Greek Gods Essay -- essays research papers

Greek Gods   Ã‚  Ã‚  Ã‚  Ã‚  Welcome to my report on Greek gods and myths. You will learn about the gods and what they did. It is also about the myths and legends of Greece. greek gods   Ã‚  Ã‚  Ã‚  Ã‚  The gods of Greece are alike many other types of gods. They were pictured a lot like human men and women. The Greeks didn't worship any animals. The gods, like people were endowed with many weaknesses. The gods could be jealous, envious, spiteful, and petty. The gods were held to be immortal, but they had a beginning. The rites of many gods came from Egypt. Most of the gods lived on Mt. Olympus. the first gods   Ã‚  Ã‚  Ã‚  Ã‚  The first gods were the Titans. They were before all the other gods. The Titans were the brothers Oceanus, Coeus, Crius, Hyperion, Iapetus, and Cronus. Also the sisters Thea, Rhea, Themis, Mnemosye, Phobe, and Tethys. the gods   Ã‚  Ã‚  Ã‚  Ã‚  Zeus was the strongest of all the gods. He ruled the weather by himself, and the universe with 11 other gods. Zeus was the spiritual father of the gods. He was usually armed with a thunderbolt He was also called Thunder. Hera was the wife of Zeus. She was the goddess of marriage and childbirth. She was also the queen of heaven . Poseidon was Zeus' somewhat unruly brother. He was god of the sea, of earthquakes, streams, and horses. Hesta was the sister of Zeus. She was the goddess of the household. Ares was one of Zeus' sons. He was the god of war. He loved ...

Comparing Crime and Punishment and Taxi Driver :: comparison compare contrast essays

Crime and Punishment and Taxi Driver He is a man whose psychological workings are dark, twisted, horrifying, and lonely. He is an absurd, anti-hero who is absolutely repulsed by his surroundings, and because he is unable to remove himself from them, he feels justified in removing other people. This profile fits Travis, portrayed by Robert DeNiro in Scorsese's film "Taxi Driver,", and Raskolnikov, the main character of Dostoevsky's novel Crime and Punishment. Their revulsion for life leads both men to commit cold-blooded murders, but the story lines contain major differences. By contrasting these differences and comparing the common themes of the classic and the film, we may come to a clearer understanding of the purpose of both stories. The root of both Travis' and Raskolnikov's problems is their complete and utter disgust with the world around them. Travis is a New York City cab driver who drives everywhere and picks up anyone. It doesn't matter to him if the customer is a prostitute who uses his backseat as her workplace. He just drives around with a glazed look of indifference in his eyes, while inside, his heart is overflowing with rage. In contrast, Raskolnikov is an ex-student living in St. Petersburg during the mid 1800's. He is extremely poor, and therefore lives in an area called the Haymarket, where all the whorehouses and bars were located. Every time he goes out, he walks past the dregs of society, which fills his heart with hatred for everyone and everything. Both characters see the world to be completely evil and devoid of all goodness, and this existential view drives them to become exactly what they so desperately hate. Their revolt against ugliness pulls both characters towards the most ugly of all deeds - murder. Travis dreams that "someday a real rain will come and wipe this scum off the streets." He feels some sort of divine calling to actually become this "real rain." Similarly, Raskolnikov plots to sacrifice one "louse of a human being" who is "no good to anyone" for the benefit of thousands. Out of this scheme he derives his Extraordinary/ Superman theory that states that humans are divided into the ordinary and the extraordinary, the men and the supermen.

Teaching and learning of Addition and subtraction

This assignment will look into the patterned advance in the instruction and acquisition of add-on and minus from baby's room to twelvemonth 4 sing the â€Å" understanding diagram † , theoretical accounts for add-on and minus, oral/mental and written methods, resources used, larning facts and the utilizing and applying/problem work outing method. One manner that kids learn about add-on is through practical experience. In mundane life people are adding by uniting two or more sets of objects. The same can be said for minus. Children learn that by taking a peculiar figure of objects from a group it ever leaves the same figure of objects eg. 4-1 is ever 3. This is the manner kids foremost learn about add-on and minus. For many kids, they begin to understand the construct of adding when learn figure vocals in their early instruction. It is really of import to supply kids with good practical experiences in order to assist them larn. It is besides critical to pattern the right linguistic communication so the kids themselves are able to get it. This gives them a good foundation as they move farther through the instruction system. Whilst kids are in a Nursery scene or a Reception category they will be following the Early Years Foundation Stage ( EYFS ) papers. Within this papers there are 6 countries of acquisition. The country of larning concentrating on the development of mathematical accomplishments is called Problem Solving, Reasoning and Numeracy. Within that country there are specific countries sing add-on and minus. Once kids enter Year 1 they will be following the National Curriculum. Although this is the statutory papers instructors frequently use the Primary National Strategies papers to be after and present lessons. This papers breaks down the aims of the National Curriculum to offer a more focused attack to learning and acquisition.Early Old agesThe instruction of add-on and minus in a baby's room scene is based on mundane state of affairss and practical activities. Counting vocals is a common manner of reenforcing Numberss and presenting simple add-on and minus. For illustration, five small ducks. This is a good illustration of a manner that simple add-on and minus is introduced and reinforced in a nursery scene. The kids shortly learn that 5 take off 1 is 4, that 4 take off 1 is 3 etc and that 0 add 5 is 5. The right linguistic communication can be modelled so the kids learn what linguistic communication to utilize when they do activities for themselves. Games are besides a good manner of presenting or reenforcing add-on and minus. Some games are non needfully made for add-on and minus but it can be encouraged. When inquiring the kids to compare the sum of Numberss each of them has, by inquiring the kids inquiries, ‘How many more do you hold? ‘ , ‘How many less do you hold? ‘ . The kids will be working with little Numberss and will shortly be able to state how many less they have merely by hearing the two Numberss alternatively of holding to number them. Simple boundaries within the schoolroom are another manner of promoting the usage of add-on and m inus. Where merely a certain sum of kids are allowed in each country at a clip and the kids have to maintain path of how many there should be, how many less or how many more? The foundation phase introductory battalion offers thoughts for activities for the different countries of larning set out in the EYFS. When looking at add-on and minus in a Nursery puting the papers offers activities for comparing two groups of objects, demoing that when you split a group of four the sum is the same and happening the entire figure of objects in two groups. Each of these activities uses physical objects in order to show the mathematical regulation. They use resources such as the figure line, plastic coins and serpents. For immature kids in peculiar good resources are indispensable in order to prosecute the kids and efficaciously learn them about add-on and minus. In the response papers activities for looking at presenting jobs such as ‘how many will at that place be when one more†¦ .. ? ‘ , promoting the kids to state the figure that is one more than a given figure and giving chances for kids to happen one more or less than a figure up to 10s are offered. Again, merely as in the baby's room, each of these activities involves physical experiences and the activities are games to learn and reenforce the mathematical regulations for these facets of add-on and minus. Although the chief papers for Nursery scenes and Reception is the EYFS the Primary Framework wants to promote the facet of utilizing and using mathematics. The utilizing and using mathematics strand has five subjects with patterned advance being built into each subject from the foundation phase right up to twelvemonth 6. The three subdivisions of ‘using and using ‘ in the National Curriculum programmes of survey are straight related. Within the foundation phase, within the work outing jobs subdivision it states that kids will be utilizing their developing mathematical thoughts and methods so they can to work out practical jobs. Therefore, any jobs they are given related to add-on and minus they will be able to work out given their anterior cognition.Year 1- Year 4From