A12-year-old girl presents with complaints of intermittent pain and stiffness involving her hands. this pain has been progressively worsening over the past 3 years. she relates that for the past 2 months she has been feeling increasingly tired and has experienced swelling and stiffness of her hands, which appears worse in the morning and is relieved as the day progresses. the physical examination shows she has a low-grade fever. there are multiple symmetrical joint swelling of the proximal interphalangeal and metacarpophalangeal joints with associated warmth, tenderness, and effusion. initial laboratory findings include a cbc that reveals mild anemia, an elevated erythrocyte sedimentation rate, a positive rheumatoid factor, and a negative antinuclear antibody (ana) test. x-rays of the hands and wrists show soft tissue swelling and periarticular osteopenia. what is your diagnosis?

low context culture   (lc.):

association:    

relationships begin and end quickly. many people can be inside one's circle; circle's boundary is not clear.

things get done by following procedures and paying attention to the goal.

one's identity is rooted in oneself and one's accomplishments.

social structure is decentralized; responsibility goes further down (is not concentrated at the top).

interaction:

low use of nonverbal elements. message is carried more by words than by nonverbal means.

verbal message is explicit. context is less important than words.

verbal message is direct; one spells things out exactly.

communication is seen as a way of exchanging information, ideas, and opinions.  

disagreement is depersonalized. one withdraws from conflict with another and gets on with the task. focus is on rational solutions, not personal ones. one can be explicit about another's bothersome behavior.

territoriality:

space is compartmentalized and privately owned; privacy is important, so people are farther apart.

temporality:

things are scheduled to be done at particular times, one thing at a time. what is important is that activity is done efficiently.

change is fast. one can make change and see immediate results.

time is a commodity to be spent or saved. one’s time is one’s own.

learning:

reality is fragmented and compartmentalized. one source of information is used to develop knowledge. thinking is inductive, proceeds from specific to general. focus is on detail.

learning occurs by following explicit directions and explanations of others.

an individual orientation is preferred for learning and problem solving.

speed is valued. how efficiently something is learned is important.

hope that                                         : )

you can get herpes by biting ur nails

explanation: