Dispatches from the editor in chief: highlights of the June edition =================================================================== * Johno Breeze I would like to welcome you to the third issue of the journal in 2019. This is our first non-special issue of the year so far, following on from the previous highly successful ‘*Blast*’ and ‘*Psychology*’ issues. The board of the journal feel that it is important to have this mixture of issue types, and this has been supported by the *BMJ*. Non-themed issues enable the diversity of the journal to continue with submissions from individual authors and groups throughout the world. These issues in particular enable us to support junior clinicians to publish what is often their first attempts at open publication. I know of few journals in the world that would identify the potential of some submissions and work with the junior author, often through multiple versions, to ensure that their paper is finally published. Our themed special issues in contrast allow us to focus on topical subjects within the overarching concept of Military Health, with three future special issues on Military Medical Ethics, Emergency Preparedness and Women in Ground Close Combat almost complete. One of the themes of this issue is on resuscitative endovascular balloon occlusion of the aorta (REBOA), with both a leading article that I have made my editor’s choice1 and a number of letters demonstrating how this subject continues to stimulate debate.2 3 The principles of REBOA use have been used as part of the endovascular and hybrid trauma and bleeding management concept in the hospital setting, combat environments and even in the earliest phases of prehospital care. Rees * *et al* * recently reported in this journal on how REBOA could be delivered using equipment currently available in the Royal Navy Role 2 Afloat equipment module and in other military settings where access to an operating table might be compromised. This could include use by the Commando Forward Surgical Group in support of littoral operations by the Royal Marines or by British Army Role 2 Light Manoeuvre units.4 The surgeon general continues to publish heavily in the journal with two papers regarding health service support planning for large-scale defensive land operations.5 6 He has also been a big proponent of Defence Engagement within the UK Defense Medical Services, with two papers in this issue demonstrating the effectiveness that we as a group can make towards the influence of the UK abroad.7 8 We also continue to publish pertinent articles on military health since World War I, with papers on blast9 and phosgene use.10 Such papers are important to demonstrate where we as a medical community have come from, but also as a repository of corporate knowledge that would be lost to future generations were it not published here. Finally, I have included another paper from our Chinese military medical colleagues about their experience in Mali.11 As someone who publishes extensively and is I hope well connected within the international medical community, I knew virtually nothing about their role in the United Nations peacekeeping effort in Africa.12–14 Some of their submissions have required me to work extensively with the authors, but without this I doubt this information would have been published so prominently in the English literature. When you read their papers it is humbling to think that their medical clinicians