Congestive heart failure (CHF) is a clinical syndrome that features a failing heart together with signs and symptoms arising from renal retention of salt and water, mediated by attendant neurohormonal activation, and which prominently includes the renin-angiotensin-aldosterone system. More than this cardiorenal perspective, CHF is accompanied by a systemic illness whose features include an altered redox state in diverse tissues and blood, an immunostimulatory state with proinflammatory cytokines and activated lymphocytes and monocytes, and a wasting of tissues that includes muscle and bone. Based on experimental studies of aldosteronism and clinical findings in patients with CHF, there is an emerging body of evidence that secondary hyperparathyroidism is a covariant of CHF. The aldosteronism of CHF predisposes patients to secondary hyperparathyroidism because of a chronic increase in Ca 2+ and Mg 2+ losses in urine and feces, with a fall in their serum ionized levels and consequent secretion of parathyroid hormone. Secondary hyperparathyroidism accounts for bone resorption and contributes to a fall in bone strength that can lead to nontraumatic fractures. The long-term use of a loop diuretic with its attendant urinary wasting of Ca 2+ and Mg 2+ further predisposes patients to secondary hyperparathyroidism and attendant bone loss. Aberrations in minerals and micronutrient homeostasis that includes Ca 2+ , Mg 2+ , vitamin D, zinc and selenium appear to be an integral component of pathophysiologic expressions of CHF that contributes to its systemic and progressive nature. This broader perspective of CHF, which focuses on the importance of secondary hyperparathyroidism and minerals and micronutrients, raises the prospect that dietary supplements could prove remedial in combination with the current standard of care.

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Corporate social responsibility (CSR) efforts are known to affect firm and societal outcomes, but little is known about their effects on consumer well-being. We address this research gap by investigating whether consumers who have integrated their self-schema with a brand's schema (i.e., high self-brand overlap consumers) vicariously balance their moral behavior against a brand's CSR efforts. Specifically, we propose that a brand's socially responsible behavior can negatively influence the moral behavior of high self-brand overlap consumers (vicarious moral licensing), while a brand's less socially responsible behavior can positively influence the moral behavior of these consumers (vicarious moral cleansing). Further, we do not predict or observe these effects among low selfbrand overlap consumers, given their lack of psychological identification with the CSR brand. Across four experiments, we demonstrate the vicarious moral balancing effect and show process evidence for the potential role of pride (guilt) in driving vicarious moral licensing (cleansing) behaviors. Importantly, we also demonstrate two potential methods to eliminate the vicarious moral licensing effect when firms conduct CSR efforts.

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