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With the emergence of World Wide Web (WWW) as the primary reference channel of information, the need for making it barrier-free for all categories of users has evolved into a critical factor. Making the web resources barrier-free for users requires action across various dimensions such as accessibility and readability. This paper presents an analysis of accessibility, readability, and site-ranking of top ranked (N = 20) government websites of India. The accessibility analysis has been carried out using aChecker and WAVE tools. The readability of the contents of the website is measured with six different indices such as Flesch-Kincaid reading ease, Flesch-Kincaid grade level, Gunning fog, SMOG, Coleman-Liau index and Automated Readability Index. The ranking of sites by National Informatics Centre (NIC) has been utilized to select the top ranked websites and their corresponding rankings are compared with global site ranking services such as Alexa. The correlation among these three factors of accessibility, readability, and site-ranking has been carried out with Spearman’s rank correlation method and the inferences derived from the results are presented. Keywords: Readability, Language complexity, Readability indices, Accessibility, Ranking, Grading, Correlation, Classification, Measurement techniques

Purpose: The average United States adult reads at an eighth-grade reading level. In an effort to ensure that patients understand written medical information, the National Institutes of Health and American Medical Association suggest that patient-directed material be written at a sixth- to eighth-grade reading level. We hypothesized that the mean reading level of surgical consent forms for hand surgery is not at or below an eighth-grade reading level (the suggested maximum from the National Institutes of Health). Methods: We conducted a retrospective review of consecutive consent forms used for hand surgery patients from 7 hand surgeons at our institution from June, 2017 to October, 2017. Consent forms were reviewed to collect the hand-written portion describing the procedure. We also assessed our institution’s consent form template. This text was assessed for readability and reading level with the following tools: Flesch-Kincaid Grade Level and Flesch Reading Ease. We categorized the procedures written on each consent form by procedure type and then created simplified language for the same procedure below an eighth-grade reading level. Results: Mean Flesch-Kincaid grade level of all consent forms was 10.5 (SD, 5.8) and mean Flesch readability was 33.6 (SD, 38.8), or difficult to read. A total of 78% and 58% of forms were written above the sixth- and eighth-grade reading levels, respectively. Readability was remarkedly poor; 94% and 88% of consent forms were written above sixth- and eighth-grade readability, respectively. The grade level of the consent form template was 17.1. Conclusions: Most consent forms were written above a sixth- to eighth-grade reading level and may not have been well-understood by patients. It is possible for physicians to write on surgical consent forms at a reading level that patients are more likely to understand by opting for less specialty-specific words and writing in shorter sentences. Improving the readability of patient-directed materials is an approach to improving patient-centered care. Type of study/level of evidence: Prognostic IV. Key words: hand surgery, readability, reading level, surgical consent form, upper-limb surgery

Supplementary data for the article Osteotomy around the Knee: Assessment of Quality, Content and Readability of Online Information is provided. 45 unique websites were evaluated. The DISCERN score, JAMA (Journal of the American Medical Association) benchmark criteria and HONcode (Health On the Net) criteria are provided for reference. Readability of online information was analysed with Readability Studio Professional Edition, Version 2019 (Oleander Software Ltd.). The software assessed readability using eight different instruments: Flesch-Kincaid Reading Grade Level (FKGL), Flesch Reading Ease Score (FRES), Raygor Estimate, SMOG, Coleman- Liau, Fry, FORCAST and Gunning Fog. Data is also provided on the percentage of complex words, long words, Dale-Chall unfamiliar words, Fog words, as well as the number of 'wordy' items, overly long sentences and longest sentence length.

School environments influence student food choices. À la carte foods and beverages are often low nutrient and energy dense. This study assessed how much money students spent for these foods, and the total kilocalories purchased per student during the 2012–2013 school year. Six elementary and four intermediate schools in the Houston area provided daily food purchase transaction data, and the cost and the calories for each item. Chi-square analysis assessed differences in the number of students purchasing à la carte items by grade level and school free/reduced-price meal (FRP) eligibility. Analysis of covariance assessed grade level differences in cost and calories of weekly purchases, controlling for FRP eligibility. Intermediate grade students spent significantly more on à la carte food purchases and purchased more calories (both p, Highlights • Intermediate schools offered >40 competitive food items. • Nine competitive food items were available in elementary schools. • Intermediate school students bought more competitive foods than younger students. • Intermediate school students spent more money on these foods than younger students. • Intermediate school students bought more calories than elementary students.

