They isolate themselves from the host countrys environment, which they come to perceive as hostile, withdraw into an (often mental) "ghetto" and see return to their own culture as the only way out. This group is sometimes known as "Rejectors" and describes approximately 60% of expatriates. These "Rejectors" also have the greatest problems re-integrating back home after return. Some people integrate fully and take on all parts of the host culture while losing their original identity. This is called cultural assimilation. They normally remain in the host country forever. This group is sometimes known as "Adopters" and describes approximately 10% of immigrants. Some people manage to adapt to the aspects of the host culture they see as positive, while keeping some of their own and creating their unique blend. They have no major problems returning home or relocating elsewhere. This group can be thought to be cosmopolitan. Approximately 30% of immigrants belong to this group.Culture shock has many different effects, time spans, and degrees of severity. Many people are hampered by its presence and do not recognize why they are bothered.There is evidence to suggest that the psychological influence of culture shock might also have physiological implications. For example, the psycho-social stress experienced during these circumstances is correlated with an early onset of puberty. Transition shock
Culture shock is a subcategory of a more universal construct called transition shock. Transition shock is a state of loss and disorientation predicated by a change in ones familiar environment that requires adjustment.
Large granular lymphocytic (LGL) leukemia is a chronic lymphoproliferative disorder that exhibits an unexplained, chronic (> 6 months) elevation in large granular lymphocytes (LGLs) in the peripheral blood.It is divided in two main categories: T-cell LGL leukemia (T-LGLL) and natural-killer (NK)-cell LGL leukemia (NK-LGLL). As the name suggests, T-cell large granular lymphocyte leukemia is characterized by involvement of cytotoxic-T cells).In a study based in the US, the average age of diagnosis was 66.5 years whereas in a French study the median age at diagnosis was 59 years (with an age range of 12–87 years old). In the French study, only 26% of patients were younger than 50 years which suggests that this disorder is associated with older age at diagnosis. Due to lack of presenting symptoms, the disorder is likely to be underdiagnosed in the general population. Signs and symptoms
This disease is known for an indolent clinical course and incidental discovery. The most common physical finding is moderate splenomegaly. B symptoms are seen in a third of cases, and recurrent infections due to anaemia and/or neutropenia are seen in almost half of cases.Rheumatoid arthritis is commonly observed in people with T-LGLL, leading to a clinical presentation similar to Feltys syndrome. Signs and symptoms of anemia are commonly found, due to the association between T-LGLL and erythroid hypoplasia. Sites of involvement
The leukemic cells of T-LGLL can be found in peripheral blood, bone marrow, spleen, and liver. Nodal involvement is rare.