ObjectivesPatient and public involvement (PPI) in health research is required by some funders and publications but we know little about how common it is. In this study we estimated the frequency of PPI inclusion in health research papers and analysed how it varied in relation to research topics, methods, funding sources and geographical regions.DesignCross-sectional.MethodsOur sample consisted of 3000 research papers published in 2020 in a general health-research journal (BMJ Open) that requires a statement on whether studies included PPI. We classified each paper as ‘included PPI’ or ‘did not include PPI’ and analysed the association of this classification with location (country or region of the world), methods used, research topic (journal section) and funding source. We used adjusted regression models to estimate incident rate ratios of PPI inclusion in relation to these differences.Results618 (20.6%) of the papers in our sample included PPI. The proportion of papers including PPI varied in relation to location (from 44.5% (95% CI 40.8% to 48.5%) in papers from the UK to 3.4% (95% CI 1.5% to 5.3%) in papers from China), method (from 38.6% (95% CI 27.1% to 50.1%) of mixed-methods papers to 5.3% (95% CI –1.9% to 12.5%) of simulation papers), topic (from 36.9% (95% CI 29.1% to 44.7%) of papers on mental health to 3.4% (95% CI –1.3% to 8.2%) of papers on medical education and training, and funding source (from 57.2% (95% CI 51.8% to 62.6%) in papers that received funding from the UK’s National Institute for Health Research to 3.4% (95% CI 0.7% to 6.0%) in papers that received funding from a Chinese state funder).ConclusionsMost research papers in our sample did not include PPI and PPI inclusion varied widely in relation to location, methods, topic and funding source.

Children and young people have much to contribute to the design and delivery of health research and care. Nevertheless, there are multiple barriers to meaningful and impactful involvement of children and young people. This narrative review synthesised existing literature on the involvement of children and young people as partners in health research. Authors screened electronic databases and reference lists to identify relevant studies. Data were extracted on how involvement was described, what young people contributed to, and the impact of their involvement. The review identified 15 reports; these reported researcher observations and findings from focus group discussions and questionnaires about the involvement. Impacts recorded in these studies included influence on research; outputs from involvement activities; shifts in researchers’ attitudes; a sense of achievement in young people; and fulfilling relationships. These impacts were associated with principles being followed: building relationships over time to allow for unexpected involvement in the research, flexibility so young people could contribute in ways that work for them, and training. Methods adapted to be youth-appropriate such as visual aids and icebreaker games also enabled impact. Impactful involvement relies on processes that respond to young people’s preferences for engagement and activities that support them to share their views.

Juanne Nancarrow Clarke's 'When Medicine Goes Awry: Case Studies in Medically Caused Suffering and Death' offers an important addition to our limited understanding of medical errors. Clarke provides a compelling and comprehensive sociological analysis of medical errors and offers a critical insight into its potential causes and solutions.Central to Clarke's argument is the notion that medical error is not the biproduct of a singular case of medical malpractice but is an intrinsic characteristic of the modern healthcare system. Clarke places particular blame on the 'expanding proves of medicalisation' (p. 4) for the irrevocability of medical error. The role of allopathic medicine has become central in contemporary society, with many aspects of everyday life being increasingly defined as medical problems. A consequence of this is an inability to recognise the shortcomings of allopathic healthcare including the limitations of medical science, practice, system organisation and pharamaceuticalisation.Drawing on 7 well-publicised Canadian cases of medical error, Clarke describes the vivid interplay between several sociological principles in the rise of medically caused suffering and death including medicalisation, pharamaceuticalisation and the social determinants of health. Clarke helpfully separates the case studies into 2 parts. The first part describes four cases where patients were the victim of medical error: the case of Brian Sinclair describes racially motivated medical negligence which resulted in the death of an Indigenous man waiting for assistance in an emergency room; the case of Ashley Smith describes the preventable death of a young person in judicial care; and the case of Vanessa Young and Marit McKenzie describes how pharmaceutical error and a reliance on medicine to solve social problems resulted in the death of two young people.In addition to describing individual victims of medical error, Carrow also draws on cases where practitioners were responsible for medical error. This includes Dr. Charles Smith, a doctor renowned for his problematic behaviours and medical harms yet received insufficient punishment due to the limited specialists within his area of expertise; Elizabeth Wettlaufer, a nurse who was accused of murdering several elderly patients; and Dr. Norman Barwin, a fertility doctor who

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