Optimizing physical activity during physical education is necessary for children to achieve daily physical activity recommendations. The purpose of this study was to examine the relationship among various contextual factors with accelerometer measured physical activity during elementary physical education. Data were collected during 2015–2016 from 281 students (1st–5th grade, 137 males, 144 females) from a private school located in a metropolitan area of Utah in the U.S. Students wore accelerometers for 12 consecutive weeks at an accelerometer wear frequency of 3 days per week during physical education. A multi-level general linear mixed effects model was employed to examine the relationship among various physical education contextual factors and percent of wear time in moderate-to-vigorous physical activity (%MVPA), accounting for clustering of observations within students and the clustering of students within classrooms. Explored contextual factors included grade level, lesson context, sex, and class size. Main effects and interactions among the factors were explored in the multi-level models. A two-way interaction of lesson context and class size on %MVPA was shown to be statistically significant. The greatest differences were found to be between fitness lessons using small class sizes compared to motor skill lessons using larger class sizes (β = 14.8%, 95% C.I. 5.7%–23.9% p, Highlights • Small class sizes relate to increased physical activity during physical education. • Fitness lessons yielded higher physical activity compared to motor skills/games. • Small classes and fitness lessons are additive for increasing physical activity.

The purpose of this study was to examine the intensity levels of PA opportunities offered in public school classrooms. Schools (N = 101) in school districts (N = 25) reported PA opportunities offered in classrooms using an online data collection tool over a two-year period (2014–2016). Using a randomized sampling technique, 20–30% of teachers in each school were selected each week to report PA in their classroom. These responses resulted in N = 18,210 usable responses. A researcher determined the intensity of PA opportunities using the 2011 Compendium of Physical Activities as a guideline; two additional researchers confirmed the coded categories. A descriptive analysis of PA opportunities was conducted to describe the proportion of opportunities whose intensity levels were light (LPA), moderate (MPA), vigorous (VPA), sedentary (SED), and those of unknown intensity. Chi-square analyses were utilized to examine differences between proportions of intensity levels offered by semester. Kruskal-Wallace tests were utilized to examine differences in proportion of physical activity opportunity intensity offered by grade level. Most PA opportunities were MPA (58.7%), followed by VPA (17.6%) and LPA (11.5%). Few responses were SED (0.5%), and 11.6% were of indeterminate intensity. A greater proportion of more physically intense activities reported during the fall versus spring semesters (p, Highlights • Most physical activity in classrooms occurs at the moderate intensity level. • A higher proportion of physical activity is offered in the fall compared to spring. • Physical activity opportunities offered decrease at higher grade levels.

Exposure to secondhand smoke (SHS) can result in several adverse health consequences. SHS concentrations in vehicles can significantly exceed levels present in other enclosed spaces. Years after the adoption of smoke-free car laws, this study examined the prevalence of exposure to SHS in vehicles among adolescents. Data were utilized from the 2016–2017 Canadian Student Tobacco, Alcohol and Drugs Survey (n = 48,444). The prevalence of exposure to SHS in cars was estimated by grade level and demographic characteristics. The results showed a gradient by grade level in exposure to SHS with students in upper-grade levels reporting a higher prevalence of SHS in cars. SHS varied by province, with the lowest rate found in British Columbia (15.6%) and the highest in Saskatchewan (36.9%). The provinces with laws that extend protections to older children also had high rates of SHS exposure among students in upper-grade levels. Students exposed to SHS were more likely to engage in risky behaviors, including the use of marijuana, alcohol, cigarettes, and e-cigarettes. Despite laws prohibiting smoking in vehicles carrying children, SHS prevalence remains high. While enforcement of these laws may be challenging, persuasion campaigns highlighting that children are especially vulnerable to the health risks of SHS may be beneficial., Highlights • Results showed a grade gradient in exposure to SHS in cars. • Students in upper-grades showed higher rates of SHS exposure. • Students exposed to SHS were more likely to engage in risky behaviors. • Areas with laws covering older children also had high SHS rates among upper-grades. • Despite laws prohibiting smoking in cars carrying children, SHS rates appear high.

