July 27, 2022

The Mediterranean Diet

The Mediterranean diet is more than a dietary pattern; it’s the heritage of millennia of exchanges of people, cultures, and foods of all countries around the Mediterranean basin.

The health benefits associated with it have been established by the pioneer Seven Countries Study, followed by numerous other ones. More specifically, it’s been proven to reduce the risk of developing metabolic syndrome, type 2 diabetes, cardiovascular disease, some neuro-degenerative diseases, and cancers. In 2010, the Mediterranean diet was also recognized as an Intangible Cultural Heritage of Humanity by UNESCO.

The Mediterranean Diet Pyramid

The Mediterranean diet pyramid provides both a qualitative and quantitative visual representation of the foods, their relative proportions, and the frequency of consumption.

At the base, we can find food items that should sustain the diet and provide the highest energy intake, and at the upper levels, foods to be eaten in moderate amounts or left for special occasions.

The base of the pyramid

Every day

  • Cereals: 1 or 2 servings per meal in the form of bread, pasta, rice, couscous, and others. Whole grain is to be preferred, as processing normally removes fiber and valuable nutrients like vitamins, magnesium, iron, etc. 
  • Vegetables: 2 or more servings per meal. One of the two servings should preferably be consumed raw, to ensure vitamin and mineral daily intakes.
  • Fruit: 1 or 2 servings per meal. For both vegetables and fruits, it’s important to consume a “variety of colors and textures”, to ensure a variety of antioxidants and other protective nutrients. 
  • Dairy products should be consumed in moderate amounts (2 servings per day) in the form of milk, kefir, yogurt, and other fermented dairy products. Although they contribute to bone health due to their richness in Ca, they can be a major source of saturated fat.
  • At the center of the pyramid, we find extra virgin olive oil, which, due to its high content in monounsaturated oleic acids and its abundance of antioxidants, should be the main source of dietary lipids and is recommended for both dressing and cooking as it’s highly resistant to elevated temperatures. EVOO has been proven to positively affect blood lipids and cardiovascular health, while also being inversely associated with some cancers. 
  • Olives, nuts, and seeds are a healthy snack choice, being good sources of healthy lipids, proteins, vitamins, minerals, and fiber.
  • Onions, garlic, herbs, and spices enhance flavor and palatability while allowing for reduced consumption of salt, known to be one of the main contributing factors to hypertension among predisposed individuals. 
  • A daily intake of 1.5–2 L. of water (equivalent to 6-8 glasses), although needs may vary among people due to age, gender, physical activity, weather conditions, and other personal circumstances. 

Weekly

  • Legumes (more than 2 servings per week).

Traditionally, Mediterranean dishes do not have animal-origin protein foods as a main source of protein. 

  • Fish and shellfish (2 or more servings per week), as they have anti-inflammatory properties due to their content of long-chain n-3 PUFA, besides healthy protein and lipids. Their consumption has been proven to reduce the risk of coronary heart disease. 
  • White meat (2 servings per week) is also a good source of lean protein without the high levels of saturated fat found in some red meat cuts. 
  • Red meat (less than 2 servings per week, preferably lean cuts) and processed meats (less than 1 serving), as their intake has been consistently associated with some chronic diseases, including coronary heart disease and cancer. 

Occasionally

Foods rich in sugars and unhealthy fat, such as candies, pastries, and beverages like sweetened fruit juices and soft drinks.

Cultural and lifestyle elements

There are cultural and lifestyle factors associated with this dietary pattern, such as moderation, a preference for seasonal, fresh, and minimally processed foods, the combination with physical activity (at least 30 minutes throughout the day), and socialization, since time devoted to meals, knowledge transmitted from generation to generation and conviviality are important for the social and cultural aspects of eating, positively affecting food behaviors and therefore health status.

This content is educational in purpose and not to be intended as medical advice. 


https://www.cambridge.org/core/journals/public-health-nutrition/article/mediterranean-diet-pyramid-today-science-and-cultural-updates/70359644D12A038AC003B935AA04E120


About the Author

Dr. Patrizia Scali is an Italian ECFMG-certified medical doctor. 

Dr. Scali graduated medical school from Università degli Studi di Milano-Bicocca in Milan, Italy and has completed all 3 USMLE Step exams. She has also completed an Accelerated Certificate Program in Business Administration at University of California, Irvine (UCI).

Dr. Scali has conducted pediatric hematology research in Italy, as well as hepatology lab research at Yale School of Medicine in the US. 

She has worked as a primary care physician in Italy, her home country, where she also had extensive experience as a telemedicine doctor.

