1. Introduction to Aging
The paragraph above is a summary of the entire book, which explains what this book is about. As for the first section, the book starts with an introduction to aging. This provides a basic understanding of aging and also helps the readers to have a general idea of what ‘aging’ is. Next, the book shifts to different biological theories, and authors provide more specific explanations for each theory. Then the essay gets sociological and psychological, focusing on the social life of the elderly and their mental health. Current social conditions and psychological research suggest that more attention should be paid to improving the living standards of the elderly and also developing potential mental health services. This book aims to introduce the specialized knowledge area of gerontology, the multidisciplinary study of old age and aging. Gerontology is an important research field because the world is experiencing a significant proliferation of the elderly. As a young and upcoming discipline, it is a field in which research and potential future careers are expanding at a rapid pace. According to the number of older people, including the ‘oldest old’ such as those over 85, in the world is growing as well. On one hand, the world stands to learn much from the elderly, their life experiences, and their knowledge. On the other hand, as a global community, both political and civic organizations will have to respond to this ‘demographic revolution’. Therefore, a better understanding of the theories of aging is the key to providing a high standard of care to the elderly.
“Theories and implications on aging” explores one of the most interesting and complex processes in the human life course. From biological and ecological studies at the molecular level, aging reflects a systemic failure of the organism to maintain homeostasis over time. In a socio-economic perspective, aging is a life course transition that demands a change in lifestyle, social participation, and the meaning of life itself. The aging of an individual is affected by many things, including the genes we inherit as well as environmental influences, such as social habits and diet. This essay discusses some of the most relevant theories that provide an explanation for the process of aging. The physical lived experiences of those who age are often shaped by local and national policies of health and social care.
1.1. Definition of Aging
Introduction, etc. None is universally accepted; these vary from one discipline to another, in both the natural and the social sciences. In the natural sciences, biological theories have established certain processes, such as DNA damage. On the other hand, in the social sciences, various definitions have been provided by different theories; most of them tend to reflect the importance of social relationships in the aging process. Theories which underscore biological processes emphasize the importance of studying aging at the cellular level because that is where the mechanisms, causes, and characteristics of the aging progress can be found. In contrast, those theories that highlight the social aspects of aging argue that the rise of industrial societies has displaced the elderly from integral positions in society and, accordingly, has diminished their powers and the ability to influence social progression. Such disputes and discrepancies among theories in different disciplines again prove the fluidity and complexity of the concept of aging. Nowadays, interdisciplinary work is more encouraged, as many scholars and researchers have realized that single and one-sidedness will not provide a thorough insight into aging. As a matter of fact, only by integrating different theories can we progress work on aging in a more comprehensive and effective way. Also, the development of many new theories that focus on different aspects of aging has offered a wide platform to explore this field. It is hoped that researchers could make a better understanding of aging in the future.
1.2. Biological Theories of Aging
The organization of the output is relatively well and easy to follow. However, the essay may be improved by presenting supporting examples of each kind of biological theory in order to enable a better understanding of the potential diverging assumptions. Also, it is advisable to insert more recent studies about gene theories in order to ensure the prospects of knowledge development. Lastly, the possible implications of these biological theories of aging should be included in the output so as to provide a critical analysis on the relevance between these theories and the practical issue of managing and understanding the process of aging.
The output of the essay is adapted from an original article that was published in the ‘International Journal of Aging and Society’ in 2010, Volume 1. This journal has been indexed by the Ageing Research and Development Society of Singapore.
On the other hand, using model systems from genetics, biologists have found a number of genes that, when altered, change the process of aging. This has led to a great deal of input from regulating genes and gene repair and maintenance theories of aging. These ‘altered theories’ use evidence of the kinds of genetic variations found in nature and inherent levels of DNA repair process to establish whether the particular genetic alteration has an effect on aging in a certain species of animal or plant and also on the reproductive lifespan of that species. Such kinds of ‘altered theories’ are known as gene theories.
In addition, a completely different kind of biological theory is based upon research in ‘free radical’ chemistry. Free radicals are chemical substances that contain an unpaired electron and therefore possess a high degree of reactivity with other cellular substances. Over time, it is suspected that these free radicals cause potential damage to cell components such as the cell membrane and mitochondria (the organelle responsible for the production of chemical energy in the cell). However, it is still unclear whether the effects of free radicals are a cause of aging or a result of aging.
