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Purpose: To assess the readability and accountability of online patient education materials related to glaucoma diagnosis and treatment. Methods: We conducted a Google search for 10 search terms related to glaucoma diagnosis and 10 search terms related to glaucoma treatment. For each search term, the first 10 patient education websites populated after Google search were assessed for readability and accountability. Readability was assessed using five validated measures: Flesch Reading Ease (FRE), Gunning Fog Index (GFI), Flesch-Kincaid Grade Level (FKGL), Simple Measure of Gobbledygook (SMOG), and New Dale-Chall (NDC). Accountability was assessed using the Journal of the American Medical Association (JAMA) benchmarks. The source of information for each article analyzed was recorded. Results: Of the 200 total websites analyzed, only 11% were written at or below the recommended 6th grade reading level. The average FRE and grade level for 100 glaucoma diagnosis-related articles were 42.02 ± 1.08 and 10.53 ± 1.30, respectively. The average FRE and grade level for 100 glaucoma treatment-related articles were 43.86 ± 1.01 and 11.29 ± 1.54, respectively. Crowdsourced articles were written at the highest average grade level (12.32 ± 0.78), followed by articles written by private practice/independent users (11.22 ± 1.74), national organizations (10.92 ± 1.24), and educational institutions (10.33 ± 1.35). Websites averaged 1.12 ± 1.15 of 4 JAMA accountability metrics. Conclusion: Despite wide variation in the readability and accountability of online patient education materials related to glaucoma diagnosis and treatment, patient education materials are consistently written at levels above the recommended reading level and often lack accountability. Articles from educational institutions and national organizations were often written at lower reading levels but are less frequently encountered after Google search. There is a need for accurate and understandable online information that glaucoma patients can use to inform decisions about their eye health. [ABSTRACT FROM AUTHOR]

This research aims to examine the readability of the 15 books in the Patatespor series of Yusuf Asal and to examine the readability of these books. The study also aims to determine the text levels and which class levels they are suitable for. For this purpose, the books in the Patatespor series, written by Asal in 3 sets of 5 books each, were examined with the readability formulas developed by Ateşman, Bezirci-Yılmaz and Çetinkaya-Uzun. Document analysis was adopted in this study as a qualitative research method. This study revealed that the books of the series included humorous elements, as well as visuals in accordance with the content, and also many well-known historical people, artists and scientists. At the end of the study, which covered 15 books, it indicated that it was at the "easy" level according to the Ateşman readability formula and at the "primary education" level according to the Bezirci-Yılmaz readability formula. Additionally, it was evaluated as at the "educational reading (8th and 9th grade)" level according to the Çetinkaya-Uzun readability formula. According to the data obtained from the readability formulas, it can be said that the books in the series can be recommended to secondary school students. It can be suggested that teachers and parents who recommend books to students should also consider the studies on the readability of the works. [ABSTRACT FROM AUTHOR]

This study empirically investigates the impact of the U.S.-China trade war on corporate social responsibility (CSR) disclosure readability. We first propose a measure of CSR disclosure readability with the latest word embedding model of Word2Vec. Using the U.S.-China trade war as an exogenous shock, we conduct a difference-in-differences analysis and find that firms release more readable CSR disclosures in response to the trade war. We interpret this finding to indicate that CSR disclosure can be a strategic tool to enhance the firms' reputations when they suffer a negative shock. Moreover, such an effect is more pronounced for firms with tighter internal governance or external supervision. Our results are robust to confining our sample with a Coarsened Exact Matching algorithm and a battery of robust checks. Finally, we find that the trade war leads to increased charitable donations, indicating that our CSR readability measure is more likely to reflect actual CSR activities. [ABSTRACT FROM AUTHOR]

