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Mobile Investigations

Mobile Investigations. I’m stuck on a Computer Science question and need an explanation.

Mobile forensics is an increasingly complex environment for investigators because of the rapid rate of innovation and adoption of new technologies, applications, and hardware. Smartphones are being used in so many different ways that they have become a central focus in digital forensic investigations. The mobile platform is a forensic challenge because of the number of third-party applications found on many devices, the rapidly evolving security measures employed by the device manufacturers and application developers, and the explosive growth in the use of mobile devices and options.
Mobile devices include cell phones, tablets, and wearables, with literally several thousand different devices, equipped with countless types of interfaces, operating systems, and connectivity options. This type of environment has many implications for the incident responder. The number of devices makes it impossible to be well-versed in each one, complicating analysis. The sheer number of devices also makes it very expensive to stay abreast of the major players in the market. Users tend to choose mobile devices based on their portability, number of communication interfaces and sensors (e.g., GPS), and easy wireless Internet connectivity. The features that make these devices popular are the same features that make them a critical piece of a digital forensics investigation.
In the steps that comprise this project, you will examine mobile investigative challenges, as well as the techniques and technologies available to perform mobile forensic examinations. First, familiarize yourself with the details of the case and the basics provided by the sheriff. Then, you will need to develop an investigation plan that describes the current state of mobile incident response and investigation. As you proceed through Project 4, you will get hands-on practice using the forensic tool MPE+ by AccessData and complete a forensic report. The next component will be a comparative analysis, in which you will describe the features of companion mobile phone forensic tools and recommend tools and techniques to use in the current investigation. The final component is a comprehensive forensic investigation report that will synthesize the investigation plan, forensic report, and comparative analysis.
Now that you know what’s ahead of you, move on to the first step of the project.
When you submit your project, your work will be evaluated using the competencies listed below. You can use the list below to self-check your work before submission.

1.1: Organize document or presentation clearly in a manner that promotes understanding and meets the requirements of the assignment.
1.2: Develop coherent paragraphs or points so that each is internally unified and so that each functions as part of the whole document or presentation.
1.3: Provide sufficient, correctly cited support that substantiates the writer’s ideas.
1.4: Tailor communications to the audience.
1.5: Use sentence structure appropriate to the task, message and audience.
1.6: Follow conventions of Standard Written English.
1.7: Create neat and professional looking documents appropriate for the project or presentation.
2.1: Identify and clearly explain the issue, question, or problem under critical consideration.
2.2: Locate and access sufficient information to investigate the issue or problem.
2.3: Evaluate the information in a logical and organized manner to determine its value and relevance to the problem.
2.4: Consider and analyze information in context to the issue or problem.
2.5: Develop well-reasoned ideas, conclusions or decisions, checking them against relevant criteria and benchmarks.
4.1: Lead and/or participate in a diverse group to accomplish projects and assignments.
4.4: Demonstrate diversity and inclusiveness in a team setting.
5.1: Demonstrate best practices in organizing a digital forensic investigation
5.3: Demonstrate the appropriate use of multiple digital forensic tools and techniques for imaging
5.4: Demonstrate an understanding of the different parts of a computer
5.5: Apply risk management principles to an investigation.
5.6: Use of multiple digital forensic tools and techniques for imaging
5.7: Use forensic tools and techniques to carry out an email investigation
6.1: Perform report creation, affidavit creation, and preparation to testify
6.2: Demonstrate ability to investigate mobile technology
6.3: Use forensic tools for investigation of multimedia technologies
6.4: Demonstrate the ability to gather file system evidence.
6.6: Perform malware analysis
6.7: Access encrypted data or process data and systems that have been subjected to anti-forensics techniques
6.9: Employ ethics throughout the forensic investigation process.
7.5: Evaluate encryption
7.7: Incorporate Geographic Information Systems into plans for conducting Digital Forensics on a network.
8.1: Employ ethics when planning and conducting forensic investigations, and when testifying in court.
8.2: Incorporate international issues including culture and foreign language to plans for investigations.
9.1: Examine Data Storage and Transport Technologies
9.2: Evaluate Enterprise Architecture
9.3: Analyze File Systems
9.4: Utilize Hexadecimal and ASCII
9.5: Investigate Operating Systems
9.6: Evaluate Information Systems/Network Security