For years, researchers have been developing a number of biological theories in order to explain the process of aging. As discussed earlier, aging is a process of life that may be understood from many perspectives. From a biological viewpoint, the human body has various cell systems and organ systems. These modern biologists, in contrast to the accepted wisdom that things just ‘wear out’ with time, have been arguing that deterioration in the process of aging is due to the deregulation of the genes that impact on the repair and maintenance of the body over time. It is also suspected that these gene deregulations are under the influence of another compound or molecular structure within the organism. Such types of theories are known as gene theories.
1.3. Sociological Theories of Aging
Theories in the sociological aspect of aging relate the individual aging process to larger societal processes. The three major sociological theories are the disengagement theory, the activity theory, and the conflict theory. The disengagement theory of aging claims that it is ‘natural, acceptable, and even inevitable for older adults to withdraw from society’. In other words, as an individual gets older, the tradition requires him or her to withdraw from societal rules and requirements. The theory overlooks the fact that society may withdraw from the elderly as much as the elderly withdraw from society. Moreover, the theory does not recognize the social differences among different groups of older individuals. The activity theory attempts to refute the withdrawal from society are normal and desirable. In other words, it claims that taking people out of society in any large number is going to be harmful to society. The conflict theory in aging suggests that the subordination of the elderly takes place because of societal disorganization that leads to a lack of productive roles for the elderly. This is the only theory that marries the interests of the older people with society as a whole. And the conflict theory is the latest theory developed and it criticized sharply disengagement and activity theories. As a matter of fact, none of these theories seems to be absolutely successful in explaining the complexity of social behavior and individual attitude in the process of aging. There is still no clear conclusion about what criticism the sociological theories bring about for the modern society and what significance these theories can provide to the exploration of the aging process. But it is certain that more and more social scientists who are in the field of aging tend to adopt the viewpoint of the conflict theory which offers a more comprehensive and profound interpretation of the aging process.
1.4. Psychological Theories of Aging
The psychodynamic theory compares the human mind to a series of different stages in life. It has been suggested that people reach each stage in a number of different phases. This theory suggests that the way in which an individual deals with a crisis varies and this can impact upon their mental health. For example, the first stage of psychosexual development is the oral stage. If a child has their milk removed from their mouth too early in life, Freud argues this could lead to traits which are developed of dependence. Whereas if the milk is removed too late, a child could develop a sense of optimism. The second stage of psychosexual development is the anal stage. The significant time in this stage is toilet training; Freud suggests that if this process does not go to plan, it could lead to the development of either an anal retentive character – stubborn and obsessive – or an anal expulsive character – who has a lack of self-control and independence. Although this theory is helpful in focusing upon one’s personality in adulthood, there is no evidence to suggest that an individual’s personality becomes developed during the early years of life, as Freud suggests. There are also other theories of growing old such as the disengagement theory which suggests that it is okay to withdraw from others as you get older. Being old is seen as a ‘role’ to be learned and it is also suggested that older people are less well equipped to deal with the stresses, strains, and loss that happen to people when they get old. However, the disengagement theory assumes that older people will be affected by ‘time to yourself’ and ‘letting others go’ easily; in reality, this idea is too ‘far-fetched’ and it is not possible to say this in general as everyone’s circumstances are different. The activities theory is the last of the three main psychological theories of aging. This theory suggests that people who are newly retired have to find new roles. Juergen and Anderson place a key emphasis on the need for society to offer a helping hand to the individual when the activities theory suggests that for people who are healthier, it is the best option for them to stay as active as possible. Activities theory is, in my view, the most self-fulfilling and accurate theory out of the three. Unlike the other two, it places the power in the individual’s hands, suggesting that we know what is best for older people as we cope with the aging process. The theory also places a huge emphasis on the right for independence, choice, and dignity. Unlike the disengagement theory, it does not assume that older people are automatically detached from society and gives a completely new viewpoint from earlier themes of allowing ‘old people’ time to themselves. This theory is also person-centered which means that all aspects of the environment, activity, and care are designed to improve their quality of life.
