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Crohn's disease is a chronic condition causing inflammation of the lining of the digestive system. Individuals suffering from this illness encounter various challenges and problems, but studies investigating the illness experiences of patients with Crohn's disease in East Asian countries are scarce. The objective of this study was to explore the illness experiences of patients with Crohn's disease in China and construct an interpretive understanding of these experiences from the perspective of the patients. A constructivist grounded theory approach was used to develop a theoretical understanding of illness experiences. This study included participants from the following four provincial capital cities in China: Hangzhou, Nanjing, Guangzhou, and Wuhan. Purposive sampling and theoretical sampling were used to select Chinese patients living with Crohn's disease. Between February 2015 and January 2018, audio-recorded interviews were conducted. The data analysis included initial coding, focused coding, and theoretical coding using the constant comparative method and memo writing. Thirty-one participants were included in the study. "Regaining normality" was identified as the core category. The following four categories were conceptualized: comparing, struggling, reflecting, and realizing. Comparing refers to distinguishing the similarities and differences or evaluating the superiority and inferiority of similar things. Comparisons could occur between patients with Crohn's disease and healthy individuals or between patients and people in similar or more unfortunate situations. Struggling reflects the dilemmas experienced by patients with Crohn's disease in acknowledging their patient identity and informing others of this identity. Reflecting refers to the consideration of the values and life attitudes held by patients before and after the diagnosis of Crohn's disease. Realizing involves patients gaining a deeper understanding of the suffering associated with Crohn's disease after experiencing the illness. This study offers an interpretive understanding of the illness experiences of patients with Crohn's disease. Regaining normality represents the basic social psychological process. Regaining normality is related to reassessing and reconstructing the self after receiving a Crohn's disease diagnosis. This paper provides new insight into patients' lives and describes the strategies patients use to cope with the challenges and problems caused by the illness. These study findings can be used to develop future complex interventions and studies. [ABSTRACT FROM AUTHOR]

Background Despite the fact that there are more and more Chinese nurses living and working in Australia, relatively little is known about the decisions to emigrate made by these nurses. Objectives To explore factors influencing China-educated nurses to emigrate to Australia. Design This was a secondary analysis of 46 semi-structured interviews with 28 China-educated nurses working in Australia. Conventional content analysis was used, and the results are presented thematically. Results The nurses emigrated for a wide variety of reasons: (a) personal factors (to improve English, to see more of the world and cultures, to seek novelty and adventure); (b) work-related factors (better work environment and more career choices); (c) social factors (better living environment and lifestyle); (d) cultural factors (positive perceptions in China of those who emigrate or have overseas experiences), and (e) economic factors (higher salaries and greater purchasing power). Conclusions Confirming findings from similar studies, China-educated nurses’ decisions to migrate are complex and not based solely on economic expectations. Personal and cultural factors play vital roles in nurses’ migration decisions. [ABSTRACT FROM AUTHOR]

Background: Automated hematology analyzers are used to perform cell counts in body fluids. However, little is known about how the results compare between different analyzers. Methods: A single batch of serous fluid samples was used to evaluate the cell counting performance of 3 hematology analyzers: CD 3700, XE 2100, and LH 750. Two hundred and seventy four serous fluid samples were used to evaluate the accuracy of the analyzers and to compare the results between different analyzers. Results: The precision and linearity of the 3 analyzers were acceptable for both white blood cell counts and red blood cell counts with a low carryover rate. The limits of detection for white blood cells with the CD 3700, XE 2100, and LH 750 analyzers were 0.033×109/l, 0.07×109/l, and 0.20×109/l, respectively. Performing background counts had no influence on cell counts for any of the analyzers. For those samples over the limit of detection, there was agreement between the automated and manual counting methods. There were also reasonably comparable cell count results between the 3 analyzers. Conclusions: When the serous fluid cell counts are over the limit of detection, the analyzers produce accurate test results. Additionally, the results are comparable between the 3 hematology analyzers. [ABSTRACT FROM AUTHOR]

Abstract: Background: The migration of registered nurses as a response to a global nurse shortage has seen a growth in research interest in this area. Much of the research focuses on differences in language and culture which are posed as the attributes of the immigrant nurse. Objectives: In reporting on an analysis of data drawn from China-educated nurses working in the Australian health care system, this paper explores the social construction of difference and the related intersection of difference and racialisation. Design: A symbolic interactionist approach informed 46 in-depth interviews with 28 China-educated nurses. The method of analysis was initial and focused coding and constant comparison of data. The focus of interpretation was on human action and interaction as contextual and thus structural factors were critical to the analysis. Results: Two levels of meaning were depicted in this study: difference as “you are you and I am I” and difference as “incompetence”. Negative meanings were ascribed to difference which in turn legitimised inequality and held the potential to perpetuate racism. Conclusions: We argue that it is problematic to conceptualise difference as individual attributes. Difference needs to be contextualised and thus explored as a complex and socially constructed concept that in its application has social and political implications for immigrant nurses in Australia and elsewhere. [Copyright &y& Elsevier]

