A 'worthy disciple of Galen', 'ardent sportsman' and 'expert swordsman': Henry Kipping (1726-1785) apothecary and surgeon at Brighton, England.

Henry Kipping (1726-1785) was an apothecary and surgeon in Brighton, England. Here we present a series of contemporary references to Kipping from newspaper, book, archive and web-based resources. Some relate to his medical practice (resuscitating a 'drowned' elderly physician and a fisherman, bleeding a member of parliament who had fallen from his horse and praising a nostrum for the 'gravel and stone'). Social references include a duel with an army officer whose sword Kipping confiscated. Kipping appears to have been popular, connected with members of Brighton's high society and passionate about traditional past times, e.g. swordsmanship, horse riding and hunting on the Sussex downs. Indeed, Kipping's horse ran in the earliest known horse race in Brighton (1770). He was consulted by notable local residents including the Thrale family of Brighton and Lady Wilhelmina Shelley (the latter evidenced by Kipping partaking in her funeral procession in 1772). Kipping lived and practised at 28 West street, a road most famous for its (now lost) George Inn where King Charles II stayed just prior to his escape to Normandy. Kipping comes across as a colourful and eccentric clinician.

Unearthing a provincial medical school and its students - A history of the 1834 'School of Practical Medicine and Surgery' at the Sussex County Hospital, Brighton, England.

The 19th century was a period of rapid change in English medical education. Little is known about the important contribution of smaller, hospital-based, provincial medical schools which sprang up to provide important practical training opportunities for students, typically as a foundation for further training and examination in London. One such example is the 1834 Brighton 'School of Practical Medicine and Surgery', which was based at the Sussex County Hospital and recognised by the Royal College of Surgeons and Worshipful Society of Apothecaries. Unlike many other 19th century medical schools, the history of the Brighton school is largely undocumented. Although it remained dependent upon London through the 'College and Hall' examination system, this article shows that the school's pragmatic and adaptive educational approach allowed it to play an important role in educating future doctors in Brighton from 1834 into at least the early 20th century.

William chambers: British army surgeon (Toulon, 1793) and his vaccination institution (1803) in Brighton, England.

Following Edward Jenner's research into cowpox, a wave of vaccination services emerged across England. Despite some resistance, these began to promote population prevention where variolation had failed. Sussex's first vaccine institution has long been considered to be that of Sir Matthew Tierney (1776-1845). Founded in 1804, Tierney's "Royal Sussex Jennerian Society for the Extermination of the Small-pox" comprised sixteen stations, including one in Kent. This article presents an earlier example: the 1803 "Brighton Royal Jennerian Institution", founded by a "Mr Chambers" to serve "the indigent poor". Given that both held royal and military appointments in Brighton, Tierney must have been aware of Chambers' efforts in vaccination. It is unclear why Tierney's 1804 plan for the Sussex Vaccine Institution makes no mention of Chambers. In 1803 Chambers also directed the establishment of Brighton's first military hospital and is noted as "surgeon extraordinary" to the Prince Regent. Chambers is identified as William Chambers of the 10th Royal Dragoons, who served at Toulon (1793) as a surgeon's mate. He is also documented at Corsica in 1794 where he examined Nelson's injured eye following the siege of Calvi. Mr Chambers' origin and more details of his biography remain unknown.

Qualitative study on mental health and well-being of Syrian refugees and their coping mechanisms towards integration in the UK.

OBJECTIVE: This study aimed to explore the mental well-being of Syrian refugees and identify their coping mechanisms and pathways towards integration into new communities. DESIGN: Qualitative study using in-depth semi-structured interviews. SETTING AND PARTICIPANTS: Adult Syrian refugees (>18 years old) currently residing in South East of England. RESULTS: 12 participants (3 women and 9 men) took part in the study, all were born in Syria and the majority (n=9) were over 45 years of age. Our findings show that Syrian refugees face constant challenges as they try to integrate into a new society. Loss of and separation from loved ones as well as the nostalgia for the homeland were often cited as a source of psychological distress that created an overwhelming sense of sadness. Participants reported that they struggled for connectedness due to cultural difference and the problematic nature of rapidly formed migrant communities in their new setting. They believed in 'being their own doctor' and turning to faith, ritual and nature for healing and comfort. Taboo and stigma around mental health and language barriers were cited as barriers to accessing mental healthcare services. CONCLUSION: Past experiences and present challenges frame Syrian refugees' sense of well-being, impact use of healthcare and risk future mental health problems. It is hoped that this study will act as a catalyst for further research on this vulnerable group to promote integration, community support and culturally sensitive mental health services.

