Bottom of the Pyramid Proposal - 1333 Words

Sean M. Hart GBUS 496 Individual BOP Proposal This paper will evaluate the potential of â€Å"bottom of the pyramid† opportunities for a multi-national electric generation and distribution company. Initially, the basic elements of strategy needed for serving this market will be examined. Next, the AAA factors will be evaluated to determine if there are advantages to be obtained by globalizing the proposal. Lastly, cultural differences that may affect the business will be examined. Company Overview PPL Corporation began in1920 when eight utilities serving central and eastern Pennsylvania merged into a single entity called Pennsylvania Power amp; Light Co., headquartered in Allentown, Pa. Today, PPL controls or owns about 19,000†¦show more content†¦Increased electric use could organically increase to a level that would justify the expense of expanding distributed power to these regions. However, the likelihood of this growth occurring at a rate that justifies the capital expenditure necessary for distributed power is minimal. Instead, PPL could stage this expansion in a way to correspond with the global markets’ continued desire to find ever-cheaper labor in rural markets. When a manufacturing facility is constructed in a rural market, PPL could mandate, as a condition of it supplying power to the facility, that the manufacturer also provide for construction of distributed power facilities in the surrounding villages. AAA Factors There is no real immediate aggregation potential of this proposal in terms of economies of scale. This is because each individual will be their own, self-contained source of generation, distribution and consumption of power. If aggregation is to occur, it will happen much later when distributed power is extended to these regions,. Aside from many in the BOP residing in sunny climates, the main arbitrage advantage is that solar is the only practical way to provide power to many in this market and should therefore receive substantial government subsidies. There seem to be no adaptation advantages associated with thisShow MoreRelatedBeasts Of Burden And A Source Of Food857 Words   |  4 Pagesbeginning the Old Kingdom and at this time the pharaoh lived in lower {northern} Egypt. In 2686 BC the architect Imhotep build the first stepped pyramid at Saqqara for the pharaoh Zoser. In 2648 BC, Zoser died. In 2575 BC another pyramid was built, The Great Pyramid at Giza by the pharaoh Cheops. Nine years later Cheops died. Pharaoh Chephren build a pyramid at Giza and the sphinx bears his head on the body of the lion in 2550 BC. 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Crafting and Executing Strategy - 1582 Words

Running Head: EXECUTING STRATEGY Crafting and Executing Strategy Whole Foods Assignment # 1 Strayer University BUS 599: Strategic Management Spring 2013 Develop an argument supporting the importance of a strategic plan for the success of the defined business. For the success of the defined business, in this case for Whole Foods Market, the importance of a strategic plan is unquestionable. In Crafting Executing Strategy: The Quest for Competitive Advantage: Concepts and Cases Arthur A. Thompson, Jr., A.J. Strickland III, and John E. Gamble (2009) state that â€Å"a company’s strategy is management’s action plan for running the business and conducting operations† (p.6). 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Whole Foods Market’s vision statement is its Declaration of Interdependence: â€Å"Whole Foods Market is a dynamic leader in the quality food business. We are a mission-driven company that aims to set the standards of excellence for food retailers. We are building a business in which high standards permeate all aspects of our company. Quality is a state of mind at Whole Food Market. Our motto – Whole Goods, Whole People, Whole Planet – emphasizes that our vision reaches far beyond just being a good retailer. Our success in fulfilling our vision isShow MoreRelatedCrafting and Executing Strategy1463 Words   |  6 PagesRunning head: ASSIGNMENT #1 CRAFTING AND EXECUTING STRATEGY Assignment #1 Crafting and Executing Strategy Jet Blue Airways Strayer University BUS599016VA016-1116-001 Strategic Management July 11, 2011 Abstract This paper examines the business strategy of Jet Blue Airways. 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(5) A key element of Costco’s pricing strategy to keep prices low to members is to cap the margins on brand-name merchandise at 14%, and on their private-label Kirkland

The Biological And Physiological Characteristics Between...

