Case Report of Secondary Narcolepsy

Case Report of Secondary Narcolepsy Title of the article: â€Å" Case Report of Secondary Narcolepsy presenting as self-inflicted genital injury † Abstract: Primary Narcolepsy is a sleep disorder with classical presentation showing tetrad of excessive daytime sleepiness, cataplexy, sleep paralysis, and Hypnogogic hallucinations. Some conditions that result in secondary narcolepsy include traumatic brain injury, tumors, and stroke. [1] A rare case of secondary narcolepsy was seen in a patient with self-inflicted genital injury. A 30 year old male was referred to Psychiatry from Surgery for a self-inflicted incised wound on hydrocoele. Since last 1 year, he had multiple episodes of 1. Sudden falls while working 2. Sleep during daytime often at unusual places 3. Periods of unresponsiveness during which he was aware but unable to move. During hospital stay, daytime somnolence, sleep paralysis and cataplexy were noted several times, but hallucinations were not consistently reported. Based on DSM-IV-TR Narcolepsy was diagnosed. Possible reasons for genital injury were 1. To remove fluid from swelling 2. Under sleep paralysis 3. Under Hypnogogic hallucinations. Patients EEG was normal. MRI brain showed Gliosis at cervico-medullary junction.MRI spine was advised to examine the cervico-vertebral junction but patient was lost to follow-up. But from history and investigations, it was concluded that he had secondary narcolep sy due to traumatic brain injury. Narcolepsy typically begins in the 2nd and 3rd decades of life and negatively impacts the quality of life of affected patients. Diagnosis relies on patient history and objective data gathered from polysomnography and multiple sleep latency testing. Treatment focuses on symptom relief through medication, education, and behavioural modification. Key-words: Cataplexy; Narcolepsy; Polysomnography; Self inflicted injury, Key Messages [D1]:Secondary narcolepsy is rare and sometimes can be missed to diagnose. Such rare presentation of secondary narcolepsy helps in diagnosing other cases of self-inflicting injuries. Introduction:[D2] Narcolepsy is neither a type of epilepsy nor a psychogenic disturbance. It is an abnormality of the sleep mechanisms specifically, REM-inhibiting mechanisms and it has been studied in dogs, sheep, and humans. Narcolepsy can occur at any age, but it most frequently begins in adolescence or young adulthood, generally before the age of 30. The disorder either progresses slowly or reaches a plateau that is maintained throughout life.[2]. The prevalence of narcolepsy varies across countries and with different ethnic groups, and so the exact prevalence is not known. Prevalence estimates have been reported to be between 168 and 799 per 100,000 in most studies, although Japanese studies have indicated a higher prevalence of 1600 per 100,000.[2,3]. There are no genetic tests current ly available for clinical use to make a positive diagnosis of narcolepsy. Genetic testing may correlate best to narcolepsy when there is already clear cataplexy.[4]. Supporting the evidence for an environmental influence is the fact that the disease is not apparent at birth, but instead commonly has its onset during the second decade of life. Additionally, there are apparent precipitating factors such as head trauma, infection, and changes in sleep-waking habits that have been identified in some cases.[6] Chronic, daytime sleepiness is a major, disabling symptom for many patients with traumatic brain injury (TBI), but thus far, its aetiology is not well understood. Extensive loss of the hypothalamic neurons that produce the wake-promoting neuropeptide hypocretin (orexin) causes the severe sleepiness of narcolepsy, and partial loss of these cells may contribute to the sleepiness of Parkinson disease and other disorders. One study has found that the number of hypocretin neurons is significantly reduced in patients with severe TBI. This observation highlights the often overlooked hypothalamic injury in TBI and provides new insights into the causes o f chronic sleepiness in patients with TBI.[7] Amphetamine usage has been associated with addiction, psychosis and self-injurious behaviour. There are reports on two patients who severely and repeatedly mutilated their own genitalia while intoxicated on amphetamines and consider possible diagnostic aetiologies.[8] Genital mutilation is common in males compared to females.[9] But narcolepsy presenting as self inflicted genital injury has not been reported so far. That is why this is a rare case. Case History[D3]: A case of secondary narcolepsy was seen in a patient presenting as self-inflicted genital injury. A 30 year old Hindi speaking illiterate male was referred to Psychiatry from Surgery for a self-inflicted incised wound on hydrocele. After primary wound closure at surgical side, patient was taken transfer to Psychiatry for detailed assessment. When detailed history was obtained from patients elder brother and father, it was found that since last 1 year, he had multiple episodes of sudden falls while working at kitchen as he was a cook. He used to sleep during daytime often at unusual places like in the courtyard, once over the road and sometimes in bathroom. Patient also had periods of unresponsiveness during which he was aware but unable to move