Browsing by Author "Wenzel, Lisa"

An amendment to this paper has been published and can be accessed via the original article.

Abstract Introduction Multiple sclerosis is a chronic inflammatory, degenerative disease of the central nervous system manifesting at first with relapses in about 85% of cases. In Germany, intravenous therapy with high-dose corticosteroids is the treatment standard of acute relapses. The treatment leads to a faster reduction of symptoms in about 25 of 100 treated patients but has no proven long-term benefits over placebo treatment. Intravenous treatment is not superior to oral treatment. Therefore, informed decisions on relapse management are required. An earlier randomised controlled trial showed that evidence-based patient information and education on relapse management leads to more informed decisions and more relapses not treated or treated with oral corticosteroids. This study aims to evaluate whether a web-based relapse management programme will positively change relapse management and strengthen autonomy in people with multiple sclerosis. Methods The pragmatic double-blind randomised controlled trial is accompanied by a mixed-methods process evaluation and a health economic evaluation and follows the UK Medical Research Council guidance on developing and evaluating complex interventions. A total of 188 people with possible or relapsing-remitting multiple sclerosis with ≥ 1 relapse within the last year and/or ≥ 2 relapses within the last 2 years will be recruited and randomised using blocks. The intervention group receives a web- and dialogue-based decision aid on relapse management, a nurse-led webinar and access to a monitored chat forum. The control group receives standard information, which will be made available via the same online platform as the intervention. The primary endpoint is the proportion of relapses not treated or treated with oral corticosteroids. Key secondary endpoints are the annualised relapse rate, decision-making, empowerment, quality of life and cost-effectiveness. Facilitators and barriers will be assessed by mixed-methods process evaluation measures. The study ends when 81 relapses have been documented or after 24 months of observation per individual patient. Analyses will follow the intention-to-treat principle. Discussion We hypothesise that the intervention will enhance patient empowerment and have a positive impact on patients’ relapse management. Trial registration ClinicalTrials.gov NCT04233970 . Registered on 18 January 2020

This paper aimed to contribute to answering three questions. First, how robust and reliable are early implicit measures of false belief (FB) understanding? Second, do these measures tap FB understanding rather than simpler processes such as tracking the protagonist's perceptual access? Third, do implicit FB tasks tap an earlier, more basic form of theory of mind (ToM) than standard verbal tasks? We conducted a conceptual replication of Garnham & Perner's task (Garnham and Perner 2001 Br. J. Dev. Psychol. 19 , 413–432) simultaneously measuring children's anticipatory looking and interactive behaviours toward an agent with a true or FB ( N = 81, M = 40 months). Additionally, we implemented an ignorance condition and a standard FB task. We successfully replicated the original findings: children's looking and interactive behaviour differed according to the agent's true or FB. However, children mostly did not differentiate between FB and ignorance conditions in various measures of anticipation and uncertainty, suggesting the use of simpler conceptual strategies than full-blown ToM. Moreover, implicit measures were all related to each other but largely not related to performance in the standard FB task, except for first look in the FB condition. Overall, our findings suggest that these implicit measures are robust but may not tap the same underlying cognitive capacity as explicit FB tasks.