Omecamtiv mecarbil in chronic heart failure with reduced ejection fraction, GALACTIC‐HF: baseline characteristics and comparison with contemporary clinical trials

Aims: The safety and efficacy of the novel selective cardiac myosin activator, omecamtiv mecarbil, in patients with heart failure with reduced ejection fraction (HFrEF) is tested in the Global Approach to Lowering Adverse Cardiac outcomes Through Improving Contractility in Heart Failure (GALACTIC‐HF) trial. Here we describe the baseline characteristics of participants in GALACTIC‐HF and how these compare with other contemporary trials. Methods and Results: Adults with established HFrEF, New York Heart Association functional class (NYHA) ≥ II, EF ≤35%, elevated natriuretic peptides and either current hospitalization for HF or history of hospitalization/ emergency department visit for HF within a year were randomized to either placebo or omecamtiv mecarbil (pharmacokinetic‐guided dosing: 25, 37.5 or 50 mg bid). 8256 patients [male (79%), non‐white (22%), mean age 65 years] were enrolled with a mean EF 27%, ischemic etiology in 54%, NYHA II 53% and III/IV 47%, and median NT‐proBNP 1971 pg/mL. HF therapies at baseline were among the most effectively employed in contemporary HF trials. GALACTIC‐HF randomized patients representative of recent HF registries and trials with substantial numbers of patients also having characteristics understudied in previous trials including more from North America (n = 1386), enrolled as inpatients (n = 2084), systolic blood pressure < 100 mmHg (n = 1127), estimated glomerular filtration rate < 30 mL/min/1.73 m2 (n = 528), and treated with sacubitril‐valsartan at baseline (n = 1594). Conclusions: GALACTIC‐HF enrolled a well‐treated, high‐risk population from both inpatient and outpatient settings, which will provide a definitive evaluation of the efficacy and safety of this novel therapy, as well as informing its potential future implementation

Global, regional, and national progress towards Sustainable Development Goal 3.2 for neonatal and child health: all-cause and cause-specific mortality findings from the Global Burden of Disease Study 2019

Background Sustainable Development Goal 3.2 has targeted elimination of preventable child mortality, reduction of neonatal death to less than 12 per 1000 livebirths, and reduction of death of children younger than 5 years to less than 25 per 1000 livebirths, for each country by 2030. To understand current rates, recent trends, and potential trajectories of child mortality for the next decade, we present the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 findings for all-cause mortality and cause-specific mortality in children younger than 5 years of age, with multiple scenarios for child mortality in 2030 that include the consideration of potential effects of COVID-19, and a novel framework for quantifying optimal child survival. Methods We completed all-cause mortality and cause-specific mortality analyses from 204 countries and territories for detailed age groups separately, with aggregated mortality probabilities per 1000 livebirths computed for neonatal mortality rate (NMR) and under-5 mortality rate (USMR). Scenarios for 2030 represent different potential trajectories, notably including potential effects of the COVID-19 pandemic and the potential impact of improvements preferentially targeting neonatal survival. Optimal child survival metrics were developed by age, sex, and cause of death across all GBD location-years. The first metric is a global optimum and is based on the lowest observed mortality, and the second is a survival potential frontier that is based on stochastic frontier analysis of observed mortality and Healthcare Access and Quality Index. Findings Global U5MR decreased from 71.2 deaths per 1000 livebirths (95% uncertainty interval WI] 68.3-74-0) in 2000 to 37.1 (33.2-41.7) in 2019 while global NMR correspondingly declined more slowly from 28.0 deaths per 1000 live births (26.8-29-5) in 2000 to 17.9 (16.3-19-8) in 2019. In 2019,136 (67%) of 204 countries had a USMR at or below the SDG 3.2 threshold and 133 (65%) had an NMR at or below the SDG 3.2 threshold, and the reference scenario suggests that by 2030,154 (75%) of all countries could meet the U5MR targets, and 139 (68%) could meet the NMR targets. Deaths of children younger than 5 years totalled 9.65 million (95% UI 9.05-10.30) in 2000 and 5.05 million (4.27-6.02) in 2019, with the neonatal fraction of these deaths increasing from 39% (3.76 million 95% UI 3.53-4.021) in 2000 to 48% (2.42 million; 2.06-2.86) in 2019. NMR and U5MR were generally higher in males than in females, although there was no statistically significant difference at the global level. Neonatal disorders remained the leading cause of death in children younger than 5 years in 2019, followed by lower respiratory infections, diarrhoeal diseases, congenital birth defects, and malaria. The global optimum analysis suggests NMR could be reduced to as low as 0.80 (95% UI 0.71-0.86) deaths per 1000 livebirths and U5MR to 1.44 (95% UI 1-27-1.58) deaths per 1000 livebirths, and in 2019, there were as many as 1.87 million (95% UI 1-35-2.58; 37% 95% UI 32-43]) of 5.05 million more deaths of children younger than 5 years than the survival potential frontier. Interpretation Global child mortality declined by almost half between 2000 and 2019, but progress remains slower in neonates and 65 (32%) of 204 countries, mostly in sub-Saharan Africa and south Asia, are not on track to meet either SDG 3.2 target by 2030. Focused improvements in perinatal and newborn care, continued and expanded delivery of essential interventions such as vaccination and infection prevention, an enhanced focus on equity, continued focus on poverty reduction and education, and investment in strengthening health systems across the development spectrum have the potential to substantially improve USMR. Given the widespread effects of COVID-19, considerable effort will be required to maintain and accelerate progress. Copyright (C) 2021 The Author(s). Published by Elsevier Ltd