Coal gangue is the main solid waste produced in coal mining, and the resource utilization of coal gangue has become a popular topic in the industry. It is gradually applied that coal gangue concrete (CGC) prepared by replacing crushed stone with coal gangue in a certain proportion. Further, adding fly ash (FA) to CGC improves not only the performance of CGC, but also the resource utilization rate of coal-based solid waste, and this helps meet low carbon and environmental protection requirements. The effect of FA on the macro performance of CGCs has been investigated extensively; however, only few studies have examined microinterface structure changes, interface transition zone (ITZ) characteristics, and mortar microcharacteristics, which are closely related to the macro performance of concrete. Therefore, exploring the effect of FA on the microstructure performance of CGC has great scientific value and engineering significance. In this study, concrete with a 40% replacement rate of coal gangue, which is widely used in engineering practice, is considered the research object. The effect of 0%, 10%, 20%, 30%, and 40% FA on ITZ thickness, mortar pore structure, and micromorphology of CGC aggregates and the relationship between the microstructure parameters and mechanical properties of concrete are analyzed using microhardness tests, mercury intrusion porosimetry, and scanning electron microscopy. The research results indicate that, (1) with an increase in FA content, the decreasing range of the ITZ thickness of gangue concrete first increases and then decreases, and the total porosity of the mortar area increases, but the proportion of serious damage pores decreases; (2) the thickness of the coal gangue ITZ is smaller than that of crushed stone ITZ, which is attributed to the refinement of FA and the filling of ITZ pores; and (3) FA has a dual improvement effect on the ITZ performance of the gangue concrete and the pore structure of the mortar area. These research results provide a reference for further research on the influence of mineral admixtures on concrete ITZ and theoretical guidance for the modification methods of CGC. [ABSTRACT FROM AUTHOR]

• Discussing the frost resistance of gangue concrete under different replacement rates. • Proposing the freeze–thaw damage evolution model of coal gangue concrete with different gangue replacement rate. • Investigating the relationship of freeze–thaw damage value of coal gangue concrete and the change of relative peak strain under different replacement rates. • Establishing the coal gangue concrete freeze–thaw damage constitutive model. This paper aims to solve one of the main problems in the application of coal gangue concrete (CGC), that is, whether its mechanical properties can meet the requirements of norms and actual engineering practice in the freeze–thaw environment. In this work, the CGC with coal gangue coarse aggregate replacement rates of 0%, 20%, 40%, and 60% were subjected to freeze–thaw cycle. The frost resistance of CGC was comprehensively analyzed and evaluated from its appearance, relative mass, compressive strength and relative dynamic elastic modulus. Based on the regular pattern of relative dynamic elastic modulus of CGC, the evolution model of freeze–thaw damage of CGC was established to analyze the development of freeze–thaw damage. The CGC specimens after 0, 25, 50, 75, and 100 freeze–thaw cycles were measured by uniaxial compression constitutive test and acoustic emission test. The mechanical properties of CGC under freeze–thaw environment were analyzed through the whole stress–strain curve and the variation of parameters with freeze–thaw cycles. Finally, based on the acoustic emission characteristics of CGC in compression failure process, a load damage evolution model of CGC was established. Combined with the freeze–thaw damage evolution model, the freeze–thaw damage constitutive relationship of CGC was established, which can consider both freeze–thaw damage and load damage. The results suggest that the replacement rate of gangue for the CGC structure that requires frost resistance should be less than 40%; The freeze–thaw damage evolution model of CGC established in this paper can truly and effectively reflect the development of freeze–thaw damage of CGC under freeze–thaw environment; The CGC freeze–thaw damage constitutive model established in this paper can accurately reflect the overall process damage characteristics of CGC under freeze–thaw and load damage. It can provide a theoretical basis for the durability evaluation and life prediction of CGC structure in cold regions. [ABSTRACT FROM AUTHOR]

• Coal gangue concrete (CGC) with 30% fly ash (FA) content has the best workability and strength. • The modification effect of FA on the working properties and strength of CGC is determined. • FA modifies CGC via physical and chemical changes in pores and ITZ structure. • Appropriate FA content enhances the effect of average gel pore size on the properties. Fly ash (FA) and gangue are common solid wastes. In this study, coarse aggregates were replaced with coal gangue at a constant substitution rate of 40% to promote the application of coal gangue in concrete production. The modification effect of FA content on the working and mechanical properties of coal gangue concrete (CGC) and its modification mechanism were revealed. At the macro level, the compression, splitting tensile, and flexural strengths were tested by using a pressure tester. From the microscopic aspect, the pore structure of the CGC was analyzed by nuclear magnetic resonance technique. The chemical products of the mortar and the micromorphology of the interfacial transition zone (ITZ) were characterized via scanning electron microscopy and energy dispersive spectroscopy. Results showed that the working and mechanical properties of the CGC can be significantly improved by adding an appropriate FA content. From a physical aspect, the modification mechanism is that fine FA particles fill the pores of the CGC during early cement hydration and contribute to the strength as microaggregates. Chemically, the secondary hydration of the FA particles changes the microstructure of the mortar and the ITZ. On the basis of grey relational analysis, the gel pore volume has the highest correlation with the concrete strength and the average gel pore size presents a linear relationship with the mechanical strength. Furthermore, appropriate addition of FA can significantly improve the average gel pore size. [ABSTRACT FROM AUTHOR]