himself even on painful stimulation. During hospital stay, daytime somnolence, sleep paralysis and cataplexy were noted several times, but hallucinations were not consistently reported. Based on DSM-IV-TR Narcolepsy was diagn osed. Possible reasons for genital injury were 1. To remove fluid from swelling 2. Under sleep paralysis 3. Under Hypnogogic hallucinations. Patients EEG was normal. MRI brain showed Gliosis at cervico-medullary junction.MRI spine advised to examine the cervico-vertebral junction but patient was lost to follow-up. But from history and investigations, it was concluded that he had secondary narcolepsy due to traumatic brain injury Discussion: Narcolepsy is a condition characterized by excessive sleepiness, as well as auxiliary symptoms that represent the intrusion of aspects of REM sleep into the wakingstate. The sleep attacks of narcolepsy represent episodes of irresistible sleepiness, leading to perhaps 10 to 20 minutes of sleep, after which the patient feels refreshed, at least briefly. They can occur at inappropriate times (e.g., while eating, talking, or driving and during sex). The REM sleep includes Hypnogogic and Hypnopompic hallucinations, cataplexy, and sleep paralysis. The appearance of REM sleep within 10 minutes of sleep onset (sleep-onset REM periods) is also considered evidence of narcolepsy. The disorder can be dangerous because it can lead to automobile and industrial accidents. Other symptoms include Hypnogogic or Hypnopompic hallucinations, which are vivid perceptual experiences, either auditory or visual, occurring at sleep onset or on awakening. Patients are often momentarily frightened, but within a minute or two they return to an entirely normal frame of mind and are aware that nothing was actually there. Here patient had symptoms of narcolepsy after head injury and patient himself injured his scrotum with sharp blade for which he had no clear memory and there was no history suggestive of epilepsy so diagnosis of secondary narcolepsy presenting as self-inflicted genital injury was considered.In this case, patient showed clinical features of narcolepsy as diagnosed by DSM- IV which was secondary type as there was history of multiple falls and MRI brain showed gliosis. But in this case, unusual presentation was genital self-inflicted injury. Possible reasons for genital injury are: Automatic behavior. Acting on Hypnogogic/Hypnopompic hallucinations. Due to impaired cognitive function/ judgment due to long-standing Narcolepsy. No cure exists for narcolepsy, but symptom management is possible. A regimen of forced naps at a regular time of day occasionally helps patients with narcolepsy and, in some cases, the regimen alone, without medication, can almost cure the condition. When medication is required, stimulants are most commonly used.[10] Although drug therapy is the treatment of choice, the overall therapeutic approach should include scheduled naps, lifestyle adjustment, psychological counselling, drug holidays to reduce tolerance, and careful monitoring of drug refills, general health, and cardiac status. References[D4]: 1. Narcolepsy: Clinical features, co-morbidities treatment Jeremy Peacock Ruth M. Benca Indian J Med Res 131, pp 338-349: 2010 2. Longstreth WT, Jr., Koepsell TD, Ton TG, Hendrickson AF, van Belle G. The epidemiology of narcolepsy. Sleep 2007; 30 : 13-26. 3.Tashiro T, Kanbayashi T, Iijima S, Hishakawa Y. An epidemiological study on prevalence of narcolepsy in Japanese. J Sleep Res 1992; (Suppl 1) : 228. 4. Bourgin P, Zeitzer JM, Mignot E. CSF hypocretin-1 assessment in sleep and neurological disorders. Lancet Neurol 2008; 7 : 649-62 5. Krahn LE, Pankratz VS, Oliver L, Boeve BF et al, Narcoleptic and schizophrenic hallucinations. Implications for differential diagnosis and pathophysiology. Eur J Health Econ. 2002; 3 (Suppl 2) : S94-8. 6. Bourgin P, Zeitzer JM, Mignot E. CSF hypocretin-1 assessment in sleep and neurological disorders. Lancet Neurol 2008; 7 :649-62. 7. Christian R. Baumann MD, Claudio L. Bassetti MD, Philipp O. Valko MD, Johannes Haybaeck MD,et al Loss of hypocretin (orexin) neurons with traumatic brain injury. 8. Joshua A. Israel and Kewchang, Lee Article first published online: Amphetamine usage and genital self-mutilation. 2002 DOI:10.1046/j.1360-0443.2002.00230.x 9. MartinT. ·GattazW.F, Psychiatric Aspects of Male Genital Self-Mutilation.Psychopathology; 24:170–178,1991. 10. synopsis of psychiatry 10th edition Case series of genital mutilation :The Journal of Urology150(4):1143-1146] 1993. [D1]1 Provide appropriate messages of about 35-50 words to be printed in centre box [D2]1 Please include why this case is unique. If it is rare, how rare, how many cases have been reported. [D3]1 Include the tables/charts at appropriate places in the text it self. Do not include images in the text. Mark the point of insertion of images (e.g. Figure 1) along with the legends. Send the images separately as jpeg files (not larger than 100 kb each) [D4]1 Follow the punctuation marks carefully. Do not include unnecessary bibliographic elements such as issue number, month of publication, etc. Include names of six authors followed by et al if there are more than six authors.

Is Globalization Americanization?

