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  1. Article ; Online: Where medical education meets artificial intelligence: 'Does technology care?'

    van der Niet, Anneke G / Bleakley, Alan

    Medical education

    2020  Volume 55, Issue 1, Page(s) 30–36

    Abstract: COLD' TECHNOLOGIES AND 'WARM' HANDS-ON MEDICINE NEED TO WALK HAND-IN-HAND: Technologies, such as deep learning artificial intelligence (AI), promise benign solutions to thorny, complex problems; but this view is misguided. Though AI has revolutionised ... ...

    Abstract 'COLD' TECHNOLOGIES AND 'WARM' HANDS-ON MEDICINE NEED TO WALK HAND-IN-HAND: Technologies, such as deep learning artificial intelligence (AI), promise benign solutions to thorny, complex problems; but this view is misguided. Though AI has revolutionised aspects of technical medicine, it has brought in its wake practical, conceptual, pedagogical and ethical conundrums. For example, widespread adoption of technologies threatens to shift emphasis from 'hands-on' embodied clinical work to disembodied 'technology enhanced' fuzzy scenarios muddying ethical responsibilities. Where AI can offer a powerful sharpening of diagnostic accuracy and treatment options, 'cold' technologies and 'warm' hands-on medicine need to walk hand-in-hand. This presents a pedagogical challenge grounded in historical precedent: in the wake of Vesalian anatomy introducing the dominant metaphor of 'body as machine,' a medicine of qualities was devalued through the rise of instrumental scientific medicine. The AI age in medicine promises to redouble the machine metaphor, reducing complex patient experiences to linear problem-solving interventions promising 'solutionism.' As an instrumental intervention, AI can objectify patients, frustrating the benefits of dialogue, as patients' complex and often unpredictable fleshly experiences of illness are recalculated in solution-focused computational terms. SUSPICIONS ABOUT SOLUTIONS: The rate of change in numbers and sophistication of new technologies is daunting; they include surgical robotics, implants, computer programming and genetic interventions such as clustered regularly interspaced short palindromic repeats (CRISPR). Contributing to the focus of this issue on 'solutionism,' we explore how AI is often promoted as an all-encompassing answer to complex problems, including the pedagogical, where learning 'hands-on' bedside medicine has proven benefits beyond the technical. Where AI and embodied medicine have differing epistemological, ontological and axiological roots, we must not imagine that they will readily walk hand-in-hand down the aisle towards a happy marriage. Their union will be fractious, requiring lifelong guidance provided by a perceptive medical education suspicious of 'smart' solutions to complex problems.
    MeSH term(s) Artificial Intelligence ; Education, Medical ; Humans ; Intelligence ; Morals ; Technology
    Language English
    Publishing date 2020-03-30
    Publishing country England
    Document type Journal Article
    ZDB-ID 195274-2
    ISSN 1365-2923 ; 0308-0110
    ISSN (online) 1365-2923
    ISSN 0308-0110
    DOI 10.1111/medu.14131
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: When I say … affordance perception.

    van der Niet, Anneke G

    Medical education

    2017  Volume 52, Issue 4, Page(s) 362–363

    MeSH term(s) Cues ; Culture ; Environment ; Humans ; Perception ; Smell
    Language English
    Publishing date 2017-10-23
    Publishing country England
    Document type Journal Article
    ZDB-ID 195274-2
    ISSN 1365-2923 ; 0308-0110
    ISSN (online) 1365-2923
    ISSN 0308-0110
    DOI 10.1111/medu.13471
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  3. Article ; Online: How clinicians discuss patients' donor registrations of consent and presumed consent in donor conversations in an opt-out system: a qualitative embedded multiple-case study.

    van Oosterhout, Sanne P C / van der Niet, Anneke G / Abdo, W Farid / Boenink, Marianne / Cherpanath, Thomas G V / Epker, Jelle L / Kotsopoulos, Angela M / van Mook, Walther N K A / Sonneveld, Hans P C / Volbeda, Meint / Olthuis, Gert / van Gurp, Jelle L P

    Critical care (London, England)

    2023  Volume 27, Issue 1, Page(s) 299

    Abstract: Background: The Netherlands introduced an opt-out donor system in 2020. While the default in (presumed) consent cases is donation, family involvement adds a crucial layer of influence when applying this default in clinical practice. We explored how ... ...