Mobile Investigations

Overview of Mammography and its Importance

Overview of Mammography and its Importance. Mammography is the radiographic imaging of the breasts. It is a special diagnostic and screening tool of the human breasts. A mammography is done with specific x-ray equipment which is able to find tumors too small to be felt. Mammography examination’s ultimate goal is the early detection of breast cancer, typically through detection of characteristics masses and / or micro calcifications. A mammogram is the best radiographic method available for early breasts cancer detection. It is ideal and indispensable for women above the age of 40 years old, for whom the risk of breast cancer is increased. Like x-rays, mammogram uses doses of ionizing radiation to create images but at lower dose amplitude-x-rays (most often around 0.7mSv). Radiologists then analyze the produced images for any abnormalities. A longer wavelength x-rays (typically Mo-K) is normally used for mammogram compared to those used in radiography of bones. Like many other medical tests, mammograms are not 100% accurate. Therefore, a regular mammogram scheduling is needed to detect any early breasts changes before any obvious signs or symptoms show up. It is also scientifically proven that mammogram can reduce breast cancer mortality rate by more than a third. Despite its function in early detection of breast cancer, mammography has a false-negative (missed cancer) rate of at least ten percent. This is due to the dense tissue obscuring the cancer and the large overlap of cancer appearance in mammograms with normal tissues appearance. Mammography first started in 1960s. However, modern mammography has only existed since 1969 when the first x-ray unit dedicated to breasts imaging was made available to the public. Such examination as a screening device became standard practice by the year of 1976. Mammography then continues to improve as lower dose of radiation able to detect smaller potential problem earlier. Throughout the years, mammography has made advances to further improve its diagnostic ability. Digital mammography and computer aided detection are two examples of recent advances in the field of mammography. Digital mammography, also known as full field digital mammography (FFDM), is a mammography system in which solid-state detectors that convert x-rays to electrical signals replace the conventional x-ray film. These detectors are similar to those found in digital cameras where electrical signals produced are used to create images of breasts which are then projected on a computer screen or printed on a special film similar to conventional mammograms. A digital mammogram is essentially the same as a conventional film screen mammogram. Computer aided detection (CAD) systems help to detect abnormalities by using computer software. A digitized mammographic image that can be obtained either from a digitally acquired mammogram or a conventional film mammogram is used by the computer aided systems. The computer software then searches for abnormal areas of mass, density or calcification that may indicate the presence of cancer. It highlights the abnormal areas on the images, alerting the radiologists to the need of further analysis. A special mammography machine is used for the screening of breasts. The machine comprises of an x-ray tube connected to a breasts support which houses the film cassette or imaging device on a C shaped arm, with moveable compression paddle between the two. There are few standard functional requirements for the mammography machine in order to produce a good quality image. The high voltage generator of mammography machine shall supply a near direct current high voltage with ripple less than 5 percent. Most modern mammography machines have a automatic selection for kilo voltage (kVp) output in order to optimize contrast. The generator produces a constant potential and the high voltage applied to the tube must be from 22 to 35kVp in increments of 1kVp. The focal spot size of mammography machine should be as small as possible to ensure adequate resolution. A focal spot size of 0.3mm is recommendable for general mammography and 0.1mm (small focus) for magnification views. The tube current of mammography machine should be set as high as possible in order to minimize exposure time and thus reducing the likelihood of motion artifact. A moving grid with grid factor of less than 2.5 at 30 kVp is essential to ensure optimum image quality. An automatic exposure control (AEC) is important in mammography machine. This is due to the wide variation in breasts sizes and compositions. There is little scope for mAs selection errors as there is a need for high radiographic contrast and consequently the system has low latitude. As for image recording material, most of the mammography facilities are still utilizing traditional cassettes, intensifying screens and single emulsion film with processing being taking place. Mammography usually uses cassette containing a single intensifying screen and the film which is usually green sensitive has a single emulsion layer. Both these equipment are essential to give optimum resolution. A mammography film requires high spatial resolution. It should has enough speed to ensure that the dose is acceptable without being so fast that it causes visible quantum mottle and high contrast with enough latitude to show both dense glandular tissue and the skin edge. Quality control, assurance programs and strict processing parameters are vital to ensure the standard in film quality is not