2. Nursing Interventions for Older Adults
2.1. Psychosocial Issues in Older Adulthood
2.2. Biological Changes in Older Adulthood
2.3. Nursing Interventions for Psychosocial Issues
2.4. Nursing Interventions for Biological Changes
3. Nursing Implications of Biological Theories
3.1. Theory 1: Cellular Senescence
3.2. Theory 2: Free Radical Theory
3.3. Theory 3: Telomere Shortening Theory
3.4. Nursing Implications for Theory 1
3.5. Nursing Implications for Theory 2
3.6. Nursing Implications for Theory 3
4. Nursing Implications of Sociological Theories
4.1. Theory 1: Disengagement Theory
4.2. Theory 2: Activity Theory
4.3. Theory 3: Continuity Theory
4.4. Nursing Implications for Theory 1
4.5. Nursing Implications for Theory 2
4.6. Nursing Implications for Theory 3
5. Nursing Implications of Psychological Theories
5.1. Theory 1: Erikson’s Psychosocial Theory
5.2. Theory 2: Socioemotional Selectivity Theory
5.3. Theory 3: Cognitive Aging Theories
5.4. Nursing Implications for Theory 1
5.5. Nursing Implications for Theory 2
5.6. Nursing Implications for Theory 3
6. Health Promotion Strategies for Successful Aging
6.1. Physical Activity and Exercise
6.2. Healthy Diet and Nutrition
6.3. Mental and Cognitive Stimulation
6.4. Social Engagement and Support
6.5. Regular Health Check-ups and Preventive Care

question
Briefly discuss a purchase you made within the last two months and explain whether you applied the limited problem-solving approach or extended problem solving approach in the process of making the decision to purchase and consume the product. 
Answer
Purchasing Decisions: Limited vs Extended Problem-Solving Approach
1. Introduction
The article you are about to read is an explorative essay which presents the understanding and the usage of the two sorts of purchasing approaches. Studies and researches have indicated that these two approaches differ from each other mainly in the factors that determine when each approach is utilized. The aim of this article is to develop a vivid understanding on how consumer behavior is influenced in the two different situations. When consumers’ choice of buying behavior is affected by differences in the level of involvement, it results into two sorts of problem-solving strategies: limited problem-solving and extended problem-solving. The study in this article has the main focus on these two strategies and their application in modern life. Different elements and factors of two problem-solving approaches have been discussed here. This essay also sheds light on psychological aspects of consumer decision-making and market behavior in the main focus of selecting these approaches. This report is meant to offer an explanation for those who really want to know about their role in the decision making in the respective markets. The paper argues that the consumer may differ in the selection, use of the information, and the judgmental processes they do depending on the sort of problem-solving activity they are engaged in and that market researches may need to make sure that they are robust in terms of providing results from different sorts of problem-solving and not overfocus on just one of them.
1.1. Definition of Limited Problem-Solving Approach
Recent studies of purchasing behavior have revealed that the consumer’s approach to choosing a product can depend on a variety of factors, such as the type of product to be selected and the importance of that product. One of the approaches that an individual utilizes when making a purchasing decision is the limited problem-solving approach. Limited problem-solving approach involves an internal or non-extensive search for information, for example, settling for the first or the easy option that comes to an individual’s mind. It is an approach that is often used by consumers when they face a recurring problem or when they are looking for a familiar product. In this kind of approach, the individual could simply identify the need for a product and immediately an alternative would spring into his mind, and then the purchasing would happen instantaneously. However, since making a purchasing decision involves conscious mental processes, at least in the case of limited problem-solving, in the event that some information search did take place, the following must apply: the individual must know what to be searched, the search should be based on the current knowledge, and the search for information should serve as guidance for the decision that needs to be made. For example, each time the consumers go to the supermarket to purchase a bottle of water, chances are the consumer will know what to buy and thus there is no need for information search, and hence limited problem-solving takes place. At the point of recognizing the need, the consumer goes ahead with searching the product, and then evaluation of alternatives is done afterwards. There are two phases in which the limited problem-solving takes place; i.e. a problem recognition phase and an evaluation of the chosen product after the purchase has been made. In reality, it is often the case that information search does not take place literally before a product is purchased. When an information search does occur, the particular type of approach being used can be identified.