Background: The internet has become an increasingly important resource for health information, especially for lay people. However, the information found does not necessarily comply with the user's health literacy level. Therefore, it is vital to (1) identify prominent information providers, (2) quantify the readability of written health information, and (3) to analyze how different types of information sources are suited for people with differing health literacy levels. Objective: In previous work, we showed the use of a focused crawler to "capture" and describe a large sample of the "German Health Web", which we call the "Sampled German Health Web" (sGHW). It includes health-related web content of the three mostly German speaking countries Germany, Austria, and Switzerland, i.e. country-code top-level domains (ccTLDs) ".de", ".at" and ".ch". Based on the crawled data, we now provide a fully automated readability and vocabulary analysis of a subsample of the sGHW, an analysis of the sGHW's graph structure covering its size, its content providers and a ratio of public to private stakeholders. In addition, we apply Latent Dirichlet Allocation (LDA) to identify topics and themes within the sGHW. Methods: Important web sites were identified by applying PageRank on the sGHW's graph representation. LDA was used to discover topics within the top-ranked web sites. Next, a computer-based readability and vocabulary analysis was performed on each health-related web page. Flesch Reading Ease (FRE) and the 4th Vienna formula (WSTF) were used to assess the readability. Vocabulary was assessed by a specifically trained Support Vector Machine classifier. Results: In total, n = 14,193,743 health-related web pages were collected during the study period of 370 days. The resulting host-aggregated web graph comprises 231,733 nodes connected via 429,530 edges (network diameter = 25; average path length = 6.804; average degree = 1.854; modularity = 0.723). Among 3000 top-ranked pages (1000 per ccTLD according to PageRank), 18.50%(555/3000) belong to web sites from governmental or public institutions, 18.03% (541/3000) from nonprofit organizations, 54.03% (1621/3000) from private organizations, 4.07% (122/3000) from news agencies, 3.87% (116/3000) from pharmaceutical companies, 0.90% (27/3000) from private bloggers, and 0.60% (18/3000) are from others. LDA identified 50 topics, which we grouped into 11 themes: "Research & Science", "Illness & Injury", "The State", "Healthcare structures", "Diet & Food", "Medical Specialities", "Economy", "Food production", "Health communication", "Family" and "Other". The most prevalent themes were "Research & Science" and "Illness & Injury" accounting for 21.04% and 17.92% of all topics across all ccTLDs and provider types, respectively. Our readability analysis reveals that the majority of the collected web sites is structurally difficult or very difficult to read: 84.63% (2539/3000) scored a WSTF ≥ 12, 89.70% (2691/3000) scored a FRE ≤ 49. Moreover, our vocabulary analysis shows that 44.00% (1320/3000) web sites use vocabulary that is well suited for a lay audience. Conclusions: We were able to identify major information hubs as well as topics and themes within the sGHW. Results indicate that the readability within the sGHW is low. As a consequence, patients may face barriers, even though the vocabulary used seems appropriate from a medical perspective. In future work, the authors intend to extend their analyses to identify trustworthy health information web sites. [ABSTRACT FROM AUTHOR]

Introduction: The informed consent process is key to safeguarding the autonomy of the participant in medical research. For this process to be valid, the information presented to the potential participant should meet their needs and be understood by them. The i‐CONSENT project has developed 'Guidelines for adapting the informed consent process in clinical trials' which aim to improve informed consent so that they are easier to understand and better adapted to the needs and preferences of the target population. The best way to tailor information to the characteristics and preferences of the target population is to involve the community itself. Methods: Following guidelines developed by i‐CONSENT, assent materials were co‐created for a mock clinical trial of the human papillomavirus vaccine in adolescents. During the process, two design thinking sessions were conducted involving a total of 10 children and 5 parents. The objectives of the sessions were to find out the children's opinion of the informed consent (assent in their case) process in clinical trials, identify the parts that were most difficult to understand and alternatives for their presentation and wording, identify the preferred formats for receiving the information and the main characteristics of these formats, design a video explaining the clinical trial and evaluate a tool for assessing comprehension. Results: Assent materials were co‐created in three formats: a web‐based material following a layered approach; a video in story format; a pdf document with an innovative way of presenting information compared to traditional assent documents. In addition, the Comprehension of Assent Questionnaire was co‐designed, based on the Quality of Informed Consent questionnaire. Conclusion: The design thinking methodology has proven to be an easy and useful tool for involving children in designing information tailored to their needs and preferences. Patient or Public Contribution: A sample of the target population participated in the design and piloting of the materials created using design thinking methodology. In addition, patient representatives participated in the design and evaluation of the guidelines developed by the i‐CONSENT project that were followed for the development of the materials in this study. [ABSTRACT FROM AUTHOR]