compromised. Any reduction in film quality may lead to misinterpretation of image and incorrect diagnosis. In the modern days, digital mammography is slowing making its way to the imaging field. This modern modality has some advantages over the conventional film mammography. The examination time and time between examining patients decreases as chemical processing and changeover of cassette is no longer necessary. Markers can be applied on image digitally. Images produced can also be manipulated. One of the major advantages of image manipulation is the ability for image magnification with significantly less unsharpness compared to those associated with macro or magnification images that are sometimes required to demonstrate suspicious areas already seen on mammograms. Unlike the conventional magnification views, digital magnification does not involve an additional exposure to radiation. Patients are required to do some preparations prior to a mammography examination. Fasting or observation in particular dietetic rules days before mammogram examination is not necessary. However, for women sensitive to caffeine, they shall refrain from taking caffeine containing products such as cola, chocolate and coffee two weeks before undergoing the test. This is because caffeine could make the breasts more tender which may affect the quality of radiograph. Menstrual cycle phase usually does not affect the outcome of the examination. However, it is also highly recommendable to schedule for mammogram one week following patients’ menstrual cycle. This is so as the breasts are less tender compared to that during pre-ovulatory and postovulatory period (half cycle) as well as during premenstrual period. It is also advisable for patients to wear two piece clothing on examination day to ease the undressing process for mammogram. Cosmetics, oils, creams, lotion and talc or deodorant must not be applied hours prior to test at the underarms and breasts areas. Failure in doing so may result in those appearing in mammogram as calcium spots. Patients are also encouraged to bring along all previous mammograms for comparison purposes by the radiologist. Most often, mammograms are done on older patients compared to younger patients. this is due to the breast tissue changes during life. The breast tissue density in younger women often makes mammogram rather difficult to interpret. However, as women age increases, some changes in the structure of breasts occurs as glandular and fibrous tissues reduce in size and this results in breasts tissues become more fatty. On the examination day, a simple interview with the patients is conducted before the examination takes place. They will be asked on any prior surgeries history, family or personal history of breasts cancer as well as hormone use. It is also the responsibility of the radiographer or technologist to enquire the patients’ last menstrual period as to determine whether the patient is pregnant. Pregnant patients are not recommendable for such examination. Upon completion of the short interview, patients are then ushered to change into hospital gown and remove all potential artifact before proceeding for the examination. When the examination takes place, the breast is compressed using compression paddle on the mammography unit. A parallel plate compression evens out the breast tissue. Compression of breast reduces the thickness of tissue that x-rays penetrate, decreases the amount of scattered radiation, and reduces the required radiation dose and holding the breast (remove movement unsharpness) still and thus improving the image quality. Both craniocaudal, CC view (head to foot) and mediolateral oblique, MLO (angled side view) of the breast are taken in screening mammography. Extra views such as geometrically magnified and spot-compressed views of particular area of concern may be taken in diagnostic mammography. While performing the craniocaudal (CC) view, the mammography unit is positioned with the breast support table (image receptor holder) horizontal and the height adjusted to slightly above the level of patient’s inframammary angle. The patient is then instructed to face the machine, standing with approximately 5-6cm back, feet facing the machine but body rotated 15-20° away from the side under examination. This is so that the breast under examination is brought closer to the image receptor holder and aligned with the center of it. The patient’s arms hang loosely by her side and head is turned away from the side to be examined. The breast is then lifted gently up and away from the chest wall of patient. While supporting the breast, the height of the machine is adjusted so that the image receptor holder makes contact with the breast at the inframammary fold and the breast is approximately 90° to the chest wall. The breast is then carefully placed in contact with the cassette. Hand is then slowly removed from the breast, whilst ensuring that no skin folds are created underneath the breast. Patient’s arm of the side under examination is then flexed at the elbow and the hand is placed on the patient’s lower abdomen or relaxed at the side of the trunk. This relaxes the pectoral muscle. Patient’s shoulder is gently pressed down to bring the outer quadrant of the breast into contact with the image receptor. Slight pressure is maintained at the patient’s back to ensure she does not inadvertently pull back from the unit and cause some tissue to be lost from the resultant image. Radiographer’s thumb is then placed n the medial aspect and middle finger on the superior aspect of the