Efeitos do treinamento de força a longo prazo sobre parâmetros hemodinâmicos e concentração de resistina em mulheres na pós-menopausa

Objetivo: Investigar a influência do treinamento de força (TF) sobre a concentração sorológica de resistina e pressão arterial de mulheres na pós-menopausa. Métodos: Estudo longitudinal, realizado na Universidade Federal de São Carlos, do qual participaram 23 mulheres sedentárias na pós-menopausa. O TF apresentou duração de 13 meses (dez/2008 a jan/2010), com duas sessões semanais, cada uma consistindo em três séries de 8-12 repetições máximas e um exercício para cada grupo muscular principal. Foi avaliada a força muscular máxima nos seguintes exercícios: supino, leg press 45° e flexão do cotovelo em pé. A concentração sérica de resistina foi determinada pelo método ELISA. No processamento estatístico, utilizou-se o ANOVA (com medidas repetidas) para comparar os momentos Pré, 6 meses e 13 meses (p<0,05). Para avaliar as correlações resistina × pressão arterial, resistina × força muscular e força × pressão arterial, utilizou-se o teste de correlação de Pearson. Resultados: As mulheres apresentaram o seguinte perfil antropométrico: 61,33±3,8 anos; estatura de 148,5±32,7 cm; massa corporal de 67,56±10,85 kg. O TF induziu a redução da concentração de resistina (30272,4±8100,1 versus 16350,6±2404,6 pg/mL) e pressão arterial sistólica (120,5±11,8 versus 115,8±1,6 mmHg), e o aumento da força muscular no leg press 45o (172,3±27,3 versus 348,6±40,8 kg), supino (31,9±4,1 versus 41,8±5,6 kg) e flexão do cotovelo (21,0±2,4 versus 26,5±2,9 kg) após os 13 meses (p<0,05). Conclusão: Os resultados deste estudo revelaram que o TF a longo prazo aumenta a força muscular máxima, diminui a pressão arterial sistólica e os níveis séricos da resistina – alterações fisiológicas benéficas para a redução do risco de doenças cardiovasculares em mulheres na pós-menopausa

Efeitos do treinamento de força a longo prazo sobre parâmetros hemodinâmicos e concentração de resistina em mulheres na pós-menopausa

