Journal of the Royal Army Medical Corps aims to publish high quality research, reviews and case reports, as well as other invited articles, which pertain to the practice of military medicine in its broadest sense. It welcomes material from all ranks, services and corps wherever they serve as well as submissions from beyond the military. It is intended not only to propagate current knowledge and expertise but also to act as an institutional memory for the practice of medicine within the military.

Journal of the Royal Army Medical Corps is the offi cial journal of the RAMC.

Editor Maj Johno Breeze Editorial Board Contact Details Consulting Editor Surgeon Captain J Smith Major E Bernthall Editorial Offi ce Lt Col (Rtd) Jeff Garner Colonel D Ross Major S Makin BMJ Publishing Group Ltd, BMA House, Tavistock Square London, WC1H 9JR, UK Deputy Editor/Web Editor Colonel D Wilson Major A Ramasamy Maj Piers Page T: +44 (0)20 7383 6909 Colonel L Holden Major A Weir E: [email protected] Guidelines for Colonel D Edwards Major D Hayhurst Production Editor Authors and Reviewers Lieutenant Colonel A Everest Dr E Kirkman Antonia Johnston Full instructions are available online at http://jramc.bmj.com/ifora. Articles Lieutenant Colonel R Reed Squadron Leader P Lavallée T: +44 (0)20 7874 6403 must be submitted electronically E: [email protected] http://submit-jramc.bmj.com. Permissions Impact factor: 0.549 See http://journals.bmj.com/misc/permissions.dtl Management Board Supplement Enquiries RAMC History T: +44 (0)20 7383 6088 The Royal Army Medical Corps (RAMC) Brigadier P Fabricius Lieutenant Colonel H Doughty E: [email protected] traces its history back to the foundation Colonel SG Mellor Major J Breeze of the Regular Army, following the Subscriptions Colonel M Pemberton Major MJT Ellis restoration of King Charles II in 1660, For all subscription enquiries and orders but it was not until 1898 that offi cers T: +44 (0)20 7111 1105 and soldiers were incorporated into E: [email protected] one body known as the Royal Army Medical Corps. Display Advertising Sales Sophie Fitzsimmons The RAMC motto is In Arduis Fidelis – T: +44 (0)20 7383 6783 Faithful in Adversity. The 31 Victoria E: sfi [email protected] Crosses won by the Corps, including http://group.bmj.com/group/advertising two double VCs and one recipient of both the VC and the Iron Cross, bear Online Advertising Sales testimony to the motto and the Marc Clifford (Sales Manager) character and ideals of the men and T: +44 (0)20 7383 6161 women who wear the badge. E: [email protected] http://group.bmj.com/group/advertising RAMC History Queries Display & Online Advertising Sales (USA) The Army Medical Services Museum Jim Cunningham is the appropriate contact for all queries Subscription Information on the history of the Royal Army T: +1 201 767 4170 Medical Corps. Email the Museum: E: [email protected] [email protected] Journal of the Royal Army Medical Corps Author Reprints Reprints Administrator RAMC Recruiting Personal Rates 2016 T: +44 (0)150 251 5161 For all enquiries regarding recruitment E: [email protected] to the Army Medical Services (AMS) go ISSN 0035-8665 (print); 2052-0468 (online) to the AMS website (http://www.army. Print (includes online access at no additional Commercial Reprints (except USA & Canada) mod.uk/army-medical-services/5318. € Nadia Gurney-Randall aspx) and follow the Joining the Army charge) US$201; £103; 140 T: +44 (0)20 7111 1105 links (http://www.army.mod.uk/join/) Online only US$164; £84; €114 M: +44 (0)7866 262344 E: [email protected] Copyright © 2016 Crown copyright. Site licences are priced on FTE basis and allow All rights reserved; no part of this Commercial Reprints (USA & Canada) publication may be reproduced, stored access by a whole institution. Ray Thibodeau in a retrieval system or transmitted in T: +1 267 895 1758 any form or by any means, electronic, For details on how to subscribe, institutional M: +1 215 933 8484 mechanical, photocopying, recording or pricing and payment methods visit http://journals. E: [email protected] otherwise without the prior permission bmj.com/subscriptions/ or contact the Subscription of Journal of the Royal Army Medical For all other JRAMC journal contacts Corps. Manager in London: tel +44 (0)20 7111 1105; http://jramc.bmj.com/site/help/index.xhtml [email protected] Journal of the Royal Army Medical Corps Regimental Headquarters RAMC Residents of some EC countries and Canada must Headquarters Army Medical Services pay VAT for online subscriptions: for details please FASC visit http://journals.bmj.com/subscriptions or Slim Road Camberley contact the Subscription Manager in London: tel Surrey +44 (0)20 7111 1105; [email protected] GU15 4NP T: +44 (0)1276 412790

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