Demystifying the link between higher education and liberal values: A within-sibship analysis of British individuals' attitudes from 1994-2020.

The link between university graduation and liberal values is well-established and often taken as evidence that higher education participation causes attitudinal change. Identification of education's causal influence in shaping individual preferences is notoriously difficult as it necessitates isolating education's effect from self-selection mechanisms. This study exploits the household structure of the Harmonized British Household Panel Study and Understanding Society data to tighten the bounds of causal inference in this area and ultimately, to provide a more robust estimate of the independent effect of university graduation on political attitudes. Results demonstrate that leveraging sibling fixed-effects to control for family-invariant pre-adult experiences reduces the size of higher education's effect on cultural attitudes by at least 70%, compared to conventional methods. Significantly, within-sibship models show that obtaining higher education qualifications only has a small direct causal effect on British individuals' adult attitudes, and that this effect is not always liberalizing. This has important implications for our understanding of the relationship between higher education and political values. Contrary to popular assumptions about education's liberalizing role, this study demonstrates that the education-political values linkage is largely spurious. It materializes predominately because those experiencing pre-adult environments conducive to the formation of particular values disproportionately enroll at universities.

Demonstrating Servant Leadership During the COVID-19 Pandemic.

ABSTRACT: Servant leadership (SL) is an especially effective leadership style for healthcare. This article relays characteristics, attributes, and essential behaviors of SL. Jesus Christ demonstrated SL by inverting the traditional leadership triangle of leader at the top. Servant leadership promotes a culture of openness, transparency, empowerment, and sharing of ownership. The servant leader values listening, developing, encouraging, building collaboration, and maintaining personal relationships, while displaying authenticity, openness, accountability, and willingness to learn. The experience of a staff nurse functioning as a servant leader for patients and colleagues during the COVID-19 pandemic elaborates how SL can be evidenced in bedside care.

Treatment of Childhood Acute Myeloid Leukemia in Uruguay: Results of 2 Consecutive Protocols Over 20 Years.

We evaluated the outcome of 71 children with de novo acute myeloid leukemia enrolled in 2 consecutive protocols in the main pediatric hospital in Uruguay. In the LAM97 protocol (n=34), patients received, as consolidation, autologous or allogeneic hematopoietic stem cell transplantation (HSCT), depending on the availability or not of a matched sibling donor. In the LAM08 protocol (n=37), patients were stratified into risk groups, autologous HSCT was abandoned, and allogeneic HSCT was limited to intermediate-risk patients with matched sibling donor and to all patients who fulfilled the high-risk criteria. Complete remission was achieved in 91% and 92% of patients in LAM97 and LAM08, respectively. Deaths in complete remission were 9.6% and 17.6%, respectively. The incidence of relapse was significantly higher in LAM97, 35.4%, versus 12.5% in LAM08. The 5-year event-free survival and overall survival were 50.0% and 55.9% in LAM97 and 59.9% and 64.8% in LAM08. The 5-year overall survival rates in each of the risk groups were 85.7% and 100% for low risk, 50.0% and 61.2% for intermediate risk, and 42.9% and 50.0% for high risk in LAM97 and LAM08 protocols, respectively. Survival has improved over the last 2 decades, and results are comparable to those published in Europe and North America.

Experiencing God in Nursing.

Christian faith supports the idea that God is always at work in the world. God invites people into relationship with him and then to join in his work. Three nurses relay supernatural events where God worked in and through their nursing practice, reinforcing the understanding of what author Henry Blackaby calls experiencing God. Christian nurses are called to enter deeply into relationship with God.

Vital Signs: Zika-Associated Birth Defects and Neurodevelopmental Abnormalities Possibly Associated with Congenital Zika Virus Infection - U.S. Territories and Freely Associated States, 2018.