are facing many of the same challenges that we and our coalition partners faced when we went to Iraq in 2003, particularly in respects to predeployment experience and maintaining clinical competencies when they return home. ## Footnotes * Competing interests None declared. * Provenance and peer review Not commissioned; internally peer reviewed. * Received May 2, 2019. * © Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ. ## References 1. Borger van der Burg BLS , Hörer TM , Eefting D , et al . Vascular access training for REBOA placement: a feasibility study in a live tissue-simulator hybrid porcine model. J R Army Med Corps 2019;165:147–51.[doi:10.1136/jramc-2018-000972](http://dx.doi.org/10.1136/jramc-2018-000972) [Abstract/FREE Full Text](http://militaryhealth.bmj.com/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6NToianJhbWMiO3M6NToicmVzaWQiO3M6OToiMTY1LzMvMTQ3IjtzOjQ6ImF0b20iO3M6MjE6Ii9qcmFtYy8xNjUvMy8xMzkuYXRvbSI7fXM6ODoiZnJhZ21lbnQiO3M6MDoiIjt9) 2. Khan M . REBOA in the role 2 afloat environment. J R Army Med Corps 2019;165:212.[doi:10.1136/jramc-2018-001014](http://dx.doi.org/10.1136/jramc-2018-001014) 3. Rees P , Waller B , Buckley AM , et al . Response to: ‘REBOA at Role 2 Afloat: resuscitative endovascular balloon occlusion of the aorta as a bridge to damage control surgery in the military maritime setting’ by Rees et al. J R Army Med Corps 2018;164:72–6.[doi:10.1136/jramc-2017-001016](http://dx.doi.org/10.1136/jramc-2017-001016) [Abstract/FREE Full Text](http://militaryhealth.bmj.com/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6NToianJhbWMiO3M6NToicmVzaWQiO3M6ODoiMTY0LzIvNzIiO3M6NDoiYXRvbSI7czoyMToiL2pyYW1jLzE2NS8zLzEzOS5hdG9tIjt9czo4OiJmcmFnbWVudCI7czowOiIiO30=) 4. Rees P , Waller B , Buckley AM , et al . REBOA at role 2 afloat: resuscitative endovascular balloon occlusion of the aorta as a bridge to damage control surgery in the military maritime setting. J R Army Med Corps 2018;164:72–6.[doi:10.1136/jramc-2017-000874](http://dx.doi.org/10.1136/jramc-2017-000874) [Abstract/FREE Full Text](http://militaryhealth.bmj.com/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6NToianJhbWMiO3M6NToicmVzaWQiO3M6ODoiMTY0LzIvNzIiO3M6NDoiYXRvbSI7czoyMToiL2pyYW1jLzE2NS8zLzEzOS5hdG9tIjt9czo4OiJmcmFnbWVudCI7czowOiIiO30=) 5. Bricknell M , Finn A , Palmer J . For debate: Health service support planning for large-scale defensive land operations (Part 1). J R Army Med Corps 2019;165:173–5. [Abstract/FREE Full Text](http://militaryhealth.bmj.com/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6NToianJhbWMiO3M6NToicmVzaWQiO3M6OToiMTY1LzMvMTczIjtzOjQ6ImF0b20iO3M6MjE6Ii9qcmFtYy8xNjUvMy8xMzkuYXRvbSI7fXM6ODoiZnJhZ21lbnQiO3M6MDoiIjt9) 6. Bricknell M , Finn A , Palmer J . For debate: Health service support planning for large-scale defensive land operations (Part 2). J R Army Med Corps 2019;165:176–9. [Abstract/FREE Full Text](http://militaryhealth.bmj.com/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6NToianJhbWMiO3M6NToicmVzaWQiO3M6OToiMTY1LzMvMTc2IjtzOjQ6ImF0b20iO3M6MjE6Ii9qcmFtYy8xNjUvMy8xMzkuYXRvbSI7fXM6ODoiZnJhZ21lbnQiO3M6MDoiIjt9) 7. Whitaker J , Bowley D . Beyond bombs and bayonets: Defence engagement and the defence medical services. J R Army Med Corps 2019;165:140–2.