Mars and Venus Sex refers to the biological and physiological characteristics between men and women, assigning them a role in reproduction, while gender refers to behaviors, roles, expectations, and activities in society that are culturally and socially constructed differences between males and females. Sex refers to male or female, while gender refers to masculine or feminine. Moreover, the differences in the sexes do not vary throughout the world, but differences in gender do. One is able to see such differences throughout various elements of society such as through mass media and objects. To explain these sex and gender differences one must understand the three main sociological perspectives, which include, structural functionalist,†¦show more content†¦This process occurs universally and can be found in mass media, for example through Disney. Disney teaches young children about what it means to be a male or female. Most people, if not all, have been raised on Disney movies without being aware of the impact that it has on them. Disney does a great job at shaping kids’ minds by teaching them about gender roles. In other words, gender roles are what allow one to allude to certain attitudes or behaviors that result in providing one with a certain stereotypical identity. Moreover, Disney deals with schooling young boys and girls on how to act and behave based on their gender. For example, in many Disney movies one can see that there is a pattern presented to young girls on how being slim, with a tiny waist, long eyelashes, big breast, and white skin is what makes up a women, as illustrated with Ariel in â€Å"The Little Mermaid†. Likewise, Disney serves as a teacher to young boys. Throughout its movies Disney constructs the ideal man, also known as a prince, to one that is important, rich, attractive, famous, and charming, making men appear superior to women, thus influencing young boys to aim for such an unrealistic individuality. Also, like young girls, young boys are being taught that being masculine means to be strong, muscular, and of course,

Descriptive Essay Ever Changing Path - 1341 Words

Ever-changing Path I started out on this journey of deciding what I wanted to be within the last couple of years. I knew I wanted to work with kids and I also knew that I wanted to pursue a career in the psychological field. This class has made me take a closer look at what specific career I want to focus on. In my first journal, I had decided that I wanted to learn and be certified in ABA therapy techniques. I still want to work with this technique, but I have narrowed it down to a specific master’s program: School Psychology. I began to look into this field more after a conversation I had with Dr. Grellner. I did a search for this career on O*NET and found that many of the responsibilities of this job would allow me to use my†¦show more content†¦In order to have a well rounded application, I need a well rounded CV. Some of the biggest experiences that go into a CV are research assistantships and teaching assistantships. The first thing I want to take on is a teachi ng assistantship. According to Landrum and Davis (2014) chapter 7, a teaching assistantship helps build relationships with faculty members in a less time consuming way than a research assistantship. Since I work and go to school five days a week, I think that a teaching assistantship would suit my schedule better at this point in my life. I have already begun to talk to professors to see who I might be able to work with. Further into my undergraduate career I do want to get involved with research. In chapter 7 of The Psychology Major: Career Options and Strategies for Success, some of the benefits of a research assistantship are listed. Some of the benefits include the opportunity to work with faculty, be involved in real-life experience, and practice writing in APA and using statistical methods (Landrum Davis, 2014). Within the next year I plan to either talk directly to faculty members about getting involved in research or go to the research lab in the education building to find research opportunities. If possible, I would also like to maybe head my own research project. Work Experience Chapter 8 of Landrum and Davis (2014) talks about the benefitsShow MoreRelatedFinding Clarity In The Obscurity Of â€Å"Why Privacy Matters†.1283 Words   |  6 PagesFinding clarity in the obscurity of â€Å"Why Privacy Matters† In his essay â€Å"Why Privacy Matters† from The Wilson Quarterly, Jeffrey Rosen offers a compelling account of the harmful effects of eradicating our privacy. Rosen ventures into several different fields affected by the ever-growing intrusion of our privacy, offering a rich compendium of illustrations from the real world. From Monica Lewinsky’s fate under her investigation, to a Charles Schwab employee, Rosen offers a prolific arsenal of incidentsRead MoreThe Arrival Of Home Video891 Words   |  4 Pagesparticular films were rare – something unimaginable to consider in times when the culture is within our reach all the time and everywhere. It’s important to acknowledge cinephilia’s changing dynamics. In fact is has not died, it resurrected as ‘new kind of cine-live’ what Sonntag foresaw at the end of her essay. Changing face of cinephilia This new cinephilia, is simply a mutation reinvented by digital technologies, Internet, and new media. It enabled film lovers to experience cinema at a differentRead MorePersonal Writing : My Personal Narrative1331 Words   |  6 Pagesdifferent stories and different scenarios. I believe that the long paragraph roleplays had to help my writing skills to some degree. I had to sit at a computer and creatively think about what I was going to make my characters do next. If you weren’t descriptive people wouldn’t continue to roleplay with you. After a while of doing it, you get an understanding of what the other people are looking for. The site I’m referring to eventually died down, and my friend and I had moved to different sites. AlthoughRead MoreSilvia Parra Dela Longa. Professor: Leslie Richardson.1404 Words   |  6 PagesRises ranks number 53 on the list of the 100 best novels of 20th century American Literature. Why does The Sun Also Rises is respected as lan dmark in the world of words? One of the reasons is about the writing style of Hemingway, which transformed the path of American and English literature. Gertrude Stein, James Joyce, and his time into journalism, helped Hemingway to shape his peculiar approach in writing prose. These influences gave born to three recursive concepts embodied in Hemingway’s works:Read MoreThe Journey: Symbolism of â€Å"a Worn Path† and â€Å"the Road Not Taken† Final2218 Words   |  9 PagesThe Journey: Symbolism of â€Å"A Worn Path† and â€Å"The Road Not Taken† Expedition. Voyage. Excursion. Pilgrimage. There are many words that are used to describe the word journey but what does it really mean? Many people consider the word journey as merely a distance in which they have traveled or will eventually travel; often they fail to recognize that there can be great meaning beyond each step that is taken. Too often, people become more focused on the destination rather than the processRead More An Analysis of the Epic Poem, Beowulf - Characterization of Beowulf1918 Words   |  8 PagesCharacterization of Beowulf  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚         The dialogue, action and motivation revolve about the characters in the poem (Abrams 32-33). It is the purpose of this essay to demonstrate the types of characters present in the anonymously written Anglo-Saxon poem, Beowulf - whether static or dynamic, whether flat or round, and whether protrayed through showing or telling.    