Is Globalization Americanization? In my opinion, I don’t believe an item's history and origin make it inevitably American. This is partly because some items don’t gain the popularity here, but rather outside the country. In addition, some franchises are seen in so many countries that while it’s likely known that it originated in America, that’s the only â€Å"American† thing about it. Lastly, some For the fast food examples such as McDonald’s or Starbucks, they are probably best known in terms of their origin and the most popular in terms of being â€Å"American†. Both chains have been around for decades – McDonalds, since 1955 (mcdonalds. com, 2012) and Starbucks, since 1971 (starbucks. com, 2012). Both chains have continued to grow and expand to immense proportions. McDonalds currently has locations in 119 countries (en. wikipedia. org, 2012), while Starbucks follows at a respectable 50 countries (starbucks. com, 2012). They are both good examples of â€Å"American† chains however I don’t think that simply originating in America created that label. I think that if that were the case, there wouldn’t have been as much success in other countries. I think that these chains have been able to expand so much simply because they’re so popular. In theory, much of their popularity might come down to the attraction from tourists, whether famous and popular or unknown. One public message about a great restaurant is good press alone and can cause frenzy. For the television show example, I think Oprah says it all. The Oprah Winfrey Show became its own in 1986 (en. wikipedia. org, 2012). Since then, she has become has become a household name both in American and internationally. At its height, the Oprah Winfrey show aired in 149 countries (en. wikipedia. org, 2012). I think that with the viewership in other countries, it just goes to show that while the Oprah phenomenon started in America, it has certainly branched out; therefore, America is only where she’s from, not who she is. The musical example falls on the Beatles. I think they are maybe an especially important example of the American versus not question. The reason being is that although they originated in England, due to their talent of singing, if you didn’t already know where they were from, there was no immediate awareness as to their origin – at least for later generations such as myself who still love their songs years after the initial release. The point is that with the Beatles as n example, if the theory about popularity or globalization meaning American is true, then one could think they originated here because they became so popular. Obviously it has been well known for years that they originated in England; but if that knowledge was not immediately known, then they could have been from anywhere. In all fairness, the argument is probably strong both ways. I can absolutely see the point of view that Globalization can be perceived as originating from America. However, I feel even more strongly, that when you take a closer look, it really doesn’t matter when an item actually originated; it all comes down to popularity. References: Our Heritage. (2012, January 9). Starbucks. com. Retrieved from: http://www. starbucks. com/about-us/our-heritage Our History. (2012, January 9). McDonald’s. com. Retrieved from: http://www. mcdonalds. com/us/en/our_story/our_history. html McDonald’s. (2012, January 9). McDonald’s Global Operations. Retrieved from: http://en. wikipedia. org/wiki/McDonalds#Global_operations Is Globalization Americanization? The question is â€Å"does an item’s history and origin make it inevitable American? † The answer to the previous question truthfully is yes and no. There are several items a part of our American culture that do make that specific item inevitable American. But quite honestly, the United States outsources their goods and resources meaning that a country as a whole maintains several items, such as fabrics, food and toys, from other countries. The only reason why we do this is because it is cheaper for our economy. Looking around the house, there are several items that say â€Å"Made in China†, â€Å"Made in Mexico†, and â€Å"Made in Vietnam†. These items are sold on the shelves of major corporations here in America, but they are clearly not American items. They are just sold in American and outsourced by America so in turn, the ‘history’ of these items make them American. For example, one of the toys that was bought for a friends daughter, was made in another country, but when looking on the package the toy was originally came in, it states that it was shipped an packaged here in the United States. Globalization is definitely a spread of American culture and vice versa. Countries nowadays are nothing but a melting pot of other cultures. The most common fast food chain that started off in America and went international was McDonalds. In week two, we had a discussion question base upon whether McDonalds was an expression of American and global cultures. McDonalds is more so an expression of the American culture in other countries. Other countries, such as China, have built a McDonalds industry in order to introduce the American culture to their youth. Our movie industry in America has taken over the world by storm. There are many films that are American films that ‘go big’ in other countries or are introduced to other countries around the same time that they are introduced to the American