La casa black and white de la UPM: la casa que sigue al sol

La casa black and white de la UPM: la casa que sigue al so

Affective and cognitive factors that hinder the banking relationships of economically vulnerable consumers

PurposeThe aim of this paper is to explore the affective and cognitive factors that condition banking relationships for economically vulnerable consumers and how these factors contribute to increasing financial difficulties and exclusion. This research, performed on a set of focus groups, bases its findings on a combination of experimental and discourse analysis methods. Design/methodology/approachFinancial decisions are not rational and can be biased by affective and cognitive factors. Behavioural finance has focused very little on analysing how consumer biases influence relationships with banking institutions. Additionally, these relationships are affected by the digitalization and transformation of banking business. Thus, in the case of economically vulnerable consumers, who are not profitable for the increasingly competitive banking industry and lack financial abilities, their risk of financial exclusion is increasing. FindingsThe results show that distrust and shame lead to financial difficulties in economically vulnerable consumers. Distrust generates problems of access and self-exclusion, while shame generates difficulties of use. This lack of trust makes them more rational when dealing with machines than with people, showing greater banking difficulties for consumers with a "person-suspicious" profile. Originality/valueThis finding can help regulators establish limits on banking behaviour, require banks to incorporate affective and cognitive factors in their convenience tests and detect new variables that can help them improve their insolvency ratios and reputations.Financial decisions are not rational and can be biased by affective and cognitive factors. Behavioural finance has focused very little on analysing how consumer biases influence relationships with banking institutions. Additionally, these relationships are affected by the digitalization and transformation of banking business. Thus, in the case of economically vulnerable consumers, who are not profitable for the increasingly competitive banking industry and lack financial abilities, their risk of financial exclusion is increasing. The aim of this paper is to explore the affective and cognitive factors that condition banking relationships for economically vulnerable consumers and how these factors contribute to increasing financial difficulties and exclusion. This research, performed on a set of focus groups, bases its findings on a combination of experimental and discourse analysis methods. The results show that distrust and shame lead to financial difficulties in economically vulnerable consumers. Distrust generates problems of access and self-exclusion, while shame generates difficulties of use. This lack of trust makes them more rational when dealing with machines than with people, showing greater banking difficulties for consumers with a “person-suspicious” profile. This finding can help regulators establish limits on banking behaviour, require banks to incorporate affective and cognitive factors in their convenience tests and detect new variables that can help them improve their insolvency ratios and reputations.UCEIF Foundatio

High medium-term incidence of major cardiovascular events in discharged patients with unstable angina

The introduction of high-sensitivity troponin (hsTn) assays has reduced the diagnosis of unstable angina (UA) in favor of non-ST elevation myocardial infarction (NSTEMI) in the context of non-ST elevation acute coronary syndrome (NSTEACS). It is unclear whether the detection of these hsTn levels affects the prognosis and therefore whether a different therapeutic approach is warranted. This study aims to determine whether using hsTn results in medium-term prognostic differences in patients with UA and NSTEMI. Methods: This multicenter, prospective registry study included consecutive patients who underwent hsTn assays and were discharged with a diagnosis of NSTEACS. Patients were followed for two years. Outcomes were the occurrence of major adverse cardiovascular events (MACE: cardiovascular death, non-fatal myocardial infarction, and non-fatal ischemic stroke), major bleeding, and all-cause mortality. Results: Patients with UA and NSTEMI did not show differences in terms of the invasive interventions received, the coronary artery disease diagnosed, the type of revascularization performed, or the proportion presenting MACE (UA 18.1% vs. NSTEMI 18.9%; p = 0.79). However, patients with NSTEMI had higher cardiovascular mortality at two years (UA 4% vs. NSTEMI 9.2%; p = 0.012), as well as, all-cause mortality (UA vs. 7.9% vs. NSTEMI 16.4%; p = 0.002). Conclusions: Medium-term incidence of MACE was similar in patients with UA and NSTEMI, but cardiovascular and all-cause mortality in NSTEMI patients was over twice that of patients with UA

Conservatively managed patients with non-ST-segment elevation acute coronary syndrome are undertreated with indicated medicines.

Introduction and aimsPatients with non-ST-elevation acute coronary syndrome (NSTE-ACS) are often managed conservatively. Clinical practice guidelines recommend treating these patients with the same pharmacological drugs as those who receive invasive treatment. We analyze the use of new antiplatelet drugs (NADs) and other recommended treatments in people discharged following an NSTE-ACS according to the treatment strategy used, comparing the medium-term prognosis between groups.MethodsProspective observational multicenter registry study in 1717 patients discharged from hospital following an ACS; 1143 patients had experienced an NSTE-ACS. We analyzed groups receiving the following treatment: No cardiac catheterization (NO CATH): n = 134; 11.7%; Cardiac catheterization without revascularization (CATH-NO REVASC): n = 256; 22.4%; percutaneous coronary intervention (PCI): n = 629; 55.0%; and coronary artery bypass graft (CABG): n = 124; 10.8%. We assessed major adverse cardiovascular events (MACE), all-cause mortality, and hemorrhagic complications at one year.ResultsNO CATH was the oldest, had the most comorbidities, and was at the highest risk for ischemic and hemorrhagic events. Few patients who were not revascularized with PCI received NADs (NO CATH: 3.7%; CATH-NO REVASC: 10.6%; PCI: 43.2%; CABG: 3.2%; pConclusionsDespite current invasive management of NSTE-ACS, patients not receiving catheterization are at very high risk for under treatment with recommended drugs, including NADs. Their medium-term prognosis is poor, with high mortality. Patients treated with PCI receive better pharmacological management, with high use of NADs