Gladys Mary Wauchope (1889-1966): Brighton physician and second female medical student at the London Hospital Medical College.

Gladys Mary Wauchope was a pioneering woman physician and general practitioner in London and Brighton. Descended from an ancient Scottish family, she was the second female medical student at the London Hospital Medical College after Elizabeth Garrett Anderson, enrolling during the brief period from 1918 to 1928 in which women were permitted to study medicine in mainstream London medical schools due to shortages of doctors caused by the First World War. Unperturbed by opposition to her gender from male colleagues, she was initially house physician on the firm of Sir Robert Hutchison at 'the London', and went on to hold an array of posts in large London hospitals at a time when finding such work was challenging for women doctors. She settled in Hove as a general practitioner in 1924, later becoming a consultant physician at several major Brighton hospitals. Made only the eighth female fellow of the Royal College of Physicians, she also set up the first diabetic clinic in Sussex and Kent. Gladys authored several books, including her autobiography 'The Story of a Woman Physician', which documents life through two world wars and the introduction of the National Health Service, whilst keenly observing the changing landscape of medicine and its place in society.

The attempted murder of a surgeon (1882): Frank Algernon Hall of Lewes, Sussex.

Frank Algernon Hall (1846-1899) was an English surgeon who practised in Lewes, Sussex. He is remembered for an attempt on his life in 1882 by "feloniously shooting". This premeditated act took place at the Lewes surgery where he practised and lived. No reason for the attack is documented and his assailant, Edwin Battersby, was removed to Broadmoor asylum. The author reflects on the value of historical accounts in promoting awareness of assaults on clinicians.

Health service needs and perspectives of remote forest communities in Papua New Guinea: study protocol for combined clinical and rapid anthropological assessments with parallel treatment of urgent cases.

INTRODUCTION: Our project follows community requests for health service incorporation into conservation collaborations in the rainforests of Papua New Guinea (PNG). This protocol is for health needs assessments, our first step in coplanning medical provision in communities with no existing health data. METHODS AND ANALYSIS: The study includes clinical assessments and rapid anthropological assessment procedures (RAP) exploring the health needs and perspectives of partner communities in two areas, conducted over 6 weeks fieldwork. First, in Wanang village (population c.200), which is set in lowland rainforest. Second, in six communities (population c.3000) along an altitudinal transect up the highest mountain in PNG, Mount Wilhelm. Individual primary care assessments incorporate physical examinations and questioning (providing qualitative and quantitative data) while RAP includes focus groups, interviews and field observations (providing qualitative data). Given absence of in-community primary care, treatments are offered alongside research activity but will not form part of the study. Data are collected by a research fellow, primary care clinician and two PNG research technicians. After quantitative and qualitative analyses, we will report: ethnoclassifications of disease, causes, symptoms and perceived appropriate treatment; community rankings of disease importance and service needs; attitudes regarding health service provision; disease burdens and associations with altitudinal-related variables and cultural practices. To aid wider use study tools are in online supplemental file, and paper and ODK versions are available free from the corresponding author. ETHICS AND DISSEMINATION: Challenges include supporting informed consent in communities with low literacy and diverse cultures, moral duties to provide treatment alongside research in medically underserved areas while minimising risks of therapeutic misconception and inappropriate inducement, and PNG research capacity building. Brighton and Sussex Medical School (UK), PNG Institute of Medical Research and PNG Medical Research Advisory Committee have approved the study. Dissemination will be via journals, village meetings and plain language summaries.

Media content analysis of general practitioners' reactions to care.data expressed in the media: what lessons can be learned for future NHS data-sharing initiatives?

