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Objectives: To examine the size and composition of the privately held firearm stock in the US; and to describe demographic patterns of firearm ownership and motivations for ownership. Design, setting and participants: A nationally representative household telephone survey of 2770 adults aged ⩾18 years living in the US, conducted in the spring of 2004. Main outcome measure: Responses to questions regarding firearm ownership, the number and types of guns owned, and motivations for ownership. Results: 38% of households and 26% of individuals reported owning at least one firearm. This corresponds to 42 million US households with firearms, and 57 million adult gun owners. 64% of gun owners or 16% of American adults reported owning at least one handgun. Long guns represent 60% of the privately held gun stock. Almost half (48%) of all individual gun owners reported owning ⩾4 firearms. Men more often reported firearm ownership, with 45% stating that they personally owned at least one firearm, compared with 11% for women. Conclusions: The US population continues to contain at least one firearm for every adult, and ownership is becoming increasingly concentrated. Long guns are the most prevalent type of gun in the US but handgun ownership is widespread. Ownership demographic patterns support findings of previous studies.

Background Fibromyalgia is a debilitating condition, characterized by extensive muscular pain and fatigue. Vitamin D is essential for overall health, with ubiquitous involvement in various inflammatory and pain pathways. Little is known about its role in fibromyalgia. We performed a systematic literature review to determine if vitamin D contributes to the pathology and disability of patients with fibromyalgia, and to assess the role of vitamin D supplementation in disease management. Methods We searched Medline, EMBASE and the Cochrane Library for clinical studies and randomized controlled trials published in English during January 2000 to June 2017, using the terms vitamin D or hypovitaminosis D combined with fibromyalgia or FMS. References were reviewed manually and articles were only included if they were specific in their diagnosis of fibromyalgia and used appropriate control groups. Results Four hundred and sixty-six studies were retrieved, of which fourteen fulfilled the inclusion criteria. Six studies, of which two had the best quality evidence, found that patients with fibromyalgia have low levels of vitamin D compared to healthy controls. Conflicting results were obtained on the effect of vitamin D on pain or symptom control, with no clear consensus as to the role of supplementation in the management of fibromyalgia. Conclusions Our results highlight an association between vitamin D deficiency and fibromyalgia. However, its role in the pathophysiology of fibromyalgia and the clinical relevance of identifying and treating this requires further elucidation with appropriately controlled studies.

Calcareous encrusters stabilize and bind reef framework and contribute significantly to reef function and biodiversity. Their calcareous skeletons have good preservation potential which, together with well-constrained habitat preferences, makes them useful indicators of past environmental conditions. However, our knowledge of environmental tolerances and spatial distribution trends of encrusters remains limited. Here, we determine the distributional trends and environmental tolerances of calcareous encrusters and delineate the relevance of particular species/genera for palaeoecological reconstructions. Artificial microhabitats were created to mimic exposed, partially cryptic, and cryptic habitats in various orientations for periods of 1 and 2 yr. Calcareous encruster coverage was high, especially in cryptic habitats (95 %), and clear successional trends were observed over time. Total encruster carbonate production was intermediate (range 72.8–476.3 g m −2  yr −1 ). Encruster species and growth morphology exhibited a defined zonation in response to reef sub-environment, microhabitat, and environmental factors such as light and wave exposure. Linear regression identified three coralline algae genera, as well as Homotrema rubrum , Planorbulina spp., and cemented bivalves as those most likely to occur in particular habitats. Therefore, the presence of these species may be used with greater confidence in distinguishing palaeomicroenvironments.

In response to the high co-occurrence of anxiety symptoms in youth with autism spectrum disorder (ASD), several interventions have been developed for this population. In spite of promising findings, some youth with ASD respond only minimally to such interventions. To understand potential factors that may impact treatment response, the current study explores the role of parental anxiety in youth treatment outcome. Thirty-one youth with ASD, ages 7–18, and their parents participated in the study. Parents completed the State/Trait Anxiety Inventory pre- and post-treatment. Contrary to previous research, there was no correlation between parental anxiety and youth anxiety at baseline or post-treatment. However, parental trait anxiety significantly decreased from pre- to post-treatment for parents of treatment responders. The findings are consistent with previous research and suggest a youth-to-parent influence.