Year 1 to twelvemonth 4 it becomes more in deepness and references add-on and minus specifically. For Year 1 kids they will be work outing jobs affecting ‘counting, adding, deducting, duplicating or ha lving in the context of Numberss, steps or money ‘ , for illustration to ‘pay ‘ and ‘give alteration ‘ . This means that a batch of the concrete experiences they have will be based around stores in their function play country in order to give the kids a more existent experience of numbering money and holding to make add-on or minus within those scenarios. Year two is much the same merely with the add-on of holding to multiply and split in the contexts of ‘numbers, steps or lbs and pence ‘ . Year three is a little measure up from this with the kids holding to take which computations to utilize and to transport them out themselves. Therefore they must make up one's mind whether it is right to add, deduct, split or multiply. Year 4 is non excessively different merely they will be larning how to utilize reckoner methods where appropriate. When kids have to work out jobs or they are asked to follow a ‘line of question ‘ , they will be demoing their thoughts, utilizing Numberss, symbols or diagrams. They will besides be involved in concluding and foretelling and pass oning those consequences, either orally or in authorship. The ‘understanding diagram ‘ put frontward by Haylock and Cockburn, shows the different facets of mathematical acquisition that are needed in order for a kid to be competent and confident in this country. One of the major parts of the diagram is concrete experiences. The instructor needs to finish undertakings themselves and utilize a scope of resources in their instruction. By making such activities it enables the kids to better retrieve what they have been taught as they are able to associate it to a physical memory. It besides allows the kids and the instructor to prosecute in duologue more easy. During these activities it is besides of import for the instructor to mode the linguistic communication they want the kids to take on and to utilize the right symbols themselves to promote the kids to make the same. Written and oral/mental methods for add-on and minus are another two of import facets of mathematical development. Oral and mental work in mathematics is indispensable. Early practical, unwritten and mental work, that is carried out in the foundation phases, is the footing for supplying kids with a good apprehension of how the four operations build on numeration attacks and a secure cognition of topographic point value and figure facts. Subsequently on their instruction kids must be able to recognize how these map s relate to each other and how the regulations can be used and applied. Oral and mental work is non merely something to be used in the beginning of instruction but must be continued to supply pattern and consolidation of these thoughts. Children must be given the chance to use the information they have learned and to do the correct determinations for themselves. To be able to cipher mentally needs an apprehension of figure forms and relationships that are developed through inquiring, the usage of theoretical accounts and images and the application of acquired figure cognition and accomp lishments. Children must hold the ability to remember figure facts immediately in order to cipher mentally. In twelvemonth 2 this would be ‘all add-on and minus facts for each figure to at least 10 ‘ . For twelvemonth 3 it would be ‘sums and differences of multiples of 10 ‘ and for twelvemonth 4, ‘the generation facts up to 10Ãâ€"10 ‘ . There must besides be an ability to utilize taught schemes in order to work out the computation. For illustration, in twelvemonth 1, to be able to ‘recognise that add-on can be done in any order and utilize this to add mentally a one-digit figure or a multiple of 10 to a one-digit or two-digit figure ‘ . To be able to ‘partition two-digit Numberss in different ways including into multiples of 10 and 1 and add the 10s and 1s individually and so recombine them ‘ in twelvemonth 2. In twelvemonth 5, to be able to ‘apply mental methods in particular instances ‘ . Finally the ability to ‘understand how the regulations and Torahs of arithmetic are used and applied ‘ . For illustration, ‘to add or subtract mentally combinations of one-digit and two-digit Numberss ‘ in twelvemonth 3 and to ‘calculate mentally with whole Numberss and decimals ‘ in twelvemonth 6. The written methods for add-on come in 4 phases and the purpose is that kids are able to utilize the mental methods where they can but when they ca n't make computations in their caput. They can utilize an efficient written method accurately and with assurance. Children need to cognize at least one efficient written method for add-on that they feel confident utilizing if they ca n't make the computation in their caput. The undermentioned phases show how the kids are able to construct up to utilize an efficient written method for add-on of whole Numberss by the terminal of twelvemonth 4. In order for the kids to add successfully they need to cognize some basic accomplishments which are ; ‘to recall all add-on braces to 9+9 and regards in 10 ‘ , ‘to add mentally a series of one-digit Numberss ‘ , ‘to add multiples of 10 or of 100 utilizing the related add-on fact ‘and ‘their cognition of topographic point value and to partition two-digit and three-digit Numberss into multiples of 100, 10 and 1 ‘ in different ways. Stage one of the written methods involve the usage of the empty figure line. Children need to be able to divide Numberss in different ways instead than ever into 10s and 1s to assist them do multiples of 10 by adding in stairss. The empty figure line is a manner of assisting them to enter their stairss when ciphering the sum. Phase 2 involves partitioning so that mental methods can be recorded. The 10s and 1s are added to organize partial amounts and those partial amounts are added together. The 3rd phase is the expanded method in columns where the kids move on to a layout that shows the add-on of the 10s and the 1s individually. As kids become more confident they can get down by adding the 1s instead than the 10s. This method leads kids to the more tight method so that they understand its construction and efficiency. The 4th and concluding phase is the column method. In this method, there is even less entering to make. The carried figures are noted below the line, either in 10s or in 100s and non in 1s. This can be made more ambitious. The kids can travel on to add three two-digit Numberss, two three-digit Numberss and Numberss of different sums of figures. The written methods for minus come in three phases. The purpose is the same as for the written methods of add-on and once more the phases show how the kids are able to construct up an efficient minuss of whole Numberss by the terminal of twelvemonth 4. In order to be able to deduct successfully the kids need to be able to ‘recall all add-on and minus facts to twenty ‘ , ‘subtract multiples of 10 utilizing the related minus fact and their cognition of topographic point value ‘ and ‘partition two-digit and three-digit Numberss into multiples of one hundred, ten and one ‘ in different ways. Phase one, merely as in add-on involves the usage of the empty figure line, which helps the kids to record and subsequently explicate the stairss they haven taken in their mental minus. After the kids have practiced this method for a piece they wo n't necessitate to enter as much information. They will necessitate to make up one's mind whether to number back or up. It is utile to inquire the kids if numbering up or back is better for certain computations. The mental method of numbering up from smaller to larger Numberss can be recorded by figure lines or in perpendicular columns. The kids will necessitate to be able to, when covering with two-digit Numberss, to cipher the replies mentally. With three-digit Numberss the Numberss of stairss can be reduced, provided that kids are able to work out replies to computations mentally. The numbering up method is a good option for those kids whose advancement is slow. Phase 2 involves partitioning. Subtraction can either be recorded utilizing partitioning to compose tantamount computations that can be carried out mentally. The 3rd and concluding phase is the expanded layout taking to the column method. Partitioning the Numberss into 10s and 1s and composing one under the other mirrors the column method. This does non straight link to mental methods of numbering back or up but parallels the breakdown method for add-on. This besides relies on secure mental accomplishments.DecisionChildren construct on their anterior cognition to come on with their mathematical accomplishments. They all start with practical experiences and changeless exposure to add-on and minus. All kids need to develop sound mental accomplishments in order to develop their written accomplishments. They have to larn the basic regulations for add-on and minus to come on with the written methods.