This paper introduces the CommonLit Ease of Readability (CLEAR) corpus, which provides unique readability scores for ~ 5000 text excerpts along with information about the excerpt's year of publishing, genre, and other metadata. The CLEAR corpus will provide researchers interested in discourse processing and reading with a resource from which to develop and test readability metrics and to model text readability. The CLEAR corpus includes a number of improvements in comparison to previous readability corpora including size, breadth of the excerpts available, which cover over 250 years of writing in two different genres, and unique readability criterion provided for each text based on teachers' ratings of text difficulty for student readers. This paper discusses the development of the corpus and presents reliability metrics for the human ratings of readability. [ABSTRACT FROM AUTHOR]

One of the unknowns associated with Alain Guiraudie's thriller L'Inconnu du lac/Stranger by the Lake (2013) is what the film is really about. Set at a lake where men have sex with men, the film follows the protagonist Franck, who pursues a relationship with a man despite witnessing that man drown his lover. Whereas some reviews have read the film as a fable about the dangers of casual sex or HIV, this article argues that a key theme is the question of 'knowability': how do we come to know, to read, to make connections? How the film itself connects to a wider viewing audience is a further question this article addresses. To do so, three aspects pertinent to its readability are considered. The first relates to genre: how the film breaks with the generic conventions of the homme fatal thriller. The second pertains to space, with Guiraudie's lakeside being compared to Jean-Didier Urbain's writing on the beach. The third concerns narrative, specifically the self-reflexive element of three 'reader' characters in the film. This article will contend that ultimately Guiraudie's film goes beyond communitarian questions to offer a post-queer vision of connectedness in a world of increasing isolation. [ABSTRACT FROM AUTHOR]

The consistency effect, prevalent in the text comprehension literature, comprises longer reading times for inconsistent than equivalent consistent text continuations. It is widely interpreted as reflecting readers' effective "validation" of text coherence. However, there are also numerous phenomena of readers' deficient validation, sometimes collectively labelled "misinformation effects." This study asked whether readers become consciously aware of the text discrepancies diagnosed by the consistency effect. Experiment 1 scrutinized (a) conspicuous conceptual inconsistencies and (b) character-trait inconsistencies. It replicated the consistency effect both at a critical target sentence and at a subsequent sentence (spillover). Experiment 2 replaced self-paced reading with consistency judgments about the target sentences. The subjects overlooked almost half of the inconsistencies, thus denying that readers reliably become aware of consistency-effect discrepancies. In Experiment 3, the former target sentences were reframed as explicit questions. Accuracy for inconsistencies was statistically indistinguishable from accuracy for consistent targets, favoring the interpretation that Experiment 2 subjects overlooked known, encoded discrepancies. The results are interpreted with reference to Kintsch's (Psychological Review, 95, 163-182, Kintsch, 1988; Comprehension. New York: Cambridge University Press, Kintsch, 1998) construction-integration model, a refinement of which adds an immediate, passive stage of validation processing to construction and integration. It is proposed that passive validation affords the detection of text inconsistencies that do not reach the level of readers' conscious awareness. [ABSTRACT FROM AUTHOR]

This article details the transcription process we developed to handle bimodal and multilingual interview data collected during our research into the teacher language awareness (TLA) of two high-quality teachers in a Swedish bilingual school for the deaf. Both teachers used a combination of spoken Swedish, spoken English, and Teckenspråk (Sweden's signed language) during our interviews. Because the interviews were being conducted in three languages and two modalities, the transcription process was particularly complex. We argue that accurate transcription in such linguistically complex contexts is possible but that it is important that the research community develop principles and procedures for transcribing multilingual and bimodal interview data in a way that honors participants' intended messages as faithfully as possible. [ABSTRACT FROM AUTHOR]

