General instructional aim: After finishing this module, the students will be able to implement human holistically approach,

based on biological, psychological, social and cultural aspects to solve medical and health problems with concerning suffer human environment factors even the others and the environments community and also the house environment.

CHAPTER 1 First Tutorial Brain Storming

1.1 Scenario Lita, 20 years old, 2nd semester student of private university, the oldest child of seven brothers had stayed in a hut at a concise village in Surabaya close to the campus for last three months. Since stayed in this hut, Lita often complained about dizziness and dyspnea when she woke up in the morning. Ani had never told the same complain.

1.2 Main Problem

1.3 Keywords Dizziness

Dyspnea Biological aspects Psychological aspects Socio-cultural aspects Environment factors

1.4 Early Hypothesis Litas dizziness and dyspnea are caused by biological aspects, psychological aspects, socio-cultural aspects and environment.

Biological Aspects Biological Aspects

Psychological Aspects

1.5 Mind Mapping

Early Litas Envionment

Early Anis Environment

Psychological Aspects Socio-cultural Aspects

Socio-cultural Aspects Biological Aspects

New Environment
Psychological Aspects

Early Litas Envionment

Early Anis Environment

Socio-cultural Aspects

Socio-cultural Aspects

Adaptatio n

Ani

Lita

SUCCESS

UNSUCCESS

UNHEALTHY

1.6 Learning Issues What is air pollution? What symptom does the air pollution cause? What does an allergy mean? Is overcrowding a stressor that can induce stress? And what significance does the answer hold for explaining Anis and Litas condition? What is adaptation?

CHAPTER 2

Second Tutorial

2.1. The Answer 2.1.1. Is overcrowding a stressor that can induce stress? And what significance does the answer hold for explaining Anis and Litas condition? Yes, it is. Examples of physical stressors include bodily injury, physical exertion, noise, overcrowding, and excessive heat or cold. Psychological stressors include challenges such as time-pressured tasks, speech tasks, mental arithmetic, interpersonal conflict, overcrowding, isolation, and traumatic life events (Cohen, Lee M. et al, 2003). Lita and Ani come from a different background of environment, thus their adaptation to the new environment will differ. Ani, who has been in city in during his livelihood, adapt much more quickly than Lita, who has never been in city before. Consequently, overcrowding in Anis and Litas current urban environment becomes a stressor for Lita, whereas it is not a stressor for Ani. So to speak, Lita becomes stressed because of her overcrowded new environment, while Lita doesnt experience any stress caused by this overcrowding.

Reference: [Cohen, Lee M., et al. The Health Psychology Handbook: Practical Issues for the Behavioral Medicine Specialist. 2003. United States of America: Sage Publications, Inc. Cara penelusuran: Google Search, with advanced search; no display pages from .com domain; keyword: overcrowding stress; cited on: December 5, 2007]

2.1.2. What is air pollution? Air pollution is a mixture of solid particles and gases in the air. Car emissions, chemicals from factories, dust, pollen and mold spores may be suspended as particles. Ozone, a gas, is a major part of air pollution in cities. When ozone forms air pollution, it's also called smog. Some air pollutants are poisonous. Inhaling them can increase the chance you'll have health problems. People with heart or lung disease, older adults and children are at greater risk from air pollution. Air pollution isn't just outside the air inside buildings can also be polluted and affect your health. http://www.nlm.nih.gov/medlineplus/airpollution.html Date last updated: 14 November 2007 Topic last reviewed: 14 November 2007 Medline plus,2007 Judul Air Pollution

2.1.3. What symptom does the air pollution cause? Air pollution cause people get mysterious headaches that only occur on weekends or sometimes just in the morning. Beside that people may have respiratory problems and allergy like symptoms that may provoke asthma attacks Air pollution can irritate the eyes, throat and lungs. Burning eyes, cough and chest tightness are common with exposure to high levels of air pollution. Indoor air pollution can affect you at home, work, or even places you visit. It is a common source of respiratory diseases, including asthma, allergies, and lung cancer. It can be worse in winter, when windows are shut tight and less fresh air can circulate. Different people can react very differently to air pollution. Some people may notice chest tightness or cough, while others may not notice any effects. Because exercise requires faster, deeper breathing, it may increase the symptoms. People with heart disease, such as

angina (chest pain), or with lung disease, such as asthma or emphysema, may be very sensitive to air pollution exposure, and may notice symptoms when others do not. Symptoms depend on the environmental cause of the illness or disease. Common symptoms include headaches, cough, fatigue, and nausea. In some cases, you may not have any symptoms for years, until a disease progresses far enough for you to notice signs of it. In other instances, exposure may cause immediate allergic reactions, such as when contact with dust mites, cockroaches, pollen, or pets triggers an asthma attack. Or symptoms may emerge more gradually and become worse as the time of exposure lengthens. For some people, going to work in a building with poor indoor air quality may cause headaches, coughs, dizziness, fatigue, and nausea. The building may be improperly ventilated, causing exposure to fumes from cleaning solvents or cigarette smoke. Or it may have bacteria, molds, or viruses that have accumulated in heating and cooling ducts, carpet, ceiling tiles, or insulation that can cause fever, chills, muscle aches, cough, and other respiratory symptoms. Outdoor Air Pollution: Possible Health Effects The University of Arizona ,2007 http://allergy.peds.arizona.edu/southwest/airpollution.html

2.1.4. What does an allergy mean? An allergy refers to an exaggerated reaction by our immune system in response to bodily contact with certain foreign substances. It is exaggerated because these foreign substances are usually seen by the body as harmless and no response occurs in non- allergic people. Allergic people's bodies recognize the foreign substance and one part of the immune system is turned on. Allergy-producing substances are called "allergens." Examples of allergens include pollens, dust mite, molds, danders, and foods. To understand the language

of allergy it is important to remember that allergens are substances that are foreign to the body and can cause an allergic reaction in certain people. Nasal Allergy Medications Skin Test for Allergy Allergies - on WebMD http://www.medicinenet.com/allergy/article.htm WebMD,2007 26 juni 2007 2.1.5. What is adaptation?