July 25, 2022

Michigan Board Of Osteopathic Medicine And Surgery

Mocingbird's research team has verified and validated with the Michigan Board Of Osteopathic Medicine And Surgery with the most up-to-date CME requirements for osteopathic doctors. Here is a quick summary of things you must know: 

License Renewal Cycle Time for Michigan (DOs)

  • Michigan state licenses for DOs must be renewed every 3 years. 
  • The license renewal cycle and requirements are not the same for MDs and DOs.

Board Rule Checklist: State of Michigan (DOs)

  • Complete 150 hours of continuing education
    • Due: Every 3 years at license renewal
  • Of the 150 hours, complete a minimum of 60 Category 1 credits 
    • Due: Every 3 years at license renewal 
  • Of the 150 hours, complete a minimum of 1 hour of CE in medical ethics
    • Due: Every 3 years at license renewal
  • Of the 150 hours, complete a minimum of 3 hours of CE in pain and symptom management
    • Due: Every 3 years at license renewal
  • If you are in the U.S. military service: You do not need to comply with the above requirements

Special Requirement for Michigan

  • Complete a one-time training requirement in identifying victims of human trafficking 
  • Due: Beginning with the first renewal cycle after the rules are promulgated and for an initial license or registration issued 5 or more years after the rules are promulgated
    • Example: If your license was issued or renewed in 2016, this requirement is due at license renewal in 2019. If your license was issued or renewed in 2017, this requirement is due at license renewal in 2020. 
  • Note: If you were initially licensed on or after 12/20/2021, you do not need to complete this requirement

For more detailed information, please visit the Michigan Department of Licensing and Regulatory Affairs website. 

*Requirements are subject to change. Please refer to your Mocingbird account for the most up-to-date accurate information.*


To view customized tasks regarding your MI license requirements, sign in to your Mocingbird profile and your virtual assistant has already created your upcoming task list.

Don’t have a Mocingbird account yet? Sign up for your free trial today at mocingbird.com

Drop us a note if you are interested in partnering up with us. Complete this contact form and our team will reach out with a free CME process consultation for your organization. 

June 22, 2022

8 Tips to Improve Your Sleep Hygiene

Millions of Americans struggle to get a good night's sleep. While this can be due to many different factors, you can adopt habits to encourage better sleep. Here are eight tips to improve your sleep hygiene.

Know the circadian rhythm 

The circadian rhythm is your “internal clock”, which helps regulate your sleep and wake cycles. It’s important to let light in first thing in the morning, as you wake up, and to get sunlight during the day (for example, by taking a walk after work) as it’s the vision of light that helps the brain coordinate this clock. On the other hand, in the evening, it’s important to keep away from bright lights and limit the exposure to electronics’ blue blight, as this will hinder the production of melatonin, a hormone that facilitates sleep. If you cannot avoid using screens 2 hours before bedtime, an inexpensive pair of blue-light-blocking glasses have been shown to improve the duration and quality of sleep.

Avoid caffeine, alcohol, nicotine, and other chemicals that interfere with sleep close to bedtime

Caffeine is a stimulant that can be found in coffee, tea, chocolate, and soda. If you drink coffee, it’s better to have your last cup before noon. Although alcohol may help you fall asleep, after a few hours it acts as a stimulant, increasing the number of awakenings and generally decreasing the quality of sleep later in the night.

Balance your fluid intake

Don’t drink too much water at bedtime as you might be awakened by the need for a trip to the bathroom.

Have a light dinner

Finish dinner several hours before bedtime and avoid foods that are spicy, difficult to digest or that might cause heartburn. 

Create a consistent sleep schedule

Going to bed and waking up at the same time is the best and easiest way of synchronizing your circadian rhythm. If you must nap, it’s better to keep it short and before 5 PM.

Turn your bedroom into a sleep oasis

The best environment to promote sleep is a dark, cool, and quiet bedroom. To achieve this you can use heavy curtains, blackout shades, or even an eye mask to block light since light communicates to the brain that it is time to wake up. Earplugs or a "white noise" appliance can also help with any external sounds. The ideal temperature of the bedroom should be between 60 and 75°F and the room should be well ventilated. A comfortable mattress, pillows, and bedding are also important. Not using a computer or work materials in the bedroom will strengthen the mental association between the room and sleep. 

Create a soothing sleep routine

Even something as simple as wearing pajamas, brushing teeth, and getting ready for bed can reinforce in your mind that it's bedtime. Some pre-sleep soothing activities include taking a bath (since the rise and subsequent fall in body temperature promotes drowsiness), reading a book, watching television with blue light blocking glasses, listening to soft music, or practicing relaxation exercises. Avoid stressful reading/TV content, doing work, or discussing emotional issues right before bed as these activities can lead to the secretion of the stress hormone cortisol, which increases alertness.