Discussion Boards Hsa 520

Has 505 The major online computer services such as Health Grades, America Online Inc. , and WebMD provide health news and medical and health forums where users can access medical libraries, exchange messages, and discuss health problems. In what ways might the growing use of these services by consumers affect future strategies for: Family practitioners? HMOs? Technology refers to the innovations or inventions from applied science and research. According to the book, adult use of the Internet as a health information source has increased dramatically. A lot of people use the Internet to find out different diseases and illness. From a family practitioner perspective use of the Internet could be a god thing. Most people find their health care providers from the Internet and also find out about health care issues. The Internet sites allow patients to gain knowledge about what is going on with their health and help solve questions they might have. Health care coverage through the use of an HMO costs less than comparable traditional health insurance, with a trade-off of limitations on the range of treatments available. HMO might view the internet site as an advantage because that’s where majority of people to research information and this could better help HMO reach out to the general population. They can get information from potential health care seekers based off the information they are providing on the sites, it could also help them use advertise strategies to put information out there to people. Internet sites have their advantages and their disadvantages but it seems there are more advantages than not. A primary care medical group has a list of patients who had once used the group on a regular basis as their primary source of care. However, in scanning their records, these patients had not been in for an appointment in the past two (2) years. The senior partner wants to send them an informational flyer about the practice and a refrigerator magnet that has the group’s telephone number and after-hours service number. As the marketing director for the practice, evaluate this approach in light of the HIPAA regulations. Is it acceptable to implement this marketing plan under the current regulations? Explain your answer. HIPPA is used to facilitate health insurance portability, protect patient security and privacy of information, and further reduce health care fraud and abuse. HIPPA requires all health care providers to have patient consent for access to their medical records or information. According to the book, data will need to be aggregated so that medical information cannot be attached to names and addresses of individual patients. Patient identifiable information cannot be use of marketing items. Under the current regulations there are some marketing strategies that can take place but it cannot have any patient information if it is not related to treatment or payment of their care. If the organization does not have the consent of the individuals to use their information that I don’t think that it would be acceptable. Has 520 Discuss the factors that should be considered when developing a consistent IM / IT strategy. Explain your rationale. Information systems should support the strategic goals, and objectives, and priorities of the organization they serve. The factors that should be considered when developing a consistent IM/IT strategy are: 1. Aligning IM/IT with organizational strategy: This is important because there is a need for interrelationships among IM/IT, the rest of the organization and the external environment. 2. Developing IM/IT infrastructure, architecture, and policies: This plan should identify the major types of information required to support strategic objectives and establish priorities for installation for computer applications. 3. Setting IM/IT project priorities, and overseeing investments: The organization needs to be aware of the investments and where their money is going and for what projects it is going to. They have to set boundaries and have set priorities. 4. Using IM/IT benefits assessment to enhance accountability: Accountability is very important to any organization. Knowing what they have and what they are missing is very vital. Analyze the various approaches to reviewing software and hardware standards and make at least three recommendations for improvement. Provide specific examples to support your response. Three recommendations for the various approaches to reviewing software and hardware standards are: 1. Data compatibility-use of common codes and data definitions for electronic information exchange across an organization. Its important that any organization make sure the soft ware and hardware is compatible to the systems they are trying to use. 2. Central review ensures that hardware and software will ne of a type that can receive technical support and maintenance from the information system staff. . Central review can help prevent illegal use of unlicensed software within the organization. Integration discusses the advantages and disadvantages of end-user computing and determines if this is an application that should be progressively pursued. Explain your rationale. End-user computing offers the potential to expand the base of IM/IT development and overcome issues that arise when a low priority is assigned to certain applications that are nevertheless viewed as important to units within the organization. Some of the advantages of end user computing are overcoming shortages of professionals, establishment of user friendly and responsive systems, and overcoming implementation problems. Some other advantages are the systems tailored to users, enables creative use of IS, generates competitive advantage, overcomes backlog by providing systems that IS could not get round to doing, puts users nearer the information, allows for variety, Increases user awareness of IS, and Relieves work load of IT professional. The disadvantages are that they produce inappropriate systems, causes duplication, takes users away from their real job, ignores long range and technical issues, courts disaster due to lack of attention to procedures, and causes integration problems. From the e-Activity, discuss what additional challenges exist with systems integration between / among health care organizations and possible solutions to those challenges.