Objective: Investigate the influence of strength training (ST) on serum resistin levels and blood pressure of postmenopausal women. Methods: Longitudinal study conducted at the Federal University of São Carlos with twenty-three sedentary postmenopausal women. The ST lasted 13 months (Dec./2008 to Jan./2010) and consisted of two weekly sessions with three sets of 8-12 maximum repetitions and one exercise for each main muscle group. Maximum muscular strength was tested in the following exercises: bench press, 45° leg press, and standing arm curl. Serum resistin level was determined using the ELISA method. ANOVA (with repeated measures) was used for the comparisons between periods Pre-, 6 months and 13 months (p < 0.05); Pearson’s correlation test was used to evaluate the correlations between resistin × blood pressure, resistin × muscle strength and strength × blood pressure. Results: Women presented the following anthropometric profile: 61.33±3.8 years; height 148.5±32.7 cm; body mass 67.56±10.85 kg. The ST decreased resistin levels (30272.4 ± 8100.1 to 16350.6 ± 2404.6 pg/mL) and systolic blood pressure (120.5 ± 11.8 to 115.8 ± 1.6 mmHg), and increased muscular strength in the leg press 45o (172.3 ± 27.3 to 348.6 ± 40.8kg), bench press (31.9 ± 4.1 to 41.8 ± 5.6 kg) and arm curl (21.0 ± 2.4 to 26.5 ± 2.9 kg) after 13 months (p < 0.05). Conclusion: The results of this study revealed that long-term ST increases maximum muscular strength, decreases systolic blood pressure and serum resistin levels, which are beneficial physiological alterations that reduce the risk for cardiovascular diseases in postmenopausal women. doi:10.5020/18061230.2013.p325Objetivo: Investigar la influencia del entrenamiento de fuerza (EF) sobre la concentración serológica de resistina y presión arterial em mujeres posmenopausia. Métodos: Estudio longitudinal realizado en la Universidad Federal de São Carlos en el cual participaron 23 mujeres sedentarias posmenopausia. El EF tuvo duración de 13 meses (diciembre de 2008 a enero de 2010) con dos sesiones semanales, siendo cada sesión constituida de tres series de 8-12 repeticiones máximas y un ejercicio para cada grupo muscular principal. Fue evaluada la fuerza muscular máxima en los siguientes ejercicios: supino, leg press 45° y flexión de codo de pie. La concentración sérica de resistina fue determinada por el método ELISA. En el procesamiento estadístico se utilizo ANOVA (con medidas repetidas) para las comparaciones entre los momentos pre, 6 meses y 13 meses (p < 0,05); se utilizó La prueba de correlación de Pearson para evaluar las correlaciones entre resistina × presión arterial, resistina × fuerza muscular y fuerza × presión arterial. Resultados: Las mujeres presentaron el siguiente perfil antropométrico: 61,33±3,8 años; altura 148,5±32,7 cm; masa corporal 67,56±10,85 kg. El EF llevó a La reducción de la concentración de resistina (30272,4±8100,1 versus 16350,6±2404,6 pg/mL) y presión arterial sistólica (120,5±11,8 versus 115,8±1,6 mmHg) y aumento de fuerza muscular en el leg press 45º (172,3±27,3 versus 348,6±40,8 kg), supino (31,9±4,1 versus 41,8±5,6 kg) y flexión de codo (21,0±2,4 versus 26,5±2,9 kg) después de los 13 meses (p < 0,05). Conclusión: Los resultados del estudio revelaron que el EF a largo plazo aumenta la fuerza muscular máxima, disminuye la presión arterial sistólica y los niveles séricos de la resistina, alteraciones fisiológicas benéficas para la reducción del riesgo de enfermedades cardiovasculares em mujeres posmenopausia. doi:10.5020/18061230.2013.p325Objetivo: Investigar a influência do treinamento de força (TF) sobre a concentração sorológica de resistina e pressão arterial de mulheres na pós-menopausa. Métodos: Estudo longitudinal, realizado na Universidade Federal de São Carlos, do qual participaram 23 mulheres sedentárias na pós-menopausa. O TF apresentou duração de 13 meses (dez/2008 a jan/2010), com duas sessões semanais, cada uma consistindo em três séries de 8-12 repetições máximas e um exercício para cada grupo muscular principal. Foi avaliada a força muscular máxima nos seguintes exercícios: supino, leg press 45° e flexão do cotovelo em pé. A concentração sérica de resistina foi determinada pelo método ELISA. No processamento estatístico, utilizou-se o ANOVA (com medidas repetidas) para comparar os momentos Pré, 6 meses e 13 meses (

Efeitos do treinamento de força a longo prazo sobre parâmetros hemodinâmicos e concentração de resistina em mulheres na pós-menopausa

