Providing recovery support to wounded, injured, and sick UK military personnel throughout the COVID-19 pandemic.

Health precautions implemented by the United Kingdom (UK) government to limit the spread of the Coronavirus Disease 2019 (COVID-19) led to the closure of many well-being support services in 2020. This created a need to re-think how impactful recovery support courses can be provided. One such service was that of the five-day Multi Activity Course (MAC) which was redesigned in accordance with national health guidelines to allow continued access for Wounded, Injured and Sick (WIS) military personnel to the service; the positive impacts of which are well established. This study investigated the influence of the newly developed Reduced numbers MAC (R-MAC) on the WIS participants lives during and for 12 months after attending. The R-MAC led to comparable impacts for participants well-being, at a time in which people's mental well-being was often being adversely affected. The positive mental well-being of the 261 participants improved by 33% throughout the course and remained 14% higher for the 37 participants who provided data six months after attending. Key facets of the experience that were most impactful for the participants were (i) shared experience with other veterans, (ii) discussing issues in a safe environment while receiving support from the staff and (iii) developing knowledge around self-help/personal development. Adapting to the challenging circumstances and developing the R-MAC mitigated against the already adverse impact of the COVID-19 pandemic for the WIS participants.

The role of Cx36 and Cx43 in 4-aminopyridine-induced rhythmic activity in the spinal nociceptive dorsal horn: an electrophysiological study in vitro.

Connexin (Cx) proteins and gap junctions support the formation of neuronal and glial syncytia that are linked to different forms of rhythmic firing and oscillatory activity in the CNS. In this study, quantitative reverse transcription polymerase chain reaction (RT-qPCR) was used to profile developmental expression of two specific Cx proteins, namely glial Cx43 and neuronal Cx36, in postnatal lumbar spinal cord aged 4, 7, and 14 days. Extracellular electrophysiology was used to determine the contribution of Cx36 and Cx43 to a previously described form of 4-aminopyridine (4-AP)-induced 4-12 Hz rhythmic activity within substantia gelatinosa (SG) of rat neonatal dorsal horn (DH) in vitro. The involvement of Cx36 and Cx43 was probed pharmacologically using quinine, a specific uncoupler of Cx36 and the mimetic peptide blocker Gap 26 which targets Cx43. After establishment of 4-12 Hz rhythmic activity by 4-AP (25 µmol/L), coapplication of quinine (250 µmol/L) reduced 4-AP-induced 4-12 Hz rhythmic activity (P < 0.05). Preincubation of spinal cord slices with Gap 26 (100 µmol/L), compromised the level of 4-AP-induced 4-12 Hz rhythmic activity in comparison with control slices preincubated in ACSF alone (P < 0.05). Conversely, the nonselective gap junction "opener" trimethylamine (TMA) enhanced 4-12 Hz rhythmic behavior (P < 0.05), further supporting a role for Cx proteins and gap junctions. These data have defined a physiological role for Cx36 and Cx43 in rhythmic firing in SG, a key nociceptive processing area of DH. The significance of these data in the context of pain and Cx proteins as a future analgesic drug target requires further study.