Comparison Of Methods Of Research Education Essay

In this chapter the writer attempts to discourse the research methods required in the context of survey and besides warrant its usage and restrictions. This survey was undertaken to analyze the impact of mega-events and the promotional schemes undertaken to shift a finish ‘s touristry industry. While carry oning this research it was indispensable that a methodological analysis be chosen to outdo suit the survey. Harmonizing to Howard and Sharp ( 1996 ) , the pick of research methods is considered to be an built-in portion of any research undertaking, which greatly influences the consequences obtained. Since the purpose of the thesis is to show the importance of mega-events and the demand to be after for these events, more self-generated and flexible attack was required to develop the apprehension of Sydney ‘s image in the touristry industry. Second, the informations had to be gathered from different beginnings, both primary and secondary, to to the full understand the phenomenon. Finally, the writer besides attempts to offer practical value and thoughts which could be utile in this issue. Based on these considerations, the research was conducted utilizing qualitative research design. Qualitative research allows the topics being studied to give much ‘richer ‘ replies to inquiries put to them by the research worker, and may give valuable penetrations which might hold been missed by any other method. It besides provides valuable information to certain research inquiries in its ain right. Robson et al. , in 1992 stated qualitative research to be ‘A wide-ranging trade embracing many different attacks, and can run from big, time-consuming Government/Social research contracts to pre-testing of consumer advertisement ‘ ( Chisnall, 2001, P195 ) . Harmonizing to Chisnall, the kernel of qualitative research is that it diagnostic ; it seeks to detect what may account for certain sorts of behaviors like trade name trueness. Qualitative research normally has no measurings or statistics but uses words, descriptions and quotation marks to research significance. Qualitative methods aim to do sense of, or construe, phenomena in footings of the significances people bring to them Qualitative research may specify preliminary inquiries which can so be addressed in quantitative surveies ( Greenhalgh & A ; Taylor, 1997 ) One of the cardinal differences between qualitative and quantitative research is that qualitative research attempts to generalise comparatively simple information by executing statistical analyses, whereas qualitative research attempts to larn about a complex phenomenon by seeking penetration. In simple words quantitative research replies ‘how many ‘ of a inquiry whereas qualitative research replies ‘why ‘ of a inquiry. Quantitative research begins with an thought ( hypothesis ) , which is converted into informations through measurings and this at the terminal helps the research worker to pull decisions. Qualitative research, in contrast, begins with an purpose to research a peculiar country, collects â€Å" informations † ( observations and interviews ) , and generates thoughts. The strength of the quantitative attack lies in its dependability ( repeatability ) -that is, the same measurings should give the same consequences clip after clip. The strengt h of qualitative research lies in cogency ( intimacy to the truth ) -that is, good qualitative research, utilizing a choice of informations aggregation methods, truly should touch the nucleus of what is traveling on instead than merely planing the surface ( Greenhalgh & A ; Taylor, 1997 ) . Of the assorted methods of qualitative research, instance survey was found to the best suitable attack for this thesis. In most of the researches undertaken, if the research involves ‘how and why inquiries, they are more explanatory and likely to take to the usage of instance surveies. This is because instance survey trades with the operational links necessitating to be traced over clip, instead than mere frequences or incidences. For illustration, if one wanted to analyze how a community successfully thwarted a proposed main road ( lupo et Al, 1971, cited by Yin, 1994 ) , it is less likely to trust on a study or scrutiny of the records and might be better off making a instance survey. Harmonizing to Yin ( 1994, P13 ) : A Case Study is an empirical enquiry that investigates a modern-day phenomenon within its real-life context, particularly when the boundaries between phenomenon and context are non clearly apparent. Harmonizing to Schramm ( 1971 ) , the kernel of a instance survey, the cardinal inclination among all types of instances survey, is that it tries to light a determination or a set of determinations: why they were taken, how they were implemented, and with what consequences ( cited in Yin,1994, P12 ) . Harmonizing to Stake ( 1994, P236 ) , a instance survey is non a methodological pick, but a pick of object to be studied. As a signifier of research, instance survey is defined by the involvement in single instances and non by the methods of enquiry used. For the writer to accomplish the purpose of this thesis, a instance survey attack was utilized. this was achieved by making a instance survey on the Sydney 2000 Olympics. The ground behind taking the Sydney 2000 Games in peculiar is due to the congratulations Australia received from the universe ‘s touristry and featuring leaders for its attack to maximizing the touristry chances presented with Sydney ‘s theatrical production of the 2000 Olympic Games. The president of the International Olympic Committee ( IOC ) , Juan Antonio Samaranch, said the Olympic games had helped get the better of perceptual experiences that Australia was excessively far off for a vacation. It provided a sporting and cultural phase for all of the continents and boosted touristry in Australia. The type of instance survey used was explanatory instance survey as bing theory was used in order for the research to understand the planning and schemes used by Sydney for the games to advance it as a finish .Restrictions of the Case Study ApproachCase surveies can be both descriptive and explanatory and are therefore considered a good attack for transporting out qualitative research. However, there are besides a few restrictions of the method attached to its usage. Yin ( 1994 ) states that instance survey ‘s findings can be generalised to theoretical propositions but non to recite frequences. Thus it is difficult to do general reappraisal from one instance survey. Yin provinces â€Å" possibly the greatest concern about the usage of instances is the deficiency of cogency of the instance study research † ( Yin, 1994, P10 ) . There ever remains a hazard of excessively much informations being gathered which may non be of existent relevancy to the survey. Case survey informations is time-consuming to roll up, and even more time-consuming to analyze. Hence, there is a reluctance to fund such a research if undertaken on a big graduated table. A Yet cutting corners on either of t hese aspects is likely to earnestly weaken the value and credibleness of any findings produced. As yin ( 1994 ) pointed out instance surveies most frequently do non impart themselves to numerical representation. Hence the in deciding grounds and colored findings may act upon the waies of the findings and the decisions. Looking at both the strengths and failings of the instance survey method, and to obtain a clear apprehension of the instance, the writer besides collected informations utilizing primary research informations aggregation methods. This was done to obtain balanced descriptive and explanatory information for the research supported by grounds of informations collected through primary research.Primary ResearchPrimary research is research used to roll up informations for a specific undertaking. Primary research involves really traveling out to the field and carry oning some type of study or fact finding probe among the existent people. Primary informations are normally gathered by the research worker via studies, experiments or observation methods. However, interviews and questionnaires are most popular and normally used methods of primary informations aggregation. The information therefore collected may be qualitative ( in the signifier of words ) or quantitative ( in the signifier of figu re ) . Primary research was used in this undertaking to place the cardinal schemes of Sydney 2000 Games and the impact of these schemes on Australia ‘s touristry. Primary research was one of the most hard facets of this thesis. To roll up primary informations, the research worker used questionnaire technique to finish this thesis. The research worker explains below the different option techniques that were considered to roll up informations before zeroing down on the questionnaire technique.InterviewsVeal ( 2006 ) is of the sentiment that interviews are likely the lone manner of obtaining a realistic image of the manner people view the topic of research. Howard and Sharp ( 1993, P139 ) suggest that most scientists