Youth activists' perspectives on climate, sexual and reproductive health and rights, and gender inequality

https://www.thelancet.com/journals/lanplh/issue/current Generation Equality is a global multistakeholder partnership mechanism advocating for a wide range of issues, including the gender and climate justice agenda. Convened by UN Women in 2020, Generation Equality is based on the landmark 25th anniversary of the 1995 Beijing Declaration and Platform for Action on the promotion of women's rights. In this Comment, we build on a Generation Equality side event held during the Sixty-Sixth Commission on the Status of Women in 2021, which placed a spotlight on the neglected but highly interconnected climate, sexual and reproductive health and rights (SRHR), and gender inequality crises.1 Among the alarming magnitude of climate disasters worldwide, the effects of climate change on people and the planet continue to be catastrophic, including the disruptions to education, health services, and SRHR services; as a result, gender equality is being threatened on a global scale. We can no longer sit back and ignore these interconnections—the lives of women, girls, and vulnerable populations are at risk. This Comment puts forth the interlinked climate–SRHR–gender crises and then shifts to young climate activists contextualising the crises in Brazil. The Lancet Commission to reduce the global burden of sudden cardiac death: a call for multidisciplinary action https://www.thelancet.com/commission/sudden-cardiac-death?dgcid=hubspot_email_conferencealerts_esc23_lancetscd23&utm_campaign=conferencealerts&utm_medium=email&_hsmi=272134971&_hsenc=p2ANqtz-8cfZJX6rGJ01xb_bC1fxy__1wHBpK4GorxZApGs9o8yJYE8gP9syMBTj6F6-6M4x5Cne7fVLJhS91fv5GAhqwpv0uROg&utm_content=272134971&utm_source=hs_email Sudden cardiac death claims millions of lives each year. It results from sudden cardiac arrest and as many as 9 out of 10 of cases result in sudden cardiac death. Chances of survival are increased with early resuscitation, but for most cases of cardiac arrest in the community effective treatment is too slow to arrive. The Commission identifies key factors that can be implemented to reduce sudden cardiac death, recommendations to improve care, and areas for research to help understand the causes and ameliorate the effects on families of people experiencing sudden cardiac death. Venoarterial extracorporeal membrane oxygenation in patients with infarct-related cardiogenic shock: an individual patient data meta-analysis of randomised trials https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)01607-0/fulltext?dgcid=hubspot_email_conferencealerts_esc23&utm_campaign=conferencealerts&utm_medium=email&_hsmi=272134971&_hsenc=p2ANqtz-8PEWcxIo0KnEGI0rpaDTZ7tb7o1YFzVm2Mt6tuKUeFBBVyrUO_5kqwY_2lqENlEnWYkFOX7ue66rNhGsbSQQfk_DFR4A&utm_content=272134971&utm_source=hs_email Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is increasingly used in patients with cardiogenic shock despite the lack of evidence from adequately powered randomised clinical trials. Three trials reported so far were underpowered to detect a survival benefit; we therefore conducted an individual patient-based meta-analysis to assess the effect of VA-ECMO on 30-day death rate. Revisiting VA-ECMO in infarct-related cardiogenic shock https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)01688-4/fulltext?dgcid=hubspot_email_conferencealerts_esc23&utm_campaign=conferencealerts&utm_medium=email&_hsmi=272134971&_hsenc=p2ANqtz-9UBBde8MBvIX4bpa4A37P7zwR9TN49wOceXhBQct6pGToxdaWJG-3cPUOE92oWkjglWdZSE8SA7nmFwbir97ZaLkTwUQ&utm_content=272134971&utm_source=hs_email Despite advances in medical therapies and coronary revascularisation, infarct-related cardiogenic shock remains a life-threatening emergency with high death rates. 1 Temporary mechanical circulatory support, including peripheral venoarterial extracorporeal membrane oxygenation (VA-ECMO), is a potential option for this condition as it can instantly improve haemodynamics while simultaneously providing gas exchange for acute cardiorespiratory failure. 2 However, this is an expensive and invasive strategy that requires large-bore vascular access and can result in serious complications including bleeding, peripheral ischaemia, and stroke. Since its introduction in 1972, 3 there has been a marked increase in VA-ECMO use for cardiogenic shock, although whether it improves outcomes in these patients is still unknown. 4 Observational data have been limited by residual confounding, not allowing for causal interpretation. Recent randomised clinical trials (RCTs) have attempted to provide answers; however, these have often been underpowered, reflecting the difficulty of conducting RCTs during acute critical illness. 5 , 6 , 7 As such, current recommendations for the use of VA-ECMO in cardiogenic shock are based on a low level of evidence. 8 Expedited transfer to a cardiac arrest centre for non-ST-elevation out-of-hospital cardiac arrest (ARREST): a UK prospective, multicentre, parallel, randomised clinical trial https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)01351-X/fulltext?dgcid=hubspot_email_conferencealerts_esc23&utm_campaign=conferencealerts&utm_medium=email&_hsmi=272134971&_hsenc=p2ANqtz-96p6sLxcM0ZWtqT62BdMCCMRVA7Kld4Dh56wD5EuMtWsKtyWNpa8oFR3T6GvhaemUsapprMhoWqlfJsZQWQhumjq8wUw&utm_content=272134971&utm_source=hs_email The International Liaison Committee on Resuscitation has called for a randomised trial of delivery to a cardiac arrest centre. We aimed to assess whether expedited delivery to a cardiac arrest centre compared with current standard of care following resuscitated cardiac arrest reduces deaths.