INTRODUCTION: Zika virus infection during pregnancy causes serious birth defects and might be associated with neurodevelopmental abnormalities in children. Early identification of and intervention for neurodevelopmental problems can improve cognitive, social, and behavioral functioning. METHODS: Pregnancies with laboratory evidence of confirmed or possible Zika virus infection and infants resulting from these pregnancies are included in the U.S. Zika Pregnancy and Infant Registry (USZPIR) and followed through active surveillance methods. This report includes data on children aged ≥1 year born in U.S. territories and freely associated states. Receipt of reported follow-up care was assessed, and data were reviewed to identify Zika-associated birth defects and neurodevelopmental abnormalities possibly associated with congenital Zika virus infection. RESULTS: Among 1,450 children of mothers with laboratory evidence of confirmed or possible Zika virus infection during pregnancy and with reported follow-up care, 76% had developmental screening or evaluation, 60% had postnatal neuroimaging, 48% had automated auditory brainstem response-based hearing screen or evaluation, and 36% had an ophthalmologic evaluation. Among evaluated children, 6% had at least one Zika-associated birth defect identified, 9% had at least one neurodevelopmental abnormality possibly associated with congenital Zika virus infection identified, and 1% had both. CONCLUSION: One in seven evaluated children had a Zika-associated birth defect, a neurodevelopmental abnormality possibly associated with congenital Zika virus infection, or both reported to the USZPIR. Given that most children did not have evidence of all recommended evaluations, additional anomalies might not have been identified. Careful monitoring and evaluation of children born to mothers with evidence of Zika virus infection during pregnancy is essential for ensuring early detection of possible disabilities and early referral to intervention services.

Reflections on Global Service Learning in India.

Global service learning is an action-oriented, pedagogical approach that engages students in the core values of academic excellence, social relevance, personal transformation, intentional diversity, and cultural competence. The experience of students and nurse educators who have participated in global service-learning trips to India is relayed, along with the healthcare system of several Indian states.

Evaluation of Placental and Fetal Tissue Specimens for Zika Virus Infection - 50 States and District of Columbia, January-December, 2016.

Zika virus infection during pregnancy can cause congenital microcephaly and brain abnormalities (1), and detection of Zika virus RNA in clinical and tissue specimens can provide definitive laboratory evidence of recent Zika virus infection. Whereas duration of viremia is typically short, prolonged detection of Zika virus RNA in placental, fetal, and neonatal brain tissue has been reported and can provide key diagnostic information by confirming recent Zika virus infection (2). In accordance with recent guidance (3,4), CDC provides Zika virus testing of placental and fetal tissues in clinical situations where this information could add diagnostic value. This report describes the evaluation of formalin-fixed paraffin-embedded (FFPE) tissue specimens tested for Zika virus infection in 2016 and the contribution of this testing to the public health response. Among 546 live births with possible maternal Zika virus exposure, for which placental tissues were submitted by the 50 states and District of Columbia (DC), 60 (11%) were positive by Zika virus reverse transcription-polymerase chain reaction (RT-PCR). Among 81 pregnancy losses for which placental and/or fetal tissues were submitted, 18 (22%) were positive by Zika virus RT-PCR. Zika virus RT-PCR was positive on placental tissues from 38/363 (10%) live births with maternal serologic evidence of recent unspecified flavivirus infection and from 9/86 (10%) with negative maternal Zika virus immunoglobulin M (IgM) where possible maternal exposure occurred >12 weeks before serum collection. These results demonstrate that Zika virus RT-PCR testing of tissue specimens can provide a confirmed diagnosis of recent maternal Zika virus infection.

Intensive, Manual-based Intervention for Pediatric Feeding Disorders: Results From a Randomized Pilot Trial.

OBJECTIVES: The aim of this pilot study was to investigate feasibility and preliminary efficacy of an intensive, manual-based behavioral feeding intervention for children with chronic food refusal and dependence on enteral feeding or oral nutritional formula supplementation. METHODS: Twenty children ages 13 to 72 months (12 boys and 8 girls) meeting criteria for avoidant/restrictive food intake disorder were randomly assigned to receive treatment for 5 consecutive days in a day treatment program (n = 10) or waitlist (n = 10). A team of trained therapists implemented treatment under the guidance of a multidisciplinary team. Parent training was delivered to support generalization of treatment gains. We tracked parental attrition and attendance, as well as therapist fidelity. Primary outcome measures were bite acceptance, disruptions, and grams consumed during meals. RESULTS: Caregivers reported high satisfaction and acceptability of the intervention. Three participants (1 intervention; 2 waitlist) dropped out of the study before endpoint. Of the expected 140 treatment meals for the intervention group, 137 (97.8%) were actually attended. The intervention group showed significantly greater improvements (P < 0.05) on all primary outcome measures (d = 1.03-2.11) compared with waitlist (d = -1.13-0.24). A 1-month follow-up suggested stability in treatment gains. CONCLUSIONS: Results from this pilot study corroborate evidence from single-subject and nonrandomized studies on the positive effects of behavioral intervention. Findings support the feasibility and preliminary efficacy of this manual-based approach to intervention. These results warrant a large-scale randomized trial to test the safety and efficacy of this intervention.