breast, gently pulling forward towards the nipple while the compression is applied slowly. Radiographer’s other hand is placed on the patient’s shoulder of the side being examined to ensure that it stays relaxed. The light beam diaphragm can be used during the application of compression. This is to ensure the nipple is in profile, all breast is included in the main beam, both medial and lateral margins are included, no skin folds and an adequate breast compression. A CC marker with left or right identifier is positioned on the axillary edge of the cassette, within the primary beam. Patient is strongly advised not to move and the projection is done quickly after that. The same CC procedure is performed on both left and right breast. The CC view with the same procedure is performed on patient’s both breasts. Besides the CC view, a mediolateral oblique (MLO) view of patient’s both breasts is also taken for screening mammogram. The positioning of patients for left breast MLO view is to have patient facing the mammography unit with feet pointing towards it. From the position used for CC projection, the unit is rotated through 45° with the x-ray tube on patient’s right and the beam angled caudally. The height is adjusted to bring the lower border of cassette 2.5cm below the inferior portion of the left breast. It may be necessary to further adjust the height during patient positioning. The lateral edge of the left of the thorax is in line with the image receptor holder so that the left breast also lies next to it. The radiographer then stands behind and slightly to the right of patient. Patient is then asked to raise her left arm and chin. The raising of chin may prevent the superimposition of the mandible over the breast. Patient’s left breast is then held with right hand and patient is kept in position by holding on to the right shoulder. Patient who is advised to lean forward into machine with feet still facing forward is asked to lean slightly laterally. The left axilla of patient should lie over the corner of image receptor that is nearest to chest wall. Radiographer then proceeds to life the posterior skin edge of the left axilla to prevent skin folds from occurring. Patient’s left arm is then pulled across and behind the image receptor holder. Patient’s elbow is also flexed so that the forearm can be placed on the unit for support and elbow is positioned so that it hangs down comfortably behind the holder. The humeral head is gently pushed forward and the corner of image receptor lies in the axilla, anterior to posterior fold. While the patient maintains the position, radiographer double check to ensure there is no skin fold in the axilla or under the lateral aspect of the breast and to check for and remove any creases at the inframammary angle. The breast is then lifted up and away from the chest wall while holding the patient’s left shoulder. The breast is then placed on the image receptor and compression is applied. Projection on the left breast is then taken. The same MLO view projection is then repeated vice versa on the right breast of patient. Upon completion of the examination, patient is advised to change back to her clothes. Patient is then escorted out and at the same time patient is informed on her next appointment for the review of results with the radiologist. Any discussion on the results with patient prior to the review of radiologist is prohibited. Mammography has been long known to be an effective modality for breast screening. Such examination improves physician’s ability to detect small tumors and early treatment can be performed to reduce mortality rate. Mammogram is also the only proven method to reliably detect tumors as well as all types of breast cancer, including invasive ductal and invasive lobular cancer. Radiation used in mammography examination is of low dosage and usually has no side effects towards patient. Moreover, radiation does not remain in patient’s body after the examination. Despite its benefits in the purpose of screening and diagnostic, mammography poses certain risks towards its patients. There is a slight chance of cancer from excessive exposure to radiation. The effective radiation dose for this procedure varies depending on the thickness of tissue. However, radiographers are trained to use the lowest radiation dose possible for radiation protection purposes while producing the best images for evaluation. False positive mammogram is also one of the risks in performing mammogram. Five percent to 15 percent of screening mammograms need more testing such as additional view for mammograms or ultrasound to further determine suspected abnormality. Most of the further tests turn out to be normal. However if there is an abnormal finding, biopsy may be performed on the patient to determine whether the tumor is benign or malignant. Women above the age of 40 are normally advised for a mammogram annually as they pose a higher risk of being diagnose with breast cancer. However, an ultrasound is more preferably performed on patients below the age of 40 as their breasts tissue is denser. Last but not least, women of all age should go for routine breast check up regularly for early detection on any breast abnormalities. Above diagram shows a conventional cassette film mammogram machine. Above diagram shows a Craniocaudal (CC) mammography view in progress. Above diagram shows a Mediolateral Oblique (MLO) view in progress. Above diagram shows a normal (left) mammography image compared to cancerous (right) mammography image. Overview of Mammography and its Importance

