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Objective: To examine the effects of exposure to conflicting nutritional information (CNI) through different forms of media on nutrition-related confusion and backlash among consumers in the UK.Design: Cross-sectional survey administered via Qualtrics among 18-75-year-old participants in the UK. The sample was stratified by age and gender with quotas defined according to the 2011 UK census distribution.Setting: Qualtrics' Online panel of respondents in the UK.Participants: 676 participants comprising nearly an equal number of females (n 341) and males (n 335) and a majority (58·6 %) from households whose income was <£30 000.Results: Our findings showed that nearly 40 % of respondents were exposed to some or a lot of CNI. We found that while exposure to CNI from TV and online news increased nutrition confusion, CNI from health professionals increased backlash. Exposure to CNI from social media and health websites was associated with reduced backlash. We also found that nutrition confusion and backlash were negatively associated with exercise behaviour and fruit and vegetable consumption, respectively.Conclusions: Our study supports the theoretical pathways that explain the influence of CNI exposure on nutrition-related cognitive and behavioural outcomes. Additionally, different types of online information sources are associated with these outcomes to varying degrees. In the context of obesity and diabetes rates in the UK, our findings call for (a) further experimental research into the effects of CNI on consumers' diet-related cognitions and behaviours and (b) multi-stakeholder, interdisciplinary approaches to address this problem. [ABSTRACT FROM AUTHOR]

Encephalitis, inflammation of the brain, is most commonly caused by a viral infection (especially herpes simplex virus [HSV] type 1 in the UK) although autoimmune causes, such as N-methyl D-aspartate receptor (NMDAR) antibody encephalitis, are increasingly recognised. Most patients present with a change in consciousness level and may have fever, seizures, movement disorder or focal neurological deficits. Diagnosis hinges crucially on lumbar puncture and cerebrospinal fluid (CSF) examination, but imaging and electroencephalography (EEG) may also be helpful. Treatment of HSV encephalitis with aciclovir dramatically improves outcome, but the optimal management of autoimmune encephalitis is still uncertain. Many patients with encephalitis are left with residual physical or neuropsychological deficits which require long-term multidisciplinary management. Here we review assessment of patients with suspected encephalitis, general aspects of management and areas of ongoing research. [ABSTRACT FROM AUTHOR]

The article discusses the similarities between the legal tests for passing off (product counterfeiting) and likelihood of confusion under Great Britain's trademark laws as of 2015, and it mentions the legal concept of misrepresentation in relation to British trademark infringement claims and consumer confusion. Several British trademark infringement legal cases are examined, including Reed Executive PLC v. Reed Business Information Ltd. and Cosmetic Warriors Ltd. v. Amazon.co.uk Ltd.

The author argues that it is important for businesses to maintain a comprehensive collection of trade marks to protect a brand, and it mentions the Great Britain High Court's ruling in the case Enterprise Holdings Inc. v. Europcar Group UK Ltd. which deals with the legality of the defendant's claim for trade mark infringement regarding its single letter "e" logo. It states that simple logos can be validly registered and protected as trade marks if owners follow trade mark management strategies.

The author focuses on a decision held by the High Court of England and Wales that the use of the word "Pink" by lingerie retailer Victoria's Secret for its clothing sub-brand infringed the registered trade marks of the retail luxury clothing company Thomas Pink under the Trade Marks Act (TMA) 1994. Topics discussed include the challenge to the validity of the mark, partial revocation of the mark, and registered trade mark infringement under TMA. Also mentioned is the likelihood of confusion.

The authors argue that the Great Britain Court of Appeal's ruling in the 2015 trade mark infringement case J.W. Spear & Sons v. Zynga Inc. will impact a trade mark holder's rights to other features that are used in association with the mark, and discuss the similarities and differences between the word-related game "SCRABBLE" and the defendant social gaming company's "SCRAMBLE" and "SCRAMBLE WITH FRIENDS" mobile apps. Product counterfeiting laws and trade mark confusion are examined.