Leg edema assessment and management.

The significance of leg edema as a symptom of multiple anomalies, from benign manifestations to underlying Graves' disease, is described. Accurate assessment, history taking, and supportive diagnostic tests will assist nurses to manage their patients' with competence. A comprehensive discussion about different types of edema, etiology, pathophysiology, management, and patient education is aimed to equip nurses in independent and collaborative management of lower-extremity edema in their patients.

Predictor variables for NCLEX-RN readiness exam performance.

AIM: To understand the relationship among NLCLEX-RN readiness exam scores and influencing variables. BACKGROUND: First-time NCLEX-RN pass rates are a visible measure of program quality.Therefore, schools have adopted aggressive prediction and remediation measures to improve NCLEX-RN pass rate success and therefore the number of licensed and practicing nurses. METHOD: This descriptive correlational study used regression analysis to investigate multivariate relationship between NCLEX-RN readiness exam scores and predictors. RESULTS: This study's findings suggest that while the input variables measured by grades in prerequisites initially appear predictive, only the presence of transfer credits, a potential marker for age and motivation, remains significant. CONCLUSION: Most transfer students are nontraditional adult learners.Therefore, it can be theorized that student personal system has a significant impact on the outcome. The first nursing course, adult health nursing plus maternal-child health nursing, appears foundational for the NCLEX readiness exam.

Temporal dynamics of attitude decisions: A test of the iterative reprocessing model using event-related potentials.

Although evaluative judgments are a central component of everyday decision making little is known about the temporal dynamics of the processes used to make them. The present study used the high temporal resolution of event-related brain potentials (ERPs) to test Cunningham and Zelazo's (2007) posited differences in the timing of attitude tag retrieval relative to stimulus categorization for 'attitudes' and 'evaluations,' as well as tenets of their Iterative Reprocessing (IR) loop model. Participants made agree/disagree decisions about their attitudes and You/Not You decisions about their autobiographical memories in separate reaction time (RT) tasks while brain activity was recorded from 32 scalp sites. A median-split analysis on RT was used to separate fast and slow decisions. Decisions about autobiographical stimuli produced the typical results in which retrieval and stimulus categorization occurred together just before the response regardless of decision difficulty. By contrast, the relative timing of tag retrieval and categorization differed with difficulty for attitude decisions as predicted by the model. Fast attitude decisions were processed similarly to fast You decisions with retrieval and categorization timing coupled to the response. Slow attitude decisions, however, differed because, while tag retrieval timing was the same as for fast attitude decisions, post-retrieval processing delayed stimulus categorization and a response by 450 msec. ERP activity over dorsolateral prefrontal cortex (DLPFC) in the pre-response interval was asymmetrical, with greater activity for attitude and autobiographical decisions over left and right hemispheres, respectively, while amplitude and duration increased with decision difficulty for both. Slow attitude decisions alone elicited a reduced pre-response positivity, a correlate of goal-directed response selection. The results provide empirical support for key aspects of Cunningham and Zelazo's (2007) attitude-evaluation dichotomy and the timing of the posited component processes in their IR model as well as novel information about the roles of stored tags and reflective processes in different attitude decisions.

The evolution of a nontraditional nursing curriculum in Switzerland.

This article introduces the transition of Haute Ecole de Santé Genève (HEDS) from Le Bon Secours (LBS). History reveals that unlike many nursing schools in Switzerland, HEDS absorbed the nurse education culture of the United States. HEDS was influenced by the vision of its founder Dr. Champendal, the support and strategies of the Rockefeller Foundation, American nurse education through its past directors, and eventually the European educational reform. Founded in 1905 with a vision to be in constant evolution, HEDS is still making a difference in the local and global community through opportunities for transcontinental presence for its students. The international vision of this school with new English-speaking strategies will lead HEDS to define and develop nursing science research in Western Europe and Switzerland. This article will inspire academics to initiate steps to provide a unique experience for their nursing students.

Does a high ranking mean success in the Situational Judgement Test?