culture. Sometimes, the films are more successful overseas than here in the States. Two perfect examples of an American film that not only took off here in The United States but internationally as well would be The Twilight Saga and all Harry Potter films. The origins of the books were from American authors but once they were made into successful films, they took off internationally. These movies are two perfect examples as to the spread of American culture globally. Music is a hard one to find an example of for the research assignment. No matter whom the artist is, the instrument is or genre, one way or another, not one of them is truly American. Artists are inspired by other artists that are, nine times out of ten, an oldies artist that originated from another country. There are many international artists. Either they started in another country an then began touring in the United States along with selling records, they then became American music ‘icons’. There are some artists that got their major record label contract the America, and then became international celebrities. The major musical groups that could pertain to the Americanization and Globalization of the music industry would be the Beatles, Monkees and Selena. In conclusion, there are many items in the American culture that have gone global. To answer the state question, is Americanization Globalization? Yes. There are so many different examples that can pertain to the said question, so, once again, the American culture has hit the global market. But then again, there are many items that are made in another country for America. The true definition of globalization can differ from person to person. In my mind and my definition, globalization is the different cultures that come together as ‘one’. Our culture is seen in several countries across the globe, as well as those countries being sought out here in America. Is Globalization Americanization? It took me a while to try to work â€Å"glocal† out. This is my way of saying I had a tough time trying to wrap my mind around what exactly is glocal. To me it is open to interpretation; people will have their own theories on what it means. To me it is something that is global but has a slight variation to fit in locally or think local but act global. I see it as thinking global but adapting business to fit local needs and demands while having a global approach to the business, basically, honoring business traditions and customs and adapting product and services for regional intake according to local culture.Cultural items become glocal when they can be seen and found around the world but are changed to fit in locally. These items can be globalized at any time, whenever a company wishes to go global then it can modify changes according to local standards. Walmart is well known just like McDonalds, they have 6,155 stores internationally. These stores have merchandise and practi ces to fit into the local cultures. This is also the case for stores in the U. S. For instance, the Walmart in our little town has merchandise specifically for our area and the Walmart 15 miles away in another town sell merchandise specifically for that town.I have been trying to say away from McDonalds; even in last week’s paper, to me it was like beating a dead horse. I tried to use examples not many classmates would have used. To me it would be nice for the reader to have something different to read instead of having a dozen or so papers all using the same examples. This worked for me because it made my research interesting and I was able to learn new things. This week I will play it safe and use only examples used in the textbook, which by the way, was informative. This brings me back to McDonalds, which is a very good example.McDonalds is a U. S based company who has expanded to 119 countries. As a glocal company they ensure their foods looks and taste the same everywher e, uniformity is essential for large corporations who want to please their customers regardless of where their travels take them. They fit in locally with local customs, such as McDonalds in New Delhi serve vegetable McNuggets or fried egg with the burgers in Montevideo. Often time’s glocal companies who offer products that fit into the local culture purchase these products locally, which helps add to their success.When it comes to a glocal movie the textbook gave a good example, Spiderman. Marvel Comics took Spiderman to a new level when they took the movie franchise to India. They made changes to the movie that fit with local customs, giving India their first superhero. The characters clothing was slightly different and the story line was changed to draw in India’s market. The Glocal franchise succeeded, even though the story had drastic changes, to the point it would be unrecognizable to U. S. viewers, it worked for India viewers. Growing up I remember MTV first com ing on the air.This was when cable first came out in the early 80’s. What I find interesting is MTV was based in New York City at the time, I believe they still are, but while reading this week’s assignment it said the first video played on MTV was a British band, I thought there was a little irony there. However, MTV meets the demand wherever they are globally. Their programming is contingent on local demands. In Brazil MTV play music videos and other programming determined by the local producers. MTV in Asia endorses Thai pop stars and play music videos sung in Mandarin.What makes the three examples I used glocal is all three have ability to be international models with the flexibility to allow for local changes, so they have a global company or product that becomes local and function as both. Other companies such as Fila, an Italian shoe maker makes the same shoe that is sold around the world. Modifications are not needed to sell the shoes internationally; this make s them an international model that does not need to be flexible. It will remain an international item or one that always reflects its culture.

