Progressive cognitive decline is a feature of Huntington’s disease (HD), an inherited neurodegenerative movement disorder. Comprehensive neuropsychological testing is the ‘gold standard’ to establish cognitive status but is often impractical in time-constrained clinics. The study evaluated the utility of brief cognitive tests (MMSE and MoCA), UHDRS measures and a comprehensive neuropsychological tests battery in monitoring short-term disease progression in HD. Twenty-two manifest HD patients and 22 matched controls were assessed at baseline and 12-month. A linear mixed-effect model showed that although the HD group had minimal change in overall global cognition after 12 months, they did show a significant decline relative to the control group. The controls exhibited a practice effect in most of the cognitive domain scores over time. Cognitive decline at 12-month in HD was found in the executive function domain but the effect of this on global cognitive score was masked by the improvement in their language domain score. The varying practice effects by cognitive domain with repeated testing indicates the importance of comparing HD patients to control group in research trials and that cognitive progression over 12 months in HD should not be judged by changes in global cognitive score. The three brief cognitive tests effectively described cognition of HD patients on cross-sectional analysis. The UHDRS cognitive component, which focuses on testing executive function and had low variance over time, is a more reliable brief substitute for comprehensive neuropsychological testing than MMSE and MoCA in monitoring cognitive changes in HD patients after 12 months.

There remain significant concerns about the accuracy of psychiatric assessment in the terminally ill. Mental processes are more relevant influences on a hastened wish to die than are the physical symptoms of terminal malignant disease. Psychiatric review of persons requesting euthanasia is relevant. It is not obligatory or emphasised in those legislations allowing assisted dying. Psychiatry needs to play a greater role in the assessment processes of euthanasia and PAS.

Distant Voices is an ongoing, interdisciplinary collaborative action research project, drawing on criminology, community development, politics, practice-led research and songwriting to explore crime, punishment and reintegration through creative conversations that aim to challenge and unsettle understandings of and approaches to rehabilitation and reintegration. In this paper, we discuss some of the thinking behind the project and we reflect on our experiences to date as a community of enquiry. Specifically, we explore the extent to which certain practices of hospitality that we have experienced in processes of collaborative songwriting and song-sharing might mediate and resist the ‘hostile environment’ that faces people leaving prison in many contemporary societies. Drawing on our experience, we argue that hospitality is often disruptive; that creating and sustaining hospitable environments is extremely challenging; and that to do so requires careful thought and planning, including in relation to problems created by the power dynamics intrinsic to criminal justice. The paper includes links to and discussion of one song written in the project – ‘An Open Door’ -- which engages with and illustrates these themes.

Palliative care patients have similar cyclizine pharmacokinetics to those reported in other patient groups. Cyclizine metabolism to norcyclizine may include CYP2D6 as the metabolic ratio varied with CYP2D6 genotype in the SC group.