BACKGROUND AND PURPOSE: The selection of medical students to the foundation programme has undergone several changes since its introduction in 2005, with the latest being the introduction of the Situational Judgement Test (SJT) in 2013. The SJT, a 2-hour exam that uses a multiple-choice format to assess an individual's judgement when presented with clinically related scenarios, now accounts for 50 per cent of the application process. The remaining 50 per cent is made up of the Educational Performance Measure (EPM) score, which includes the medical student's performance at medical school, allocated by points attributed according to decile ranking. Coming out of its pilot year, there is little research into the results of the SJT. This project aims to discover whether there is a correlation between high-performing students who succeeded at medical school (i.e. by decile ranking) and those who scored high in the SJT. This project aims to discover whether there is a correlation between high- performing students and those whoscored high in the SJT METHOD: A survey was circulated to fifth-year medical students across the UK applying to the foundation programme in 2013, and who had sat the pilot year of the SJT. Students were asked to enter numerical values for their EPM and SJT scores. RESULTS: A total of 239 students from 12 UK medical schools responded to the questionnaire. In addition to their EPM, academic and SJT scores, all participants provided data on gender, duration of course (i.e. 4 or 5 years) and whether or not additional resources were used for the SJT. There was no correlation between the SJT and the academic scores (Spearman's = 0.0458; probability of any relationship = 0.4865).

High Risk Neuroblastoma in Uruguay. Where are we? / Neuroblastoma de Alto Riesgo en Uruguay. ¿Dónde estamos? / Neuroblastoma de Alto Risco no Uruguai. Onde estamos?

Introdução: El neuroblastoma es el tumor sólido extracraneal más frecuente en niños. Aproximadamente el 50 % de los pacientes son clasificados como de alto riesgo, con base en características clínicas, biológicas e histológicas. Objetivo: Describir a la población asistida en el Centro Hemato-Oncológíco Pediátrico (CHOP) del Centro Hospitalario Pereira Rossell (CHPR) con diagnóstico de neuroblastoma de alto riesgo, su tratamiento y sobrevida. Método: Estudio descriptivo y retrospectivo de todos los pacientes con neuroblastoma de alto riesgo diagnosticados en el CHOP entre el 2001 y el 2015. En el CHOP se ubica el Registro Nacional de Cáncer Pediátrico, así como también el Archivo de Historias Clínicas de todos los pacientes. Los datos son recolectados y analizados por el sector de estadística. Resultados: Se diagnosticaron 35 pacientes, de los cuales 20 (57%) eran varones con mediana de edad de 36,6 meses (5-93), localización suprarrenal 23 (66%) y 100% estadio IV. Metástasis, médula ósea y hueso: 27 (71%). Treinta y tres pacientes recibieron autotransplante de progenitores hematopoyéticos (TPH) (94%). Estatus previo a TPH, remisión completa: 19 (58 %), remisión parcial: 14 (42%). Mortalidad relacionada al tratamiento: 15 % y de recaídas: 68 %. Mediana de tiempo de recaída: 15 meses (3-52). La probabilidad de sobrevida global y sobrevida libre de eventos a 5 años fue de 37,8% ± 8,4 y 23,8% ± 7,3 (mediana de seguimiento 40 meses). Conclusión: A pesar del tratamiento intensivo y de las medidas de soporte adecuadas, el pronóstico en los niños con neuroblastoma de alto riesgo sigue siendo pobre en nuestro país. Es necesario incorporar nuevas estrategias terapéuticas aún no disponibles en nuestro medio.

Introduction: Neuroblastoma is the most common extracranial solid tumor in children. Approximately 50% of patients are classified as high risk on the basis of clinical, biological, and histological characteristics. Objective: To describe the population of patients diagnosed with high-risk neuroblastoma at the Centro Hemato-Oncológíco Pediátrico (CHOP, Center for Pediatric Hematology and Oncology) of the Centro Hospitalario Pereira Rossell (CHPR, Pereira Rossell Hospital), in terms of their treatment and survival. Method: Descriptive, retrospective study of all patients diagnosed with highrisk neuroblastoma at the CHOP between 2001 and 2015. The National Registry of Pediatric Cancer is located at the CHOP, as is the Archive of Patient Clinical Histories. The data are collected and analyzed by the statistics sector. Results: Among the 35 patients diagnosed, 20 (57%) were men, the median age was 36.6 months (range, 5-93 months), and the tumor had an adrenal location in 23 (66%). All of the tumors were classified as stage IV. Metastasis to the bone marrow or bone was seen in 27 (71%). Thirty-three patients (94%) received autologous hematopoietic stem-cell transplantation (HSCT). The status prior to HSCT was complete remission in 19 (58%) and partial remission in 14 (42%). The treatment-related mortality rate was 15%, and the relapse rate was 68%. The median time to relapse was 15 months (3-52 months). The probability of overall survival and 5-year event-free survival was 37.8% ± 8.4 and 23.8% ± 7.3 (median follow-up of 40 months), respectively. Conclusion: Despite intensive treatment and adequate support measures, the prognosis for high-risk neuroblastoma in children remains poor in Uruguay. There is a need to incorporate new therapeutic strategies not yet available in our country.