Human Rights Act Of 1998 - 2095 Words

Rights that protect human beings and the extent of legality of what they are entitled to as people are a core part of each constitution globally. The extent of human rights protection varies from country to country, with total democracies having most human rights that encompass freedom of speech and expression among other freedoms. These are the most sovereign of laws as they express how liberal and powerful the majority can be as opposed to the minority being powerful in some countries or kingdoms. In some countries, the part of the constitution (just answer legal) is referred to as the Bill of Rights. In the United Kingdom, they are referred to as the human rights act of 1998. It was previously referred to as the Bill of rights though. As expressed in the UK parliament official website, the Human rights Act came into life in 1998 to â€Å"bring rights home† (www.parliament.uk, 2014). Section 3 of the 1998 Human Rights act has equally been center of controversy and light about various issues as who decides the extent to which the human rights stretch. The human rights act expresses the human rights that are contained in the European Convention (Jeeves) on Human rights as part of the UK laws in three forms as follow: The UK laws should be interpreted in so far as possible to do so, to reflect the consideration for the human rights act. If Parliament passes an act that is in contravention with the Human rights act, the courts have the mandate to declare such acts asShow MoreRelatedHuman Rights Act 1998 ( Hra )3755 Words   |  16 PagesSection C: 8 Before the Human Rights Act 1998 (HRA) coming into force, the UK subscribed to a ‘weak’ judicial review. However, the Act has brought a drastic change into the practice of judicial review in the UK. In this essay, I shall argue that with the new powers conferred to the courts under sections 3 and 4 (ss 3 and 4) of the HRA, they have developed a mechanism which allows the court to communicate with Parliament through their interpretations although the practice of judicial review remainsRead MoreSignificance of Section 3 and 4 of the Human Rights Act 19981312 Words   |  5 PagesThe power to strike down Acts of Parliament is defined as the power to declare legislation invalid because it is unconstitutional. This paper will critically assess sections 3 and 4 of the HRA 1998 by defining them, reviewing case law surrounding their use, and by evaluating the powers that they give to the judiciary. 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Explanation will be made of the way that the UK addresses the implementation of the rights in the English legal system. Issues such as conflicting rights and legal limitations will also be considered. An evaluation will be made of whether or not The Human Rights Act 1998 protects the fundamental rights of UKRead MoreThe Human Rights Act 19981486 Words   |  6 Pages The Human Rights Act 1998 The Human Rights Act 1998 was fully enforced in 2000 and describes further effect to freedoms and rights that are entitled under the ECHR (the European Convention on Human Rights) (Ward, Wragg Walker 2011, p. 146). The constitutional framework of the United Kingdom implies that the Human Rights Act 1998 is not ‘embedded’ in the same way as the human rights papers that are adopted by many nations in the world. 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Furthermore, it is important to note that the introduction of the Human Rights Act 1998 has affected the law of negligence, a breach of duty that results in damage to the claimant. This area of law has shown to beRead MoreThe Human Rights Act 19981470 Words   |  6 PagesThe Human Rights Act 1998 sets out fundamental rights for everyone within the UK. This incorporates the rights in which were set out in the European Convention on Human Rights, meaning if a persons’ rights are breached, the case can be brought to UK court rather than seeking justice from the European Court of Human Rights located in Franc e. In practice, this ensures all new laws are compatible with the Human Rights. The European Court of Human Rights; which focuses on humanities basic necessitiesRead MoreThe Human Rights Act 1998914 Words   |  4 Pagesimplications in regards to this study and the relevance to this particular case. The Human Rights Act 1998 according to Wild and Weinstein (2013-p217) came into force on the 2nd of October 2010. It seeks to protect the rights of all European nations. (LIST ALL RIGHTS IF YOU HAVE THE WORD COUNT) The Equality Act 2006 according to personnel today (2006) was firstly to establish the Commission for Equality and Human Rights, this is applicable to discrimination on grounds of beliefs and religions in the