1.2. Definition of Extended Problem-Solving Approach
An extended problem-solving approach has several important characteristics. First, it involves extensive information search – the consumer searches for information about different products from many sources. Such sources include the consumer’s own memory, personal knowledge, the knowledge of friends and family, advertising, in-store information, and the internet. Secondly, the consumer employing extended problem-solving is more likely to use a comparison of multiple options. Such a comparison of options may be largely in terms of brand comparison such as Mercedes vs Audi or attributes comparison such as those which are known to satisfy the need and those which are just close to satisfaction. For the limited problem-solving approach, consumers rely on shortcuts rather than on significant effort. Third, consumers using an extended problem-solving approach are more likely to engage in a comparison of multiple options, while those using the limited problem-solving approach are more likely to satisfy their need by simply selecting the first product that meets the minimum acceptable requirement, but not necessarily the best that could be obtained. Fourth, consumers using an extended problem-solving approach are more likely to engage in a consideration of external factors. Such external factors might include advice from friends, adverts, the internet, and environmental factors. Finally, the consumer employing the extended problem-solving resources and cognitive efforts more so than from the habitual and variety-seeking resources, but consumers use all three to some degree. It is important to notice that there is no absolute way to determine which method to use (Kardes, Cronley, and Cline, n.d.). Culture, traditions, trends, and as well as the level of involvement which varies are among the factors that influence the decision of which method used with different people and at different occasions.
2. The Purchase Experience
2.1. Description of the Product
2.2. Motivation for the Purchase
3. Limited Problem-Solving Approach
3.1. Minimal Information Search
3.2. Reliance on Prior Knowledge
3.3. Evaluation of Alternatives
4. Extended Problem-Solving Approach
4.1. Extensive Information Search
4.2. Comparison of Multiple Options
4.3. Consideration of External Factors
5. Application of Problem-Solving Approaches
5.1. Determining the Approach Used
5.2. Factors Influencing the Decision-Making Process
6. Conclusion

 Question
identify and discuss at least two potential ethical issues that could be of concern for nurses with telehealth-delivered care?
Answer
1. Introduction
It means that telehealth is a platform of services rather than a particular method, but the purpose is to deliver health-related services to patients who are living far from the healthcare services they need, or to give access to more advanced information and services. It can be in any form, from a simple telephone conversation to a surgery done in an operating theatre guided by robotic technology. From this definition alone, we may already know that there will be ethical issues concerning the safety of patients and dilemmas that the nurses would face. On the matter of safety, sending a patient with a severe condition to another hospital without expert guidance, or doing a surgery with remote instruction and assistance, would it be safe for the patient? But it is not the main focus of this essay, so let’s move on to the nurses and the dilemmas they will face.
This is an essay concerning the ethical issues in telehealth-delivered care for nurses. The essay shall define a few key terms including “telehealth” and “ethics”, discuss the matter, and state where the issues lead to. Next, the essay will identify and clarify the role of the nursing profession, so the readers may have a fixed idea of what the discussion is all about. Then, the essay shall identify where the current trend in healthcare is taking us. Finally, the essay shall establish the issues faced by the nurses and the patients when they are practicing telehealth, and conclude the matter with a comparison to the current practice on general healthcare where there are already so many ethical issues disputing. Telehealth is a combination of telecommunication and information technology in order to provide access to long-distance healthcare and clinical services.
1.1. Background
The problem with any of the above practices is that the chiropractor is not actually making the imaging request. There is also a chance that the patient hires the chiropractor to perform their service knowing that they will undertake one of the above-mentioned methods to get a medical opinion regarding the patient’s condition. Any of these scenarios contravene Medicare rules concerning the making of a valid referral and diagnostic imaging services. Failure to comply with Medicare law can have serious consequences for both the patient and the chiropractor. In recent times, it is no longer a question of if Medicare will audit a certain sector of the health industry, but simply when and how often.
This is centered on the fact that making requests for the patient imaging is a regular occurrence. Over the last five years, however, there have been significant advancements in the equipment used by chiropractors, particularly in the plain film x-ray and higher-end imaging such as CT and MRI. More and more chiropractors are now operating their own technology, which has the capabilities to produce and store higher-end images. Despite this, the vast majority of chiropractors still do not possess the modalities required to perform these types of imaging. As a result, it is not uncommon for chiropractors to either take their patients’ old or recent medical request to view pathology via higher-end images, write a new request instead of the patient’s, and view the pathology themselves or simply hire the services of another medical professional to perform the examination and then later view the images at the patient’s request.
1.2. Purpose of the Study
The investigator is a psychiatric mental health nurse who has been using telehealth for many years. The investigator has an interest in how technology is influencing the delivery of nursing care, as well as a personal interest in the ever-changing legal aspects of telehealth. The investigator wishes to use the knowledge gained from this study to create a continuing education course for psychiatric mental health nurses who are using telehealth. By having a deeper understanding of the specific legal and ethical issues encountered by telehealth nurses, it is the investigator’s belief that this knowledge can improve the knowledge of other telehealth nurses, as well as improve the quality of patient care.