Knowing what information a user wants is a paramount challenge to information science and technology. Implicit feedback is key to solving this challenge, as it allows information systems to learn about a user's needs and preferences. The available feedback, however, tends to be limited and its interpretation shows to be difficult. To tackle this challenge, we present a user study that explores whether tracking the eyes can unpack part of the complexity inherent to relevance and relevance decisions. The eye behavior of 30 participants reading 18 news articles was compared with their subjectively appraised comprehensibility and interest at a discourse level. Using linear regression models, the eye‐tracking signal explained 49.93% (comprehensibility) and 30.41% (interest) of variance (p <.001). We conclude that eye behavior provides implicit feedback beyond accuracy that enables new forms of adaptation and interaction support for personalized information systems. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to analyze the readability of the Individuals with Disabilities Education Act (IDEA) Part B procedural safeguard notices written in Spanish, as distributed by each of the 50 states in the United States and the District of Columbia. Results were compared with the 6th–8th grade document readability guideline recommended by experts in health communication. Method: A commercially available readability software program was used to assess document readability using three readability indices: the Gilliam–Peña– Mountain Graph, SOL, and the Fry Readability Adaptation for Spanish Evaluation. Results: All procedural safeguard notices were written at a reading grade level greater than established guidelines. This finding agrees with research that has examined the readability of English-language versions of IDEA Part B procedural safeguard notices. Conclusions: Literacy-related skills and demands may influence the ability of the parent to advocate on behalf of his or her child with a disability within the school setting. Educators and specialists should be sensitive to parent reading preferences and proficiency when reviewing IDEA procedural safeguards notices. Authors of procedural safeguard notices should account for the native language and culture of the intended reader as revisions to, and translations are made of, IDEA procedural safeguards notices. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to explore the contributions of phonological awareness (PA) and morphological awareness (MA) to the reading comprehension skills of Chinese-speaking children with hearing loss (HL) and examine the possible mediation effect of vocabulary knowledge on the relationships of PA and MA with their reading comprehension. Method: The participants were 28 Chinese-speaking children with HL, who were followed from Grade 1 through Grade 2. They were administered a series of tests that measured their PA and MA at the beginning of Grade 1, vocabulary knowledge at the end of Grade 1, and reading comprehension at the end of Grade 2. Results: MA significantly accounted for additional variance in reading comprehension beyond the effect of PA but not vice versa. Both PA and MA contributed uniquely to vocabulary knowledge, which completely mediated the relationships of PA and MA with reading comprehension. Conclusions: PA and MA are both essential to the development of vocabulary knowledge and reading comprehension in Chinese-speaking children with HL; however, MA seems to be more important than PA in their reading comprehension. PA and MA significantly affect children’s reading comprehension through their influence on vocabulary knowledge. This study has replicated previous evidence on the importance of PA, MA, and vocabulary knowledge in the reading comprehension of children with typical hearing, and has extended its significance to children with HL. In addition, the findings have the potential to inform educational practitioners regarding the importance of teaching essential reading skills to Chinese-speaking children with HL. [ABSTRACT FROM AUTHOR]

Purpose: Benign prostatic hyperplasia (BPH) affects nearly half of men in their fifties. Patients often search the Internet to better understand their diagnosis, but online health information is not well regulated and can be difficult for patients to comprehend. This study aims to evaluate not only readability, but also the quality of online information about BPH, as well as the effect of commercial bias on readability and quality. Methods: Three search engines (Google, Bing, and DuckDuckGo) were used with broad search terms including "BPH," "BPH treatment," and "BPH surgery," to mimic a patient diagnosed with BPH seeking further information. 204 total websites were identified, of which 62 were unique websites. Among those unique websites, 23 were advertisements. Three readability formulas (Flesch−Kincaid Grade Level, Flesch−Kincaid Reading Ease, SMOG) were used to generate readability scores. DISCERN standardized questionnaire was used to evaluate website quality. Results: Average reading level of online information about BPH was significantly higher than the recommended level by the American Medical Association (AMA) and United States Department of Health and Human Services (USDHHS). Advertisements had significantly easier readability than nonadvertisements. Average website quality was "excellent" for nonadvertisements, but only "fair" for advertisements. Conclusion: Although advertisements may hold optimal search result positions and have better readability than nonadvertisements, they have biased and lower quality information. It is important to guide patients to high quality online information of appropriate reading level. Continued efforts should be made to create and share with patients high quality resources with improved readability to facilitate comprehension and minimize misinformation. [ABSTRACT FROM AUTHOR]