    Abstract Background: The Netherlands introduced an opt-out donor system in 2020. While the default in (presumed) consent cases is donation, family involvement adds a crucial layer of influence when applying this default in clinical practice. We explored how clinicians discuss patients' donor registrations of (presumed) consent in donor conversations in the first years of the opt-out system.
    Methods: A qualitative embedded multiple-case study in eight Dutch hospitals. We performed a thematic analysis based on audio recordings and direct observations of donor conversations (n = 15, 7 consent and 8 presumed consent) and interviews with the clinicians involved (n = 16).
    Results: Clinicians' personal considerations, their prior experiences with the family and contextual factors in the clinicians' profession defined their points of departure for the conversations. Four routes to discuss patients' donor registrations were constructed. In the Consent route (A), clinicians followed patients' explicit donation wishes. With presumed consent, increased uncertainty in interpreting the donation wish appeared and prompted clinicians to refer to "the law" as a conversation starter and verify patients' wishes multiple times with the family. In the Presumed consent route (B), clinicians followed the law intending to effectuate donation, which was more easily achieved when families recognised and agreed with the registration. In the Consensus route (C), clinicians provided families some participation in decision-making, while in the Family consent route (D), families were given full decisional capacity to pursue optimal grief processing.
    Conclusion: Donor conversations in an opt-out system are a complex interplay between seemingly straightforward donor registrations and clinician-family interactions. When clinicians are left with concerns regarding patients' consent or families' coping, families are given a larger role in the decision. A strict uniform application of the opt-out system is unfeasible. We suggest incorporating the four previously described routes in clinical training, stimulating discussions across cases, and encouraging public conversations about donation.
    MeSH term(s) Humans ; Tissue and Organ Procurement ; Presumed Consent ; Tissue Donors ; Qualitative Research ; Communication ; Decision Making
    Language English
    Publishing date 2023-07-28
    Publishing country England
    Document type Journal Article
    ZDB-ID 2041406-7
    ISSN 1466-609X ; 1364-8535
    ISSN (online) 1466-609X
    ISSN 1364-8535
    DOI 10.1186/s13054-023-04581-9
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  4. Article ; Online: Relationship between physical activity and physical fitness in school-aged children with developmental language disorders.

    van der Niet, Anneke G / Hartman, Esther / Moolenaar, Ben J / Smith, Joanne / Visscher, Chris

    Research in developmental disabilities

    2014  Volume 35, Issue 12, Page(s) 3285–3291

    Abstract: Children with developmental language disorders (DLD) often experience difficulty in understanding and engaging in interactive behavior with other children, which may lead to reduced daily physical activity and fitness levels. The present study evaluated ... ...

    Abstract Children with developmental language disorders (DLD) often experience difficulty in understanding and engaging in interactive behavior with other children, which may lead to reduced daily physical activity and fitness levels. The present study evaluated the physical activity and physical fitness levels of 8-11 year old children with DLD (n = 27) and compared this to typically developing (TD) age and gender matched controls (n = 27). In addition, it was investigated whether interrelationships existed between physical activity and physical fitness in children with DLD and in TD children. Physical activity was measured using accelerometers. Physical fitness was measured using five tests of the Eurofit test battery (standing broad jump (SBJ), sit-ups (SUP), handgrip (HG), 10 × 5 m shuttle run (10 × 5 m SR), and the 20 m shuttle run test (20 m SR)). Physical activity of children with DLD did not significantly differ from TD children. Physical fitness of children with DLD was significantly lower on the SBJ, SUP, HG and 10 × 5 m SR than TD controls, while no significant difference was found on the 20 m SR. Strong significant relationships were found between physical activity variables and sedentary behavior and some physical fitness measures (SBJ and SUP) in children with DLD, while in TD children a strong significant relationship was found between time spent in moderate to vigorous physical activity and performance on the SBJ. This study reveals important differences in fitness between children with DLD and TD children, which should be taken into account when creating physical activity interventions. Special attention has to be paid to children with DLD who show low physical activity and low physical fitness performance.
    MeSH term(s) Case-Control Studies ; Child ; Exercise ; Exercise Test ; Female ; Hand Strength ; Humans ; Language Development Disorders ; Male ; Motor Activity ; Muscle Strength ; Physical Fitness
    Language English
    Publishing date 2014-12
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 639175-8
    ISSN 1873-3379 ; 0891-4222
    ISSN (online) 1873-3379
    ISSN 0891-4222
    DOI 10.1016/j.ridd.2014.08.022
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    Zs.B 2592: Show issues Location:
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  5. Article ; Online: Effects of a Cognitively Demanding Aerobic Intervention During Recess on Children's Physical Fitness and Executive Functioning.

    van der Niet, Anneke G / Smith, Joanne / Oosterlaan, Jaap / Scherder, Erik J A / Hartman, Esther / Visscher, Chris

    Pediatric exercise science

    2016  Volume 28, Issue 1, Page(s) 64–70

    Abstract: The objective of this study was to analyze the effects of a physical activity program including both aerobic exercise and cognitively engaging physical activities on children's physical fitness and executive functions. Children from 3 primary schools ( ... ...