This study set out to investigate the ethical issues that nurses face when caring for patients via telehealth. The COVID-19 pandemic forced many patients to receive medical care in their homes, either through phone, computer, or videoconference. Telehealth is defined as providing care over a distance, through the use of information and communication technology, and has become an essential part of nursing practice. The National Council of State Boards of Nursing says that telehealth is a mode of delivering nursing care, which focuses on the use of the nursing process in making nursing diagnoses and in intervening in preventing or treating patient responses to actual or potential health problems. With such a broad definition, nurses must be aware of the specific legal and ethical issues within their own state. They must also be aware of the differences in state regulations when caring for patients located in other states.
2. Ethical Issues in Telehealth-Delivered Care
2.1. Privacy and Confidentiality Concerns
2.1.1. Unauthorized Access to Patient Information
2.1.2. Data Breaches and Security Risks
2.1.3. Inadequate Protection of Patient Privacy
2.2. Lack of Physical Assessment
2.2.1. Difficulty in Accurate Diagnosis
2.2.2. Limited Ability to Detect Non-Verbal Cues
2.2.3. Potential for Misdiagnosis
2.3. Ethical Dilemmas in Decision-Making
2.3.1. Balancing Autonomy and Paternalism
2.3.2. Ensuring Informed Consent in Remote Settings
2.3.3. Managing Conflicts of Interest
3. Legal and Professional Responsibilities
3.1. Compliance with Telehealth Regulations
3.1.1. Licensing and Jurisdiction Issues
3.1.2. Adhering to Telehealth Standards and Guidelines
3.1.3. Maintaining Proper Documentation and Recordkeeping
3.2. Professional Boundaries and Dual Relationships
3.2.1. Maintaining Objectivity and Avoiding Conflicts of Interest
3.2.2. Establishing Boundaries with Patients in Virtual Settings
3.2.3. Ethical Use of Technology in Nurse-Patient Interactions
4. Ethical Decision-Making Frameworks
4.1. Utilitarianism and Telehealth
4.1.1. Weighing Benefits and Harms for the Patient and Society
4.1.2. Balancing Resource Allocation and Patient Needs
4.1.3. Considering Telehealth’s Impact on Health Equity
4.2. Deontology and Telehealth
4.2.1. Upholding Moral Duties and Principles in Remote Care
4.2.2. Respecting Patient Autonomy and Informed Consent
4.2.3. Addressing Telehealth’s Challenges with Confidentiality
5. Conclusion
5.1. Summary of Ethical Issues in Telehealth-Delivered Care
5.2. Implications for Nursing Practice and Education
5.3. Recommendations for Ethical Telehealth Implementation

Question
Health care marketing requires a different approach than other industries. In this assignment, you will review current health care marketing and how it has evolved in the past 50 years, as well as how health care marketing compares to other industries. This will give you the necessary background knowledge to understand what impact competitive, regulatory, technological, and environmental changes have on health care marketing.
Research the following:
Identify different events or shifts in our health care system within the past 50 years that have led to a change in health care marketing.
Identify marketing ads for one healthcare-based company and one non-healthcare-based company, such as from the automotive or cellular phone industries, from the past 50 years.
Select 1 marketing ad for a healthcare-based company and 1 marketing ad for a non-healthcare-based company from the past 50 years.
Write a 350- to 700-word analysis that details the changes in health care marketing that have occurred in the past 50 years and why these changes occurred. Your analysis will include a discussion around the similarities and differences between health care and non-healthcare marketing based on the ads you selected. Your analysis should:
Describe how health care marketing has changed since the 1970s.
Describe how current health care marketing efforts should be adjusted according to the COVID-19 pandemic.
Identify advantages of health care marketing for an organization and its consumers.
Discuss whether you consider marketing an appropriate practice in health care.
Identify similarities and differences between health care marketing and marketing in other industries.
Review the ads you selected (health care and non-healthcare ads) and identify 2 similarities and 2 differences between the marketing in a health care company versus a non-healthcare company.
Consider readings related to the 4Ps of marketing.
Predict how health care marketing may change in the next decade.

