Evaluating financial performance of insurance companies using rating transition matrices

YesFinancial performance of insurance companies is captured by changes in rating grades. An insurer is susceptible to a rating transition which is a signal depicting current financial conditions. We employ Rating Transition Matrices (RTM) to analyse these transitions. Within this context, credit quality can either improve, remain stable or deteriorate as reflected by a rating upgrade or downgrade. We investigate rating trends and forecast rating transitions for UK insurers. We also provide insights into the effects of the global financial crisis on financial performance of UK insurance companies, as reflected by rating changes. Our analysis shows a significant degree of rating changes, as reflected by rating fluctuations in rating matrices. We conclude that insurers with higher (better) rating grades depict rating stability over the long-run. An unexpected but interested finding shows that insurers with good rating grades are nevertheless susceptible to rating fluctuations. General insurers are more likely to be rated and they demonstrate higher levels of rating grade variations over the period studied. Using comparative rating transition matrices, we find more variations in rating movements in the post-financial crisis period. We also conclude that general insurers reflect less stable rating outlooks compared to life and general insurers

Irbesartan in Marfan syndrome (AIMS): a double-blind, placebo-controlled randomised trial

BACKGROUND: Irbesartan, a long acting selective angiotensin-1 receptor inhibitor, in Marfan syndrome might reduce aortic dilatation, which is associated with dissection and rupture. We aimed to determine the effects of irbesartan on the rate of aortic dilatation in children and adults with Marfan syndrome. METHODS: We did a placebo-controlled, double-blind randomised trial at 22 centres in the UK. Individuals aged 6-40 years with clinically confirmed Marfan syndrome were eligible for inclusion. Study participants were all given 75 mg open label irbesartan once daily, then randomly assigned to 150 mg of irbesartan (increased to 300 mg as tolerated) or matching placebo. Aortic diameter was measured by echocardiography at baseline and then annually. All images were analysed by a core laboratory blinded to treatment allocation. The primary endpoint was the rate of aortic root dilatation. This trial is registered with ISRCTN, number ISRCTN90011794. FINDINGS: Between March 14, 2012, and May 1, 2015, 192 participants were recruited and randomly assigned to irbesartan (n=104) or placebo (n=88), and all were followed for up to 5 years. Median age at recruitment was 18 years (IQR 12-28), 99 (52%) were female, mean blood pressure was 110/65 mm Hg (SDs 16 and 12), and 108 (56%) were taking β blockers. Mean baseline aortic root diameter was 34·4 mm in the irbesartan group (SD 5·8) and placebo group (5·5). The mean rate of aortic root dilatation was 0·53 mm per year (95% CI 0·39 to 0·67) in the irbesartan group compared with 0·74 mm per year (0·60 to 0·89) in the placebo group, with a difference in means of -0·22 mm per year (-0·41 to -0·02, p=0·030). The rate of change in aortic Z score was also reduced by irbesartan (difference in means -0·10 per year, 95% CI -0·19 to -0·01, p=0·035). Irbesartan was well tolerated with no observed differences in rates of serious adverse events. INTERPRETATION: Irbesartan is associated with a reduction in the rate of aortic dilatation in children and young adults with Marfan syndrome and could reduce the incidence of aortic complications

The Canakinumab Antiinflammatory Thrombosis Outcome Study trial—the starting gun has fired

Authors work in the area has been supported by UK Medical Research Council Experimental Medicine Grant (G0502131), the National Institute for Health Research and a UK Medical Research Council Clinical Research Training Fellowship (AR -MR/K002406/1). AR is supported by a Wellcome Trust Clinical Research Career Development Fellowship 206632/Z/17/Z.Publisher PDFPeer reviewe

The Context of Emotional Responses to Athletic Injury: A Qualitative Analysis

This study used grounded theory to describe the emotional responses of athletes following injury and their situational and temporal contexts. Sixteen seriously injured athletes were interviewed. The NUD*IST (Nonnumerical Unstructured Data Indexing Searching and Theorizing) computer program was used to search, store, explore, and organize the qualitative material. The main emotional responses, appraisals, events, and behaviors that emerged from the analysis were represented diagrammatically. Frustration and depression were the prevalent emotional responses throughout rehabilitation, although the situational corollaries differed as recovery progressed. In the early phase of rehabilitation, frustration and depression resulted from disruption to normal function, in the middle phase they were provoked by a negative appraisal of rehabilitation progress, and. at the end of rehabilitation the main instigator was impatience to return to sport. Whether to risk returning prematurely to sport emerged as a key theme, as did the confounding effects of exercise withdrawal. symptoms in extremely committed athletes. The results were considered in terms of both cognitive appraisal and risk models