OBJECTIVES: Care.data was a 2013 UK government initiative to extract patient data from general practices in England to form a centralised whole-population database for service planning and health research. After a public outcry, the scheme was postponed and cancelled. Public views of care.data have previously been analysed; this study aimed to understand contemporary general practitioners' (GPs) views of the scheme, which may have been influential in its downfall. DESIGN: Systematic search of media articles, followed by media content analysis. SETTING: UK-based mainstream and GP-facing media in 2013 and 2014. PARTICIPANTS: Articles were eligible if they focused on care.data, and GPs were quoted, authored the article, or if articles were written for a majority GP audience. INTERVENTIONS: N/A. PRIMARY AND SECONDARY OUTCOME MEASURES: Themes which explained GPs' reactions to care.data and which could explain support for or opposition to the scheme. RESULTS: 162 media articles met inclusion criteria and were drawn from newspapers, news websites and GP-facing websites. GPs recognised care.data's potential value for research and improving care, but had grave concerns about the scheme's implementation. These centred the lack of safeguards and purpose around the scheme which meant patients were not able to make informed decisions about opt-out. GPs perceived they were poorly resourced to meet competing demands to both share patients' data and protect confidentiality. They distrusted the government's likely uses of the data and perceived a risk of patient reidentification if the data were sold onto commercial entities. CONCLUSIONS: Findings show specific concerns which GPs had about care.data which led to the withdrawal of support. Future NHS patient data-sharing schemes should engage with GPs and other clinicians as key stakeholders from the earliest moments of planning, so that their views and needs are incorporated into the design of such schemes.

Sir Matthew Tierney and the foundation of the 1804 Sussex Vaccine Institution.

Irish physician Sir Matthew John Tierney (1776-1845) was a vaccine pioneer who learnt the procedure directly from Edward Jenner in Gloucestershire. In 1802 Tierney completed an MD at Glasgow on vaccination and moved to Brighton, where he was appointed physician to the Prince of Wales (the future King George IV). This paper considers Tierney's role in the foundation of the 1804 Sussex Vaccine Institution. Tierney was the first president of the Institution's Medical Council. His leadership lay in his knowledge of vaccination (including transporting cowpox material) and his close relationship with the Prince of Wales. The Institution's official name was the Royal Sussex Jennerian Society for the Extermination of the Small-pox and offered vaccination at 16 stations across the county and one in Kent. Vaccination was undertaken by local surgeons at their houses at set hours. In its first year, the Institution vaccinated 946 individuals, of whom 509 for free. Despite this, concerns were raised over uptake by poorer members of society. The Institution's Brighton station was probably absorbed into the new 1809 dispensary. Tierney's promotion of vaccination and instructions for new practitioners represent the embryonic beginnings of evidence-based medicine and modern medical education in Brighton.

"One Big Family": Pastoral Care and Treatment Seeking in an Egyptian Coptic Church in England.

Little is known about Coptic migrants' chronic disease health beliefs and treatment-seeking behaviours. Interviews to explore these issues and their relationship with church membership were conducted with 15 Coptic migrants in Southern England. Obesity and cardiovascular disease (CVD) were most frequently identified as health risks for Coptic migrants. CVD was ascribed to stress and considered amenable to spiritual healing. Lay referral to medical practitioners who were church members was common but may devalue perceptions of family medicine. The Coptic Church functions as a community that addresses members' wider vulnerability. Central to this is the "parish nurse" role of the priest.

Near-death experience and out of body phenomenon during torture--a case report.

A case of a near death experience (NDE) associated with an "Out of body" phenomenon in an African man as a result of torture is presented. Although NDEs occur in approximately ten per cent of survivors of cardiac arrest, case reports emerging from the medical examination of torture victims are lacking. This may be due to cultural/linguistic barriers and fear of disbelief. Low NDE incidence during torture would suggest that torture techniques rarely induce the critical brain ischaemia considered necessary to provoke an NDE. Alternatively psychological or physical characteristics of torture may render NDE harder to recall. Proof of low incidence during torture would counter the theory that NDEs are a psychological response to perceived threat of death. NDEs often induce transformational benefits in patients' lives and for this reason the author urges physicians to consider the possibility of NDE amongst torture victims under their care. A request for information about similar cases is made.