BackgroundPeople who undergo weight loss surgery require a comprehensive treatment program to achieve successful outcomes. eHealth solutions, such as secure online portals, create new opportunities for improved health care delivery and care, but depend on the organizational delivery systems and on the health care professionals providing it. So far, these have received limited attention and the overall adoption of eHealth solutions remains low. In this study, a secure eHealth portal was implemented in a bariatric surgery clinic and offered to their patients. During the study period of 6 months, 60 patients and 5 health care professionals had access. The portal included patient information, self-management tools, and communication features for online dialog with peers and health care providers at the bariatric surgery clinic.ObjectiveThe aim of this study was to characterize and assess the impact of an eHealth portal on health care professionals’ interaction with patients in bariatric surgery.MethodsThis qualitative case study involved a field study consisting of contextual interviews at the clinic involving observing and speaking with personnel in their actual work environment. Semi-structured in-depth interviews were conducted with health care professionals who interacted with patients through the portal. Analysis of the collected material was done inductively using thematic analysis.ResultsThe analysis revealed two main dimensions of using an eHealth portal in bariatric surgery: the transparency it represents and the responsibility that follows by providing it. The professionals reported the eHealth portal as (1) a source of information, (2) a gateway to approach and facilitate the patients, (3) a medium for irrevocable postings, (4) a channel that exposes responsibility and competence, and (5) a tool in the clinic.ConclusionsBy providing an eHealth portal to patients in a bariatric surgery program, health care professionals can observe patients’ writings and revelations thereby capturing patient challenges and acting and implementing measures. Interacting with patients through the portal can prevent dropouts and deterioration of patients’ health. However, professionals report on organizational challenges and personal constraints related to communicating with patients in writing online. Further development of guidelines and education of health care professionals about how to handle, prioritize, communicate, and facilitate patients online is required in addition to increased attention to the organizational infrastructures and incentives for enabling such solutions in health care.

Tea [Camellia sinensis (L.) O. Kuntze] is an aluminum (Al) hyperaccumulator plant and is commercially important due to its high content of antioxidants. Although Al induced growth is well-known for the plants growing in acid soil, yet the cause underlying the stimulatory effect of Al has not been fully understood. To investigate the possible role of Al in growth induction, we studied morphological, physiological as well as biochemical changes of tea plant under different Al concentrations (0-4,000 μM). In hydroponics, Al (15 μM), enhanced shoot and root growth, but at higher concentrations, it caused oxidative damage which culminated in a cascade of biochemical changes, Al content increased concurrently with the maturity of the leaf as well as stem tissues than their younger counterparts. Hematoxylin staining indicated that Al accumulation started after 6 h of exposure in the tips of young roots and accumulation was dose dependent. The physiological parameters such as pigments, photosynthetic rate, transpiration and stomatal conductance were declined due to Al toxicity. Alteration in activated oxygen metabolism was also evidenced by increasing lipid peroxidation, membrane injury, evolution of superoxide anions and accumulation of H(2)O(2). Contents of phenols initially exhibited an acceleration which gradually plummeted at higher levels whereas total sugar and starch contents decimated beyond 15 μM of Al concentration. Activities of antioxidant defense enzymes were increased with the elevated concentration of Al. Expression of citrate synthase gene was up-regulated in the mature leaves, young as well as old roots simultaneously with increased concentration of Al in those parts; indicating the formation of Al-citrate complex. These results cooperatively specified that Al concentration at lower level promoted growth but turned out to be a stressor at elevated stages indicating the sensitivity of the cultivar (T-78) to Al.

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BackgroundMany patients who undergo weight loss (bariatric) surgery seek information and social support in online discussion forums, but the vast amount of available information raises concerns about the impact of such information. A secure online discussion forum was developed and offered to bariatric surgery patients. The forum was moderated and allowed contact with peers and health care professionals.ObjectiveThe purposes of this study were to explore how individuals undergoing bariatric surgery used the moderated discussion forum and to better understand what influenced their participation in the forum.MethodsThe study was designed as an explorative case study. We conducted participant observation of the discussion forum over a time period of approximately six months. For further insight, we carried out in-depth semistructured interviews with seven patients who had access to the forum. We analyzed the material inductively, using content and thematic analysis.ResultsThe patients used the forum as an arena in which to interact with peers and providers, as well as to provide and achieve informational and social support. The analysis suggests that there are three major themes that influenced participation in the online discussion forum: (1) the participant’s motivation to seek information, advice, and guidance, (2) the need for social support and networking among peers, and (3) concerns regarding self-disclosure.ConclusionsThe findings of this study imply that a moderated discussion forum for bariatric surgery patients has potential for use in a therapeutic context. The discussion forum fulfilled the informational and support needs of the bariatric surgery patients and was particularly useful for those who excluded themselves from the traditional program and experienced barriers to expressing their own needs. Even though our findings imply that the patients benefitted from using the forum regardless of their active or passive participation, restraining factors, such as considerations regarding self-disclosure, must be further investigated to prevent certain users from being precluded from participation.

Zinc is the most widespread deficient micronutrient in the tea growing soils of India which affects growth of the plants. In order to investigate the structural, physiological, and biochemical changes under Zn stress (i.e. both deficient and excess supply) of tea [Camellia sinensis (L.) O. Kuntze cv. T-78] plants, we treated young plants with ZnSO 4 at 0 (deficiency), 0.3, 3 (optimum), and 30 µM (toxic) concentrations for 8 weeks. Zn deficiency and excess resulted in considerable decrease in shoot and root fresh and dry masses, and transmission electron microscopy (TEM) revealed disorganization of some cellular organelles. Further, Zn-stress decreased net photosynthetic rate (P N ), transpiration rate (E), stomatal conductance (g s ), and content of chlorophylls a and b. On the other hand, content of superoxide anion, malondialdehyde, hydrogen peroxide, and phenols, and electrolyte leakage were elevated in stressed plants. The activities of ascorbate peroxidase, catalase, superoxide dismutase, and peroxidase as well as expression of respective genes were up-regulated under Zn-stress. Nevertheless, antioxidant system as a whole did not afford sufficient protection against oxidative damage.