Introducción:O neuroblastoma é o tumor sólido extracraniano mais frequente em crianças. Aproximadamente 50% dos pacientes são classificados como de alto risco considerando as características clínicas, biológicas e histológicas. Objetivo: Descrever a população atendida no Centro Hemato-Oncológíco Pediátrico (CHOP) do Centro Hospitalario Pereira Rossell (CHPR) com diagnóstico de neuroblastoma de alto risco, seu tratamento e sobrevida. Método: Estudo descritivo, retrospectivo, de todos os pacientes com neuroblastoma de alto risco diagnosticados no CHOP, no período entre 2001 e 2015. O Registro Nacional de Câncer Pediátrico está localizado no CHOP, bem como o Arquivo de Histórias Clínicas de todos os pacientes. Os dados são coletados e analisados pelo setor estatístico. Resultados: Foram diagnosticados 35 pacientes. Vinte (57%) eram do sexo masculino. Mediana de idade: 36,6 meses (5-93). Localização suprarrenal: 23 (66%). Estádio IV 100%. Metástases, medula óssea e osso: 27 (71%). Trinta e três pacientes receberam transplante de células-tronco hematopoiéticas (TCTH) (94%). Status prévio a TCTH, remissão completa: 19 (58%), remissão parcial: 14 (42%). Incidência de mortalidade relacionada ao tratamento: 15% e de recaídas: 68%. Mediana do tempo de recaída: 15 meses (3-52). A probabilidade de sobrevida global e sobrevida livre de eventos aos cinco anos foi de 37,8% ± 8,4 e 23,8% ± 7,3 (mediana de seguimento 40 meses). Conclusão: Apesar do tratamento intensivo e medidas de suporte adequadas, o prognóstico em crianças com neuroblastoma de alto continua sendo pobre no Uruguai. É necessário incorporar novas estratégias terapêuticas que ainda não estão disponíveis em nosso meio

The role of episodic memory in controlled evaluative judgments about attitudes: an event-related potential study.

Event-related potentials (ERPs) are unique in their ability to provide information about the timing of activity in the neural networks that perform complex cognitive processes. Given the dearth of extant data from normal controls on the question of whether attitude representations are stored in episodic or semantic memory, the goal here was to study the nature of the memory representations used during conscious attitude evaluations. Thus, we recorded ERPs while participants performed three tasks: attitude evaluations (i.e., agree/disagree), autobiographical cued recall (i.e., You/Not You) and semantic evaluations (i.e., active/inactive). The key finding was that the parietal episodic memory (EM) effect, a well-established correlate of episodic recollection, was elicited by both attitude evaluations and autobiographical retrievals. By contrast, semantic evaluations of the same attitude items elicited less parietal activity, like that elicited by Not You cues, which only access semantic memory. In accord with hemodynamic results, attitude evaluations and autobiographical retrievals also produced overlapping patterns of slow potential (SP) activity from 500 to 900ms preceding the response over left and right inferior frontal, anterior medial frontal and occipital brain areas. Significantly different patterns of SP activity were elicited in these locations for semantic evaluations and Not You cues. Taken together, the results indicate that attitude representations are stored in episodic memory. Retrieval timing varied as a function of task, with earlier retrievals in both evaluation conditions relative to those in the autobiographical condition. The differential roles and timing of memory retrieval in evaluative judgment and memory retrieval tasks are discussed.

