Children in care who live in a regional setting have similar health-care needs compared with urban children. Given restricted health services in regional settings, there is difficulty in accessing services to meet these needs.

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Background Frequent visiting and communication with patients’ families are embedded within normal ICU practice, however the COVID-19 pandemic has challenged this, and it is unclear how ICUs are managing. We aimed to investigate how NHS ICUs are approaching family communications and visiting during the COVID-19 pandemic. Methods An electronic snapshot survey was delivered between 16th April and 4th May 2020 and was open to NHS ICUs. Replies from 134 individual ICUs with COVID patients were included. Results All reported that visiting was more restricted than normal with 29 (22%) not allowing any visitors, 71 (53%) allowing visitors at the end of a patient’s life (EOL) only, and 30 (22%) allowing visitors for vulnerable patients or EOL. Nearly all (n = 130, 97%) were updating families daily, with most initiating the update (n = 120, 92%). Daily telephone calls were routinely made by the medical (n = 75, 55%) or nursing team (n = 50, 37%). Video calling was used by 63 (47%), and 39 (29%) ICUs had developed a dedicated family communication team. Resuscitation and EOL discussions were most frequently via telephone (n = 129, 96%), with 24 (18%) having used video calling, and 15 (11%) reporting discussions had occurred in person. Clinicians expressed their dissatisfaction with the situation and raised concerns about the detrimental effect on patients, families, and staff. Conclusions COVID-19 has resulted in significant changes across NHS ICUs in how they interact with families. Many units are adapting and moving toward distant and technology-assisted communication. Despite innovative solutions, challenges remain and there may be a role for local and national guidance.

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Science is a dynamic subject and it was never free of misconduct or bad research. Indeed, the scientific method itself is intended to overcome mistakes and misdeeds. So, we aimed to assess various factors associated with retraction of scientific articles from 2004 to 2013. Data were retrieved from PubMed and Medline using the keywords retraction of articles, retraction notice, and withdrawal of article in April 2014 to detect articles retracted from 2004 to 2013. Statistical analysis was carried out using t-test and Karl Pearson's correlation coefficient. Results showed that a total of 2343 articles were retracted between 2004 and 2013, and original articles followed by case reports constituted major part of it. Time interval between submission and retraction of article has reduced in recent times. Impact factor and retraction do not have any significant correlation. We conclude that although retraction of articles is a rare event, its constant rise in scientific literature is quite worrisome. It is still unclear whether misconduct/mistakes in articles are increasing hastily or the articles are retracted at a rapid rate in recent times. So, it should be considered as an urgent issue and it is the responsibility of journal editors to track misconduct by following Committee on Publication Ethics (COPE) guidelines and making an effective strategy.

Background: Central venous catheters are inserted ubiquitously in critical care and have roles in drug administration, fluid management and renal replacement therapy. They are also associated with numerous complications. The true number of central venous catheters inserted per year and the proportion of them associated with complications are unknown in the UK. Methods: We performed a prospective audit at five hospitals, as a feasibility pilot for a larger, nationwide audit. Using a novel secure online data collection platform, developed earlier and adapted for this project, all central venous catheters inserted for patients admitted to the Intensive Care Units were documented at five pilot sites across the UK. Results: A total of 117 data collection forms were submitted. Users found the electronic data collection system easy to use. All data fields were ready for analysis immediately after data input. Out of the 117 central venous catheters, 17 were haemodialysis catheters and five pulmonary artery introducers. Experienced practitioners (at least three years' experience) inserted 85% of the central venous catheters. The site of insertion was the internal jugular vein for 80%, femoral for 12% and subclavian for 8% of central venous catheters. Most central venous catheters were inserted in ICU (49%) or theatres (42%). Ultrasound was used for 109 (93%) of central venous catheter insertions and its use was not associated with fewer complications. In 15 cases venopuncture was attempted more than once (all with ultrasound) and this was associated with significantly increased risk of complications. There were eight immediate complications (6.8%): five related to venopuncture and inability to pass a guidewire, two carotid artery punctures and one associated with significant arrhythmia. Conclusion: This study demonstrates the ease and feasibility of collecting detailed descriptive data on central line insertion and its immediate complications in the UK over two weeks. In our proposed nationwide audit, organisation-level data on local policies and standard operating procedures is required to complete the picture on this important aspect of intensive care practice.

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Introduction: Effectiveness of vibratory stimulus from a commonly available battery-powered tooth brush in accelerating orthodontic tooth movement was tested by a randomized controlled split-mouth study. Materials and Methods: Twenty-three subjects with bimaxillary protrusion, requiring extraction of all first premolars and requiring maximum anchorage, were chosen. After initial leveling and aligning, miniscrews were placed between the first molar and the second premolar in the maxillary right and left quadrants and loaded with 150-g nickel–titanium closed-coil springs for individual canine retraction. Additional 5 min of vibratory stimulus thrice daily was applied on the experimental side. The mean treatment duration was 3 months. Results: There was no significant difference of means of the canine distal movement between the experimental and the control sides ( P = 0.70). Conclusion: Application of vibratory stimulus with powered tooth brush during canine retraction was not seen to have an acceleratory effect on orthodontic tooth movement.