TONI - One for all? Participatory development of a transtheoretic and transdiagnostic online intervention for blended care.

Background: Internet-based interventions offer a way to meet the high demand for psychological support. However, this setting also has disadvantages, such as the lack of personal contact and the limited ability to respond to crises. Blended care combines Internet-based interventions with face-to-face psychotherapy and merges the benefits of both settings. To ensure the uptake of blended care in routine care, Internet-based interventions need to be suitable for different therapeutic approaches and mental disorders. Objective: This paper describes the participatory development process of the Internet-based intervention "TONI" using a common therapeutic language and content on various transdiagnostic topics to be integrated into routine outpatient psychotherapy. Methods: To develop this intervention in a participatory manner, we followed the Integrate, Design, Assess, and Share (IDEAS) framework. In a multilevel development process, we used a combination of interviews, focus groups, and proofreading to optimally tailor online modules to routine outpatient psychotherapy. Building on well-established cognitive-behavioral online content, we included expert interviews with psychodynamic (n = 20) and systemic psychotherapists (n = 9) as well as focus groups with psychotherapists of different approaches (n = 10) and persons with lived experience of mental illness (PWLE; n = 10). Results: We describe the development process of TONI step-by-step, outlining the specific requirements that therapists from different therapeutic approaches as well as PWLE have and how we implemented them in our intervention. This includes the content and specific exercises in the online modules, aspects of data protection, language, design, and usability. Conclusion: Internet-based interventions that use a common therapeutic language and address therapeutic principles across different approaches have the potential to advance digitalization in psychotherapy. Involving psychotherapists and PWLE in intervention development may positively impact acceptance and usage in practice. This study shows how participatory intervention development involving both psychotherapists and PWLE can be carried out.

An examination of individual responses to ischemic preconditioning and the effect of repeated ischemic preconditioning on cycling performance.

PURPOSE: To use repeated control trials to measure within-subject variability and assess the existence of responders to ischemic preconditioning (IPC). Secondly, to determine whether repeated IPC can evoke a dosed ergogenic response. METHODS: Twelve aerobically fit individuals each completed three control and three IPC 5-km cycling time trials. IPC trials included: (i) IPC 15-min preceding the trial (traditional IPC), (ii) IPC 24-h and 15-min preceding (IPC × 2), (iii) IPC 48-h, 24-h, and 15-min preceding (IPC × 3). IPC consisted of 3 × 5-min cycles of occlusion and reperfusion at the upper thighs. To assess the existence of a true response to IPC, individual performance following traditional IPC was compared to each individual's own 5-km TT coefficient of variation. In individuals who responded to IPC, all three IPC conditions were compared to the mean of the three control trials (CONavg) to determine whether repeated IPC can evoke a dosed ergogenic response. RESULTS: 9 of 12 (75%) participants improved 5-km time (-1.8 ± 1.7%) following traditional IPC, however, only 7 of 12 (58%) improved greater than their own variability between repeated controls (true responders). In true responders only, we observed a significant mean improvement in 5-km TT completion following traditional IPC (478 ± 50 s), IPC × 2 (481 ± 51 s), and IPC × 3 (480.5 ± 49 s) compared to mean CONavg (488 ± 51s; p < 0.006), with no differences between various IPC trials (p > 0.05). CONCLUSION: A majority of participants responded to IPC, providing support for a meaningful IPC-mediated performance benefit. However, repeated bouts of IPC on consecutive days do not enhance the ergogenic effect of a single bout of IPC.

Isolation of a DNA Probe for Lactobacillus curvatus.

A genomic library of Lactobacillus curvatus DSM 20019 was constructed in bacteriophage lambda gt11. A 1.2-kilobase DNA probe specific for L. curvatus was isolated from this library. When this probe was hybridized to DNA from Lactobacillus isolates from different sources classified by conventional techniques, differing degrees of hybridization were obtained. This could imply that these isolates may have been incorrectly classified.