XMM-Newton survey of the Local Group galaxy M 33

In an XMM-Newton raster observation of the bright Local Group spiral galaxy M 33 we study the population of X-ray sources (X-ray binaries, supernova remnants) down to a 0.2--4.5 keV luminosity of 10^35 erg/s -- more than a factor of 10 deeper than earlier ROSAT observations. EPIC hardness ratios and optical and radio information are used to distinguish between different source classes. The survey detects 408 sources in an area of 0.80 square degree. We correlate these newly detected sources with earlier M 33 X-ray catalogues and information from optical, infra-red and radio wavelengths. As M 33 sources we detect 21 supernova remnants (SNR) and 23 SNR candidates, 5 super-soft sources, and 2 X-ray binaries (XRBs). There are 267 sources classified as hard, which may either be XRBs or Crab-like SNRs in M 33 or background AGN. The 44 confirmed and candidate SNRs more than double the number of X-ray detected SNRs in M 33. 16 of these are proposed as SNR candidates from the X-ray data for the first time. On the other hand, there are several sources not connected to M 33: five foreground stars, 30 foreground star candidates, 12 active galactic nucleus candidates, one background galaxy and one background galaxy candidate. Extrapolating from deep field observations we would expect 175 to 210 background sources in this field. This indicates that about half of the sources detected are sources within M 33.Comment: 14 pages, 6 figures, accepted for publication in A&A, the images of Figs. 1,2,3,4,6 are available in jpg format, a full version of the paper is available at ftp://ftp.xray.mpe.mpg.de/people/fwh/docs/M33_AA0068.p

Effective communication and the osteoporosis care gap

Many pharmacological treatments are now available to prevent the occurrence of fragility fractures in patients with osteoporosis. Despite this there are persisting concerns that many individuals who might benefit from osteoporosis treatment do not receive it – the so called “osteoporosis treatment gap”. The underlying reasons for this gap are diverse and include those who are not identified as being eligible for treatment as well as those who intentionally choose not to take medications because of uncertainty, unanswered questions or inability to understand or do what is being asked of them. In this perspective article we highlight the importance of providing information on the causes and consequences of osteoporosis during encounters when treatment is being discussed as well as what osteoporosis treatment can achieve and what it cannot. We also review the importance of communicating the benefits and risks of treatment in absolute terms so that patients can understand what taking treatment will mean for them and discuss the utility of decision aids to assist in these conversations. We suggest it is not the treatment gap which is the problem but the care gap. This language acknowledges the importance of healthcare providers identifying those likely to benefit from treatment and increasing the quality of clinical conversations to promote patient engagement and involvement, while respecting that treatment is not suitable or wanted by all