Business Aligning And Business Impact Information Technology Essay

order essay cheap There are many views on what constitutes business strategy. Definitions for business strategy and its features include the following. A business strategy … • should encapsulate a statement of an organisation’s mission or vision so that there is a clear and consistent point of focus (King, 1978); • provides a deliberate plan of action (Kaplan

Oak Hills Facility’s Supply Chain Implementation Case Study

The implementation of the lean system at Oak Hills and its impact on employees The implementation of a lean system at the Oak Hills facility can be viewed as the managers’ response to the necessity of optimizing all production processes, increasing the quality of products, and reducing costs. A lean system is discussed as the most appropriate way to avoid wasting resources, to increase efficiency in manufacturing, and to achieve flexibility in the organization and control of processes (Karim and Arif-Uz-Zaman 170). All steps associated with implementing a lean system are directed to optimizing processes and operations, improving the quality of work, and increasing effectiveness. As a result, changes in operations and the number of employees, as well as their responsibilities, are expected. Currently, there are many drawbacks in the work of employees which should be addressed while implementing a lean system. For instance, the work of employees is scheduled and organized improperly, and these aspects lead to decreasing the quality of products and the speed of operations when employees work as teams. Also, the quality control conducted by employees is not enough and appropriate to prevent providing customers with damaged products. The employee morale was also affected by the recent changes in the work of the company, and the lack of communication between managers and workers led to spreading rumors and decreasing employees’ motivation to work. To overcome the identified problems and guarantee that all employees will contribute to implementing a lean system, it is necessary to make sure that they are educated and trained regarding new principles of the working process applied at the Oak Hills facility. As a result, the implementation of a lean system will affect employees in terms of the organization of their work and operation processes, their education and training, scheduling, as well as changes in responsibilities and tasks to complete (Martínez-Jurado and Moyano-Fuentes 135). Furthermore, it is possible to expect the dismissal of those employees whose quality and speed of work do not contribute to increasing efficiency. From this point, such changes can be rather stressful for workers, and it is important to make the transition to a new system smoother. The first step is the communication of the company’s goals to employees to discuss expected changes, share a new vision, and explain the benefits of changes to employees. At this stage, employees are motivated to participate in the reorganization process and demonstrate their potential. Changes are required for the bonus system applied in the organization to motivate teams and individual employees. Currently, employees are not motivated to demonstrate the ability to work with different teams and on various tasks. The second step is the education and training of employees. The principles of cooperation between team members and overall tasks will change, and they should be properly trained to work as members of multifunctional or cross-functional teams. Thus, the assessment of employees’ work, productivity, and adherence to quality standards is the final step which is important to avoid retaining employees who cannot contribute to the optimization of processes. The stage in the development of a supply chain in Oak Hills A well-developed supply chain plays a key role in influencing the interaction of facility management with customers. When a supply chain is developed appropriately, there are no delays in operations and product deliveries (Brandenburg et al. 300). As a result, the level of customer satisfaction increases. Currently, Oak Hills needs to cooperate with Precision Milling to purchase machined cases and with Black Dome to buy sensor boards. The problem is that Black Dome refers to inappropriate delivery records, and delays in delivering required products cause changes in processes at the Oak Hills facility even though it takes only fifteen minutes to drive to Oak Hills from Black Dome. Furthermore, the necessity to address possible delays and problems associated with the lack of cooperation and communication between the Oak Hills and suppliers results in increasing inventory costs as well as lead times for both rush and domestic orders. It is important to pay attention to the fact that weaknesses in organizing and managing a supply chain are also observed concerning