Why Do Women Reject Bisphosphonates for Osteoporosis? A Videographic Study

Despite access to effective, safe, and affordable treatment for osteoporosis, at-risk women may choose not to start bisphosphonate therapy. Understanding the reasons women give for rejecting a clinician's offer of treatment during consultations and how clinician's react to these reasons may help clinicians develop more effective strategies for fracture prevention and medication adherence.We conducted a videographic evaluation of encounters in the Osteoporosis Choice randomized trial of a decision aid about bisphosphonates vs. usual primary care. Eligible videos involved consultations with women with an estimated 10-year fragility fracture risk >20% who verbalized at least one reason to not take bisphosphonates. Two reviewers independently reviewed eligible videos and verbatim transcripts, classifying patient views about bisphosphonate use, clinicians response to those views, and patient adherence at 6 months post visit.Eighteen video recordings (12 with decision aid) were eligible for analyses. We identified 37 reasons for and against bisphosphonate therapy. Eleven patients rejected treatment, offering 9 (average of 2 per patient) unique reasons against initiating bisphosphonates (most common: side effects 39% and distrust of medications in general 33%). When physicians conceded to patient views the outcome was no bisphosphonate use. Adherence to choices at 6 months was 100%.The expression of patient preferences is sometimes unfavorable to bisphosphonates treatment even among well-informed patients at high risk for osteoporotic fractures. At 6 months, patients who expressed concerns about these medicines behaved consistently with the decision made during the visit

Properties of submillimeter galaxies in the CANDELS GOODS-south field

We derive physical properties of 10 submillimeter galaxies located in the CANDELS coverage of the GOODS-S field. The galaxies were first identified as submillimeter sources with the LABOCA bolometer and subsequently targeted for 870 m continuum observation with ALMA. The high angular resolution of the ALMA imaging allows secure counterparts to be identified in the CANDELS multiband data set. The CANDELS data provide deep photometric data from UV through near-infrared wavelengths. Using synthetic spectral energy distributions, we derive photometric redshifts, stellar masses, extinction, ages, and the star formation history. The redshift range is z = 1.65-4.76, with two of the galaxies located at z > 4. Two submillimeter galaxy (SMG) counterparts have stellar masses 2-3 orders of magnitude lower than the rest. The remaining SMG counterparts have stellar masses around 1 x 1011 M. The stellar population in the SMGs is typically older than the expected duration of the submillimeter phase, suggesting that the star formation history of SMGs is more complex than a single burst. Non-parametric morphology indices suggest that the SMG counterparts are among the most asymmetric systems compared with galaxies of the same stellar mass and redshift. The Hubble Space Telescope images show that three of the SMGs are associated with ongoing mergers. The remaining counterparts are isolated. Estimating the dust and molecular gas mass from the submillimeter fluxes, and comparing with our stellar masses shows that the gas mass fraction of SMGs is ~28% and that the final stellar mass is likely to be ~(1 - 2) x 1011 M.IS

CANDELS: The Cosmic Assembly Near-infrared Deep Extragalactic Legacy Survey - The Hubble Space Telescope Observations, Imaging Data Products and Mosaics

This paper describes the Hubble Space Telescope imaging data products and data reduction procedures for the Cosmic Assembly Near-IR Deep Extragalactic Legacy Survey (CANDELS). This survey is designed to document the evolution of galaxies and black holes at $z\sim1.5-8$, and to study Type Ia SNe beyond $z>1.5$. Five premier multi-wavelength sky regions are selected, each with extensive multiwavelength observations. The primary CANDELS data consist of imaging obtained in the Wide Field Camera 3 / infrared channel (WFC3/IR) and UVIS channel, along with the Advanced Camera for Surveys (ACS). The CANDELS/Deep survey covers \sim125 square arcminutes within GOODS-N and GOODS-S, while the remainder consists of the CANDELS/Wide survey, achieving a total of \sim800 square arcminutes across GOODS and three additional fields (EGS, COSMOS, and UDS). We summarize the observational aspects of the survey as motivated by the scientific goals and present a detailed description of the data reduction procedures and products from the survey. Our data reduction methods utilize the most up to date calibration files and image combination procedures. We have paid special attention to correcting a range of instrumental effects, including CTE degradation for ACS, removal of electronic bias-striping present in ACS data after SM4, and persistence effects and other artifacts in WFC3/IR. For each field, we release mosaics for individual epochs and eventual mosaics containing data from all epochs combined, to facilitate photometric variability studies and the deepest possible photometry. A more detailed overview of the science goals and observational design of the survey are presented in a companion paper.Comment: 39 pages, 25 figure

CANDELS: The Cosmic Assembly Near-infrared Deep Extragalactic Legacy Survey

The Cosmic Assembly Near-infrared Deep Extragalactic Legacy Survey (CANDELS) is designed to document the first third of galactic evolution, over the approximate redshift (z) range 8--1.5. It will image >250,000 distant galaxies using three separate cameras on the Hubble Space Telescope, from the mid-ultraviolet to the near-infrared, and will find and measure Type Ia supernovae at z>1.5 to test their accuracy as standardizable candles for cosmology. Five premier multi-wavelength sky regions are selected, each with extensive ancillary data. The use of five widely separated fields mitigates cosmic variance and yields statistically robust and complete samples of galaxies down to a stellar mass of 10^9 M_\odot to z \approx 2, reaching the knee of the ultraviolet luminosity function (UVLF) of galaxies to z \approx 8. The survey covers approximately 800 arcmin^2 and is divided into two parts. The CANDELS/Deep survey (5\sigma\ point-source limit H=27.7 mag) covers \sim 125 arcmin^2 within GOODS-N and GOODS-S. The CANDELS/Wide survey includes GOODS and three additional fields (EGS, COSMOS, and UDS) and covers the full area to a 5\sigma\ point-source limit of H \gtrsim 27.0 mag. Together with the Hubble Ultra Deep Fields, the strategy creates a three-tiered "wedding cake" approach that has proven efficient for extragalactic surveys. Data from the survey are nonproprietary and are useful for a wide variety of science investigations. In this paper, we describe the basic motivations for the survey, the CANDELS team science goals and the resulting observational requirements, the field selection and geometry, and the observing design. The Hubble data processing and products are described in a companion paper.Comment: Submitted to Astrophysical Journal Supplement Series; Revised version, subsequent to referee repor

Frequency of patient verbalizations for and against bisphosphonate treatment as well as physician response style in relation to acceptance or rejection of treatment.

<p>Frequency of patient verbalizations for and against bisphosphonate treatment as well as physician response style in relation to acceptance or rejection of treatment.</p

Reasons to take or not take bisphosphonates.

<p>Most women gave multiple reasons for and against bisphosphonate therapy. This figure represents the overlap of multiple reasons presented during a single visit for patients who A) accepted treatment and B) rejected therapy.</p

Clinician and patient characteristics.

<p>Clinician and patient characteristics.</p