Involving, Empowering, and Training End Users with Disabilities to Fully Participate in the Web Accessibility Directive Objectives First Results from the UPowerWAD Project.

In this paper, we present the first results from the UPowerWAD Project - a project which aims to raise awareness and to empower and train people with disabilities to take active participation in the implementation of the Web Accessibility Directive (WAD). We give an overview of the results on how to capture and categorize feedback from users in the context of web accessibility and present best practices for structuring and reporting web accessibility issues. The results will be discussed focusing on the relevance and implications for further steps in the project.

The Effects of Alcohol Use on Prospective Memory: A Systematic Literature Review.

Objectives: Alcohol use remains a public health concern with accumulating evidence pointing to alcohol-associated prospective memory (PM) deficits. PM is the cognitive ability to remember to perform an intended action at some point in the future. Following PRISMA guidelines, we searched the evidence base to identify and explore the evidence of a relationship between alcohol use and PM. Methods: We conducted a systematic literature search in Medline, Embase, Pubmed, CINAHL, PsycINFO and Web of Science databases. Studies were included if they met the following criteria: English language publication, healthy adult participants (16 years and over), primary data on the effects of alcohol on PM. Results: Eight peer-reviewed studies were eligible for inclusion, of which five were randomized controlled trials examining the acute effects of a mild dose of alcohol and three were cross-sectional studies assessing the long-term effects of different drinking patterns on PM. Four main findings were supported by the literature: (1) compared with placebo, an acute administration of a mild alcohol dose to healthy social drinkers may lead to poorer PM performance, (2) alcohol consumption over the recommended weekly units can be associated with impaired PM function, (3) other cognitive domains can play a contributing role in alcohol-induced PM impairment, and (4) following future event simulation alcohol-induced PM impairment may be improved. Conclusion: Alcohol consumption potentially impairs PM, even at a low modest dose. Considering the small number of studies and their methodological flaws, additional research is needed to decipher the alcohol-PM relationship and provide further supporting evidence.

Assessing the European impact of alcohol misuse and illicit drug dependence research: clinical practice guidelines and evidence-base policy.

BACKGROUND: Despite alcohol and illicit drug dependence being one of the most common diagnoses in Europe, there is heterogeneity of research evidence used in policy and practice. OBJECTIVE: We sought to (1) evaluate European research outputs on alcohol misuse and drug addiction in 2002-2018 in the Web of Science, (2) compare these with their burden of disease and (3) determine their impact in several ways. METHODS: A bibliometric research was undertaken including an assessment of the citation counts, the influence of research on members of national health advisory committees, and their contribution to the evidence base of clinical practice guidelines (CPGs). FINDINGS: There were 3201 analysed references cited in 28 CPGs across 11 European Countries on alcohol misuse and illicit drug abuse. Research conducted in the USA dominated both sets of CPGs, while many European countries were overcited relative to their research presence. The illicit drug research appeared to be adequate relative to the evidence of harm in Europe. However, alcohol misuse research appeared grossly inadequate to the harm it causes by a factor of 20. CONCLUSIONS: The volume of research on illicit drug addiction is commensurate to the European burden, whereas alcohol misuse is far below what is needed to curb a significant source of harm. CLINICAL IMPLICATIONS: The research asymmetries call for attention to the causes of the problem. Development of research-based solutions to a serious social harm is needed, including minimum pricing and collaborative work to harmonise efforts on disease management and treatment practices across European countries.

Withdrawing Benzodiazepines in Patients With Anxiety Disorders.

The large class of CNS-depressant medications-the benzodiazepines-have been extensively used for over 50 years, anxiety disorders being one of the main indications. A substantial proportion (perhaps up to 20-30 %) of long-term users becomes physically dependent on them. Problems with their use became manifest, and dependence, withdrawal difficulties and abuse were documented by the 1980s. Many such users experience physical and psychological withdrawal symptoms on attempted cessation and may develop clinically troublesome syndromes even during slow tapering. Few studies have been conducted to establish the optimal withdrawal schedules. The usual management comprises slow withdrawal over weeks or months together with psychotherapy of various modalities. Pharmacological aids include antidepressants such as the SSRIs especially if depressive symptoms supervene. Other pharmacological agents such as the benzodiazepine antagonist, flumazenil, and the hormonal agent, melatonin, remain largely experimental. The purpose of this review is to analyse the evidence for the efficacy of the usual withdrawal regimes and the newer agents. It is concluded that little evidence exists outside the usual principles of drug withdrawal but there are some promising leads.