would see the interview as supplying higher quality information that is free from bias than many other methods available to them. Types of interviews range from a to the full formal structured interview to an informal unstructured interview and semi-structured interviews. Structured interview A to the full structured interview is when the research worker has drafted a elaborate questionnaire. The inquiries are asked as per their order for every interview so as to follow a common form and guarantee that all the subjects have been covered. This method is like utilizing a questionnaire but by being face-to-face with the interviewee and there is besides a range of some personal interaction. However, due to a stiff construction and the form of inquiry that the interviewer follows, the interviewee has less range to set forth extra information. Unstructured interview An unstructured interview is based on a more flexible and adaptable attack. In simple words it is a little more than a conversation. In this method the research worker refrains from seeking to construction the interview. The interview keeps the conversation unfastened in order to derive more information. This method besides follows a fixed lineation but is non driven by prepared inquiries. There is a range for interview to spread out the issues or supply information of related issues as there is no limitation on the type of information provided. Semi-structure Interview This type of interview provides a balance between the other two signifiers of interview. It is basically conducted with the interviewee possessing and following a list of inquiries but at the same clip gives the interviewee the chance to show positions freely. A major advantage of this type of interview is its adaptability. Veal ( 2006 ) suggests that the usage of a checklist is more practical than to the full elaborate inquiries as the latter can disrupt the flow of interviewThere is a possibility that the interviewee might touch upon an of import and untapped facet of the researched issue and may alter the class of research in order to look into them. Bryman ( 2001, P313 ) suggests, â€Å" qualitative semi-structured questioning tends to be flexible, reacting to the way in which interviewees take the interview and possibly seting the accent in the research as a consequence of important issues that emerge in the class of interviews. † Interviews may be conducted face-to-face, via telephone or mail questionnaires. The method in which the interviews can be conducted depends on assorted factors like budget and clip. The research worker was in England to make the research between December and May, but the interviewees were from Sydney. Thus, sing the clip and budget restraint, the research worker used e-mail questionnaires as a method of carry oning the research. the research worker contacted the respondents via mail saying the intent of thesis and the method that will be followed to roll up informations. After a positive answer from the respondents, a questionnaire was prepared and was e-mailed to the research workers. Over a period of 5months from January 2010 to may 2010 assorted e-mail were exchanged back and Forth to roll up as much information as possible. The respondents were besides happy to give entree to assorted studies and paperss sing the subject researched. The type of inquiries that were usages were non-directive and unfastened to let more latitude for response, generalized and probed to do the respondents experience more comfy to talk freely. Questionnaires Questionnaires are a popular agencies of roll uping informations. They are utile when the research is to be undertaken on a big graduated table. They can be easy posted e-mailed and faxed and hence, have a broad geographic coverage. They are peculiarly utile when the respondents are willing to supply information but want to keep their namelessness at the same clip. Unlike other research methods, the respondent is non interrupted by the research instrument. Questionnaires reduceA interviewer biasA because there is unvarying inquiry presentation ( Jahoda, et al. , 1962 ) However, it may be hard to obtain a good response rate as frequently there is no strong motive for the respondents to react. It could be a delayed and a boring method when the research worker has to wait for the responses to be returned. One of the chief drawbacks of this method is that there is no control over who completes the questionnaire. Furthermore, respondent can read all inquiries beforehand and so make up one 's mind whether to finish or non. For illustration, possibly because it is excessively long, excessively complex, uninteresting, or excessively personal. They do non give the respondents the freedom to set forth their positions and sentiments on the subject researched. Hence, it is hazardous and non wholly fruitful to utilize this method on its ain for informations aggregation. Recording Recording is a technique in which the research worker uses a tape recording equipment to enter the informations to be gathered. One of the of import things to retrieve in this method is that recording equipments can be used by the research worker merely if the interviewee/respondents agree to its usage. Gillham ( 2000 ) justifies the usage of tape-recorder as a method strongly recommended if the interviewee agrees. This helps the research to maintain a word by word history of the information the interviewee provides so as non to lose out any of import information. although it is said that the interviewee might experience uncomfortable with the usage of tape recording equipment, taping the interview aids the hearing procedure and provides an indifferent record of responses. Harmonizing to Gill and Johnson ( 1991 ) , in contrast to observe pickings, after a few proceedingss of taping, respondents become unaware of the recording equipment. However, one of the most of import grounds for the research non following this technique is due to the boring, time-consuming and dearly-won techniques of transcripiting the information recorded. Furthermore, Some people are really self-aware in forepart of cameras or audio recording equipments. Recording the session may make a barrier between you and them, and do them less blunt than they would otherwise be. Sampling Roll uping informations is clip devouring and expensive, even for comparatively little sums of informations. Hence, it is extremely improbable that a complete population will be investigated. Because of the clip and cost elements the sum of informations you collect will be limited it is really of import to take a little sample to roll up the information from. Harmonizing to Fink ( 1995, P1 ) ‘the best sample is representative, or a theoretical account, of the population ‘ . A right taken sample of an appropriate size will give consequences that can be applied to the population as a whole. Due to the characteristic and nature of this research, the writer chose to concentrate on the sentiments of the people who were in any manner involved with the 2000 Games. These were people in cardinal places from the Australian Tourism Commission, Tourism New South Wales and the Sydney Olympic Park Authority. The respondents were encouraged to talk as much, or every bit small as they wi shed bout the issue. One individual from the Australian Tourism Commission, two from Tourism NSW and one from the SOPA were interviewed. Besides in order to derive penetration on the research subject from an academic point of view, a A professor in the school of leisure, athletics and touristry at the University of Technology was besides interviewed. The research worker is of the sentiment that the respondents have provided the thesis with sufficient qualitative information to pull decision and the signifier recommendations. Not merely did the respondents respond to the inquiries e-mailed to them but they were really accessible and flexible in their attack and provided the research worker with a figure of of import paperss and studies which proved to be truly of import for the research. As the subject that the writer has undertaken to research is an event which has occurred in the yesteryear, there is already huge and utile stuff available through assorted beginnings like, journal articles, newspapers, media and cyberspace which can turn out every bit of import to the thesis. At this phase the usage of primary research methods is limited and the research had to utilize assorted beginnings of informations. This is called secondary research.Restrictions of primary researchPrimary research is considered to be one of the most widespread and effectual ways of garnering reliable informations. However, there are a figure of possible jobs and restrictions to utilizing primary research as a exclusive method of informations aggregation. The most of import job faced by the research worker was of clip money and distance. the research worker was based in Sheffield during the clip of this thesis and the respondents were from Sydney, hence, the research worker found it really expensive to really go to Sydney to carry on the