Don’t stress about falling asleep

If you find yourself struggling to fall asleep, try to stop focusing on the thought of falling asleep and instead try concentrating on relaxing yourself through breathing and meditation exercises. If after approximately 20 minutes you still cannot fall asleep, the best option is to get out of the bedroom and do a relaxing activity, such as reading or listening to soft music. Once you start getting tired again, go back to sleep in your bedroom.

This content is educational in purpose and not to be intended as medical advice. 


https://www.cdc.gov/sleep/about_sleep/sleep_hygiene.html

https://www.sleepfoundation.org/sleep-hygiene

https://healthysleep.med.harvard.edu/healthy/getting/overcoming/tips

https://www.headspace.com/sleep/sleep-hygiene


About the Author

Dr. Patrizia Scali is an Italian ECFMG certified medical doctor. 

Dr. Scali graduated medical school from Università degli Studi di Milano-Bicocca in Milan, Italy and has completed all 3 USMLE Step exams. She has also completed an Accelerated Certificate Program in Business Administration at University of California, Irvine (UCI).

Dr. Scali  has conducted pediatric hematology research in Italy, as well as hepatology lab research at Yale School of Medicine in the US. She has worked as a primary care physician in Italy, her home country, where she also had extensive experience as a telemedicine doctor.

June 8, 2022

Mocingbird Interviewed About Life After Being Crowned 2021 Winner of The Get Started RI Shark Tank Style Pitch Competition

In 2021, Scott Duarte took home the Get Started Rhode Island victory for Mocingbird. Here's a quick recap of his podcast interview with John Loughlin.

Read more

May 31, 2022

Long Weekends Aren’t Meant For Unexpected CME Deadlines

Memorial day weekend (#MDW) is an important time to reflect on all of those who have served and have given the ultimate sacrifice for our way of life.  Unfortunately, this weekend is also associated with many clinicians as a time to “catch up” on all those looming deadlines with some state licenses due for renewal.

Read more

May 3, 2022

Dr. Ian Madom Sits Down With StartUp Health for Moonshot Moment Interview

Dr. Ian Madom, CEO and Co-Founder of Mocingbird had the chance to sit down with our partner StartUp Health for a Moonshot Moment interview while at VIVE 2022.

Read more

April 11, 2022

Neonatal Abstinence Syndrome (NAS): A Chat With Neonatologist Dr. Dawn Forbes Of NASCEND

eam had the pleasure to sit down for a chat with Dr. Dawn Forbes, neonatologist, founder, and CEO of NASCEND, one of our CME content providers at Mocingbird. 

Read more

April 6, 2022

Artificial Intelligence Will See You Now: AI In Healthcare

What is AI?

Artificial intelligence (AI) refers to computer systems that simulate or exhibit a specific aspect of human intelligence or intelligent behavior, such as learning, reasoning, and problem-solving. 

It is not a single technology, but rather a range of computational models and algorithms, the most important of which being Machine Learning (ML), which refers to a system that identifies patterns of data from input and makes predictions from new, never-before-seen data.  

ML algorithms can automatically learn and improve from experience without being explicitly programmed, and such “learnability” represents a key feature of AI. 

The benefits of AI in healthcare

Healthcare is a field in which AI is rapidly evolving, leading to a digital transformation that is:

  • improving the access, quality, safety, and efficiency of various health services
  • supporting evidence-based decision making 
  • fostering communication and coordination
  • allowing for the optimization of health systems' performance
  • unlocking big data to gain insights into patients
  • delivering value at reduced costs, while still improving outcomes and patient experience

Current AI uses in healthcare

Recently, many ML algorithms have been approved for safe use in healthcare by the US FDA. Stanford developed an AI algorithm that can diagnose up to 14 types of medical conditions simultaneously from imaging, Mayo Clinic started using AI to find molecular biomarkers in MRI imaging instead of testing samples collected during surgery, while MIT developed an AI prediction model that can anticipate the development of breast cancer up to 5 years in advance.

Many big tech companies such as Google, Microsoft, Apple, Amazon, and IBM are providing organizations with AI cloud platforms and services as well as ML algorithms. There have also been various cross-sector collaborations, with Apple partnering with over 100 hospitals and clinics for its health records project, allowing consumers to exchange their health data with healthcare providers, or IBM partnering with various hospitals, enabling them to use Watson to make cancer diagnoses and treatment recommendations, a system that can digest information and make recommendations much more quickly and more intelligently than perhaps any machine before it, processing up to 60 million pages of text per second. 

AI-assisted surgical robots are an example of this, as they can be operated both locally and remotely and are able to analyze data from pre-operative medical records to physically guide a surgeon’s instrument in real-time. 