Unfolding models are frequently used to develop scales for measuring attitudes. Recently, unfolding models have been applied to examine rater severity and accuracy within the context of rater-mediated assessments. One of the problems in applying unfolding models to rater-mediated assessments is that the substantive interpretations of the latent variable are challenging. The purpose of this study is to evaluate the use of Coh-Metrix indices as an approach for defining the characteristics of essays related to their scoring difficulty. Essays from a rater-mediated writing assessment were selected (N = 100), and rater accuracy was defined using an unfolding model. The scoring difficulty of essays along the unfolding scale (i.e., difficult-to-score below, easy-to-score, and difficult-to-score above) was related to essay feature indices defined with the Coh-Metrix text analyzer. Six areas of essay features were considered: descriptive, text readability, lexical diversity, latent semantic analysis, syntactic complexity, and word information. The results suggest that the substantive interpretation of the underlying unfolding scale can be enhanced by examining essay characteristics with Coh-Metrix indices. This methodology offers a promising approach for understanding the unfolding continuum and gaining information about the characteristics of difficult-to-score essays. Suggestions and implications for evaluating rater-mediated assessment systems using unfolding models are discussed. [ABSTRACT FROM AUTHOR]

Open Educational Resources aim to offer learning to all, yet the language level used in resources could be a barrier to many potential learners. This paper examines the readability of 200 OER courses in English from two major OER course platforms. We compared the means of readability metrics between these OER courses at different educational levels and subject categories that the platforms offer using inferential statistics as well as cluster analyses. Results prove that there is a progression of difficulty between lower and higher educational levels with introductory courses being easier to read. However, the analysis also highlighted that more than 86% of the courses require an advanced level of English language proficiency. On the other hand, subject matter does not appear to be linked with the readability of the courses. This study contributes further to the current discussion of the inclusiveness of OER and the factors that hinder its universal use. The study addresses a gap in the literature as, to our knowledge, no other studies have analysed the linguistic accessibility of OER English learners and consideration of the meaning of the educational levels assigned to OER courses has been limited. [ABSTRACT FROM AUTHOR]

This study aimed to determine the level of readability of online information on gestational diabetes mellitus (GDM). Readability of 100 English-language websites was assessed by five readability measures: Flesch-Kincaid Grade level (FKGL), Gunning Fox Index (GFI), Coleman Liau Index (CLI), Simple Measure of Gobbledygook (SMOG), and Flesch Reading Ease (FRE). A majority (90%+) of the sample was determined to have unacceptable readability levels, with averages at least one standard deviation away from recommended levels. Not more than a tenth of the websites measured readability to be acceptable or not equivalent to grade seven and above. Results suggest an urgent need for health professionals who create online information related to GDM to revisit and revise the text to be simplified and more readable. [ABSTRACT FROM AUTHOR]

This study was conducted to examine whether online information regarding male infertility on Swedish fertility clinics' websites was readable, suitable, and of appropriate quality. A cross-sectional design was used to evaluate 22 fertility clinics' websites focusing on male infertility by using the Suitability Assessment of Materials (SAM), and the DISCERN instrument. Results showed that information focusing on male infertility was scanty but had an "adequate" readability and was easy to comprehend. The conclusion was that the information on the websites must be reliable, so that men can base their choices concerning their fertility issues on reliable facts. It is important that health care professionals develop high quality sources of information regarding male infertility. [ABSTRACT FROM AUTHOR]

