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Objective: To investigate racial/ethnic differences in teachers' and other adults' identification and/or encouragement of parents to seek treatment for psychiatric problems in their children and to evaluate if and whether identification/encouragement is associated with service use. Method: Data on identification/encouragement to seek treatment for externalizing disorders (i.e., attention-deficit/hyperactivity disorder, oppositional-defiant disorder, and/or conduct disorder) and internalizing disorders (i.e., major depressive episode/dysthymia and/or separation anxiety disorder) and services used were obtained for 6,112 adolescents (13-17 years of age) in the National Comorbidity Survey Adolescent Supplement. Racial/ethnic differences were examined for Latinos, non-Latino blacks, and non-Latino whites. Results: There were few racial/ethnic differences in rates of youth identification/encouragement and how identification/encouragement related to service use. Only non-Latino black youth with low severity internalizing disorders were less likely to be identified/encouraged to seek services compared with non-Latino white youth with the same characteristics (odds ratio [OR] = 0.4, 95% confidence interval [CI] = [0.2-0.7]). Identification/encouragement increased the likelihood of seeking services for externalizing and internalizing disorders for all youth. However, compared with their non-Latino white counterparts, non-Latino black youth who met criteria for internalizing disorders appeared less likely to have used any services (OR = 0.4, 95%, CI = 0.2-0.7), after adjusting for identification/encouragement, clinical, and sociodemographic characteristics. Non-Latino black youth with internalizing disorders and without identification/encouragement were less likely to use the specialty care sector than their non-Latino white counterparts. Conclusions: In this study of a nationally representative sample of adolescents, almost no ethnic/racial differences in identification/encouragement were found. However, identification/encouragement may increase service use for all youth. (Contains 6 tables.)

Objectives. We examined potential pathways by which time in the United States may relate to differences in the predicted probability of past-year psychiatric disorder among Latino immigrants as compared with US-born Latinos. Methods. We estimated predicted probabilities of psychiatric disorder for US-born and immigrant groups with varying time in the United States, adjusting for different combinations of covariates. We examined 6 pathways by which time in the United States could be associated with psychiatric disorders. Results. Increased time in the United States is associated with higher risk of psychiatric disorders among Latino immigrants. After adjustment for covariates, differences in psychiatric disorder rates between US-born and immigrant Latinos disappear. Discrimination and family cultural conflict appear to play a significant role in the association between time in the United States and the likelihood of developing psychiatric disorders. Conclusions. Increased perceived discrimination and family cultural conflict are pathways by which acculturation might relate to deterioration of mental health for immigrants. Future studies assessing how these implicit pathways evolve as contact with US culture increases may help to identify strategies for ensuring maintenance of mental health for Latino immigrants. (Am J Public Health. 2009;99:2247-2254. doi: 10.2105/AJPH.2008.137091)

This article presents analyses of a representative sample of U.S. Latinos (N = 2,540) to investigate whether family cohesion moderates the effects of cultural conflict on psychological distress. The results for the aggregated Latino group suggest a significant association between family cohesion and lower psychological distress, and the combination of strong family cohesion with presence of family cultural conflict is associated with higher psychological distress. However, this association differs by Latino groups. In this study, no association for Puerto Ricans is seen; Cuban results are similar to the aggregate group, family cultural conflict in Mexicans is associated with higher psychological distress whereas family cohesion in other Latinos is associated with higher psychological distress. Implications of these findings are discussed to unravel the differences in family dynamics across Latino subethnic groups. Keywords: family cohesion; family conflict; psychological distress; Latino ethnic groups

Motivated by the need to meaningfully implement the Institute of Medicine's (IOM's) definition of health care disparity, this paper proposes statistical frameworks that lay out explicitly the needed causal assumptions for defining disparity measures. Our key emphasis is that a scientifically defensible disparity measure must take into account the direction of the causal relationship between allowable covariates that are not considered to be contributors to disparity and non-allowable covariates that are considered to be contributors to disparity, to avoid flawed disparity measures based on implausible populations that are not relevant for clinical or policy decisions. However, these causal relationships are usually unknown and undetectable from observed data. Consequently, we must make strong causal assumptions in order to proceed. Two frameworks are proposed in this paper, one is the conditional disparity framework under the assumption that allowable covariates impact non-allowable covariates but not vice versa. The other is the marginal disparity framework under the assumption that non-allowable covariates impact allowable ones but not vice versa. We establish theoretical conditions under which the two disparity measures are the same and present a theoretical example showing that the difference between the two disparity measures can be arbitrarily large. Using data from the Collaborative Psychiatric Epidemiology Survey, we also provide an example where the conditional disparity is misled by Simpson's paradox, whereas the marginal disparity approach handles it correctly., Statistics

This Letter describes how gold pyramidal nanoshells (nanopyramids) can be assembled into low- and high-order structures by varying the rate of solvent evaporation and surface wettability. Single-particle and individual-cluster dark field scattering spectra on isolated, dimers and trimers of nanopyramids were compared. We found that the short wavelength resonances blue-shifted as the particles assembled; the magnitude of this shift was greater for high-order structures. To test which assembled architecture supported a larger Raman-active volume, we compared their surface enhanced Raman scattering (SERS) response of the resonant Raman molecule methylene blue (λ(ex) = 633 nm). We discovered that high-order structures exhibited more Raman scattering compared to low-order assemblies. Finite-difference time-domain modeling of nanopyramid assemblies revealed that the highest electromagnetic field intensities were localized between adjacent particle faces, a result that was consistent with the SERS observations. Thus, the local spatial arrangement of the same number of nanoparticles in assembled clusters is an important design parameter for optimizing nanoparticle-based SERS sensors.