[doi:10.1136/jramc-2017-000838](http://dx.doi.org/10.1136/jramc-2017-000838) [FREE Full Text](http://militaryhealth.bmj.com/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiRlVMTCI7czoxMToiam91cm5hbENvZGUiO3M6NToianJhbWMiO3M6NToicmVzaWQiO3M6OToiMTY1LzMvMTQwIjtzOjQ6ImF0b20iO3M6MjE6Ii9qcmFtYy8xNjUvMy8xMzkuYXRvbSI7fXM6ODoiZnJhZ21lbnQiO3M6MDoiIjt9) 8. Bowley DM , Lamb D , Rumbold P , et al . Nursing and medical contribution to defence healthcare engagement: initial experiences of the UK defence medical services. J R Army Med Corps 2019;165:143–6.[doi:10.1136/jramc-2017-000875](http://dx.doi.org/10.1136/jramc-2017-000875) [Abstract/FREE Full Text](http://militaryhealth.bmj.com/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6NToianJhbWMiO3M6NToicmVzaWQiO3M6OToiMTY1LzMvMTQzIjtzOjQ6ImF0b20iO3M6MjE6Ii9qcmFtYy8xNjUvMy8xMzkuYXRvbSI7fXM6ODoiZnJhZ21lbnQiO3M6MDoiIjt9) 9. Kinch K , Fullerton JL , Stewart W . One hundred years (and counting) of blast-associated traumatic brain injury. J R Army Med Corps 2019;165:180–2.[doi:10.1136/jramc-2017-000867](http://dx.doi.org/10.1136/jramc-2017-000867) [Abstract/FREE Full Text](http://militaryhealth.bmj.com/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6NToianJhbWMiO3M6NToicmVzaWQiO3M6OToiMTY1LzMvMTgwIjtzOjQ6ImF0b20iO3M6MjE6Ii9qcmFtYy8xNjUvMy8xMzkuYXRvbSI7fXM6ODoiZnJhZ21lbnQiO3M6MDoiIjt9) 10. Nicholson-Roberts TC . Phosgene use in World War 1 and early evaluations of pathophysiology. J R Army Med Corps 2019;165:183–7.[doi:10.1136/jramc-2018-001072](http://dx.doi.org/10.1136/jramc-2018-001072) [Abstract/FREE Full Text](http://militaryhealth.bmj.com/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6NToianJhbWMiO3M6NToicmVzaWQiO3M6OToiMTY1LzMvMTgzIjtzOjQ6ImF0b20iO3M6MjE6Ii9qcmFtYy8xNjUvMy8xMzkuYXRvbSI7fXM6ODoiZnJhZ21lbnQiO3M6MDoiIjt9) 11. Sun R , Tian J , Jia Z , et al . Developing a hospital-based combat injury registry at the Chinese Peacekeeping level 2 military hospital in GAO, Mali. J R Army Med Corps 2019;165:169–72.[doi:10.1136/jramc-2018-000995](http://dx.doi.org/10.1136/jramc-2018-000995) [Abstract/FREE Full Text](http://militaryhealth.bmj.com/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6NToianJhbWMiO3M6NToicmVzaWQiO3M6OToiMTY1LzMvMTY5IjtzOjQ6ImF0b20iO3M6MjE6Ii9qcmFtYy8xNjUvMy8xMzkuYXRvbSI7fXM6ODoiZnJhZ21lbnQiO3M6MDoiIjt9) 12. Li J , Tian J , Wang YB , et al . Comparison of severe trauma treatment standards in civilian China with current practice in the Chinese military peacekeeping level 2 military hospital in Gao, Mali. J R Army Med Corps 2018;164:180–2.[doi:10.1136/jramc-2018-000918](http://dx.doi.org/10.1136/jramc-2018-000918) [Abstract/FREE Full Text](http://militaryhealth.bmj.com/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6NToianJhbWMiO3M6NToicmVzaWQiO3M6OToiMTY0LzMvMTgwIjtzOjQ6ImF0b20iO3M6MjE6Ii9qcmFtYy8xNjUvMy8xMzkuYXRvbSI7fXM6ODoiZnJhZ21lbnQiO3M6MDoiIjt9) 13. Zhang D , Li Z , Cao X , et al . Four years of orthopaedic activities in Chinese role 2 hospital of eastern Mali peacekeeping area. J R Army Med Corps 2019;165.[doi:10.1136/jramc-2018-000981](http://dx.doi.org/10.1136/jramc-2018-000981) 14. Zhao Y , Ma X , Li Y , et al . Analysis of cases managed by the otolaryngology service in the Chinese military peacekeeping level 2 medical treatment facility in Mali. J R Army Med Corps 2018;164:414–8.[doi:10.1136/jramc-2018-000946](http://dx.doi.org/10.1136/jramc-2018-000946) [Abstract/FREE Full Text](http://militaryhealth.bmj.com/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6NToianJhbWMiO3M6NToicmVzaWQiO3M6OToiMTY0LzYvNDE0IjtzOjQ6ImF0b20iO3M6MjE6Ii9qcmFtYy8xNjUvMy8xMzkuYXRvbSI7fXM6ODoiZnJhZ21lbnQiO3M6MDoiIjt9)