Robots can also be used in the rehabilitation of patients with stroke, to deliver equipment and medical supplies as well as to assist in the care of elderly patients. 

Many hospitals in the United States have also started using ML algorithms for predictive analytics (eg, predicting adverse events, mortality rates, the number of patients in the emergency department), obtaining data that allows them to take proactive measures for the foreseen events days in advance.

EHRs (Electronic Health Records) are the backbone of this process and currently, many EHR vendors, including Epic, Cerner, Allscripts, and Athena have started to add AI into their systems with the purpose of supporting workflows, and clinical decision-making as well as patient engagement. 

Another potential use that can enable clinicians to make quicker and smarter decisions about their patients uses the smartphone as a catalyst. Various companies are developing sensors that attach to phones to collect all sorts of biological data. 

Ultimately, these applications can fall into 4 different categories:

  • Patient-facing
  • Doctor-facing
  • Research
  • Telehealth

The future of AI in healthcare

As more and more data are captured, and as computers become better and faster at processing them autonomously, the possibilities keep expanding. The application of AI in healthcare is disruptive, so a good question to ask is whether it will change not only how medicine is practiced, but who is practicing it. As some Silicon Valley investors are speculating, one day AI could take the place of doctors, serving as a diagnostician and even a surgeon, maybe doing the same work with better results for less money. 

But physicians, after all, do more than data processing. They educate and walk the patients through the difficult times of disease and perhaps death, attend at their bedsides, and counsel them. They grasp nuance and learn to master uncertainty. No AI could replace that humanity in the eyes of a sick patient. 


Chen M, Decary M. Artificial intelligence in healthcare: An essential guide for health leaders. Healthc Manage Forum. 2020 Jan;33(1):10-18. doi: 10.1177/0840470419873123. Epub 2019 Sep 24. PMID: 31550922.


About the Author

Dr. Patrizia Scali is an Italian ECFMG certified medical doctor. 

Dr. Scali graduated medical school from Università degli Studi di Milano-Bicocca in Milan, Italy and has completed all 3 USMLE Step exams. She has also completed an Accelerated Certificate Program in Business Administration at University of California, Irvine (UCI).

Dr. Scali  has conducted pediatric hematology research in Italy, as well as hepatology lab research at Yale School of Medicine in the US. She has worked as a primary care physician in Italy, her home country, where she also had extensive experience as a telemedicine doctor.

March 15, 2022

The Medical Supply Chain

The global healthcare system we experience today is the consequence of an extremely efficient, yet fragile, supply chain. This efficiency, therefore, comes at the expense of resilience, meaning it is vulnerable to “black swan” events like Covid-19.

Healthcare facilities work with one another in a group purchasing organization. They contract with two or three large distributors, which either purchase from wholesalers or contract directly with manufacturers. 

As the Covid-19 pandemic ravaged the world, we can all remember the shortages the healthcare system suffered. As the caseload kept increasing, the need for PPEs soared, filling the news with images of healthcare workers improvising hospital gowns and face shields. The same thing happened with some critical medical supplies. By April 2020, prices for N95 masks were up 6,136%, while those of isolation gowns had spiked by 2,000%. U.S. health care leaders had to resort to protocols for rationing testing and ventilators as the shortages continued.  

This supply chain failure led to a paradigm shift from a centralized supply chain in the US into thousands of domestic manufacturers stepping up and producing PPEs as well as other critical medical supplies. An example of this included Austin-based Tito’s, which transitioned from producing vodka to hand sanitizer. Cumbersome vendor-approval processes and inflexible funding rules did not help.

In a world where large-scale disruptions such as climate change and natural disasters, shifting global economic or geopolitical conditions as well as cyberattacks are likely to become more common, the Covid-19 pandemic has opened our eyes to the dangers of a supply chain that focuses exclusively on efficiency.


https://hbr.org/2021/02/one-way-to-build-more-resilient-medical-supply-chains-in-the-u-s


About the Author

Dr. Patrizia Scali is an Italian ECFMG certified medical doctor. 

Dr. Scali graduated medical school from Università degli Studi di Milano-Bicocca in Milan, Italy and has completed all 3 USMLE Step exams. She has also completed an Accelerated Certificate Program in Business Administration at University of California, Irvine (UCI).

Dr. Scali  has conducted pediatric hematology research in Italy, as well as hepatology lab research at Yale School of Medicine in the US. She has worked as a primary care physician in Italy, her home country, where she also had extensive experience as a telemedicine doctor. 

February 10, 2022

Filling The Gap Of The US Healthcare Workforce: IMGs and Their Road To Licensure

The US demand for physicians has been higher than the number of US medical school graduates. One way to fulfill this is by seeking IMGs. 

Read more

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