Aim To study the prevalence of nearpoint vergence anomalies (convergence insufficiency, convergence excess and fusional vergence dysfunction) and association with gender, age groups, grade level and study site (suburban and rural). Methods The study design was cross sectional and data was analyzed for 1201 high school students aged 13–19 years who were randomly selected from 13 high schools in uMhlathuze municipality. Of the total sample, 476 (39.5%) were males and 725 (60.5%) were females. The visual functions evaluated included refractive errors, heterophoria, near point of convergence, accommodative functions and fusional vergences. Possible associations between vergence anomalies and demographic variables (gender, age groups, school grade levels and study site) were explored. Results Prevalence estimates were 11.8%, 6% and 4.3% for low suspect, high suspect and definite convergence insufficiency, and 1.9% for the pseudo convergence insufficiency. Convergence excess prevalence was 5.6%, and fusional vergence dysfunction was 3.3%. The prevalence of low suspect CI was significantly higher in suburban than in rural participants (p = 0.01), the reverse was the case for pseudoconvergence insufficiency while the prevalence of convergence excess was significantly higher in the younger than in the older age group (p = 0.02). No other category showed any statistically significant associations with vergence anomalies. Conclusion The prevalence estimates for vergence anomalies in a sample of black high school students in South Africa were relatively low. Only study location and age influenced some vergence anomalies. Identification and referrals are important steps toward diagnosis and treatment for vergence anomalies. Further studies to compare vergence anomalies in various racial populations will be relevant.

The aim and objective of this study was to evaluate the quality and readability of leaflet and online Oral and Maxillofacial Surgery patient information leaflets (PILs). The quality, readability and grade level of each PIL was assessed using the DISCERN, Flesch Reading Ease and Flesh-Kincaid Grade Level instruments respectively. In total, 140 patient information leaflets were assessed. For both leaflet and online PILs, many items of the DISCERN instrument were deemed of low quality and poorly reported. The median overall quality score was 30.2. Variation in the quality and readability scores between leaflet and online PILs and those produced by various societies was evident. Overall, PILs were deemed to be of moderate quality. Online PILs were of lower quality, more difficult to read and aimed at a higher reading age level.

The achievement of recommended levels (≥ 30 min/day) of school moderate-to-vigorous physical activity (MVPA) is paramount to decrease risk of chronic disease in children from low-income families. The purpose of this study was to examine the predictors and grade-level trends of school day MVPA achievement in low-income children. Data were collected during the Fall of 2014 on 1232 children (Mean age = 8.8 ± 1.6 years; 625 girls, 607 boys) recruited from three low-income schools from the state of Utah in the U.S. Children wore pedometers for one school week and a stratified random subsample (n = 533) also wore accelerometers to record sedentary time and MVPA. Generalized linear mixed models were employed to calculate odds ratios for achieving school MVPA standards (≥ 30 min/day) from various predictors and to determine odds of achievement across grade levels, accounting for school and classroom clustering. Odds of meeting MVPA standards were 3 times greater if a student achieved at least 6000 steps during the school day (p, Highlights • Pedometer steps and sedentary time are predictors of school day MVPA achievement. • The prevalence of children achieving MVPA standards is lower in older grades. • Classroom and school affiliation explained significant variance in school day MVPA.

Attention skills include noticing or attending to salient stimuli and events when they are presented or occur in the environment. Learners with sharp attention skills are able to distinguish between stimuli that deserve attention versus stimuli that should be ignored, and they are able to disengage with unimportant stimuli to continue to attend to those that are important. As learners continue to advance in grade level, their attention skills will be tested greatly, as they will need to be able to multitask and shift their attention between stimuli. This chapter presents step-by-step lessons that can help practitioners, educators, and parents teach children to sustain their attention to tasks such as morning and evening routines, homework, practicing sports or musical instruments, puzzles, constructive play activities, and projects of any kind. Data sheets, worksheets, and graphs are also provided for monitoring progress.

