Heart failure (HF) is a chronic progressive disease with marked morbidity and mortality. Patients enduring this condition suffer from fluctuations in symptom burden such as fatigue, shortness of breath, chest pain, sexual dysfunction, dramatic changes in body image and depression. As physicians, we often ask patients to trust in our ability to ameliorate their symptoms, but oftentimes we do not hold all of the answers, and our best efforts are only modestly effective. The suffering endured by these individuals and their families may even call into question one's faith in a higher power and portends to significant spiritual struggle. In the face of incurable and chronic physical conditions, it seems logical that patients would seek alternative or ancillary methods, notably spiritual ones, to improve their ability to deal with their condition. Although difficult to study, spirituality has been evaluated and deemed to have a beneficial effect on multiple measures including global quality of life, depression and medical compliance in the treatment of patients with HF. The model of HF treatment incorporates a multidisciplinary approach. This should involve coordination between primary care, cardiology, palliative care, nursing, patients and, importantly, individuals providing psychosocial as well as spiritual support. This review intends to outline the current understanding and necessity of spirituality's influence on those suffering from HF.

Deciding who should receive maximal technological treatment options and who should not represents an ethical, moral, psychological and medico-legal challenge for health care providers. Especially in patients with chronic heart failure, the ethical and medico-legal issues associated with providing maximal possible care or withholding the same are coming to the forefront. Procedures, such as cardiac transplantation, have strict criteria for adequate candidacy. These criteria for subsequent listing are based on clinical outcome data but also reflect the reality of organ shortage. Lack of compliance and non-adherence to lifestyle changes represent relative contraindications to heart transplant candidacy. Mechanical circulatory support therapy using ventricular assist devices is becoming a more prominent therapeutic option for patients with end-stage heart failure who are not candidates for transplantation, which also requires strict criteria to enable beneficial outcome for the patient. Physicians need to critically reflect that in many cases, the patient’s best interest might not always mean pursuing maximal technological options available. This article reflects on the multitude of critical issues that health care providers have to face while caring for patients with end-stage heart failure.

Financial cybercrime in the metaverse has become increasingly more significant for authorities, corporations, and individuals to address, requiring new regulatory and compliance frameworks, as well as novel cybersecurity mechanisms in order to prevent these crimes. Financial cybercrimes in the metaverse have increased in the last years significantly, with either the massive stealing of cryptocurrencies from exchanges or the sale of fake or dubious NFT and other financial products that have lost significant value within a short period of time. Cybercrimes in the metaverse have taken place at significant scales and given the infancy of regulations as well as the virtual nature of these activities, only few crimes have been prosecuted. Islamic finance may represent a considerable opportunity for the metaverse via connecting the financial services and instruments to real and virtual assets free of speculation. The article provides several recommendations for regulators to address these cybercrime challenges and how Islamic finance can assist in these cybercrimes.

Chronic heart failure is a lifelong disease that involves a large variety of symptoms and, ultimately, the entire organism relatively early in the disease process. At least in part, this is in contrast to other chronic conditions such as diabetes, renal failure or cancer. Modern treatment of patients with chronic heart failure goes beyond the mere prescription of vasodilators or inotropes. The multitude of multi-organ involvements and associated symptoms unrelated to pure cardiac contractile failure, as well as the psychosocial burden for patients and their direct environment, calls for a re-engagement with the philosophical aspects of medical care. Such a process may well challenge the approach commonly taken by health care providers. We further suggest a broader and more holistic view of medical care--in this case in regard to heart failure--and one that is based on patients' and physicians' understanding of health and disease, autonomy, suffering, existential values and expectations that might positively affect treatment strategies and outcomes.

We examined factors related to the uptake of two malaria prevention measures, insecticide-treated bed-nets and prophylactic sulphadoxine-pyrimethamine (SP), among pregnant women in Nnewi, Nigeria. The survey had a quantitative and qualitative part. For each part, the subjects meeting our inclusion criteria were systematically identified in a population-based manner. For the qualitative part, focused group discussions, in-depth interviews with a wide variety of stakeholders (e.g., health workers, males whose wives are pregnant, and drug and net sellers), and key informants including doctors and nurses were held. All data covered various aspects related to the topics. A total of 384 subjects participated. The mean age was 28.9 years (95% CI 23.4–34.5). The primigravidae (odds 1.8–2.3) and illiterates (odds 4.1–13.5) were less likely to sleep under the net. Primigravidae were 2.0x less likely to uptake adequate SP. The uptake was also associated with having adequate knowledge on SP (2.4x), completing usual (≥4 visits) antenatal visits (3.9x), and being in the best (≥9 visits) antenatal visit scenario (10.5x). Other barriers identified were thermal discomfort, lack of availability, cost, and unsupervised uptake of SP. Based on a representative sample, systematic procedures, and within current evaluation limits, we conclude that primigravidae and those with no formal education and inadequate antenatal visits should be the foremost group for encouraging uptake of malaria prevention measures. The policymakers should resolve issues of thermal discomfort, availability, cost, unsupervised uptake, and inadequate awareness and confidence on SP prophylaxis. The solutions are available and should be actively sought.