the communication of Oak Hills’s managers with leaders and customers of Triangle Corp. which was acquired by the discussed organization. There are no available contacts and well-developed procedures to work with customers of Triangle Corp. Furthermore, it is important to note that there are no effective plans to control the progress of domestic projects to decide regarding inventory levels and loads related to operations. Such weaknesses in the work of the organization’s supply chain support the idea that it is underdeveloped, and it requires further improvement in the context of a lean system that is planned to be applied at the Oak Hills facility. To improve the discussed supply chain, it is necessary to focus on creating a strong communication channel and a system of exchanging information between managers of Oak Hills and Triangle Corp., as well as their suppliers. This information should be updated regularly to control the work on different types of projects. The improvement in scheduling is also important to organize the work with suppliers and to guarantee the on-time delivery of components that are required for completing urgent orders (Marodin et al. 418). Get your 100% original paper on any topic done in as little as 3 hours Learn More The next approach to improving the work of the supply chain is the focus on developing communication with customers who should receive opportunities to place orders in the timeliest manner and inform the managers of Oak Hills regarding their potential demand for products for a certain period (Marodin et al. 418). Even though the organization uses the Materials Requirements Planning (MRP) system to realize the process of ordering components, it should also be improved with the focus on including it in scheduling and the work with Precision Milling to control all areas of operations at the facility. These strategies can be viewed as rather effective to overcome the discussed challenges. The connection between demand management and the supply chain for Oak Hills It is important to pay attention to the fact that demand management is essential for the Oak Hills facility because its results influence scheduling and operations for a certain period. Thus, demand management is associated with a set of methods that are used to predict customers’ demands for certain products within a selected time frame (Touboulic and Walker 17). While discussing the connection between specifics of demand management and the Oak Hills’s supply chain from the strategic perspective, it is possible to note that this linkage is direct and important because the supply chain management depends on demand management in such organizations as Oak Hills. Thus, the number of products manufactured by this organization directly depends on forecasting customers’ needs because it is necessary to cooperate with suppliers and plan inventories to address the planned demand (Karim and Arif-Uz-Zaman 171). Furthermore, at the Oak Hills facility, the work of the supply chain depends on both short-term and long-term forecasts regarding the potential demand. Therefore, if demand management is organized appropriately, a supply chain will work effectively to meet the projected customers’ needs (Touboulic and Walker 18). However, in the context of Oak Hills, the problem is that demand management is not realized properly. It is important to focus on the point that the demand for testing instruments produced at the Oak Hills facility usually fluctuates, and changes in orders of international or domestic customers depend on a variety of factors. Thus, the surveys which were completed to predict the demand for testing instruments are based on rather questionable data. Also, managers and employees at the Oak Hills facility lack information regarding Exploration and Extraction unit projects and orders for Triangle Corp. One more point is that customers’ rush orders seem to be unlimited. Therefore, if demands increase significantly, Oak Hills has only a few resources to rearrange the manufacturing process, and there are often changes in schedules and operations when employees need to work on scheduled orders along with rush ones. From this perspective, it is important to state that weaknesses in demand management and overall capacities of managers to predict and control orders and lead times are associated with problems in the work of the organization’s supply chain (Karim and Arif-Uz-Zaman 171; Touboulic and Walker 18). When there many rush orders, the work of the chain should be adapted to the situation, and regular procedures to manage this process seem to be underdeveloped concerning weaknesses in demand management. Furthermore, it is important to note that the connection between demand management and the work of the supply chain is obvious, and any problems with predicting the demand can result in increasing