School achievement is greatly moderated by sociodemographic factors, such as socioeconomic status, minority status, students' gender and grade level as well as the location of schools. Based on a comprehensive review of the literature, the effect of socioeconomic status on school achievement is illustrated with empirical evidence.

Publisher Summary Modern filter design has evolved through the years from a subject known only to specialists in the field (because of the advanced mathematics involved) to a practical well-organized catalog of ready-to-use circuits available to anyone with knowledge of eighth grade level math. This chapter presents an introduction to the characteristics of four of the most commonly used filters and enables the user to design very quickly and easily a filter that will meet, or exceed, most of the common filter requirements that are encountered. It covers Butterworth, Chebyshev, and Bessel filters in all of their common configurations: low-pass, high-pass, bandpass, and bandstop. It also helps a user learn how to take advantage of the attenuation characteristics unique to each type of filter. Finally, this chapter aids in designing some very powerful filters in as little as five minutes by merely looking through a catalog to choose a design to suit particular needs.

Publisher Summary This chapter describes recent program developments in the Morningside Model of Generative Instruction. Morningside Teachers' Academy (MTA) is a school for elementary and middle school students, most of who have performed poorly in their previous schools, to catch up and get ahead. Morningside Teachers'Academy's elementary school students typically enroll for 1 to 3 years to catch up to their grade level. Many middle-school students enroll for all of middle school. Morningside Teachers' Academy's teachers coach students to perform their best using clearly defined rules and expectations for performance and productivity, explicit modeling of high performance, and moment-to-moment monitoring and feedback. Morningside Teachers' Academy helps public and private schools as well as agencies implement its programs through formal external partnerships. MTA offers a 4-week intensive summer institute for individual teachers, graduate students, parents, and other professionals who want to learn the programs. Each Morningside program is competency and mastery based, with a set of procedures and expected outcomes for both learners and teachers. Morningside takes an applied science approach to teaching the competencies to mastery.

Publisher Summary This chapter focuses on school-based bullying interventions and various school factors concerning bullying. School context refers to predetermined characteristics of a school, such as grade level, size of student enrollment, class size, racial and ethnic composition, and the school location. School climate refers to the inner workings of the school such as the social organization of the school, the system of social relations among teachers and students, and the cultural system of norms and values in the school. Schools in which teachers are more likely to discuss bullying with students, recognize bullying behavior, are interested in stopping bullying, and actually intervene in bullying incidents are less likely to have a bullying problem. One aspect of school climate that would seem to greatly influence the level of bullying in a school is the social organization of the school. Either as an isolated problem, or as a precursor to more violent behavior, schools should focus on the reduction and prevention of bullying. Research on school-level predictors and school-based interventions clearly indicates the importance of both the school context and school climate factors. However, more research is needed before firm conclusions can be drawn. The effects of several school context factors, such as size and location, are still unclear.

Publisher Summary This chapter deals with the Pygmalion effect in children. It presents case studies to highlight the signs and symptoms of this effect, highlighting the uniformity of effects observed across studies. It also demonstrates the method of measuring teacher expectations and explores the question of whether or not the challenge level and teachers' statements impact children's performance. Some of these methods are more direct while some are less direct. More direct procedures include asking teachers to make global overall assessments of the expectations they hold for each of the children in their class. Somewhat less global, more specific, estimates can be obtained from teachers by asking, for each of their students, the grade level at which they will be reading at the end of the year, or the percentile level they will achieve on any one of a number of standardized achievement tests. Finally, the chapter examines what happens when greater intellectual gains are expected of children by adults, and the reason this works to result in higher student achievement.