University Students in Wales

Sample details Pages: 10 Words: 2937 Downloads: 7 Date added: 2017/06/26 Category Statistics Essay Did you like this example? International Student Recruitment at University of Wales (Positioning, Target Market, Servicesand Advantages) Don’t waste time! Our writers will create an original "University Students in Wales | Education Dissertations" essay for you Create order ABSTRACT: The higher education market globally is becoming increasingly dynamic and competitive. Options for students have increased at a dramatic rate. The education industry is regarded no less then any other business, prospecting and attracting students from around the world. Consequently, we can say with utmost confidence that it is misleading to separate the word marketing from education industry. Students have been over loaded with information due to globalization, and realize that to survive in this competitive market, they need to equip themselves with the best knowledge. INTRODUCTION: The university once established can serve as an efficient self recruitment tool for students. Universities have been spending so much on recruitment activities but not on the right track. It is essential for universities to help, identify and clarify what their name in particular means and how it is different from other alternatives.The role of a university is to widen horizons and challenge existing paradigms. This university will pursue these goals in their more traditional sense. However, the uniqueness of the institution means that special focus will be placed upon widening the horizons of its students and raising their own confidence to achieve their full potential. The title of the University underscores our commitment to the region within which its campuses are located whilst reaffirming its responsibility, as a university, to the wider academic and international community. Mazarrol (1998) suggested that higher education is a considerable marketable service and it possess all the necessary characteristics of services identified earlier by Zeithaml et al (1985). Among the characteristics, difficulty in marketing intangibility of services prevails more in education industry as it is difficult to define (Mazzarol, 1998). Marketing of educational institutions in UK started in 1980s (Brown and Oplatka, 2006) and due to increasing competitive environment, nationally and internationally, universities are sensing the need to market themselves aggressively and after careful situational analysis, they carefully need to adapt strategies to effectively position their in the mind of students (Ivy, 2001). Higher education has become a positional good in the sense that students, parents and employers view some institutions as offering better social life and future prospects and vice versa, institutes seek for the best students (Hirsch, 1976; Maringe, 2006). University of Wales is already enormously diverse on any number of dimensions, including ethnicity and nationality. The University celebrates this diversity and looks further to widen its international reputation and appeal. Any firm, no matter which business they are in, works in vacuum. You need to observe actively which environment you are working in, considering all the external factors which might influence your business. Competitors, especially, have a massive impact on companys profitability. Rivalry among existing competitors takes the familiar form of jockeying for a better position, pushing companies to adapt tactics such as price cuts, product innovation etc in order to have competitive advantage. All these devices one way or the other, affect the overall profitability of the firm. BACKGROUND: University of Wales is s a confederalPontypridd. It also accredits courses abroad and has over 100,000 students. The Chancellor of the University of Wales isArchbishop of Wales, Dr. Barry Morgan. The Vice-Chancellor is Professor Marc Clement The University was composed ofPrivy Councilto change its name to the University of Wales, Newpo Cardiff University and the University Of Wales College Of Medicine (UWCM) merged on2005to study other subjects are awarded Cardiff University degrees The University has a clear mission as a regional institution which aims to extend opportunity and widen participation in further and higher education and, to that end, commits itself primarily to teaching and learning rather than research. It is a relatively large institution, with some 31,000 registered students in 1996 97, of whom 65 per cent were studying part-time, 64 per cent were women and 59 per cent were aged over 25. 48 per cent of students described themselves as non-white. 