میں اور تو
ہماری زندگی ہے کچھ یوں منتشر
جیسے دو متوازی خطوط کا سفر
نہ ابتدا میں لچک
نہ انتہا پہ خم
بس محو ِ سفر ہیں
نہ ابتدائے سفر کا جنوں
نہ وصال منزل کی لذت
فقط اک خلا ہے
جو درمیاں پڑا اونگھ رہا ہے
یہ ’’تُو‘‘،’’میں‘‘کے دو خطوط
Introduction: Adaptive expertise is the ability of individuals to create innovative solutions when they come across novel problems or workplace challenges. Clinicians are often adept at handling routine clinical procedures but lack confidence and a proper strategy when previously un-encountered situations arise. Lots of research has been conducted on basic concepts and development of adaptive expertise however major chunk of literature belongs to non- medical fields. Little is studied about assessment of adaptive expertise in medical professionals and postgraduate residents. Objective: To measure adaptive expertise (AE) of radiology residents and to assess any association between the AE of postgraduate radiology residents (PGR) and their years of training. Methods: This multicenter correlational study involved 181 radiology residents from nine major teaching hospital of Lahore, Pakistan from May to October 2019. Katerina Bohle Carbonell Adaptive Expertise Inventory was used as a data collection tool. The questionnaire contained a total of eleven items encompassing two dimensions of AE: domain-specific and innovative skills. Total scores representing AE of PGRs were measured. AE scores and years of training were correlated using Spearman rho correlation. One-way ANOVA was conducted to further evaluate the association between AE and years of postgraduate training. Results: Out of 181 residents there were 78 (43.1%) males and 103 (56.9%) females. Most of them, 97 (53.6%) were enrolled in four years fellowship (FCPS) program and 62 (34.3%) were in the first year of their residency. Total AE scores of all radiology residents ranged from 33 to 54. AE scores and years of residency were positively correlated (rs= 0.4, p < 0.01). One-way ANOVA and Post hoc comparisons using Tukey HSD test further revealed significant pairwise differences between mean scores of residents’ groups (p = < 0.05) rejecting the null hypothesis. Conclusion: Overall, this study concludes that residents acquire adaptive expertise perpetually with progression in their training. KEYWORDS: Adaptive Expertise (AE), Radiology, Postgraduate Residents (PGRs)
The objective of this study is to measure the level of heavy metals such as As, Cd, Cr, Cu, Ni, Pb, Se, Co, Fe and Mn in smokeless tobacco products (STPs), to know about the ingredients used in the manufacture of STPs, to estimate the potential risk by calculating the daily intake (DImetals) and target hazard quotients (THQ). The individual incremental cancer risk (ILTR) of various types of smokeless tobacco products (STPs) and population incremental lifetime cancer risk (ILTR) of selected age groups for consumption of inorganic Arsenic (iAs) were also calculated to excess the cancer risk associated with the smokeless tobacco products (STPs). Samples of STPs and their major ingredients were randomly collected from different markets of Karachi city (Pakistan) and classified into different categories. Samples were digested by using the nitric acid (HNO3) and analyzed by atomic absorption spectroscopy. The daily consumption of STPs was calculated by a questioner, which helped to estimate daily intake of metals (DImetals) and target hazard quotient (THQ) of metals. The high concentration of As, Cr, Se, Fe and Mn were found, while Cu, Ni, Pb and Co were found in low concentration in different STPs. The consumption of STPs obtained as 5.11 – 42.38, 7.67 – 98.55 and 6.39 – 108.46 g/day for the three age groups, below 20, between 21- 40 and above 40 years respectively. The average metal concentration and multivariate analysis indicate that the source of As, Cr, Se, Fe and Mn may be associated with processing of STPs or addition of additive raw ingredients. The high ingestion beyond the safe limit of Cu, Ni, Pb and Co is noted in regards to their consumption pattern. The total THQ (TTHQ) of studied categories of STPs exceeded the safe limit of >1 which indicates the health risk and the ILTR values for individual types of STPs and population ILTR of different age groups specifies the cancer risk associated with their excessive use.