manufacturing, inventory, labor, and delivery costs. Therefore, a new system for demand management should be used at the Oak Hills facility, and this system needs to be implemented in connection with the system that regulates the work of the organization’s supply chain. The implementation of recommendations, possible problems and their solutions To overcome a range of identified weaknesses in the organization of employees’ work, scheduling, cooperation with suppliers, and communication with customers and partners, Oak Hills needs to focus on some recommendations which are oriented to preparing the organization for implementing a lean system. The first recommendation to follow is the reorganization of communication with employees and the improvement of teamwork and the proposed system of bonuses. This step is important to help employees adapt to a new lean system (Wang et al. 686). The second recommendation is associated with the improvement of the supply chain with the focus on developing contacts with suppliers and customers concerning the work of the MRP system. The third recommendation is the improvement of processes and operations, as well as the quality control system, with the help of applying the principles of a lean system. However, the process of implementing a lean system and related organizational changes can be associated with the appearance of significant challenges for the management team of Oak Hills. Possible problems can include further negative changes in the morale of employees as well as their opposition to the observed changes and increased requirements for the speed and quality of operations according to the principles of optimization (Martínez-Jurado and Moyano-Fuentes 136). Currently, employees demonstrate the unwillingness to improve the performance of teams, and the inappropriate organization of their work along with the lack of communication can be viewed as key issues that require effective solutions. Another controversial question is the necessity of firing employees after completing the final stage of a merger. Thus, risks or threats of being fired can cause decreases in employees’ motivation. To avoid this problem or minimize negative outcomes, it is necessary to share the vision of benefits caused by the change with employees and motivate them to participate in the process while improving communication and teamwork and providing rewards (Martínez-Jurado and Moyano-Fuentes 136). More problems can be associated with expenses related to the implementation of a lean system. Even though the integration of the lean system principles is expected to result in decreasing costs and optimizing processes, the realization of the project requires the reorganization of the followed system, and this situation is almost often associated with high expenses. To prevent these problems, the management team of the Oak Hills facility needs to forecast and analyze all possible expenses and create a budget for implementing a lean system most efficiently. This budget plan should include the analysis of all operations associated with changes in the supply chain management to improve the cooperation of managers, employees, suppliers, and customers (Marodin et al. 418). As a result, it will be possible to avoid considerable high costs which are associated with the implementation of the change in the organization. Furthermore, these steps are essential to help employees adapt to a new situation and improve their performance. We will write a custom Case Study on Oak Hills Facility’s Supply Chain Implementation specifically for you! Get your first paper with 15% OFF Learn More Works Cited Brandenburg, Marcus, et al. “Quantitative Models for Sustainable Supply Chain Management: Developments and Directions.” European Journal of Operational Research, vol. 233, no. 2, 2014, pp. 299-312. Karim, Azharul, and Kazi Arif-Uz-Zaman. “A Methodology for Effective Implementation of Lean Strategies and Its Performance Evaluation in Manufacturing Organizations.” Business Process Management Journal, vol. 19, no. 1, 2013, pp. 169-196. Marodin, Giuliano Almeida, et al. “Contextual Factors and Lean Production Implementation in the Brazilian Automotive Supply Chain.” Supply Chain Management: An International Journal, vol. 21, no. 4, 2016, pp. 417-432. Martínez-Jurado, Pedro José, and José Moyano-Fuentes. “Lean Management, Supply Chain Management and Sustainability: A Literature Review.” Journal of Cleaner Production, vol. 85, no. 1, 2014, pp. 134-150. Touboulic, Anne, and Helen Walker. “Theories in Sustainable Supply Chain Management: A Structured Literature Review.” International Journal of Physical Distribution and Logistics Management, vol. 45, no. 1, 2015, pp. 16-42. Wang, Yulan, et al. “Service Supply Chain Management: A Review of Operational Models.” European Journal of Operational Research, vol. 247, no. 3, 2015, pp. 685-698.