Objetivo: Investigar a influência do treinamento de força (TF) sobre a concentração sorológica de resistina e pressão arterial de mulheres na pós-menopausa. Métodos: Estudo longitudinal, realizado na Universidade Federal de São Carlos, do qual participaram 23 mulheres sedentárias na pós-menopausa. O TF apresentou duração de 13 meses (dez/2008 a jan/2010), com duas sessões semanais, cada uma consistindo em três séries de 8-12 repetições máximas e um exercício para cada grupo muscular principal. Foi avaliada a força muscular máxima nos seguintes exercícios: supino, leg press 45° e flexão do cotovelo em pé. A concentração sérica de resistina foi determinada pelo método ELISA. No processamento estatístico, utilizou-se o ANOVA (com medidas repetidas) para comparar os momentos Pré, 6 meses e 13 meses (p<0,05). Para avaliar as correlações resistina × pressão arterial, resistina × força muscular e força × pressão arterial, utilizou-se o teste de correlação de Pearson. Resultados: As mulheres apresentaram o seguinte perfil antropométrico: 61,33±3,8 anos; estatura de 148,5±32,7 cm; massa corporal de 67,56±10,85 kg. O TF induziu a redução da concentração de resistina (30272,4±8100,1 versus 16350,6±2404,6 pg/mL) e pressão arterial sistólica (120,5±11,8 versus 115,8±1,6 mmHg), e o aumento da força muscular no leg press 45o (172,3±27,3 versus 348,6±40,8 kg), supino (31,9±4,1 versus 41,8±5,6 kg) e flexão do cotovelo (21,0±2,4 versus 26,5±2,9 kg) após os 13 meses (p<0,05). Conclusão: Os resultados deste estudo revelaram que o TF a longo prazo aumenta a força muscular máxima, diminui a pressão arterial sistólica e os níveis séricos da resistina – alterações fisiológicas benéficas para a redução do risco de doenças cardiovasculares em mulheres na pós-menopausa

Pertinencia de la oferta de los programas de pregrado de la Universidad Cooperativa de Colombia, seccional Medellín.