At the very outset of the poem the reader is introduced, through â€Å"telling† by the scop, to Scyld Scefing, forefatherRead MoreAnalysing the Tallabugdera Creek Area Essays2010 Words   |  9 PagesTallebudgera Creek including Burleigh heads national park and on the opposite side, the Tallebudgera Recreation Camp all the way down to the Tallebudgera Creek Conservation Park. Because of this, this is the area is what will be analysed for this essay. In order to fully understand the centre I will look at it through the theory presented in Responsive Environments by Sue McGlynn, Graham Smith, Alan Alcock, Paul Murrain and Ian Bentley. 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Adjectives like red, lusty, morose, striped, sparkling, and crestfallen are all illustrative. * Explain:  Author wanted to break down an idea into simpler terms Clue Words:  Look for words that turn a complicated process into simple language. A descriptive text will use more adjectives. An explanatory text will usually be used with a complicated idea. *Read MoreModern Drama And Modern Criticism2836 Words   |  12 Pagesof the nineteenth century, the most popular dramatic form of its age, a form that depended more on graphic exhilaration and the thrill of the moment – qualities almost beyond critical recall – than anything ever written for the stage. Now it is all gone, and I will hopefully through this essay bring some of this back to life. Yet because of its energy and vividness, something of its nature can be imparted. Melodrama had never been rated highly by dramatic critics or historians, whose most contemptuous

Analysis Of The Story The Story Of An Hour By Kate Chopin

Eddly Noel English Literature and Writing Professor Johnson 27 October 2014 Oppression In Kate Chopin’s short story â€Å"The Story of an Hour† oppression is epitomized as the state of being subject to control or distress. At the beginning of the story, Louise Mallard’s family gently informs her of her husband’s death in a train accident. Knowing that Mrs. Mallard suffered from heart trouble, they had to carefully convey the sad message. At this moment, Mrs. Mallard is feeling heavily burdened and retreats away from her family and has locked herself in her room, a place she frequently spends time in. Alone in this room, Louise is overcome with a sense of freedom, she realizes that she is now an independent woman. It seems as if Mrs. Mallard frequently spending time in her room is the cause of having no personal freedom, my theory is that she felt socially oppressed around her family. Mrs. Mallard feeling rather entranced at her husbands death portrays that she must have felt trapped in her marriage. Mrs. Mallard is a victim of oppression . â€Å"Josephine was kneeling before the closed door with her lips to the keyhold, imploring for admission. Louise, open the door! I beg; open the door--you will make yourself ill. What are you doing, Louise? For heaven s sake open the door.† — Why must Josephine, Louise’s sister, beg of Louise to let her in. Conceivably, Josephine felt that a time like this ,where Louise is emotionally depressed , with her illness it would be better for LouiseShow MoreRelatedAnalysis Of The Story Of An Hour By Kate Chopin811 Words   |  4 Pages2015 What’s in a Protagonist: An Analysis of The Story of an Hour In Kate Chopin’s short story, The Story of an Hour, the reader is introduced to three characters and an event that has occurred prior to the beginning of the story. The three characters that the reader is introduced to are: Mrs. Mallard, who is the protagonist of the story, Josphine, who is her sister, and Mr. Richards, who does not play a major role in the story. Throughout the plot of the story, the reader can gain a sense of sympathyRead MoreAnalysis Of The Story The Story Of An Hour By Kate Chopin751 Words   |  4 PagesHardi Patel Mr. Ogle ENGL 1020 10 July 2015 The Joy of Independence In the short story â€Å"The Story of an Hour†, by Kate Chopin, the episode begins with the exposition. It is the story about a dynamic character, Mrs. Mallard, who is given the horrible news of her husband’s death in a railroad disaster. Overwhelmed by her husband’s immediate death, she suddenly rushes in her bedroom. Here we see a different side of Mrs. Mallard’s attitude. Mrs. Mallard portrays herself as a coin. Mrs. Mallard, theRead MoreThe Story Of An Hour By Kate Chopin Literary Analysis1432 Words   |  6 PagesMaking a literary analysis involves writing an argumentative analysis about a particular literature. The analyst is supposed to carefully read the literature and better understand the contents so as to come up with legal analysis. It requires some summary, but it is not a report about the book or the story. It is important in making the reader to understand the message in the book as well as the improvements necessary the literature. It is also important in understanding how a particular author articulatesRead MoreAnalysis Of Kate Chopin s The Story Of An Hour955 Words   |  4 PagesLiterally analysis of Naturalism and the Short Story Form: Kate Chopin’s ‘The Story of an Hour† While Scott D. Emmert in Naturalism and the Short Story Form: Kate Chopin’s ‘The Story of an Hour’ points out the short stories cannot form a narrative because of their length and others would disagree. Admittedly, even though according to Scott short stories cannot form a narrative they are perfect for naturalist writers because short stories and poems tend to focus more on natural surroundings and theRead MoreAnalysis Of The Story The Story Of An Hour By Kate Chopin1219 Words   |  5 Pageshave to embark, sooner or later. Death can be the beginning of the end to many people, an event which can bring everlasting happiness, but also