This chapter reviews instructional design principles that have been induced from instructional experiments. . The instructional design principles for transforming a non-reading brain into a reading brain at the novice stage and at the developing stage have been explained. The brain learns in two ways from experience, through induction and deduction. Induction is the abstraction from experience of general principles, rules, patterns, or generalizations. Deduction is the experience of applying general principles, rules, patterns, or generalizations. Brains vary in the way they learn through each of these approaches to experience. Unlike many instructional experiments, the treatments are derived from neurodevelopmental theory of functional brain systems for reading. Within a lesson, instruction is aimed at all levels of language, close in time, and to create a functional system with coordinated components. Some of these experiments can be controlled experiments in which children are randomly assigned to contrasting treatments and control groups. Some can be design experiments in which all the necessary instructional components are provided to bring children up to grade level in reading. Most brains lie in between these extremes and need a mix of these two approaches—(1) opportunities to induce spelling-sound correspondences from experience in reading, and (2) explicit instruction in spelling-sound correspondences for deductive application to reading. The chapter illustrates these contrasting approaches.

A very important question, with the present focus on mathematical modelling in the primary/lower secondary school, is: What kind of e-tools will promote children's ability to build models? Partly because it is widely and readily available the spreadsheet has become a very popular tool for building algebraic models. However, it can be debated whether the spreadsheet programs in their current format are properly suited for mathematics education at the primary/lower secondary level. A glaring weakness in today's spreadsheet programs, from a pedagogical point of view, is the fact that the mathematics describing the model is hidden. In other words the formulas are not directly visible in a spreadsheet. In a spreadsheet model you can manipulate the input and observe the effect on the output, but you can't directly see the mathematical relations between them. Ideas for an e-tool for modelling in school, that builds on the core idea in a spreadsheet program, but in which the model is directly visible, is presented. Activities for a first implementation of the ideas (a program called miniCALC) has been developed and used successfully in school on the third to eight grade level.

Deep-context teaching involves addressing the conditions surrounding a subject matter, in general, and students' expectations, beliefs, and values relating to learning, in specific. Deep-context teaching is directly related to motivating and readying students for deep learning. Deep context is crucially important because it filters how students encode the information they receive, which in turn influences how they are able to store it, retrieve it, and apply it; all of which influences transfer. The degree to which deep context needs to be addressed, and how it is to be applied, depends on a number of factors. One obvious factor is the grade level of the student. A second factor is the individual level of awareness and motivation for learning. For the underprepared student, the benefit of deep-context teaching is largely an increase in motivation and readiness to learn, whereas for the higher-ability student the increase seems to be the integration and transfer of the learning. A third factor is the degree to which deep context needs to be addressed and the fourth is how it is to be addressed in a specific subject matter. There is a downside to deep-context teaching however, the time spent dealing with deep contexts reduces the traditional time committed to directly teaching the subject matter itself. So teachers must make a decision about whether the priority is effectively teaching to all students in a class, or to reduce the amount of deep-context teaching by directing it to only a certain proportion of students.

Publisher Summary This chapter examines whether relationship factors (with parents, the most respected teacher, and peers) serve as correlates and predictors of life satisfaction in Chinese adolescents. For this purpose, a total of 480 Grade 8 and Grade 10 students were recruited from three secondary schools in Hong Kong. Among the 245 Grade 8 students, 103 were males and 142 females, and among the 235 Grade 10 students, 108 were males and 127 females. Children's are classified as the children of working class parents in terms of their socio-economic status and their type of accommodation. The questionnaire administered to the students is in Chinese and it consisted of two parts. The first part is on demographic information of respondents, including age, gender, grade level, parental education, and type of housing. The second part consisted of self-concept scales, relationship scales, and life satisfaction scales. Results suggests that adolescents' subjective perception of life satisfaction is positively related to various dimensions of self-concept and relationships with significant others, relationship factors play an important role in predicting life satisfaction, and relationship with Parents is the most effective factor.

Publisher Summary This chapter provides an overview of the education system in the ASEAN countries. The central quantitative objective to which all five nations are committed is that of universal primary education. This means entering 100% of six- or seven-year-olds in school and ensuring that all of these children progress through the primary-school system of five to seven years in length. Singapore has already achieved this goal, and the Philippines and Malaysia are making good progress toward it. Indonesia and Thailand have yet a long way to go. In addition, all five nations are attempting to expand their secondary education enrollments. However, what proportion of teenage youths the nations' leaders intend to educate and to what grade level is difficult to identify from official documentation.