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Cholesterol Absorption and Synthesis in Vegetarians and Omnivores.
Mol Nutr Food Res. 2018 Feb 10;:
Authors: Lütjohann D, Meyer S, von Bergmann K, Stellaard F
SCOPE: Vegetarian diets are considered health promoting, however, a plasma cholesterol lowering effect is not always observed. We investigated the link between vegetarian diet-induced alterations in cholesterol metabolism.
METHODS AND RESULTS: We studied male and female omnivores, lacto-ovo vegetarians, lacto vegetarians and vegans. Cholesterol intake, absorption and fecal sterol excretion were measured as well as plasma concentrations of cholesterol and non-cholesterol sterols. These served as markers for cholesterol absorption, synthesis and catabolism. The biliary cholesterol secretion rate was estimated. Flux data were related to bodyweight. Individual vegetarian diet groups were statistically compared to the omnivore group. Lacto vegetarians absorbed 44% less dietary cholesterol, synthesized 22% more cholesterol and showed no differences in plasma total and LDL cholesterol. Vegan subjects absorbed 90% less dietary cholesterol, synthesized 35% more cholesterol and had a similar plasma total cholesterol, but a 13% lower plasma LDL cholesterol. No diet-related differences in biliary cholesterol secretion and absorption were observed. Total cholesterol absorption was lower only in vegans. Total cholesterol input was similar under all vegetarian diets.
CONCLUSIONS: Unaltered biliary cholesterol secretion and higher cholesterol synthesis blunt the lowered dietary cholesterol intake in vegetarians. LDL cholesterol was significantly lower only in vegans. This article is protected by copyright. All rights reserved.
PMID: 29427539 [PubMed – as supplied by publisher]
Navigating the Complexities of Undergraduate Medical Curriculum Change: Change Leaders’ Perspectives.
Acad Med. 2018 Feb 06;:
Authors: Velthuis F, Varpio L, Helmich E, Dekker H, Jaarsma ADC
PURPOSE: Changing an undergraduate medical curriculum is a recurring, high-stakes undertaking at medical schools. This study aimed to explore how people leading major curriculum changes conceived of the process of enacting change and the strategies they relied on to succeed in their efforts.
METHOD: The first author individually interviewed nine leaders who were leading or had led the most recent undergraduate curriculum change in one of the eight medical schools in the Netherlands. Interviews were between December 2015 and April 2016, using a semi-structured interview format. Data analysis occurred concurrently with data collection, with themes being constructed inductively from the data.
RESULTS: Leaders conceived of curriculum change as a dynamic, complex process. They described three major challenges they had to deal with while navigating this process: the large number of stakeholders championing a multitude of perspectives, dealing with resistance, and steering the change process. Additionally, strategies for addressing these challenges were described. The authors identified an underlying principle informing the work of these leaders: being and remaining aware of emerging situations, and carefully constructing strategies for ensuring the intended outcomes were reached and contributed to the progress of the change process.
DISCUSSION: This empirical, descriptive study enriches the understanding of how institutional leaders navigate the complexities of major medical curriculum changes. The insights serve as a foundation for training and coaching future change leaders. To broaden the understanding of curriculum change processes, future studies could investigate the processes through alternative stakeholder perspectives.Written work prepared by employees of the Federal Government as part of their official duties is, under the U.S. Copyright Act, a “work of the United States Government” for which copyright protection under Title 17 of the United States Code is not available. As such, copyright does not extend to the contributions of employees of the Federal Government.
PMID: 29419547 [PubMed – as supplied by publisher]
Posted in Acad Med
Tagged PubMed, TOP25
Malaria in Venezuela requires response.
Science. 2018 Feb 02;359(6375):528
Authors: Grillet ME, Villegas L, Oletta JF, Tami A, Conn JE
PMID: 29420282 [PubMed – in process]
Posted in Science
Tagged PubMed, TOP25
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