a shattering sadness. The short story â€Å"The Story of an Hour,† by Kate Chopin, which was published in 1894, presents a not so common viewpoint of death. One could say that this story has brought about a brief renewing love for life with one of the main characters. On the other hand, â€Å"The Moths† by Helena Ma ria Viramontes shows a painful reaction to deathRead MoreLiterary Analysis Of The Story Of An Hour By Kate Chopin856 Words   |  4 PagesEnglish 1302 11 November 2017 Literary Analysis of â€Å"The Story of an Hour† by Kate Chopin The Story of an Hour is a short story written by Kate Chopin which was published in 1894 as â€Å"The Dream of an Hour† in Vogue. When the word marriage hits our mind, we think it as a lasting relationship. Marriage is a commitment between two individuals bonded by holy ceremony. The story of an hour presents the side of marriage which is usually unheard. The main character of the story is Mrs. Louise Mallard. She cameRead MoreAnalysis of â€Å"the Story of an Hour† Written by Kate Chopin1697 Words   |  7 PagesAnalysis of â€Å"The Story of an Hour† written by Kate Chopin The story under analysis is written by Kate Chopin. Kate Chopin was an American author of short stories and novels. She wrote for both children and adults. She is considered as a forerunner of feminist author. Unlike many of the feminist writers of her time who were mainly interested in improving the social conditions of women, she looked for an understanding of personal freedom. She put much concentration on women’s lives and their continualRead MoreAnalysis Of The Story Of An Hour By Kate Chopin895 Words   |  4 PagesIrony and Foreshadowing in Story of an Hour In the short story, Story of an Hour, Kate Chopin chronicles the short journey of a woman who has recently learned of the death of her husband from a railroad accident. Kate Chopin is known for her stories which revolve around women and the world from their perspective, and Story of an Hour is no exception. As a writer, Chopin utilizes and employs many rhetorical devices to add emotion and depth to her world. Though Story of an Hour is riddled with rhetoricalRead MoreKate Chopin The Story Of An Hour Analysis1137 Words   |  5 Pagesâ€Å"The Story of an Hour† by Kate Chopin is a wonderful short story bursting with many peculiar twists and turns. Written in 1894, the author tells a tale of a woman who learns of her husband’s death but comes to find pleasure in it. The elements Kate Chopin uses in this story symbolize something more than just the surface meaning. In less than one thousand one hundred words, Kate Chopin illustrates a deeper meaning of Mrs. Mallardâ€⠄¢s marriage through many different forms of symbolism such as the openRead MoreAnalysis Of Kate Chopin s Story Of An Hour993 Words   |  4 PagesIrony in â€Å"Story of an Hour† In Kate Chopin’s short story â€Å"Story of an Hour†, Irony, or the expression of meaning that traditionally indicates the contrary of what is expected, plays a huge role in deciphering the theme and underlying motifs of the story that takes the reader through the hour of Mrs. Mallard’s life after her husband supposedly dies. Through Irony, Kate Chopin effectively portrays the forbidden joy of independence (SparkNotes Editors). The theme is portrayed by the author’s emphasis

Programming of the System

Question: Describe about the programming of the system. Answer: 1. C++ C++ has been designed for the programming of the system resource which has been set for a better performance and the system efficiency. This has been directed towards handling the constrained applications along with the hold of the servers, ecommerce and the web search. The performance is based on handling the standardisation with the ratification for including the servers with the critical application and performance. The language has been able to equip with the actual problems as well as the features which need to handle all the real world programs. The programmers need to use the features which have been important for the prevention of the misuse of the C++. All the facilities are based on organising the programs along with the well-defined approach for the combined development parts. 2. Java Java has been the best computer language of the programing for the handling of the class based programs with the object oriented system. These are able to compile the Java codes to run on the platform which is able to run on the system of Java without any compilation process. The implementation is based on handling the processes as well as taking hold of the Sun technologies. The major goal has been to handle the Java platform with the means to run the similar processes with the hardware and the operating system combination for the adequate runtime support. 3. Python This has been widely used for the interpretation with the higher level general purpose language for the dynamic programming process. This is major for the handling of the readability of the code as well as allowing all the programmers to work on the code to provide the best constructs which are related to the both small and the large scale patterns. This has been including the object oriented imperative with certain styles that direct to the running of the system with the third party tools. The work has been executed based on the operating systems with the process set for the distribution. This has been the free and the open source software with the hold of the different implementation setup. 4. Perl It is a higher level interpretation with the dynamic programming language which is able to use the proper UNIX scripting as well as the processing of the report. This has been for borrowing the features from the other languages like C and the shell script. This is mainly for handling the processing facility as well as the data length limits. The contemporary setup has been for the use of the graphic programming along with handling the bioinformatics and the network programming applications. These are able to work on the decision open source projects that direct to the document which is able to handle the requests with the designs for the next generation. Reference Prechelt, L. (2000). An empirical comparison of C, C++, Java, Perl, Python, Rexx and Tcl.IEEE Computer,33(10), 23-29. de Hoon, M. J., Imoto, S., Nolan, J., Miyano, S. (2004). Open source clustering software.Bioinformatics,20(9), 1453-1454. Fourment, M., Gillings, M. R. (2008). A comparison of common programming languages used in bioinformatics.BMC bioinformatics,9(1), 82. Prechelt, L. (2000).An empirical comparison of C, C++, Java, Perl, Python, Rexx and Tcl for a string processing program. Technical Report Technical Report 2000-5, Universitt Karlsruhe, Fakultat fr Informatik.