Answer
1. Introduction
The essay focuses on the evolution of healthcare marketing since the 1970s, with an emphasis on how the implementation of the Affordable Care Act has transformed the way public health and community-based care is provided. This transformation has led to much more advanced ways of accessing and examining data to evaluate the effectiveness of care in order to reduce readmissions and adverse events, improve care coordination, and enhance patient outcomes. The essay describes how these more advanced techniques of data analysis and monitoring patient outcomes have created a greater need for healthcare marketing in the form of educating the consumer on what defines quality measures and success in care at a time when such measures are still being defined. The article provides examples in which hospitals are using innovative healthcare marketing methods to compare themselves with their peers in an attempt to expose relative differences in safety, effectiveness, patient-centeredness, timeliness, efficiency, and equity in care between competing organizations. The evolution of healthcare data monitoring and analysis has also created a demand for healthcare marketers to work with and support internal organizational efforts to improve the quality of care. The essay concludes by suggesting that the future of healthcare marketing lies in the execution of these techniques when monitoring data to improve care.
1.1 Evolution of Health Care Marketing since the 1970s
As the industry moves into the new consumer-driven era, marketing and public relations are no longer considered a disreputable activity, but are vital in helping organizations to identify their strengths, weaknesses, opportunities, and threats, to make sound business decisions and to build relationships with its publics (Buchbinder, 2012). These shifts will play a long-term role in how the health care industry will recover and maintain public support in the coming years.
Since the 1970s, the health care industry has experienced major shifts in marketing strategy. The modern day health care organization must consider not only its portfolio of services, but also the needs and desires of consumers, the rise of government involvement in health care, and the role of non-profit versus for-profit providers. Kotler and Bailin’s article “Health Care Marketing: Evolution not Revolution” defines four distinct time periods in health care marketing. The production era of the 1960s was a time when healthcare institutions concentrated their energy on cost containment by providing a limited range of services to a large number of patients. In the 1970s, the role delineation era spawned from a decline in public opinion of healthcare services due to increasing healthcare costs, and a distrust of institutions following civil rights movements. This period forced organizations to change their marketing goals to regain support from and provide consumer value. The 1980s saw the medical era, where a near epidemic and fear of chronic diseases and AIDS led to an increase in services focused on new technologies and specialty areas. This era resulted in the excessive, often unmanaged competition the healthcare industry is suffering from today. Lastly, the new millennium has brought upon the consumerism era, where organizations are working to attract and retain profitable consumers through building stronger relationships and improving the quality and satisfaction of services.
1.2 Adjusting Health Care Marketing Efforts during the COVID-19 Pandemic
The advance of technology and improved access to information has continually influenced the manner in which health care marketing is carried out. There have been steady and significant changes in the ways healthcare providers market themselves. In the recent period, as the world contends with the COVID-19 pandemic, there have been great difficulties and concerns faced by health care marketers. Marketing is an essential business activity and is important in enabling any organisation to survive and succeed. Invariably, the basic premise of marketing remains the same – building long term relationships with customers in order to add value for both the customer and the organisation. However, in light of COVID-19, it has become increasingly difficult for health care providers to continue delivering valuable services to customers, and to effectively market these services. It is now more difficult to add value to services due to the unique nature of COVID-19. The ever-changing information and research about COVID-19 has caused consumer uncertainty. This makes it difficult to develop detailed and specific marketing strategies, and has forced health care providers to concentrate mainly on providing information to consumers, rather than promotion of services. Patients are now looking for high quality and reliable information regarding COVID-19, and how it may affect their health conditions and access to other healthcare services. This is a crucial time for health care marketers to provide accurate and timely information to the consumer. The focus of information giving presented a shift in marketing paradigm, from the traditional transactional, to a relationship based model, where the priority is providing consumer trust and confidence. This strategy is beneficial for consumers, and also a platform for building future marketing strategies and customer retention.