interviews in individual and had to therefore usage alternate methods. Furthermore, clip restraint was another job the research worker faced. The research worker besides had troubles in contacting and acquiring the right people for garnering the information from. Sometimes it was non possible to speak to the right people and this created troubles in making a program for informations aggregation. And in conclusion, the research worker ain deficiency of experience in be aftering the research and the inquiries as good. If the inquiries did non cover all the of import issues, if they were non good phrased or if the research did non win to obtain the right replies and relevant informations, so the research would non supply qualitative informations and the research worker would hold to get down the whole procedure once more from abrasion. In malice of all these jobs, the research worker managed to garner the relevant information required. The contacts were obtained from an extended hunt and the respondents were besides really helpful and accessible and provided with a huge sum of informations to the research which proved really utile for the thesis.Secondary ResearchSecondary research occurs when a undertaking requires a drumhead or aggregation of bing informations. As opposed to primary research informations, secondary research informations already exist. in simple words, Secondary research is where you use information that other people have gathered through primary research. Normally, secondary research is used in order to place what earlier research workers have done and it besides helps to supply countries of possible probe which would be interesting and valuable. It helps to place possible spreads or logical extensions between old and bing work. . Sometimes secondary research is required in the preliminary phases of research to find what is known already and what new informations are required, or to organize research design. Harmonizing to HHHHHH Howard and crisp ( 1996 ) , secondary research means to seek for information that is given by other research workers and published in some signifier that is already accessible. The secondary beginnings could include old research studies, newspaper, magazine and journal content, and authorities and NGO statistics. In order to acquire a elaborate apprehension of the research issue information was gathered from newspaper articles, diaries and books which were available at the Sheffield Hallam university library. Besides on-line diary articles, intelligence web sites and computing machine database was besides used to garner information. The bing literature enabled the research worker to place any repeating issues or subjects. The books and diary articles, in peculiar, helped the research worker to make a background for theoretical cognition.MediaEvents like the Olympic games are a universe phenomenon and are therefore captured by the universe media. These events attract a batch of promotion from the imperativeness. For this ground, newspapers, magazines and telecasting were of great significance to the research, non merely because they provided with tonss of up -to-date information but besides because they contained interviews, and articles with different attacks on the research topic. These interviews provided information on how the games were perceived by the locals, the promotional schemes adopted.Books and DiariesBooks and diaries in general are considered to be a good beginning of information in any research. They are utile in peculiar to organize the theoretical background of the research. The diaries contain documents written by pervious research worker on the researched subject. They form a background for research and are besides utile in taking any irrelevant points or issues in the bing research worker and frailty versa. In this research besides, the research worker has made extended usage of book and diaries in every phase and chapter of the thesis. It helped the research worker to acquire a good apprehension of the subject. These were readily accessible at the Sheffield Hallam university library.Computer Data Base ( Internet )H armonizing to Howard and Sharp ( 1996 ) , computing machine database is a beginning of considerable importance. There are a figure ofA hunt enginesA that can be utile in seeking the cyberspace, The cyberspace has the advantage that it is easy to entree, it has tonss of information, and it is sometimes the most up-to-date beginning of information.A Databases for merchandises and services are available online. These databases like EMRALD are maintained by dedicated international organic structures and are besides developed straight by universities and other research establishments. The subject of this thesis is an event which occurred in the yesteryear ; hence, the electronic database was of huge aid for this thesis in peculiar. The research worker used Emerald and Google Scholar to entree online articles and documents of trade diaries. Handiness to the information was reasonably easy. However, due to the huge sum of relevant and irrelevant informations available online it was necessary to be critical of the cogency of any information available online.Restrictions of secondary researchIn malice of the easy handiness and the sum of informations available through these secondary resources, there are some restrictions to this signifier of research as good. The most of import is the inquiry on the quality and relevancy of the available informations. Data available through these resources is of the work and researches done in yesteryear and might non be up-to-date information. There are besides several contrasting informations available online which make it more har d for the research worker to critically analyze the information and rely n his inherent aptitudes with respects to the usage of this information. This can sometimes take to irrelevant information being included in the research and the research might besides lose its path. Many times a research worker finds that research that appears assuring is in fact a â€Å" teaser † released by the research provider. This frequently occurs when a little part of a survey is disclosed, frequently for free, but the full study, which is frequently expensive, is needed to derive the full value of the survey. Keeping all these facets in head, the research worker has tried her best to utilize the most recent publications and articles from books, diaries and magazines in order to cover all the facets of the subject researched. The research worker tried to look for the most up-to-date information available.Datas AnalysisSum uping and analyzing the information was one of the most hard parts of the thesis. Harmonizing to Veal ( 2006 ) the research worker is faced with practical jobs of how to pull off the pile on interview notes and transcripts. There are many different types of qualitative informations analysis methods. The type of analysis used depends on the information collected, the purpose of research and the clip and fundss available. For the informations to be analysed, it must be put in simple words which can be easy analyzed. This might be in the signifier of transcripts from the interview, notes and replies from the open-ended questionnaires and the journals and diaries maintained b y the research worker. When multiple instance surveies are used to roll up the information and where the research worker has to happen and analyze recurrent subjects in each survey the research worker can utilize thematic analysis. However, where the focal point is on secondary stuff in general and media analysis in peculiar, content analysis method is used. Contented analysis is a technique that has applications in touristry research ( Finn et al, 2000, P135 ) . It is a technique that is applied to non-statistical informations and allows analysing it in a systematic manner. A Using this method the research worker surveies the transcripts in item and assigns codifications ( figure or words ) , to specific characters within the text.. The research worker may already hold a list of classs or she may read through each transcript and allow the classs emerge from the information. This type of analysis can be used for open-ended inquiries which have been added to questionnaires in big quantitative studies, there fore enabling the research worker to quantify the replies. This is farther supported by Finn, who states that content analysis is a quantitative agencies of analysing qualitative informations ( Finn et al. , 2000, P134 ) .DecisionThe chapter has discussed the informations aggregation procedure and methods used by the research worker to garner information. In order to garner the most relevant and appropriate information, the research worker has made usage of both primary and secondary methods of research. This has helped the research worker to cover all the of import facet and to derive both practical and theoretical cognition. The research was completed in a period of four months. The following chapter take a expression at the consequences and analysis of the information gathered.

