permissão concedida pela Elsevier para reprodução do material em português somente. Abreviações: 2D: bidimensional 3D: tridimensional Área A: área abaixo da curva da onda A da fluxo mitral Onda A: Fluxo mitral correspondente ao momento da contração atrial Onda a': Onda obtida no nível do anel mitral pelo Doppler tecidual durante a contração atrial Onda Ar: Velocidade de fluxo reverso pulmonar ou sistêmico durante a contração atrial VAo: Valva aórtica ASE: Sociedade Americana de Ecocardiografia AV: Atrioventricular SC: Superfície corpórea CC: Cardiopatia congênita Onda D: Componente diastólico do fluxo venoso pulmonar ou sistêmico dP/dt: Primeira derivado de pressão em relação ao tempo Área A: Área abaixo da curva da onda A do fluxo mitral (diástole precoce) Onda E: Fluxo mitral correspondente ao componente diastólico precoce Onda e': Onda obtida pelo Doppler tecidual no nível do anel valvar mitral durante a diástole precoce DDF: Diâmetro diastólico final VDF: Volume diastólico final FE: Fração de ejeção DSF: Diâmetro sistólico final VSF: Volume sistólico final VCI: Veia cava inferior TCIV': Tempo de contração isovolumétrica obtido ao Doppler tecidual TRIV: Tempo de relaxamento isovolumétrico obtido ao Doppler convencional TRIV': Tempo de relaxamento isovolumétrico obtido ao Doppler tecidual L: Comprimento AE: Átrio esquerdo VE: Ventrículo esquerdo RNM: Ressonância nuclear magnética VM: Valva mitral PFR SV : Taxa máxima de enchimento/volume ejetado VP: valva pulmonar AD: Átrio direito VD: Ventrículo direito Onda s': Onda obtida pelo Doppler tecidual no nível do anel valvar mitral durante a sístole Onda S: Componente sistólico do fluxo venoso pulmonar ou sistêmico ▲D: Fração de encurtamento TAPSE: Deslocamento do anel tricúspide durante a sístole VT: Valva tricúspide V: Volume ventricular VTI: Integral da velocidade x tempo

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The mini-CEX has good overall utility for assessing aspects of the clinical encounter in an undergraduate setting. Strengths include fidelity, wide sampling, perceived validity, and formative observation and feedback. Reliability is limited by variable examiner stringency, and validity by confounding variables, but these should be viewed within the context of overall assessment strategies.

Inreach teams identified and managed only a small proportion of prisoners with SMI. Prison-based services need to improve screening procedures and develop effective care pathways to ensure access to appropriate services. Improved identification of mental illness is needed in both the community and the Criminal Justice System to better engage with socially transient individuals who have chaotic lifestyles and complex needs.

Staff training on diversity issues is required to encourage institutional buy-in and establish consistent educational and clinical environments. By tackling cultural diversity within the context of patient-centred care, cultural humility, the approach students valued most, would become the default model. Reflective practice and the development of a critical consciousness are crucial in the improvement of cultural diversity training and thus should be facilitated and encouraged. Educators can adopt a bidirectional mode of teaching and work with students to decolonise medical curricula and improve medical practice.

Children and adults with mental retardation were tested on their ability to recognize facial expressions of emotion. The sample consisted of 80 children and adults with mental retardation and a control group of 80 nonhandicapped children matched on mental age and gender. Ekman and Friesen's normed photographs of the six basic emotions (anger, disgust, fear, happiness, sadness, and surprise) were used in a recognition task of facial expressions. Subjects were individually read two-sentence stories identifying a specific emotion, presented with a randomized array of the six photographs of the basic facial expressions of emotion, and then asked to select the photograph that depicted the emotion identified in the story. This procedure was repeated with 24 different stories, with each of the six basic emotions being represented four times. Results showed that, as a group, individuals with mental retardation were not as proficient as their mental-age-matched nonhandicapped control subjects at recognizing facial expressions of emotion. Although adults with mild mental retardation were more proficient at this task than those with moderate mental retardation, this finding was not true for children. There was a modest difference between the children with moderate mental retardation and their nonhandicapped matched controls in their ability to recognize facial expression of disgust.

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