Objective: To explore whether recent declines in household firearm prevalence in the United States were associated with changes in rates of suicide for men, women, and children. Methods: This time series study compares changes in suicide rates to changes in household firearm prevalence, 1981–2002. Multivariate analyses adjust for age, unemployment, per capita alcohol consumption, and poverty. Regional fixed effects controlled for cross sectional, time invariant differences among the four census regions. Standard errors of parameter estimates are adjusted to account for serial autocorrelation of observations over time. Results: Over the 22 year study period household firearm ownership rates declined across all four regions. In multivariate analyses, each 10% decline in household firearm ownership was associated with significant declines in rates of firearm suicide, 4.2% (95% CI 2.3% to 6.1%) and overall suicide, 2.5% (95% CI 1.4% to 3.6%). Changes in non-firearm suicide were not associated with changes in firearm ownership. The magnitude of the association between changes in household firearm ownership and changes in rates of firearm and overall suicide was greatest for children: for each 10% decline in the percentage of households with firearms and children, the rate of firearm suicide among children 0–19 years of age dropped 8.3% (95% CI 6.1% to 10.5%) and the rate of overall suicide dropped 4.1% (2.3% to 5.9%). Conclusion: Changes in household firearm ownership over time are associated with significant changes in rates of suicide for men, women, and children. These findings suggest that reducing availability to firearms in the home may save lives, especially among youth.

Recent research on executive function (EF) deficits in autism has led investigators to conclude that EF deficits are secondary to the disorder. The current study has two major goals: (1) Examine whether specific EF deficits are present in the youngest autism group to date (mean = 22.9 years), and (2) examine whether such deficits are secondary to autism, or act as an early non-specific cognitive risk factor for autism by comparing EF abilities of this autism group to a CA-matched typically developing group. Results from Experiment 1 suggest no specific EF deficits in autism relative to MA-matched controls, while results from Experiment 2 are consistent with the hypothesis that EF deficits may emerge as a secondary deficit in autism. Alternative hypotheses are also considered.

The forms, functions, and complexity of nonverbal communication used by 14 young (ages 2-3) children with autism were investigated. Comparison with children with developmental delays and/or language impairments on a structured assessment found that autistic children directly manipulated the examiner's hand and requested more often but were less likely to comment, point, show objects, or use eye gaze to communicate. (Author/DB)

An increase in leucocyte apoptosis and impaired clearance of apoptotic cells has been observed in patients with systemic lupus erythematosus (SLE). Apoptotic cells are likely to be a key source of autoantigens in SLE as they express many of the nuclear autoantigens (in surface blebs and apoptotic bodies) that are relevant to this disease. The clearance of apoptotic cells is usually a rapid process, such that few cells are usually seen in the extracellular environment in vivo. We report a case in which multiple apoptotic bodies were observed in the bone marrow of a patient with SLE that was complicated by an immune-mediated pancytopenia. We have subsequently examined the frequency of apoptotic cells, identified morphologically, and by caspase-3 staining in bone-marrow trephine samples taken from patients with SLE over a 10-year period of follow-up. A high proportion of bone marrows contained apoptotic debris. The novel demonstration of apoptotic bodies in vivo in patients with SLE is unusual and supports the notion that the marrow may be a target organ in the disease. Their abundance is also consistent with the hypothesis that normal clearance mechanisms are defective and/or overwhelmed in SLE.

Objective—To determine the association between licensing and registration of firearm sales and an indicator of gun availability to criminals. Methods—Tracing data on all crime guns recovered in 25 cities in the United States were used to estimate the relationship between state gun law categories and the proportion of crime guns first sold by in-state gun dealers. Results—In cities located in states with both mandatory registration and licensing systems (five cities), a mean of 33.7% of crime guns were first sold by in-state gun dealers, compared with 72.7% in cities that had either registration or licensing but not both (seven cities), and 84.2% in cities without registration or licensing (13 cites). Little of the difference between cities with both licensing and registration and cities with neither licensing nor registration was explained by potential confounders. The share of the population near a city that resides in a neighboring state without licensing or registration laws was negatively associated with the outcome. Conclusion—States with registration and licensing systems appear to do a better job than other states of keeping guns initially sold within the state from being recovered in crimes. Proximity to states without these laws, however, may limit their impact.