Different Research strategies you can use in your Dissertation

Different Research strategies you can use in your Dissertation Different Research strategies you can use in your Dissertation One of the key problems you need to address early on when writing your dissertation is that of the best strategy to use to conduct your researchThat is, how will you go about answering the research questions you want to investigate Defining your research strategy means deciding whether you want to do primary research or confine yourself to the existing literature. You can get help deciding whether a primary or secondary study is best for you from one of our helpful guides. Research strategy for secondary studies is fairly straightforward, although you do have to look at your search methods and define key words and so on. However, defining different research strategies you can use in your dissertation to conduct primary studies is slightly more involved. This guide will help you understand the basics by looking at some of the most common research strategies.Case StudiesCase studies are a type of descriptive research looking at individuals, a small group of people or a unit (an organ isation for example). Data is collected by observation, participation and a range of other methods including examining existing records, interviews and tests Case studies may include participants own accounts Conclusions are relevant primarily to the people or unit studied, they are not as appropriate if you want to generalise to a much wider population Case studies tend not to look at cause and effect, rather they focus upon exploring and describing A typical case study looks at the way a number of variables interact in order to fully understand a given situation Case studies are usually used for qualitative research Case studies are useful for ‘how’ and ‘why’ questions, where context is important, and where the researcher has little control over events.SurveysSurvey research is frequently used in social science research. Surveys are also used in commercial settings, primarily market research. Surveys often gather quantitative data, but can also gather qua litative information through open-ended questions Surveys are carried out on a sample of respondents from a selected population through the administration of a questionnaire. The questionnaire can be done online, face-to-face or over the telephone. Surveys are very flexible and can be used to collect different types of data from small or large numbers of people Surveys can also be useful across a wide range of disciplines from business to anthropology The data collected in surveys needs to be analysed to produce useful results. Quantitative data (numbers) is typically analysed using statistical software like SPSS. Qualitative data can be analysed by a number of techniques including coding and thematic analysis.InterviewsAn interview is a discussion with one or more people. The matters raised are recorded (video-taped, audio-recorded or written down) and subsequently analysed Interviews are very flexible. They can be highly structured and formalised, with all the possible options det ermined in advance (a quantitative survey administered face-to-face would be an interview of this type) or unstructured and relaxed. Interviews are usually divided into three groups, depending upon the degree to which they are structured: structured, semi-structured and unstructured interviews. Structured interviews are based on a pre-determined set of questions and allow little-to-no scope for deviation from the structure. Unstructured interviews start with a few broad questions or areas for discussion, and the interviewer uses techniques like prompting and probing to elicit responses from the participants. Interviews can involve one subject, or a group of subjects, but typically no more than 5 or 6 people in a group. The dynamics of a one-to-one interview and a group interview are different and are suitable for different purposes: one-to-one interviews are useful where you want people to open up about personal or private matters, while group interviews allow people to interact and create group dynamics.Other StrategiesAction research, also known as participatory research and collaborative inquiry can be seen as a process of research through doing something. It involves the ability to usefully reflect upon process in order to improve understanding of practices and situations Ethnomethodology as an approach tries to understand the way people interact with each other, and therefore studies social realities, often of the day-to-day lives of ordinary people. Its concern is with how people make sense of their world. Grounded theory research does not have a set of assumptions or research objectives which are tested against reality. Rather it generates theory by first examining a social situation and seeing what explanations could account for the phenomena.BibliographyBadke, W (2012) Research Strategies: Finding your way through the information fog (4th edn), iUniverse, USA Colorado State University (2013) ‘Case Study’ [online] (cited 6th March 2013) available from http://writing.colostate.edu/guides/guide.cfm?guideid=60 Marsden, P V and Wright, J D (2010) Handbook of Survey Research (2nd edn.), Emerald Group Publishing, London. Punch, K (2003) Survey Research: The Basics, SAGE, Thousand Oaks, CA.

Bilateral Trans-Scaphoid Perilunate Fracture Dislocation

Bilateral Trans-Scaphoid Perilunate Fracture Dislocation BILATERAL TRANS-SCAPHOID PERILUNATE FRACTURE DISLOCATION OF THE CARPUS. (CASE REPORT) Abstract: Trans-scaphoid perilunate fractures-dislocations are rare lesions. They occur in a high-energy trauma. The concomitent lesion of both wrists is exceptional. We report a case of bilateral trans-scaphoid perilunate dislocated wrist fracture in a 21-year-old man. The dislocation was treated by opened reduction and fractures by internal fixation. The functional outcome was satisfying after two years of follow-up. Introduction: Trans-scaphoid perilunate fracture-dislocations are relatively uncommon. 1 These are the most common form of the complex carpal dislocations 2,3 causing marked disruption of the carpal anatomy. Time from injury to treatment (delay in treatment), anatomic classià ¯Ã‚ ¬Ã‚ cation, and open or closed nature of the injury are the major factors that determine the clinical outcome in trans-scaphoid perilunate fracture-dislocations. 4,5 Late presentation combi ned with missed diagnosis often causes critical delay in the treatment of these injuries. If the acute phase is missed, then some authors recommend alternative procedures such as wrist arthrodesis and proximal row carpectomy which are relatively mutilating surgeries that leave a significant functional deficit. 4,6,7 The acute phase is defined as the first week after injury, whereas the delayed phase is the period between the seventh and 45th day and after 45 days the injury is said to be in the chronic phase. 4 We report the case of a patient who referred to our department two weeks after the initial trauma with bilateral dorsal trans-scaphoid perilunate fracture-dislocations of the carpus. Anatomic reduction, percutaneous pin fixation of the carpus and fixation of scaphoid fractures of both wrists were performed by opened reduction under fluoroscopic control. Presentation of case: A 21-year-old, right-hand-dominant man sustained an isolated injury to his both wrists after a fall from a height of approximately 4.5 m. The carpal injuries of both wrists were missed initially and both wrists had been bandaged for two weeks after the trauma. He was referred to our department two weeks later with increasing pain. The patient reported that he fell on his outstretched hands with both wrists in extension. Both wrists were deformed in marked dorsiflexion, painful, swollen, and tender to palpation, with limitation of movement. The patient complained of paresthesia in both of his hands. On physical examination, meticulous cutaneous sensory mapping was performed of both hands to determine the area of decreased sensation. This was done with the use of the sharp end of a paperclip while applying a constant pressure. This revealed minor numbness in the median nerve distribution area of both hands (thumb, index, middle finger, and the radial side of the ring finger). The two-point discrimination was normal on both sides. The mobility of the fingers was normal but pai nful, and there was a slight decrase in grip strength of both hands. Motor power in abductor pollicis brevis and opponens pollicis muscles was full (5/5) on both sides. The Tinel’s sign was negative over the carpal tunnel in both sides. The findings of the patient led us to think that there is not any condition like acute carpal tunnel syndrome due to fracture-dislocation.We thought that the numbness of the patient was due to temporary traction injury of the median nerve caused by dislocation on both sides. The vascular status was normal on physical examination. Study of the anteroposterior, oblique and lateral plane radiographs showed that the patient had bilateral dorsal trans-scaphoid perilunate fracture-dislocations of the carpi ( Fig. 1 ). According to the classification described by Herzberg et al., the fracture-dislocations were trans-scaphoid as path of trauma and Stage 1 as displacement of capitate on both sides. 