Las políticas de igualdad sexual y de género en educación en tres sociedades europeas del sur: los casos de Andalucía y la Comunidad Valenciana (España) y Portugal

Gender mainstreaming is an international strategy in Europe relating to gender equality using an intersectional approach. It deals, specifically, with new challenges for sexuality and diversity in education. From within this context, this paper focuses on two goals. The first is to analyse sex and gender equality policies in education, since the 2000s, in three Southern European societies: Andalusia and Valencian Community, in Spain, and Portugal. The second goal is to arrive at some comparative conclusions about the recent developments in sex and gender equality policies in education in these three societies. We end with some comparative conclusions. First, there is the political orientation of governments, which seems to be of relevance. Second, there are the policies and plans reviewed, which show a move from (binary) gender equality to a more inclusive gender equality that intersects with sexuality and diversity. Sexuality education, already available in Portugal, is still absent from Spanish schools. These three experiences can inform European public policies.La incorporación de la perspectiva de género es una estrategia internacional en Europa hacia la igualdad de género, que aborda nuevos retos relativos a la sexualidad y la diversidad en educación, desde un enfoque interseccional. En este contexto, este artículo se propone dos objetivos. Primero, analizar las políticas de igualdad sexual y de género en educación desde la década de 2000 en tres sociedades del sur de Europa: Andalucía y la Comunidad Valenciana, en España y Portugal; en segundo lugar, llegar a algunas conclusiones comparativas sobre los desarrollos recientes en las políticas de igualdad sexual y de género en educación en estas tres sociedades. El artículo se cierra con algunas conclusiones comparativas. Primero, la orientación política del gobierno parece ser relevante. En segundo lugar, las políticas y los planes revisados muestran un cambio de la igualdad de género (binaria) a una igualdad de género más inclusiva que intersecciona con sexualidad y diversidad. La educación para la sexualidad, incorporada ya en Portugal, está todavía ausente en la escuela española. Estas tres experiencias pueden ser de utilidad para las políticas públicas europeas

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Effect of SGLT2 Inhibitors on Stroke and Atrial Fibrillation in Diabetic Kidney Disease: Results From the CREDENCE Trial and Meta-Analysis

BACKGROUND AND PURPOSE: Chronic kidney disease with reduced estimated glomerular filtration rate or elevated albuminuria increases risk for ischemic and hemorrhagic stroke. This study assessed the effects of sodium glucose cotransporter 2 inhibitors (SGLT2i) on stroke and atrial fibrillation/flutter (AF/AFL) from CREDENCE (Canagliflozin and Renal Events in Diabetes With Established Nephropathy Clinical Evaluation) and a meta-analysis of large cardiovascular outcome trials (CVOTs) of SGLT2i in type 2 diabetes mellitus.METHODS: CREDENCE randomized 4401 participants with type 2 diabetes mellitus and chronic kidney disease to canagliflozin or placebo. Post hoc, we estimated effects on fatal or nonfatal stroke, stroke subtypes, and intermediate markers of stroke risk including AF/AFL. Stroke and AF/AFL data from 3 other completed large CVOTs and CREDENCE were pooled using random-effects meta-analysis.RESULTS: In CREDENCE, 142 participants experienced a stroke during follow-up (10.9/1000 patient-years with canagliflozin, 14.2/1000 patient-years with placebo; hazard ratio [HR], 0.77 [95% CI, 0.55-1.08]). Effects by stroke subtypes were: ischemic (HR, 0.88 [95% CI, 0.61-1.28]; n=111), hemorrhagic (HR, 0.50 [95% CI, 0.19-1.32]; n=18), and undetermined (HR, 0.54 [95% CI, 0.20-1.46]; n=17). There was no clear effect on AF/AFL (HR, 0.76 [95% CI, 0.53-1.10]; n=115). The overall effects in the 4 CVOTs combined were: total stroke (HRpooled, 0.96 [95% CI, 0.82-1.12]), ischemic stroke (HRpooled, 1.01 [95% CI, 0.89-1.14]), hemorrhagic stroke (HRpooled, 0.50 [95% CI, 0.30-0.83]), undetermined stroke (HRpooled, 0.86 [95% CI, 0.49-1.51]), and AF/AFL (HRpooled, 0.81 [95% CI, 0.71-0.93]). There was evidence that SGLT2i effects on total stroke varied by baseline estimated glomerular filtration rate (P=0.01), with protection in the lowest estimated glomerular filtration rate (<45 mL/min/1.73 m2]) subgroup (HRpooled, 0.50 [95% CI, 0.31-0.79]).CONCLUSIONS: Although we found no clear effect of SGLT2i on total stroke in CREDENCE or across trials combined, there was some evidence of benefit in preventing hemorrhagic stroke and AF/AFL, as well as total stroke for those with lowest estimated glomerular filtration rate. Future research should focus on confirming these data and exploring potential mechanisms. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT02065791