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Reply to this discussion. Can you help me understand this Nursing question?

This 21-year-old patient presenting with right ear pain for 2 days which started shortly after scuba lessons. Pain is described as pressure, crackling, and dizziness. Further questioning should include:

What part of the ear hurts?
Is it constant or intermittent?
What makes it worse?
How have you treated it?
What makes it better?
Any other symptoms, fever, discharge from ear, runny nose?
Rate the pain on a scale of 1-10
Have you had this before?
Have you been sick recently?
Do you smoke, use alcohol or rec drugs?
What is your medical hx?
Do you have “tubes” in your ears?
Any pain when you chew?
Does the pain prevent you from sleeping?
Any difficulty hearing?
Have you had recent dental work?
Do you have TMJ?

Time Course
In this case, since the patient was just scuba diving and the symptoms occurred “shortly after”, this could be middle ear barotrauma (MEB) since the pain and symptoms start within the first 24 hours after diving. Acute otitis media develops most often in children and the elderly following a cold or respiratory infection. Meniere’s usually occurs in those over age 50. Otitis externa usually develops in people age 30-60 (Dunphy et al., 2015).
Patient age
Children are more likely to develop acute otitis media, swimmers are more likely to develop otitis externa, barotrauma is caused by scuba diving, and temporal arteritis and neoplasms would be more likely for older adults with comorbidities (Earwood, 2018).
Diagnostic tests
For this patient, history and exam with otoscope would be appropriate. If hearing loss is involved, referral to a neurologist for further testing would be warranted.

DDx
Dx testing
Pharm
Rationale

Middle Ear Barotrauma
History/otoscope/neuro
Decongestants
This can be caused by blocked Eustachian tubes due to too rapid descent in diving. Chewing gum or yawning may help (Harvard Health Publishing, 2018).

Otitis Externa (swimmer’s ear)
History/exam/neuro
Topical corticosteroids, antibiotics
This is external ear inflammation, usually fungal (Balch, 2019)

Otitis media
History/otoscope/neuro
Tylenol/ibuprofen/amoxicillin
Management of pain if there is no fever; fever would indicate infection, necessitating the use of antibiotics (Dunphy, 2015).

Meniere’s disease
History/exam/neuro/ abnormal Weber/Rinne
Bedrest, low sodium diet, diuretics
This is caused by allergies/stress, excess sodium imbalance in the ear (Dunphy, 2015)

Balch, Graeme, et al. “Oral Corticosteroids for Painful Acute Otitis Externa (Swimmer’s Ear): A Triple-Blind Randomized Controlled Trial.” Australian Journal of General Practice, vol. 48, no. 8, Jan. 2019, pp. 565–572., doi:10.31128/ajgp-12-18-4795.
Dunphy, L., Winland-Brown, J., Porter, B., Thomas, D. (2015). Primary care: The art and science of advanced practice nursing. F.A. Davis Company.
Earwood, J. S., Rogers, T. S., & Rathjen, N. A. (2018). Ear Pain: Diagnosing Common and Uncommon Causes. American Family Physician, 97(1), 20–27. Retrieved from https://search-ebscohost-com.libauth.purdueglobal….
https://www.health.harvard.edu/a_to_z/barotrauma-a-to-z
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