Counselling in Mental Health Nursing Practice

Question: Discuss about theCounselling in Mental Health Nursing Practice. Answer: Introduction A clinical reflection is a positive attempt by healthcare professional describing their clinical investigation, assessment, practice and applied skills. This clinical reflection works as a tool for development of critical clinical skills, thinking power, professional role, active learning and personal potential in clinical practice. In reflective writing, the professional try to evaluate their own practice determining the pros and cons of their healthcare practice. This self-assessment enables them to explore their strengths as well as weaknesses that help further to initiate improvements in practice (Stuart, 2014). These clinical reflections are performed with the use of reflection models that help to describe the professional and personal competencies developed after any incidence or helps to process thought after any clinical incidence (Lees, 2014). In the present clinical reflection paper, a critical incidence is described that is judged on the basis of ethical, racial, religious and gender sensitivity required in counselling practice. As a professional counsellor or therapist working in mental health services, learner implements suitable clinical interventions using clinical decision-making framework to treat the on-going mental health issues of the patient. This reflective clinical paper will help the learner for professional and personal development in the field of mental healthcare. Beddoe (2010) indicated that clinical reflective writing has now become an important part of contemporary nursing and counselling practice to manage diversified clinical situations, incidences and scenario. Description of Incidence The patient named Liliana is an old lady, 62 years of age was admitted to mental health services on 2-oct-2016 having referrals from NEMHS following referral from MHT. Liliana is a divorcee living with her only daughter Maria and three grandchildren at Sheidow Park. She was presented to the clinical department with daughter Maria. Liliana is having a long history of clinical conditions that involves physical impairment includes bursitis of L shoulder, high cholesterol, osteoarthritis and fibromyalgia, further, mental impairment or conditions includes bipolar disorder (diagnosed in 1996), stress, anxiety, depression, mood, eating and sleep disorder. The referral received from NEMHS and MHT indicated that Liliana is at the critical stage of distress, unwilling to take medication and no locomotion or movement and lacking of interest in personal coping activities. On analysing the clinical history of Liliana it was identified that she had multiple admission to psychiatric units from 2006 for managing her bipolar disorder. She confronted the depressed and manic phases of bipolar disorder till 2010. In total, she had nine referrals to acute mental health services having a persistent history of lacking engagement in clinical processes, aggressive behaviour and poor insight of her mental health condition. Liliana is right now on medication for bipolar disorder (Sodium valproate), anxiety (venlafaxine) along with cholesterol medication to manage high cholesterol level. She is having panic attacks and lacking psychological support. On performing a Mental Health Examination of Liliana present medical condition indicates that she is an old woman having an exceptional appearance with anxious behaviour in initial stages followed by the calm, friendly and cooperative behaviour in the interview session. The mood rate obtained was 10/10 (bad mood) having normal flow if speech and no evidence of formal thought disorder. Further, perception analysis indicated no fluctuation and denied the thought of suicide intent. The cognitive functionality was TPP oriented and judgement was impaired in distress. The sleep, energy and appetite were poor with weight loss. The risk assessment of Liliana indicated that although she is not having thoughts if suicide but she wants to end up with her psychological pain. She is also having a historical attempt of anti-depressant overdose and DSH. However, history of the suicidal attempt was unknown. Further, presently Liliana is willing to get engaged with mental health services although she was showing a lack of personal engagement in her previous admissions to mental health services. As per this assessment, Liliana is having a critical condition of bipolar disorder as a sufferer from last 20 years. Liliana denies the intent of risk behaviour like suicide but still she requires observations and monitoring, further, her physical pain (osteoarthritis) and psychological pain (hurt, misery, anguish) are reason hindering the pathway of recovery and self-management. Her anxiety, mood disorder, stress and depression are outcomes of lifelong unmanaged bipolar disorder. Demonstrating Ethical, Racial, Religious and Gender Sensitivity in Counselling As a professional counsellor for providing therapeutic services and counselling there is a critical requirement to follow certain ethics, regulations, laws and regulation to address aspects of race, religion, gender and diversity in the clinical scenario. According to Laszloffy and Habekost (2010) the ethical principles that counsellor needs to follow involves respecting humanity and dignity if people surrounding the practice. Counsellor needs to respect the religion, colour and race of every individual involved in the clinical process. They further, need to provide the right of informed consent to the patient further following other laws of their working zone. The protection of patient autonomy, restrictions, rights and the decision is also a part of counselling practice. Lastly, the counsellor needs to maintain professional boundaries as well as relationships as a part of ethical practice. The race, religion, gender and age are some of the critically sensitive factors that disturb the pathway of ethical practice especially while handling trauma and mental disorder (Cooper et al. 2013). Any therapeutic practice for mental illness requires modifications in attitude, behaviour, spirituality, conscious; values and beliefs of the patient, which are, develop as per the cultural and religious principle of society. Therefore, these factors create complexity and sensitivity in counselling practice (Collins and