11 per cent of students were from non-UK EU countries, and 22 per cent were from countries outside the EU. An important feature of the University is that some 22 per cent of its students are seeking further education qualifications, for which the University is not the awarding body, and for which it bears no formal responsibility for the standards of the awards. Similarly, many of the vocationally-based undergraduate and postgraduate programmed are accredited by professional or statutory bodies, whose standards and quality criteria the University is obliged to meet. In some of these cases, however, the University itself has been accredited by the awarding body (for BTEC courses, for example) and thus has effective sole control of quality and standards. A further important feature of the University is the strength of commitment of its staff to the institutional mission. We were constantly struck by the way in which this permeated many of our meetings with staff at all levels, from the Vice-Chancellor to the most junior support staff. The mission is ambitious: given the remarkable variety of the student body, the University has set itself a very demanding objective in seeking to provide higher and further educational opportunities which are comparable in standard of outcome, as well as quality of experience, with the generality of higher education institutions in the UK. It is a tribute to the Universitys staff that its mission remains a source of inspiration despite the difficulties that many of them have experienced in recent years. Briefs of Aims and Objectives: Research Aim: University of Waleswas established long time back providing services to facilitate students in attaining better education at different levels. It is facing fierce competition from other universities in London. Preliminary research has indicated that students fail to make associations about the positioning about key benefits of the University over its competitors and cannot identify a unified identity. Therefore, the University clearly needs to position itself against competitors in order to remain attractive in the domestic and international market. Research Objectives: In order to satisfy the aim for which this research is being undertaken, following objectives need to be accomplished which will lead to provide us the clear view of current position ofUniversity of Wales. To systematically collect data from current students about perception of University in relation to their competitors. To identify the needs and expectations of students from the University. To identify the current positioning ofUniversity of Wales. To critically analyze the findings about current positioning. Depending on the analysis, to reinforce the current image of its brand. OR, to re-position theUniversity of Walesimage. Finding developments necessary for university to make in order to meet gaps in provision. Key Words:Positioning; Target Market, Service; Higher Education; Research Question: Q1) what are the perceptions of students about theUniversity of Walesin relation to competitors? Q2) what is the current positioning of theUniversity of Wales? Hypothesis Perception HO1:University of Waleshas no effect on perception of students. H11:University of Waleshas positive effect on students perception. Positioning H02:University of Waleshas no effect on to attracting students. H12:University of Waleshas positive effects on attracting students. Research Methodology: In order to accomplish the end objectives for which this research is being conducted, both qualitative and quantitative techniques will be used, which are discussed further. Data collection, both primary and secondary has been divided into two phases. Phase 1 constitutes exploratory research aiming to look for secondary data from different sources as well as qualitative method of conducting focus groups in order to gather primary data necessary for the next step. Phase 2 accompanies quantitative techniques in the form of survey to gather finalized results to be analyzed. Data Collection (Phase 1): Exploratory research is investigation informal studies to provide background information. It is not intended to provide conclusive evidence from which to follow a concrete direction, rather it provides a basis that subsequent research will be a requirement to achieve final results. The basic purpose behind exploratory research is to exhaust inexpensive readily available data which may help to prevent mistakes like rushing into expensive detailed surveys (Zikmund, 1997). Exploratory research can be conducted using various techniques. For our research objectives, and considering the mind in limitations, the most suitable are secondary data and focus groups. Secondary Data:Also termed as holistic data previously collected for some project other than the one at hand. It is relatively inexpensive and readily available, but we need to make sure it is consistent with the problem definition as they are not designed for the purpose to serve research needs (Zikmund, 1997). External sources where we can gather secondary data for this research includes Libraries (Huge source of information including databases, books and periodicals, journal articles) British Library,University of Waleslibrary , EBSCO database, Emerald Management full text database, Athens DA Resources etc. The Internet (Provides secondary data, authenticity is a bit doubtful but in many cases huge information can be acquired). Focus Groups:The second step of phase 1 is conducting focus group which is a qualitative method of data gathering. It is an unstructured, free flowing interview with a small group of people. Focus groups are not rigidly structured; rather they are of a flexible discussion format. The moderator introduces the topic to the participants who in turn carry out the discussion and as this discussion progresses, new topics emerge. It freely allows the participants to truly reflect their feelings and