4 The patient was informed about his pathology and a dvised to undergo surgery. If possible the patient’s preference was closed treatment. Therefore, we initially recommend closed reduction and percutaneous fixation. However, if this was not possible or in the situation of a failure we informed him about the open procedure. Under general anesthesia, a closed reduction was attempted with traction manoeuvre described by Tavernier 8 under fluoroscopic control. The reduction was not satisfactory,we opted for the open reduction by posterior approach.After anatomical reduction was achieved, intercarpal fixation was applied to carpal bones using three K-wires. The first K-wire was applied to scaphoide- lunate, the second K-wire was applied to- lunate-triquetrum and the third K-wire was applied to capitatum-lunate. After the procedure, reduction and fixation of carpal bones was confirmed under fluoroscopy. The same procedure was repeated for the other wrist. We noticed that the scaphoid fracture was reduced spontaneously along with t he reduction of the carpal bones. So we performed   fixation of the left scaphoid fracture using a 3.5 mm mini Acutrak headless compression screw through the fracture line from a dorsal-proximal to a volar-distal direction. Intraoperative fluoroscopic control confirmed anatomic reduction of the scaphoid fracture.. Finally, standard radiograms were obtained and both wrists were immobilized in a short arm cast ( Fig. 2 ). The patient noted complete relief of symptoms the day after surgery. The pain and the paresthesia that the patient complained preoperatively was relieved dramatically and the function recovered. The post-operative period was uneventful. Four weeks after surgery, the casts and the K-wires were removed. New casts were applied for another 4 weeks when union was visible on radiographs. The casts were removed eight weeks after surgery. There was radiographic evidence of union of the scaphoid on the left side, but on the right side radiography revealed delayed union of the scaphoid. The patient subsequently underwent 3 months of intensive range-of-motion and muscle-strengthening exercises. Intermediate clinical and radiographic examinations were performed 6 and 12 months after surgery. At the two-year follow-up, the radiographs showed normal carpal bone relationships on both sides, complete union of the scaphoid on the left side(Fig.3). Wrist motion on the left side was excellent with 70 ° of palmar flexion, 80 ° of dorsiflexion, full supination and pronation, full radial and ulnar deviation. The right wrist could achieve 60 ° of palmar flexion and 70 ° of dorsiflexion, full supination and pronation, but with a mild decrease in radial and ulnar deviation. The grip strength of the right hand was 30 kg while that of the left side was 38 kg, measured with the Jamar dynamometer (J.A. Preston, Jackson, Michigan) . Fig.3 Right wrist and Left wrist anteroposterior and   lateral view after two-years. At the two-year follow-up, the patient was symptom-free concerning median nerve functions. The patient was free of pain on the left side. On the right side there was mild pain with wrist motions due to non-union of the scaphoid.The patient was able to perform activities of daily living and he had returned to all of his previous activities. The functional outcome was good on the left side, with a Mayo wrist score of 80/100. The functional outcome was satisfactory on the right side, with a Mayo wrist score of 65/100. Radiographs of both wrists revealed no evidence of radiocarpal or midcarpal arthritis. No osteonecrosis of the lunate or the scaphoid was evident. The lunate position was correct, without signs of instability. Anatomic relationships of the carpal bones were maintained. Discussion Carpal fracture-dislocations are rare injuries; thus their classification and treatment are rather difficult. Osseous variants of this injury are common; the trans-scaphoid perilunate fracture-dislocation constitutes 61% of all perilunate dislocations and 96% of fracture-dislocations. 4 The trans-scaphoid perilunate fracture-dislocation is an uncommon injury sustained due to force transmission through a hyperextended wrist. 9,10 These injuries may be easily overlooked or misdiagnosed. 4 After a delay in diagnosis of several weeks or months, the clinical prognosis is poor compared with injuries that are treated acutely. 11 According to the classification described by Herzberg et al., we initially diagnosed our patient in the delayed phase. 4 Regarding the literature, the management of such injuries in case of delayed presentation is rare. 12,13 Dislocation in this region requires rapid realignment, as untreated perilunate dislocation will lead to serious secondary damage. 13,14 Perilunate fracture-dislocations are high-energy injuries, produced by wrist hyperextension. 3,15 There is disruption of the palmar capsuloligamentous complex, starting radially and propagating through the carpus in an ulnar direction. 3,15 This dislocation takes a transosseous route through the scaphoid resulting in a trans-scaphoid perilunate fracture-dislocation. 10 In trans-scaphoid perilunate dislocations the fractured scaphoid is the initial destabilizing factor of the carpus. 16 Regarding the literature, we believe that the mechanism of injury in our patient was fall from a height on the outstretched hands. Treatment options currently used for perilunar instability patterns include closed reduction and cast immobilization, closed reduction and percutaneous pinning, and open reduction. As the awareness of the anatomy and biomechanics of these injury patterns has evolved, authors have tended toward treatment approaches that attempt to repair the injured intrinsic and extrinsic carpal ligaments, that is, open techniques. 4,8,11 Most authors agree that closed reduction is the initial treatment of choice for trans-scaphoid perilunate fracture-dislocations. 2,8,17 In addition, treatment often r equires intercarpal fixation within the proximal carpal row. Most authors have agreed that the key to a good clinical result in the management of trans-scaphoid perilunate dislocation is the anatomic union of the scaphoid and the restoration of proper alignment of the carpal bones. 17 In this case, we prefer a opened reduction and intercarpal fixation with K-wires, as well as screw fixation of the scaphoid, because we didn’t achieve a good fracture alignment after closed reduction . Gellman et al. suggested that anatomical reductions of the scaphoid, as well as the mid-carpal joint, and the restoration of the articular surface of the lunate are the most important aspects determining the prognosis. 11 An open reduction further increases the risk of a scaphoid blood supply interruption, whereas percutaneous screw fixation of the scaphoid minimizes this risk. 3,17,18 In addition, a rigid fixation with a percutaneous screw can also reduce the immobilization period and allow for an earlier rehabilitation. Acutrak screw fixation allows earlier discontinuance of the cast than K-wire fixation. In our case, the range-of-motion exercises of the wrist were started earlier after the initial operation. The nonunion rate was relatively higher in the series that were treated by closed reduction. 19,20 In our case study the radiographs obtained two years after surgery revealed a non-union of the right scaphoid. We believe that the delay in treatment and maybe the malrotation of the scaphoid that we overlooked on the initial radiographs led to the interruption of the blood supply which was possibly responsible for the non-union of the scaphoid. Despite the non-union of the scaphoid, the functional outcome of our patient was satisfactory, with mild pain, good range of movement and good grip strength. Similarly, Herzberg et al. 4 reported that unsatisfactory radiographs did not equate to a poor clinical outcome. We planned to perform open reduction and internal f ixation with grafting for the non-union of the right scaphoid. Conclusion As the injury have led bilateral dorsal trans-scaphoid perilunate fracture-dislocations,  we therefore recommend minimally invasive techniques if an anatomical closed reduction and  a percutaneous rigid fixation of the scaphoid is achieved on the intraoperative evaluations.