Arthur, 2010). According to Boyd-Franklin (2010), a counsellor needs to develop a multicultural approach to address the sensitive issues related to race, colour and religion. A multicultural competency helps in better communication, understanding others perceptions and better therapist-client relationship. In the present incidence, race or religion is not an issue in counselling performance, however, to address the requirement of informed consent, however, to address this issue, consent from Liliana has already been provided with referrals. The only need is to develop interventions that involve patient autonomy and beneficence a primary part of counselling practice. London et al. (2012) studied that counselling practice should involve gender aware counselling goals that work to provide stability on controversial issues related to gender sensitivity. In the present incidence, as Liliana is a female it is appropriate to involve feminist counselling practice where women issues are handled with their gender sensitivity. This counselling process works to provide respect, empathy and dignity to female patients. Further, as Liliana is an old lady of 62 years, therefore, age can be a major issue while developing effective intervention because she is already confronting physical and psychological pain that can hinder her recovery process. Therefore, the age factor should be a major consideration while developing interventions for Liliana. Collins and Arthur (2010) indicated that proper counselling practice should involve aspects like ethical stability, the value of individuality, respecting autonomy and democratic relationship. Articulating about Clinical Interventions and Clinical Decision Making for Provided Incidence As a counsellor, in the case of Liliana, the interventions were planned to address the most dynamic issues hindering the recovery process related to bipolar disorder. The dynamics like physical pain (osteoarthritis) and psychological pain, mood disorder, physical immobility, anxiety and stress. The interventions developed for these issue help to accelerate the recovery from bipolar disorder and provide an effective quality of life to the patient. As a professional practitioner, the National Framework of clinical decision-making was implemented to develop these counselling interventions. This framework provided principles, skills and processes to make an effective clinical decision (Curran et al. 2012). I implemented the skills of critical thinking, pattern recognition, communication skills, sharing information and reflection while performing my counselling practice. All the clinical decisions are as per evidence-based approaches as guided in the framework (Lees, 2014). For the purpose of reflection, the client feedback was considered as an effective strategy to evaluate the clinical practice (Curran et al. 2012). The decision-making process involves four steps, firstly gathering and analysing patient data, secondly making judgements as per the collected information. Further, making the decision for clinical interventions for which I took advice and support from other team members as well and lastly, evaluating the outcomes of feedback collection process (Lyons, 2010). Starting from the very first and most effective intervention developed to cure the bipolar disorder of Liliana is Cognitive Behaviour Therapy (CBT) a monitoring mental state intervention. According to Bauer et al. (2012), this therapy works to modify negative thought process and behaviour patterns that place difficulty in recovery from bipolar disorder. Liliana is facing mood swings (depression episodes) involving aggressive behaviour and unintentional risk of relapse. Therefore, to address these issue CBT works as a complete package because mood swings are under the influence of thought process, further, mood determines the behaviour of the individual. Therefore, by implementing CBT as an intervention, the negative thought process and behaviour patterns will get modify to control moods swings and aggressive behaviour of the patient. Magalhaes et al. (2012) provided six strategies to practice CBT for bipolar disorder, As a professional consultant, I provided this six-step CBT therapy that involves accepting your (patient) condition, monitoring mood, cognitive restructure, frequent problem-solving approach, encouraging social engagement and stabilising routine. This six-step CBT was considered to be perfect for addressing bipolar disorder of Liliana. In the first step, Liliana was allowed to understand and acknowledge about her condition, however, Liliana already had a good insight perception that helped to develop the base of CBT. Further, in next step, Liliana was told to rate her mood daily on the scale of 0-10 making her more aware of fluctuations and triggers. In the third step of CBT, detecting the problems and correcting them for balanced thinking modified thought process. In the fourth step, the patient was allowed to detect problems in therapy, predict solution and implement an effective solution to solve their problem. Further, for enhancing social skills, assertiveness helped to manage interpersonal relationships in a better manner. Lastly, the routine was stabilised using morning exercise, relaxation, proper meals, sleep and social plans to improve the quality of life (Pfennig et al. 2014). Further, Bonsall et al. (2012) provided some techniques to maximise CBT treatment for bipolar disorder that involves listening carefully to the doctor, completing CBT homework and gathering knowledge about your disorder. These techniques were also provided as consultation advice for Liliana to cope up with bipolar disorder. Now, another intervention described in studies of Parikh et al. (2012) is providing regular medication as prescribed by the professional doctor to manage the clinical conditions hindering therapeutic intervention because bipolar disorder recovery is critically affected by other clinical conditions. In the case of Liliana, her high cholesterol and osteoarthritis can hinder the bipolar recovery process. Therefore, it is essential to monitor medication and provide regular medication to the patient. As Liliana was detected with the unwillingness to take medication this intervention will help to overcome this psychological issue. Further, supporting and monitoring medication compliance will help to evaluate the effectiveness