Con el fin de identificar la pertinencia de la oferta de los programas de pregrado de la Universidad Cooperativa de Colombia, Seccional Medellín, se desarrolló una investigación con empresas de los 10 Municipios que comprenden el Área Metropolitana tendiente a: - Clasificar por áreas de conocimiento las necesidades educativas que requieren los profesionales que se desempeñan en las empresas del Área Metropolitana. Evaluar la opinión que tienen los empresarios con respecto al desempeño laboral de los egresados de los diferentes programas de la Universidad Cooperativa de Colombia. - Actualizar los datos de los egresados que laboran en las empresas que comprenden la muestra de este estudio. - Enumerar las fortalezas y debilidades, que en opinión de los egresados encuestados, identificaron en su proceso formativo. - Identificar el nivel de formación profesional que requieren las empresas del Área Metropolitana, para la vinculación de empleados. - Una vez aplicados los instrumentos en la muestra seleccionada, realizado el trabajo de campo, tabulado y analizada la información, los resultados que caracterizaron el estudio son: Se detectaron fortalezas y debilidades de formación en competencias específicas por los empresarios en los profesionales vinculados en sus organizaciones. Los resultados arrojados de las encuestas de egresados los permiten detectar las debilidades de formación, así como las fortalezas y necesidades con respecto no sólo a las exigencias en el campo laboral, sino también en lo que le concierne a la relación Universidad – Egresados. Estos datos ayudan a complementar la información recopilada de los empresarios, para implementar la formación en nuevas competencias y nuevas alternativas de actualización académica en seminarios, diplomados, postgrados y maestrías. - Este estudio se basó en las pautas del Ministerio de Educación Nacional y otras entidades pertinentes para el mejoramiento continuo de los procesos de formación académica profesional en Colombia y Latinoamérica.Glosario. -- Resumen. -- Introducción. -- 1. Planteamiento del problema. -- 2. Delimitación. -- 2.1 Temporal. -- 2.2 Espacial. -- 3. Justificación. -- 4. Objetivos. -- 4.1 Objetivo general. -- 4.2 Objetivos específicos. -- 5. Marco teórico. -- 5.1. Reseña histórica de la Universidad Cooperativa de Colombia. -- 5.1.1 Características de la reseña histórica. -- 5.1.2 Antecedentes. -- 5.1.3 Un antecedente remoto: El “Plan de Estudio” del Fiscal Moreno y Escandón (siglo XVIII). -- 5.1.4 Orígenes del cooperativismo en Colombia (siglo XX). -- 5.1.5 El Instituto M.M. Coady de Educación y Capacitación Cooperativa (1958). -- 5.1.6 El Instituto de Economía Social y Cooperativismo (Indesco). -- 5.1.7 Orientaciones básicas en las épocas referidas. -- 5.2. La Universidad Cooperativa de Colombia. -- 5.2.1 Constitución de Indesco. -- 5.2.2 Imagen corporativa. -- 5.2.3. Plan Estratégico Nacional. -- 5.3. Bases teóricas. -- 5.3.1 El Subsistema De Educación Superior. -- 5.3.2 Indicadores. -- 5.3.3 Principios y propósitos que orientan la formación. -- 5.4. Los perfiles de formación. -- 6. Variables. -- 7. Metodología. -- 7.1 Tipo de investigación. -- 7.2. Método de investigación. -- 7.2.1 Deductivo. -- 7.2.2 Análisis. -- 7.2.3 Síntesis. -- 7.2.4 Inducción. -- 7.3 Fuentes y técnicas de recolección de información. -- 7.3.1 Fuentes Primarias. -- 7.3.2 Fuentes Secundarias. -- 8. Población y muestra. -- 8.1 Población. -- 8.2 Muestra. -- 8.2.1 Tamaño de la muestra. -- 8.2.2 Selección del proceso de muestreo de egresados. -- 8.2.3 Unidad Muestral. -- 9. Aspectos administrativos. -- 9.1 Talento humano. -- 9.2 Recursos técnicos. -- 9.3 Recursos institucionales. -- 9.4 Recursos financieros. -- 10. Cronograma de actividades. -- 11. Procesamiento de la información. -- 11.1 Empresarios. -- 11.1.1. Vinculación profesional en las empresas del área Metropolitana. -- 11.1.2 Nivel de formación profesional. -- 11.1.3 Disciplinas a las que pertenecen los profesionales vinculados. -- 11.1. 4 Requerimientos de nuevos profesionales por el sector empleador. -- 11.1.5 Requerimiento de nuevos profesionales por las empresas. -- 11.1.6 Nivel de competencias requerido por las empresas para la vinculación de profesionales. -- 11.1.7 Competencias profesionales necesarias para un desempeño laboral competitivo. -- 11.1.8 Fortalezas y debilidades de formación en competencias específicas por los empresarios en los profesionales. -- 11.1.9 Debilidades especificas identificadas para un óptimo desempeño laboral. -- 11.1.10 Alternativas para el mejoramiento del desempeño profesional. -- 11.1.11 Disciplinas de los posgrados que especifican los empresarios. -- 11.1.12 Egresados de la Universidad Cooperativa de Colombia vinculados. -- 11.1.13 Programas académicos de egreso. -- 11.1.14 Calificación del desempeño de los egresados de la Universidad Cooperativa de Colombia. -- 11.1.15 Calificación del desempeño de los egresados de la Universidad Cooperativa de Colombia. -- 11.2 Encuestas realizadas a los egresados de la universidad cooperativa de Colombia. -- 11.2.2 Nivel de respuesta a las exigencias del mercado laboral, según la formación recibida. -- 11.2.1 Relación cargo – profesión. -- 11.2.3 Áreas para cursos de formación continuada. -- 11.2.4 Fortalezas que los empresarios identifican en los egresados de la Universidad Cooperativa de Colombia. -- 11.2.5 Acciones a implantar por la Universidad Cooperativa de Colombia para estrechar vínculos con sus egresados. -- 11.2.6 Sugerencias. -- 11.2.7 Sugerencias por disciplina. -- 12. Análisis de resultados. -- 13. Conclusiones. -- 14. Recomendaciones. -- Bibliografía. -- Anexos. -

Global, regional, and national progress towards Sustainable Development Goal 3.2 for neonatal and child health : all-cause and cause-specific mortality findings from the Global Burden of Disease Study 2019