Background: To develop items for an early warning score (RECAP: REmote COVID-19 Assessment in Primary Care) for patients with suspected COVID-19 who need escalation to next level of care., Methods: The study was based in UK primary healthcare. The mixed-methods design included rapid review, Delphi panel, interviews, focus groups and software development. Participants were 112 primary care clinicians and 50 patients recovered from COVID-19, recruited through social media, patient groups and snowballing. Using rapid literature review, we identified signs and symptoms which are commoner in severe COVID-19. Building a preliminary set of items from these, we ran four rounds of an online Delphi panel with 72 clinicians, the last incorporating fictional vignettes, collating data on R software. We refined the items iteratively in response to quantitative and qualitative feedback. Items in the penultimate round were checked against narrative interviews with 50 COVID-19 patients. We required, for each item, at least 80% clinician agreement on relevance, wording and cut-off values, and that the item addressed issues and concerns raised by patients. In focus groups, 40 clinicians suggested further refinements and discussed workability of the instrument in relation to local resources and care pathways. This informed design of an electronic template for primary care systems., Results: The prevalidation RECAP-V0 comprises a red flag alert box and 10 assessment items: pulse, shortness of breath or respiratory rate, trajectory of breathlessness, pulse oximeter reading (with brief exercise test if appropriate) or symptoms suggestive of hypoxia, temperature or fever symptoms, duration of symptoms, muscle aches, new confusion, shielded list and known risk factors for poor outcome. It is not yet known how sensitive or specific it is., Conclusions: Items on RECAP-V0 align strongly with published evidence, clinical judgement and patient experience. The validation phase of this study is ongoing., Trial Registration Number: NCT04435041., Competing Interests: Competing interests: MD’s company makes templates for general practice record systems. All other authors declare no competing interests., (© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ.)

Clinical observations suggest that tinnitus may interfere with programming cochlear implants (CIs), the process of optimizing the transmission of acoustic information to support speech perception with a CI. Despite tinnitus being highly prevalent among CI users, its effects and impact on CI programming are obscure. This study characterized the nature, time-course, and impact of tinnitus effects encountered by audiologists and patients during programming appointments. Semistructured interviews with six CI audiologists were analyzed thematically to identify tinnitus effects on programming and related coping strategies. Cross-sectional surveys with 67 adult CI patients with tinnitus and 20 CI audiologists in the United Kingdom examined the prevalence and time-course of those effects. Programming parameters established at CI activation appointments of 10 patients with tinnitus were compared with those of 10 patients without tinnitus. On average, 80% of audiologists and 45% of patients reported that tinnitus makes measurements of threshold (T) levels more difficult because patients confuse their tinnitus with CI stimulation. Difficulties appeared most common at CI activation appointments, at which T levels were significantly higher in patients with tinnitus. On average, 26% of patients reported being afraid of "loud" CI stimulation worsening tinnitus, affecting measurements of loudest comfortable (C) stimulation levels, and 34% of audiologists reported observing similar effects. Patients and audiologists reported that tinnitus makes programming appointments more difficult and tiresome for patients. The findings suggest that specific programming strategies may be needed during CI programming with tinnitus, but further research is required to assess the potential impact on outcomes including speech perception. [ABSTRACT FROM AUTHOR]

Introduction: Delirium is a severe neuropsychiatric syndrome of rapid onset, commonly precipitated by acute illness. It is common in older people in the emergency department (ED) and acute hospital, but greatly under-recognised in these and other settings. Delirium and other forms of cognitive impairment, particularly dementia, commonly coexist. There is a need for a rapid delirium screening tool that can be administered by a range of professional-level healthcare staff to patients with sensory or functional impairments in a busy clinical environment, which also incorporates general cognitive assessment. We developed the 4 'A's Test (4AT) for this purpose. This study's primary objective is to validate the 4AT against a reference standard. Secondary objectives include (1) comparing the 4AT with another widely used test (the Confusion Assessment Method (CAM)); (2) determining if the 4AT is sensitive to general cognitive impairment; (3) assessing if 4AT scores predict outcomes, including (4) a health economic analysis., Methods and Analysis: 900 patients aged 70 or over in EDs or acute general medical wards will be recruited in three sites (Edinburgh, Bradford and Sheffield) over 18 months. Each patient will undergo a reference standard delirium assessment and will be randomised to assessment with either the 4AT or the CAM. At 12 weeks, outcomes (length of stay, institutionalisation and mortality) and resource utilisation will be collected by a questionnaire and via the electronic patient record., Ethics and Dissemination: Ethical approval was granted in Scotland and England. The study involves administering tests commonly used in clinical practice. The main ethical issues are the essential recruitment of people without capacity. Dissemination is planned via publication in high impact journals, presentation at conferences, social media and the website www.the4AT.com., Trial Registration Number: ISRCTN53388093; Pre-results., Competing Interests: Competing interests: No competing interests., (© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)

The article discusses the Great Britain High Court's determination in the 2015 case Sebry v. Great Britain's Companies House that the British Registrar of Companies owed no duty of care to ensure that a winding-up order was not entered against the wrong company. Claims for damages based on negligence and breach of statutory duty are mentioned, along with Great Britain's Companies Act 2006 and a reasonable care legal standard. The impact of a company's liquidation on bankers is examined.