Neuroblastoma en niños menores de 18 meses. Experiencia de 10 años en Centro Hematooncológico / Neuroblastoma less than 18 months of age. 10 years experience in pediatric hematooncologic of the Pereira Rossell Hospital Center

Introducción: el neuroblastoma es el tumor maligno más frecuente en los lactantes. Su curso clínico es variable, desde la regresión espontánea a la progresión maligna, y los factores pronósticos son múltiples, como edad, estadio, amplificación de N-myc y ploidía tumoral. Se describen las características de todos los pacientes con neuroblastoma menores de 18 meses asistidos en CHOP. Pacientes y métodos: estudio observacional, descriptivo y retrospectivo en el período entre 31 de enero de 2000 y 31 de enero de 2011. El diagnóstico se realizó por histología y aspirado de médula ósea. Los pacientes se estadificaron por INSS; el tratamiento se decidió según estadio y riesgo. Resultados: se incluyeron 22 pacientes menores de 18 meses (52% de todos los neuroblastomas), con una media de edad de 9,6 meses. Once pacientes se encontraban en estadio 4. La localización más frecuente fue suprarrenal; presentaban metástasis 13 pacientes. Quince niños recibieron poliquimioterapia y 20 fueron tratados quirúrgicamente. La amplificación del gen N-myc se demostró en tres pacientes. La sobrevida global fue de 77% y la sobrevida libre de enfermedad fue de 77%. Discusión y conclusiones: la mayor parte de los casos fueron diagnosticados en niños menores de 9 meses. Fueron más frecuentes los estadios 4 y 1. No se pudo demostrar asociación entre N-myc y estadio de enfermedad. La sobrevida fue excelente.

Introduction: neuroblastoma is the most common malignant tumor in infants. Its clinical behavior is variable, from spontaneous regression to malignant progression; prognostic factors are multiple, such as age, stage, N-myc amplification and tumor ploidy. We describe the characteristic of all patients with neuroblastoma less than 18 months of age assisted in CHOP. Patients and methods: retrospective, observational and descriptive study in the period between 31/1/00 y 31/01/11. Diagnose was made from histology and bone marrow aspirate. Patients were classified by INSS stage; treatment was decided according to stage and risk. Results: 22 patients were included (52% of all neuroblastomas), with a mean age of 9,6 months. Eleven patients were classified in stage 4. The most frequent localization was adrenal; 14 patients presented methastasis. Fifteen patients received chemotherapy and 20 were surgically intervened. N-myc amplification was detected in 3 patients. Overall survival was 77% and event-free survival was 77%. Discussion and conclusions: the majority of cases were diagnosed in children younger than 9 months. Stages 4 and 1 were the most frequent. No association between N-myc and stage could be determined. Overall and event-free survival were excellent.

Neuroblastoma de Alto Riesgo en Uruguay. ¿Dónde estamos? / High Risk Neuroblastoma in Uruguay. Where are we?

Introdução: el neuroblastoma es el tumor sólido extracraneal más frecuente en niños. aproximadamente el 50 % de los pacientes son clasificados como de alto riesgo, con base en características clínicas, biológicas e histológicas. Objetivo: describir a la población asistida en el centro Hemato-oncológíco Pediátrico (cHoP) del centro Hospitalario Pereira Rossell (cHPr) con diagnóstico de neuroblastoma de alto riesgo, su tratamiento y sobrevida. Método: estudio descriptivo y retrospectivo de todos los pacientes con neuroblastoma de alto riesgo diagnosticados en el cHoP entre el 2001 y el 2015. En el cHoP se ubica el registro nacional de cáncer Pediátrico, así como también el archivo de Historias clínicas de todos los pacientes. los datos son recolectados y analizados por el sector de estadística. Resultados: se diagnosticaron 35 pacientes, de los cuales 20 (57%) eran varones con mediana de edad de 36,6 meses (5-93), localización suprarrenal 23 (66%) y 100% estadio iV. Metástasis, médula ósea y hueso: 27 (71%). treinta y tres pacientes recibieron autotransplante de progenitores hematopoyéticos (tPH) (94%). estatus previo a tPH, remisión completa: 19 (58 %), remisión parcial: 14 (42%). Mortalidad relacionada al tratamiento: 15 % y de recaídas: 68 %. Mediana de tiempo de recaída: 15 meses (3-52). la probabilidad de sobrevida global y sobrevida libre de eventos a 5 años fue de 37,8% ± 8,4 y 23,8% ± 7,3 (mediana de seguimiento 40 meses). Conclusión: a pesar del tratamiento intensivo y de las medidas de soporte adecuadas, el pronóstico en los niños con neuroblastoma de alto riesgo sigue siendo pobre en nuestro país. Es necesario incorporar nuevas estrategias terapéuticas aún no disponibles en nuestro medio(AU)