The uncertainty of knowing: an analysis of the nature of knowledge in a small business context

It is argued that the tendency for small businesses to operate under conditions of internal and external uncertainty determines and affects the knowledge that is developed and deployed. The article is theoretical in intent and approach and offers a conceptulization of one aspect of the small business in order to stimulate debate and to propose a potential framework for future fieldwork and empirical examination. It is argued that types of knowledge-as-knowing and the 'bundles' that form will vary in 2 ways: 1. There will be differences among small businesses that experience uncertainty, in terms of the knowledge-as-knowing that emerges and is applied. 2. The nature of knowledge and its manifestation may differ depending upon context, suggesting the knowledge and its production and application are essentially contextually contingent and determined

Cauda equina syndrome: a review of the current clinical and medico-legal position

Cauda equina syndrome (CES) is a rare condition with a disproportionately high medico-legal profile. It occurs most frequently following a large central lumbar disc herniation, prolapse or sequestration. Review of the literature indicates that around 50–70% of patients have urinary retention (CES-R) on presentation with 30–50% having an incomplete syndrome (CES-I). The latter group, especially if the history is less than a few days, usually requires emergency MRI to confirm the diagnosis followed by prompt decompression by a suitably experienced surgeon. Every effort should be made to avoid CES-I with its more favourable prognosis becoming CES-R while under medical supervision either before or after admission to hospital. The degree of urgency of early surgery in CES-R is still not in clear focus but it cannot be doubted that earliest decompression removes the mechanical and perhaps chemical factors which are the causes of progressive neurological damage. A full explanation and consent procedure prior to surgery is essential in order to reduce the likelihood of misunderstanding and litigation in the event of a persistent neurological deficit