Background Sustainable Development Goal 3.2 has targeted elimination of preventable child mortality, reduction of neonatal death to less than 12 per 1000 livebirths, and reduction of death of children younger than 5 years to less than 25 per 1000 livebirths, for each country by 2030. To understand current rates, recent trends, and potential trajectories of child mortality for the next decade, we present the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 findings for all-cause mortality and cause-specific mortality in children younger than 5 years of age, with multiple scenarios for child mortality in 2030 that include the consideration of potential effects of COVID-19, and a novel framework for quantifying optimal child survival. Methods We completed all-cause mortality and cause-specific mortality analyses from 204 countries and territories for detailed age groups separately, with aggregated mortality probabilities per 1000 livebirths computed for neonatal mortality rate (NMR) and under-5 mortality rate (USMR). Scenarios for 2030 represent different potential trajectories, notably including potential effects of the COVID-19 pandemic and the potential impact of improvements preferentially targeting neonatal survival. Optimal child survival metrics were developed by age, sex, and cause of death across all GBD location-years. The first metric is a global optimum and is based on the lowest observed mortality, and the second is a survival potential frontier that is based on stochastic frontier analysis of observed mortality and Healthcare Access and Quality Index. Findings Global U5MR decreased from 71.2 deaths per 1000 livebirths (95% uncertainty interval WI] 68.3-74-0) in 2000 to 37.1 (33.2-41.7) in 2019 while global NMR correspondingly declined more slowly from 28.0 deaths per 1000 live births (26.8-29-5) in 2000 to 17.9 (16.3-19-8) in 2019. In 2019,136 (67%) of 204 countries had a USMR at or below the SDG 3.2 threshold and 133 (65%) had an NMR at or below the SDG 3.2 threshold, and the reference scenario suggests that by 2030,154 (75%) of all countries could meet the U5MR targets, and 139 (68%) could meet the NMR targets. Deaths of children younger than 5 years totalled 9.65 million (95% UI 9.05-10.30) in 2000 and 5.05 million (4.27-6.02) in 2019, with the neonatal fraction of these deaths increasing from 39% (3.76 million [95% UI 3.53-4.021) in 2000 to 48% (2.42 million; 2.06-2.86) in 2019. NMR and U5MR were generally higher in males than in females, although there was no statistically significant difference at the global level. Neonatal disorders remained the leading cause of death in children younger than 5 years in 2019, followed by lower respiratory infections, diarrhoeal diseases, congenital birth defects, and malaria. The global optimum analysis suggests NMR could be reduced to as low as 0.80 (95% UI 0.71-0.86) deaths per 1000 livebirths and U5MR to 1.44 (95% UI 1-27-1.58) deaths per 1000 livebirths, and in 2019, there were as many as 1.87 million (95% UI 1-35-2.58; 37% [95% UI 32-43]) of 5.05 million more deaths of children younger than 5 years than the survival potential frontier. Interpretation Global child mortality declined by almost half between 2000 and 2019, but progress remains slower in neonates and 65 (32%) of 204 countries, mostly in sub-Saharan Africa and south Asia, are not on track to meet either SDG 3.2 target by 2030. Focused improvements in perinatal and newborn care, continued and expanded delivery of essential interventions such as vaccination and infection prevention, an enhanced focus on equity, continued focus on poverty reduction and education, and investment in strengthening health systems across the development spectrum have the potential to substantially improve USMR. Given the widespread effects of COVID-19, considerable effort will be required to maintain and accelerate progress. Copyright (C) 2021 The Author(s). Published by Elsevier Ltd.Peer reviewe

Covid-19: consecuencias y desafíos en la economía colombiana. Una mirada desde las universidades

Este libro reúne diferentes hallazgos, perspectivas y efectos ante un fenómeno que, más de un año después, todavía representa un reto científico, médico y social para todos. Igualmente, esta obra representa el objetivo de la Red Investigadores de Economía: aunar esfuerzos para encontrar respuestas y para fortalecer la investigación en el país, aumentar la difusión de trabajos de calidad y propiciar el encuentro entre académicos, universidades y el Banco de la República. Las investigaciones expuestas en este libro pasaron por un proceso de selección por parte del comité científico, asegurando que hubiese una pluralidad de miradas y de instituciones educativas, además del Banco, donde se relacionaran los efectos de la pandemia y la actividad económica en el país, las consecuencias sociales y regionales. El texto está dividido en cuatro partes. En la primera se hace un análisis macroeconómico de los efectos de la pandemia; para ello se examinan los efectos de la emergencia sanitaria a nivel nacional y regional mediante modelos macroeconómicos que permiten obtener respuestas ante preguntas muy relevantes. La segunda sección trata sobre el impacto en el mercado laboral, el efecto del Covid-19 en la distribución del ingreso y el efecto de corto plazo en el mercado urbano. La tercera parte aborda los efectos de la pandemia en los agentes económicos y en otros mercados. Ello incluye la exposición del empleo al Covid-19, la vulnerabilidad económica de los hogares en el país y su respuesta en el consumo, patrones de actividad laboral y salud mental, efectos en la educación, inseguridad alimentaria de la población migrante, entre otros. Por último, el cuarto segmento hace un énfasis especial en los efectos diferenciales entre las regiones del país y la heterogeneidad de dicho impacto; para ello se analizan temas de informalidad, vulnerabilidad, fuerza de trabajo disponible, entre otros, en distintas regiones del país