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Advisory Committee on Immunization Practices and the American Academy of Family Physicians generic 75 mg imipramine mastercard anxiety killing me. January 2007 A-71 International Association Infectious Diseases of Fire Fighters Appendices U cheap imipramine 25 mg fast delivery anxiety symptoms to get xanax. Similarly, rodents and snails are also potential reservoirs for a number of diseases besides their contribution economic to losses. These vector borne diseases, however, could have through the application of environmental modification methods. This lecture note contains 13 chapters where the general feature, life cycle, medical importance and appropriate prevention and control strategies are touched with some practical examples and review questions. In been prevented or controlled through the application of vector control methods, particularly other words, it will guide the reader to the subject matter of vector and rodent control by presenting general information first and then specific diseases transmitted by the vector and its control methods. A lecture note on vector and rodents control was prepared in 2002 by Ato Solomon Tassew for Diploma environmental health students by collecting the necessary information relevant to the course from existing books, journals, and lecture materials. Now by putting similar effort that material is reorganized and updated with the aim of making it a sufficient reference material for degree Environmental health science students. Comments of different instructors from department of Environmental health, Faculty of health sciences, Haramaya University were also incorporated which brought the material to its present status. Generally, Environmental health professionals have the responsibility to plan and apply appropriate vector control programs at community level to prevent diseases transmitted by arthropods, rodents and snails through organized community participation. It is based on the previous lecture note that this material with wider content is made. We are also grateful to all Carter Center-Ethiopia staffs, to staffs of Haramaya University, Faculty of health science especially Ato Tesfayie Gobena and Andualem Sitotaw who reviewed the material with great courage. We also extend our appreciations to Ato Yohannes Tesfaye (Defence unvesity college), Ato Ahmed Mohammed (Jimma University), Ato Tesfaye Tilaye (Gondar University) and Ato Alemayehu Woldecherkos ( Hawassa University) who have critically reviewed and contributed a lot to bring this lecture note in to this stage.

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A con- Percentages of decline across ethnic groups were sensus among researchers is not apparent generic 50 mg imipramine amex anxiety treatment, but ethnicity roughly similar with two major exceptions: (a) the rate (and gender) continue to be used as if they are poten- of suicide for American Indians/Alaskan Natives actually tial causes in a wide range of health outcomes generic imipramine 50mg without prescription anxiety symptoms electric shock. But reli- argue that ethnicity and race are simply sociopolitical gious preference would still be a substitute variable concepts that have little, if any, basis in scientific real- since many Hispanics may express a Catholic religious ity. Knowledge about gious doctrine or prior experiences with birth control or such factors might contribute to more effective diagno- the lack of experience with birth control methods. Still others argue that even if Measures of these might well show much better ability group genetic differences do matter, cultural and social to predict birth control use than simply having the sta- differences between ethnic groups contribute greatly to tus of Hispanic ethnicity. Commonly, nic groups may be predictors of average health status, that means measuring past behaviors or current atti- it is much more important to examine differences tudes or beliefs fairly directly rather than simply assess- within the ethnic group than to examine the differences ing ethnic group status. Additional problems with using mixed ethnicity or individuals who are not aware ethnicity to explain or predict health are substantial. Two major of great diversity within ethnic groups is compounded problems are apparent with this thinking. First, as pre- by researchers who homogenize so-called minority viously discussed, there is considerable variation among groups by comparing the responses of all minority eth- individuals within an ethnic group on almost all char- nic groups to whites, as if all members of all minority acteristics. Second, ethnicity usually serves as a substi- ethnic groups share something in common. Researchers often attempt to associated with the outcome is easier to defend scien- control for such differences using statistics, but seri- tifically. For example, if a researcher were studying use ous problems exist for interpreting such analyses that of birth control and determined that those who identi- equate groups using various covariates. Simply put, fied themselves as Hispanic were significantly less real differences in groups cannot be meaningfully elim- likely to use birth control pills, it would be scientifically inated using abstract mathematical corrections. A variable that might be closer to the outcome Recommendations for the application of several (here, use of a specific birth control method) might be guidelines for using ethnicity in research have been religious preference because Hispanics predominantly made by many authors: (a) make clear the assumptions 256 Exercise that are the basis for the use and assessment of ethnicity Suggested Reading in a particular context; (b) test specific hypotheses Alvidrez, J. Psychosocial treatment research about specific aspects of culture or other characteristics with ethnic minority populations: Ethical considerations in con- of ethnicity rather than using ethnicity as a substitute ducting clinical trials. The importance of race and ethnic background in bio- diversity within the group; (d) fully report in scientific medical research and clinical practice. Trends in racial likely to be found in naturally occurring groups; (f) use and ethnic-specific rates for the health status indicators: United several measures and several assessment methods, States, 19901998. The structuring of ethnic inequalities in health: where feasible, to be sure that the concept being mea- Economic position, racial discrimination, and racism.

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