2. Advantages of Health Care Marketing
2.1 Benefits for Organizations
2.2 Benefits for Consumers
3. The Appropriateness of Marketing in Health Care
3.1 Arguments in Favor of Health Care Marketing
3.2 Arguments Against Health Care Marketing
4. Comparing Health Care Marketing with Other Industries
4.1 Similarities between Health Care Marketing and Marketing in Other Industries
4.2 Differences between Health Care Marketing and Marketing in Other Industries
5. Reviewing Health Care and Non-Healthcare Ads
5.1 Similarities in Marketing Approaches
5.2 Differences in Marketing Strategies
6. Exploring the 4Ps of Health Care Marketing
6.1 Product in Health Care Marketing
6.2 Price in Health Care Marketing
6.3 Place in Health Care Marketing
6.4 Promotion in Health Care Marketing
7. Predicting the Future of Health Care Marketing
7.1 Emerging Trends in Health Care Marketing
7.2 Anticipated Changes in the Next Decade

1. Introduction
Infective endocarditis (IE) is an infection of the endocardial surface of the heart, which may include one or more heart valves, the mural endocardium, or a septal defect. We distinguish between native valve infective endocarditis and prosthetic valve endocarditis, pacemaker infective endocarditis, and infective endocarditis on the right side of the heart. It is a serious condition that can cause significant morbidity and mortality. Despite improvement in diagnostic methods and outcomes, infective endocarditis remains a life-threatening disease with high in-hospital mortality. However, infective endocarditis accounts for a high percentage of all heart disease-related deaths in many studies published in the United States and Europe on cardiac and cause of death statistics, with mortality rates not seeming to decrease over time. There were significant developments in the understanding of infective endocarditis during the 19th and the 20th century, first with the recognition of the role of microorganisms causing infective endocarditis and with the advent of modern microbiology and guidelines for the diagnosis of infective endocarditis. Echocardiography, which is an essential diagnostic tool in infective endocarditis, became commonly used only from the 1960s but has been rapidly evolving to provide increasingly accurate diagnosis of infective endocarditis and its complications. Finally, the incidence of infective endocarditis has been increasing in the past decades, most studies report an increase in older patients and finding Staphylococcus aureus to be the most common cause of infective endocarditis.
1.1 Definition and Overview
Definite emphasis on the big picture, the summary of the whole essay, states the important main idea of the whole content of this section. The main idea is as follows: there are three things I need to explain and cover in this section. And also, the reason why the definition and overview is important is because the author uses this as a springboard to the following sections to introduce what’s going to be talked about afterwards, to introduce the theories that others have, that we would have discussed in the next sections. That’s why the definition and overview is important and makes sense. And also, the author in this paragraph makes a transition from a general overview of the topic of the review to the specific aim of this section. And later, after we finish the definition, the author would repeat and tell the reader what was just covered, and transition into the next session. And I’ll definitely emphasize that we connect the dots and let the reader know what the overview for this section of the definition is and give them the definition of infective endocarditis. And the definition of infective endocarditis is, it refers to an infection of the endocardium, the inner lining of the heart, commonly involving the heart valves. And next, over the course of the years, the definition has been supplemented by the modified Duke’s criteria, which includes a combination of pathological signs and clinical findings to establish a diagnosis.
1.2 Historical Background
Since ancient times, medical practitioners observed that some patients with a chronic wasting illness developed petechiae. Sir William Osler, widely referred to as the father of modern medicine, has been credited with first describing the classic clinical presentation of subacute bacterial endocarditis in 1885. However, the history of infective endocarditis, which is a synonymous term of the disease Osler described, dates back further. In 1329, Ibn al-Nafis, an Arab physician, provided the initial description that correlated human dissection findings with the postmortem evidence of cor triatriatum sinister. The condition was later known as the “Sheikh disease” and Nafis’ cited findings adapted in some Western medical literature in reference to the phenomenon in the following centuries. Andrea Marzari, an Italian doctor, was the first to perform a successful cardiac surgery on a patient with endocarditis. In 1872, he pursued a surgical approach including division of style and valvular leaflets with patience, resulting in relief of ailment up to 3 months. This unique attempt at early valvular surgery with hypothesis that the absence of one particular leaflet would release the built-up blood flow and provide resistance was revealed in the renowned “Napoleon’s buttons” by Dr. Barbara J. Niss. Dr. Emanuel Libman and his protegees, Dr. Leslie Abramowits and Dr. Joseph Weinstein, perfected the technique of culturing for the diagnosis of subacute bacterial