of this intervention. World Health Organization (2016) recommended in their study the intervention to provide sleep hygiene to control the sleeplessness disorder developed as a symptom of bipolar disorder. This intervention involves light exercise before sleep, natural light exposure and regular relaxation. Liliana facing sleeplessness can recovery her sleep with the help of this intervention. Further, Somers et al. (2012) studied the use of Family-focussed counselling approach as liaise with the family of the patient to increase support in the treatment process. In this intervention, the family members are provided with consultation regarding managing medications, providing mood stabilisers, identification of manic and depression in their family member suffering bipolar disorder. In the case of Liliana, this intervention is very important to overcome her psychological pain along with bipolar disorder where her daughter will be guided by the professional consultant. Bonsall et al. (2012) indicated the Assist and support with transition home intervention that involves different strategies practised by caregiver handling patient at home. The strategies are talk therapy, relaxation training, self-management training, walking aids, stress management and pain coping techniques. This intervention can work to overcome the symptoms and side effects of bipolar disorder in the case of Liliana. These techniques help to control stress, pain, anxiety and maintains the quality of life. The guidance and practice provided under this intervention will help to overcome the issue of lacking self-engagement in the case of Liliana. Somers et al. (2012) studied about psychoeducation that is provided by counsellors to BD patient that was observed to be effective in controlling relapse and overall functionality of the patient. Under psychoeducation a complete awareness about the disorder, avoiding substance abuse, adherence treatment and early identification of new episode is provided to the patient. As Liliana is facing episodes of the relapse this psychoeducation will work to control this situation. A 21-session group-psychoeducation helps to develop social skills, education and knowledge about once condition. Further, for the management of osteoporosis (physical pain), Liliana was advised to take Pain Coping Skills Training for the management of her pain. Magalhaes et al. (2012) studies about this intervention where behavioural modifications are made in lifestyles using coping technique that patient learn through this training. The pain coping skills training involves three-component approach where in the first component is educational rationale where the patient is trained to better understand their feelings, thoughts and behaviours In the second component, therapist teach the patient about coping strategies and the third component involves home practice and lifestyle modification training for painful situations confronted by the patient. These were the counselling advices and interventions provided to Liliana as per her identified issues and illnesses. Reflection on Mental Health Nursing Practice and Benefits of Current Clinical Supervision Clinical supervision is considered to be the most important and essential competency for healthcare professional practice that promotes effective treatment (Stuart, 2014). As a mental health counsellor for the provided incidence, the overall clinical supervision was an effective attempt to understand the patient situation and provide workable counselling and therapy. According to Lam et al. (2010), clinical supervision involves the model of practice, strategic implementation and systematic evaluation of applied strategies by professionals. It is also consolidated as a reflection of personal performance and case review to achieve the best care process. The present clinical supervision involves effective management, positive support, effective recommendations and workable professional supervision as benefits for current incidence. The case of Liliana was properly handled in a manner of initial assessment of Mental Health Status (MHS), stressors, medical history followed by determination of risk summary and dynamics of incidence. Further, recommendations or plan were provided that involves counselling and therapeutic approaches that can benefit the patient to overcome serious dynamics. This highlights the positive support provided by clinicians in this incidence. The recommendations are effective enough to cover all the serious health issues identified for Liliana. Further, MSE assessment in clinical supervision provided a complete detailed identification of patient current status and health. For reflecting on the feeling and learning I gained from the present incidence of clinical supervision I used Gibbs reflection cycle that helped me to evaluate the six stages of clinical reflection. According to Beddoe (2010), Gibbs reflection cycle helps to understand learning from experience by describing incidence as a six-stage process that involves description, feelings, evaluation, analysis, conclusion and action plan. The description of incidence indicates that Liliana case is a critical and serious case of bipolar disorder that requires workable counselling and therapy for her survival. She has already referred to various mental health services previously but yet not accommodated effective recovery. Further, her unwillingness to take medications and engagement in care process is also creating major drawbacks in the recovery process. I realised that recovery in such attitude and behaviour will be a tough process to deal with, therefore, along with other stakeholders decisions about interventions were developed to provide an improvement in these hurdles of the recovery process. Further, describing my feelings as second stage of Gibbs cycle, I felt this situation as an alarming one for my professional career because I havent faced any such complex situation before where it is critically essential to manage the mental issues (bipolar disorder, anxiety, stress), physical issue (osteoporosis) and psychological issues (unwilling attitude and behaviour) with one stage therapeutic practice. I didnt want the patient to feel threatened or serious about their present situation and used talk therapy as a part of consolidation in the counselling process. I took advice from my mentor and seniors