been made. He had no relevant family history. Examination revealed bilateral optic atrophy on fundoscopy. He was unable to stand unassisted and had reduced reflexes in the lower limbs. MRI brain and spine, together with routine bloods including neuropathy screen were unremarkable. Nerve conduction studies/EMG showed evidence of a large fibre sensorimotor axonal peripheral neuropathy, which was worse in the lower limbs. Given his constel- lation of symptoms, genetic testing was arranged and revealed a heterozygous pathogenic variant in OPA1 gene. This was consistent with a diagnosis of autosomal dominant optic atrophy plus syndrome.This condition is rare and often first detected in childhood. Diagnosis can be challenging due to variable clinical phenotypes and markedly variable expression of disease within families. There is a need for strong clinical suspicion for the disease in any patient with a history of blindness.declanbrennan.1@ucdconnect.ie56

PurposeDrawing on social network and social capital literature, this study aims to explore how digital entrepreneurs utilize social networks to build their entrepreneurial capability, creating and developing business ventures in a digitally networked society.Design/methodology/approachThe study takes a qualitative approach, interviewing 35 digital entrepreneurs with businesses operating across multiple industry sectors in Western Australia.FindingsThe findings suggest that structural social capital provides a key resource with groups of relational contacts who facilitate in building entrepreneur capability, the venture and customer markets. Relational social capital provides a foundation of trust between entrepreneurs and social network members that is strategically important for digital entrepreneurship (DE). Cognitive social capital provides mechanisms to form relationships based on shared values across social networks.Research limitations/implicationsThe study produces early evidence that in a multiplexed networking world, social capital accrual and use online is different from that of off-line. More empirical studies are needed to understand the complexity of the changing nature of online and off-line social networks, the consequential social capital and their interdependence in DE.Practical implicationsThis is an exploratory qualitative study using a limited sample of 35 Australian digital entrepreneurs to explore the impact of social network interaction on digital entrepreneurs and their ventures, with the purpose of stimulating a social network approach when studying DE. This study confirms the critical importance of entrepreneurial social networks in the digital age and provides empirical evidence that online networks foster business development, while off-line networks feed self-development.Originality/valueThe study contributes to current research on DE as a dedicated new research stream of entrepreneurship. Specifically, the study contributes to a greater understanding of how digital entrepreneurs leverage social networks in today's digitally connected society.

Energy audits can provide businesses with valuable information and advice about their current energy use and costs and where changes can be made to improve both the environmental performance of the business and their triple bottom line. There is literature on the use of energy audits outside Australia, but little provision of empirical data that would help a business decide whether engagement is economically viable. This paper reports on 49 SME energy audits in Australia, and the results verify that economic returns can vary significantly and alone are not a reason for most SMEs to act. Thus, more will need to be done to engage them as their collective impact on the environment should be a catalyst for action and support from stakeholders.

This paper outlines a proposed study employing the critical incident technique aimed at uncovering factors influencing owner-managers' decisions when employees in medium-sized enterprises request access to external training and development opportunities. Employees in these enterprises form part of a 'disadvantaged' group within the workforce that receives less access to formal training and development than employees in large firms. The owner-manager's decisional role is critical when considering employee access to training and development. Unfortunately, there is scant research into factors affecting owner-managers' decisions regarding employee access to a requested development opportunity in medium-sized enterprises. To address this research gap, we intend to conduct semistructured interviews incorporating critical incidents with a sample of 20 owner-managers. We anticipate that the interviews will provide rich, nuanced and contextualized information on the decision-making role of owner-managers that can be analysed for key themes. 1

This paper extends our understanding of how casino patrons are affected by COVID-19 restrictions and how they cope by substituting gambling with alcohol consumption. We conducted two studies using a nationwide survey sample collected in Australia during the pandemic lockdown. Study 1 compares the casino patrons with two reference groups (other gambling patrons and non-gambling individuals) and investigates the lockdown restrictions on respondents’ relational strength, and their potential impact on mental health and future prospects. Study 2 applies the stress-response dampening model (SRD) and tests how respondents used alcohol consumption to cope with the lack of access to casinos during the lockdown. The results from Study 1 suggest that lockdown restrictions on respondents’ relational strength have significant negative impacts on anxiety, life satisfaction and post-pandemic outlook. Study 2 finds that casino patrons substituted gambling with alcohol consumption during the lockdown, with increased alcohol consumption negatively related to life satisfaction. Paradoxically, Australian gambling venue owners may not be adversely affected as many also run liquor retail operations.

Purpose In a highly competitive globalised environment, the innovation behaviour of employees plays a key role in the economic viability and competitive advantage of organisations. In this context, developing the understanding of innovation work behaviour is important for the field of individual innovation and this is the focus of the study. The paper aims to discuss this issue. Design/methodology/approach Data were collected using a survey from 549 employees in organisations operating in four major business centres in South Africa. Findings On-the-job embeddedness was positively and significantly related to innovation behaviours by employees in organisations operating in diverse industries. Consistent with the view that small organisations have a “behavioural” innovation advantage over larger organisations, the size of the organisation moderated the positive relationship between on-the-job embeddedness and innovation behaviours. On-the-job embeddedness was more positively related to innovation behaviours in small organisations than in larger organisations. Practical implications Employees who are highly embedded in their jobs (but not necessarily their communities) are more likely to enact innovation behaviours than employees who are not similarly embedded. Human resource management professionals and line managers can potentially foster employee innovation behaviours through adopting strategies aimed at positively influencing the fit, links and sacrifice dimensions of on-the-job embeddedness. Originality/value The study contributes to theoretical and empirical expansion of job embeddedness (JE) by examining: how work and non-work forces that attach employees to their organisations influence their propensity to enact innovation behaviours; and how organisation size moderates the relationship between JE and innovation behaviours. The results will help managers who wish to foster innovation.

Purpose There is strong and growing evidence of the importance of leadership and management factors influence on employee engagement and discretionary effort. However, the problem is that there has been limited recent effort to review where research gaps exit and provide a direction to guide future research. The purpose of this paper is to provide an integrated perspective on the influence of leadership and management factors on employee engagement and discretionary effort. Design/methodology/approach The review of the literature includes empirical research and case studies related to employee engagement and discretionary effort from various databases such as Business Premier, Cambridge University Press, JSTOR, Springer, Emerald, Wiley, ProQuest and ISI Web of Science. Supporting material was also accessed from reference books regarding similar concepts and theories. Findings The review provides a current view of the key topics, identifies three key research gaps, suggests a refined, up-to-date definition of both employee engagement and discretionary effort, and proposes a conceptual framework to inform future research. In doing so, it offers new directions for progressing studies on these critical workplace practices and behaviours particularly the inclusion of national culture as a moderating variable when investigating or implementing employee engagement and discretionary effort strategies. Research limitations/implications Findings are based on existing literature and require empirical testing. Practical and theoretical implications are discussed. Originality/value Undertaking a review of the literature is an important part of any research and this review aims to organise, describe and appraise the current literature with a view to gaining a critical perspective for the benefit of researchers.