emotions in their own words (Zikmund, 1997). The role of the moderator is to ensure that all members participate in the session and none dominates it. Though focus groups are the least expensive ways of gathering information; it should be kept in mind that data gathered from focus groups only provide qualitative information. Another limitation to them is that since the members are not selected scientifically, they may not truly reflect the opinions of the whole population at large. However, the e xploratory information collected through focus groups can be a basis for further scientific research. We will be conducting two focus groups of 6 students each. One group will contain a random sample from the international students and other from the domestic students. The objective of the focus groups is to generate further insights about students and the factors they might feel important to them in their ultimate decision of selecting a University. We may or may not come up with factors other than discussed earlier. There is no scientific method to analyze qualitative data. Therefore recording of the whole focus group discussion will be carried out which will help to reduce any risk of biases. Face expressions is a short coming, and it solely based on moderators interpretation. Data Collection (Phase 2): The second phase of collecting data is by gathering quantitative data by asking respondents to fill in the finalized self administered questionnaire. We have selected a sample size of 200 students purely based on judgment and keeping in mind the limitations of the study. However, if further we might feel that the sample size is not justified; further alterations may be carried out. Non probability sampling technique is one in which sample is selected on personal judgment or experience and the probability of any member from the population is not known and within that framework, we will be using Quota Sampling (Zikmund, 1997). Quota sampling is a procedure which ensures that all the sub groups present in the population will represent the sample to the extent on the desire of investigator. A logical drawback of quota sample is it tends to select people which are easily available therefore careful supervision is required in order to gather a true representative sample of the population. Obviously, the logic for using quota sampling for questionnaires is that we want student representingUniversity of Walesfrom different geographical backgrounds and level of education to be part of the sample. Quota allocation is explained below: Total Sample = 200 100 International Students 100 Domestic Students 50 Post Graduate Students 50 Graduate Students 50 Post Graduate Students 50 Graduate Students 10 Students from each geographic division Americas Asia Europe Australia Africas 10 Students from each geographic division Americas Asia Europe Australia Africas Data Analysis: The number of questions in the final questionnaire is not known as yet since they will depend on the findings from the primary data from focus groups. However, a few sample questions are listed below (not necessarily the part of final questionnaire): Q: The achievements of the institution for you? Q: TheUniversity of Walesavenues for religious practices? Q: Stable political economy of the host country is important? The most appropriate technique for measuring the attitude of students for this research is through Likert scale which is a type on an ordinal scale. It is a bipolar attitude measurement technique most widely used which allows respondents to rate how strongly they agree or disagree with these carefully constructed statement. Therefore, for our research we will construct a 5 point Likert Scale ranging from Strongly Disagree to Strongly Agree and weights are assigned to answers accordingly. An example is shown below: Q: The achievements of the institution for you? Strongly Disagree Disagree Uncertain Agree Strongly Agree (1) (2) (3) (4) (5) Each dimension as mentioned will contain certain questions which will reflect the attitude towards the overall dimension. Therefore in order to achieve this, we will use the method of cross-tabulation. It is a technique for organizing data by groups, categories or classes facilitating comparison between them). For individual question, calculation of confidence interval will be conducted using the t distribution. This will help us in finding out attitude of students that how many respond favorably or unfavorably to a certain question. The results will be measured and analyzed with the help of most extensively used statistical software called SPSS. Once data is input, immediate reports are generated and there is no probability of human calculation error. Conclusion: The aspect of positioning university brands in students mind is an increasingly growing phenomenon and now a pre requisite for institutions to effectively compete in domestic and international markets. Options for students have proliferated at a progressive rate. Globalization and competitive employment environment at the same time have lead students to treat education as a return on investment in order to safeguard their careers. The research will help theUniversity of Walesestablish a unique position in relation to its competitor which is favorable to students. 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