regarding the case history and developing appropriate interventions for Liliana. My mentor suggested me to have patients and carefully handle the critical aspects of incidence. When evaluating this incidence at the third stage of Gibbs cycle, I realised that the incidence was extremely and exceptionally challenging one for me. However, I tried my best to develop the most workable advice and interventions for Liliana. I got a positive response from my mentors for my planning, practice and management. I took the help of other stakeholders as well for implementing the interventions into practice. The interventions developed can work in a multidimensional manner to cure the mental as well as physical issues of Liliana. The cognitive behavioural therapy, pain coping training, family-focussed counselling and psychoeducation are some of the most incredible interventions that assure positive response. On further, analysing the situation, I can predict that these clinical interventions will surely work to improve the on-going issues of Liliana resulting in better quality of life for this aged women. For further analysing the effectiveness of intervention a feedback collection strategy can be adopted where Liliana will provide her feedback on the effectiveness created by these interventions. However, I would establish some more strategies to analyse the effectiveness of interventions and develop a more versatile plan for nursing care if provided with other chance to re-examine this incidence. Conclusion The study on clinical reflection about provided incidence indicates that counselling practice is highly dependent on clinical experiences gained from the new incidence of complex health issue that helps to elaborate and amend the defects in caring practice. Each and every incidence is a new experience for learning in the life of healthcare professionals. This clinical reflection provides a deep inside of one such clinically complex incidence of Liliana patient suffering from mental, physical and psychological disturbances in life. As a healthcare professional, learner worked to analyse her condition, detect the defects and provide appropriate interventions. A clear reflection on complete incidence followed by demonstrating ethical, racial, religious and gender sensitivity in counselling is described in the study. Further, a detailed elaboration on the development and importance clinical interventions for Liliana conditions is provided in the study. The complete reflection on learning , thinking, experience and feelings is provided using Gibbs reflection cycle also describing benefits of this clinical supervision. This clinical reflection will help me in the detection of the defects and develop lacking competencies in my clinical practice. Further, the work can also be useful for other professionals to enhance their clinical knowledge and skills. References Books Cooper, M., O'Hara, M., Schmid, P.F. and Bohart, A. eds., 2013.The handbook of person-centred psychotherapy and counselling. Palgrave Macmillan. Lees, J., 2014.Clinical counselling in context: an introduction. Routledge. Lyons, N. ed., 2010.Handbook of reflection and reflective inquiry. Springer US. Stuart, G.W., 2014.Principles and practice of psychiatric nursing. Elsevier Health Sciences. Journals Bauer, M., Ritter, P., Grunze, H. and Pfennig, A., 2012. Treatment options for acute depression in bipolar disorder.Bipolar disorders,14(s2), pp.37-50. Beddoe, L., 2010. Surveillance or reflection: Professional supervision in the risk society.British Journal of Social Work,40(4), pp.1279-1296. Bonsall, M.B., Wallace-Hadrill, S.M., Geddes, J.R., Goodwin, G.M. and Holmes, E.A., 2012. Nonlinear time-series approaches in characterizing mood stability and mood instability in bipolar disorder.Proceedings of the Royal Society of London B: Biological Sciences,279(1730), pp.916-924. Boyd-Franklin, N., 2010. Incorporating spirituality and religion into the treatment of African American clients.The Counseling Psychologist. Collins, S. and Arthur, N., 2010. Culture-infused counselling: A model for developing multicultural competence.Counselling Psychology Quarterly,23(2), pp.217-233. Curran, G.M., Bauer, M., Mittman, B., Pyne, J.M. and Stetler, C., 2012. Effectiveness-implementation hybrid designs: combining elements of clinical effectiveness and implementation research to enhance public health impact.Medical care,50(3), p.217. Lam, C.S., Tsang, H.W., Corrigan, P.W., Lee, Y.T., Angell, B., Shi, K., Jin, S. and Larson, J.E., 2010. Chinese lay theory and mental illness stigma: implications for research and practices.Journal of Rehabilitation,76(1), p.35. Laszloffy, T. and Habekost, J., 2010. Using experiential tasks to enhance cultural sensitivity among MFT trainees.Journal of marital and family therapy,36(3), pp.333-346. London, B., Downey, G., Romero-Canyas, R., Rattan, A. and Tyson, D., 2012. Gender-based rejection sensitivity and academic self-silencing in women.Journal of personality and social psychology,102(5), p.961. Magalhaes, P.V., Dodd, S., Nierenberg, A.A. and Berk, M., 2012. Cumulative morbidity and prognostic staging of illness in the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD).Australian and New Zealand journal of psychiatry, p.0004867412460593. Parikh, S.V., Zaretsky, A., Beaulieu, S., Yatham, L.N., Young, L.T., Patelis-Siotis, I., MacQueen, G.M., Levitt, A., Arenovich, T. and Cervantes, P., 2012. A randomized controlled trial of psychoeducation or cognitive-behavioral therapy in bipolar disorder: a Canadian Network for Mood and Anxiety treatments (CANMAT) study [CME].The Journal of clinical psychiatry,73(6), pp.803-810. Pfennig, A., Correll, C.U., Marx, C., Rottmann?Wolf, M., Meyer, T.D., Bauer, M. and Leopold, K., 2014. Psychotherapeutic interventions in individuals at risk of developing bipolar disorder: a systematic review.Early intervention in psychiatry,8(1), pp.3-11. Somers, T.J., Blumenthal, J.A., Guilak, F., Kraus, V.B., Schmitt, D.O., Babyak, M.A., Craighead, L.W., Caldwell, D.S., Rice, J.R., McKee, D.C. and Shelby, R.A., 2012. Pain coping skills training and lifestyle behavioral weight management in patients with knee osteoarthritis: a randomized controlled study.Pain,153(6), pp.1199-1209. World Health Organization, 2016. mhGAP intervention guide for mental, neurological and substance use disorders in non-specialized health settings.Lancet.