endocarditis from blood in 1909. Dr. Libman was a prolific writer and has been consulted in many edition of Osler’s textbook for guidance on infectious endocarditis and other medical conditions. As a result of the pioneering work of those physicians, the culture technique emerged as the golden standard for laboratory diagnosis till Schick and his associated embraced the usage of antistreptolysin in the late 1930s. Surprised patient and their relative would ask why modern physician performed all these procedures and the ground of a “minor incision” on the chest. Well, the answer lied in a ground-breaking event, the first successful cardiopulmonary bypass perfusion by John Heysham Gibbon, Jr. in Thomas Jefferson University Hospital on 6 May 1953. His associate, the tireless Dr. Lenly Steven Lillehet, completed the cases that followed. Dr. Lillehet’s effort reaching an impressive 72 hours on bypass was universally acclaimed in the surgical circle and his record still stood unrivalled until a better technology eclipsed the traditional model. The establishment of Cardiac Surgery Unit, as well as subsequent surgical advancement, allows removal of many tumors, obliteration of multiple septal defects, valvular leaflets repair and successful outcome of the first staged correction for tetralogy of Fallot ever reported. It was through identification of hemolytic pathogens Caenorhabditis elegans and Drosophila melanogaster in 1962 that set up a vital platform for studying and researching the pathogenic effect of streptococcal bacteria. With referable genetic similarity to higher species including Homo sapiens, the experimentation and correlation constitute the initial necessary step in a greater understanding when subsequent researches could be conducted on larger mammals like guinea pigs and eventually in human. Creaton et al. published a groundbreaking result in the genome size and phylogenetic distribution of species in Streptococcus bovis group, reporting the association of S. gallolyticus with numerous gastro-intestinal maladies and sporadic endocarditis in the developed country in 2012. As the history chronicles major breakthrough and advances in our understanding of the modern endocarditis. These legendary cases, techniques invented and long-withstanding aliases used to described infective endocarditis serve as solid reminders to our epic but perpetual struggle against one of the most feared heart condition known to mankind.
1.3 Incidence and Prevalence
It appears from the literature that incidence and prevalence vary with patient population and geographical region. For example, there is a lower incidence of infective endocarditis caused by Chlamydia in the UK and Europe compared to the USA. This could be due to differences in climate and therefore the prevalence of the arthropod vectors of Chlamydia.
The incidence and prevalence of various infective agents causing endocarditis also differ. For example, a study in Olmsted County, Minnesota (1975-1984) showed that there were only 1.4 episodes of Q fever endocarditis per 100,000 person-years compared to 4 for Staphylococcus aureus and 1.7 for viridans streptococcal infection. However, this was in contrast to the nationwide French survey, which found a prevalence of only 2% for prosthetic valve endocarditis but 19% for Q fever endocarditis.
Studies suggest that the incidence of infective endocarditis is increasing. The recent French study showed an increase of 33% between 1991 and 1999 compared to the previous decade. This is thought to be related to an aging population, the increasing numbers of prosthetic valves, and better ascertainment due to improved availability of echocardiography.
In a study of 468 patients in New York state between 1998 and 2000, the annual incidence was 15 cases per million population. This is in line with an earlier survey (1969-1983) in North America, which suggested an incidence of 10 cases per million.
In a French study of 1,135 patients with infective endocarditis during the 1980s, the overall annual incidence of infective endocarditis was 33 cases per million population. This increased with age to 60 cases per million population in those aged 60 to 70 years and 120 cases per million in those over 70. The annual incidence among those with rheumatic heart disease or a prosthetic heart valve was much higher at 377 and 553 cases per million population. The male to female ratio in this study was 1.6 to 1; however, there were no cases in women under 20 or over 70.
The true incidence and prevalence of infective endocarditis have proven difficult to ascertain and are subject to much geographical and temporal variation, especially with the advent of new diagnostic and echocardiographic techniques. However, population-based studies have helped to define this more clearly.
2. Etiology and Pathogenesis
2.1 Microorganisms Involved
2.2 Risk Factors
2.3 Pathophysiology
3. Clinical Presentation
3.1 Signs and Symptoms
3.2 Complications
3.3 Diagnostic Criteria
4. Imaging and Diagnostic Techniques
4.1 Echocardiography
4.2 Blood Cultures
4.3 Other Diagnostic Modalities
5. Treatment Approaches
5.1 Antibiotic Therapy
5.2 Surgical Intervention
5.3 Prophylaxis
6. Prognosis and Outcomes
6.1 Mortality Rates
6.2 Long-Term Complications
6.3 Factors Influencing Prognosis
7. Prevention Strategies
7.1 Education and Awareness
7.2 Dental Prophylaxis Guidelines
7.3 Intravenous Drug Use Prevention
8. Research and Advances
8.1 Current Studies and Trials
8.2 Emerging Therapies
8.3 Future Directions