    Abstract The objective of this study was to analyze the effects of a physical activity program including both aerobic exercise and cognitively engaging physical activities on children's physical fitness and executive functions. Children from 3 primary schools (aged 8-12 years) were recruited. A quasi-experimental design was used. Children in the intervention group (n = 53; 19 boys, 34 girls) participated in a 22-week physical activity program for 30 min during lunch recess, twice a week. Children in the control group (n = 52; 32 boys, 20 girls) followed their normal lunch routine. Aerobic fitness, speed and agility, and muscle strength were assessed using the Eurofit test battery. Executive functions were assessed using tasks measuring inhibition (Stroop test), working memory (Visual Memory Span test, Digit Span test), cognitive flexibility (Trailmaking test), and planning (Tower of London). Children in the intervention group showed significantly greater improvement than children in the control group on the Stroop test and Digit Span test, reflecting enhanced inhibition and verbal working memory skills, respectively. No differences were found on any of the physical fitness variables. A physical activity program including aerobic exercise and cognitively engaging physical activities can enhance aspects of executive functioning in primary school children.
    MeSH term(s) Case-Control Studies ; Child ; Cognition/physiology ; Executive Function/physiology ; Exercise/psychology ; Female ; Humans ; Inhibition (Psychology) ; Male ; Memory ; Motor Activity ; Physical Fitness/psychology
    Language English
    Publishing date 2016-02
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1042382-5
    ISSN 1543-2920 ; 0899-8493
    ISSN (online) 1543-2920
    ISSN 0899-8493
    DOI 10.1123/pes.2015-0084
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  6. Article ; Online: Associations between daily physical activity and executive functioning in primary school-aged children.

    van der Niet, Anneke G / Smith, Joanne / Scherder, Erik J A / Oosterlaan, Jaap / Hartman, Esther / Visscher, Chris

    Journal of science and medicine in sport

    2015  Volume 18, Issue 6, Page(s) 673–677

    Abstract: Objectives: While there is some evidence that aerobic fitness is positively associated with executive functioning in children, evidence for a relation between children's daily physical activity and their executive functioning is limited. The objective ... ...

    Abstract Objectives: While there is some evidence that aerobic fitness is positively associated with executive functioning in children, evidence for a relation between children's daily physical activity and their executive functioning is limited. The objective was to examine associations between objectively measured daily physical activity (total volume, sedentary behavior, moderate to vigorous physical activity) and executive functioning in children.
    Design: Cross-sectional.
    Methods: Eighty primary school children (36 boys, 44 girls) aged 8-12 years old participated in the study. Physical activity was measured using accelerometers. Executive functions measured included inhibition (Stroop test), working memory (Visual Memory Span test), cognitive flexibility (Trailmaking test), and planning (Tower of London). Total volume of physical activity, time spent in sedentary behavior and moderate to vigorous physical activity were calculated and related to performance on executive functioning.
    Results: More time spent in sedentary behavior was related to worse inhibition (r = -0.24). A higher total volume of physical activity was associated with better planning ability, as reflected by both a higher score on the Tower of London (r = 0.24) and a shorter total execution time (r = -0.29). Also, a significant moderate correlation was found between time spent in moderate to vigorous physical activity and the total execution time of the Tower of London (r = -0.29).
    Conclusions: Children should limit time spent in sedentary behavior, and increasing their total physical activity. Total volume of physical activity, which consisted mostly of light intensity physical activity, is related to executive functioning. This opens up new possibilities to explore both the quantity and quality of physical activity in relation to cognition in children.
    MeSH term(s) Accelerometry ; Child ; Cross-Sectional Studies ; Executive Function ; Female ; Health Behavior ; Humans ; Inhibition (Psychology) ; Male ; Memory, Short-Term ; Motor Activity ; Physical Exertion ; Physical Fitness/psychology ; Sedentary Lifestyle ; Stroop Test ; Trail Making Test
    Language English
    Publishing date 2015-11
    Publishing country Australia
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1437829-2
    ISSN 1878-1861 ; 1440-2440
    ISSN (online) 1878-1861
    ISSN 1440-2440
    DOI 10.1016/j.jsams.2014.09.006
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