Aim: The aim of the paper is to compare the quality of nursing documentation in the Children's Hospital before and after the NANDA‐I nursing diagnoses training. Methods: Research employed the interventional study design, and pre–post study design. Before and after the NANDA‐I nursing diagnoses training, 50 nursing records were analyzed in the interventional pre–post study, using D‐Catch instrument. Results: The most often documented problem‐centered nursing diagnosis before training was anxiety and after the training, hyperthermia. The most common risk diagnoses before and after the training was risk of infection. Before the training, one health promotion diagnosis was determined in the nursing records, and after the training the number increased to four. The highest value was given to readability of the nursing documentation both before and after the training. The lowest score before the training was given to the quality determiners of the accurate nursing diagnoses and after the training given to the determiners of the results' quantity. The sum score of documenting the nursing interventions was the most inconsistent before the training and after the training. The most consistent was the readability of the nursing records before and after the training. Statistically significant differences in the improvement of quality were revealed in all areas except for the readability of the nursing documentation and the quantity of nursing assessment. Conclusions: The results of the study revealed that following the training, the quality of nursing documentation improved, the wording of the nursing diagnoses improved, and the number of accurate nursing diagnoses had increased. Implications for Nursing Practice: Results of the research provide an overview of the importance of the training in improving the quality of nursing documentation and aid the educators in planning the trainings, focusing more on the challenges in the documentation. [ABSTRACT FROM AUTHOR]

We examined how readers process content and function words in sentence comprehension with ERPs. Participants read simple declarative sentences using a rapid serial visual presentation (RSVP) with flankers paradigm. Sentences contained either an unexpected semantically anomalous content word, an unexpected syntactically anomalous function word or were well-formed with no anomalies. ERPs were examined when target words were in the parafoveal or foveal vision. Unexpected content words elicited a typically distributed N400 when displayed in the parafovea, followed by a longer-lasting, widely distributed positivity starting around 300 ms once foveated. Unexpected function words elicited a left lateralised LAN-like component when presented in the parafovea, followed by a left lateralised, posteriorly distributed P600 when foveated. These results suggested that both semantic and syntactic processing involve two stages – the initial, fast process that can be completed in parafovea, followed by a more in depth attentionally mediated assessment that occurs with direct attention. [ABSTRACT FROM AUTHOR]

Background: Patient-reported outcome measures (PROMs) are useful instruments that give providers insight into patients' experiences with disease by quantifying the symptoms that matter most to patients. Results of these questionnaires can help guide management in chronic rhinosinusitis. However, these tools are often developed for native English speakers, which disadvantages others, who already have a language barrier to care. The aim of this study is to evaluate accessibility and readability of Spanish PROMs used to evaluate rhinosinusitis. Methods: Three Spanish readability measures, Gilliam, Peña & Mountain; SOL; and Fernandez-Huerta were used to evaluate PROMs utilized for rhinosinusitis. PROMs with sixth-grade readability level or easier were considered to meet health literacy recommendations. Results: Four Spanish PROMs utilized in assessment of rhinosinusitis were identified and evaluated. Cuestionario Español de Calidad de Vida en Rinitis (ESPRINT-15) was the most readable PROM and met readability recommendations in two of three measures. Nasal Obstruction Symptom Evaluation met suggested levels in one measure. The remainder of readability scores were more difficult than recommended. Conclusion: PROMs are powerful clinical tools that help patients communicate their symptoms and self-advocate. For providers to gain accurate and useful information, these measures should be written at appropriate readability levels. Most Spanish PROMs used for assessment of rhinosinusitis were above recommended readability. Development of future PROMs should ensure appropriate readability levels to provide good patient-centered care for our primarily Spanish speaking patients. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To understand the method of developing initial codes from interview recordings • To learn the advantages and disadvantages of generating initial codes from reading transcriptions and from listening to recordings • To create strategies for efficiently analysing data in a grounded theory study Background: Interviewing is a vital and common method of collecting data in qualitative research. The interview is usually recorded and a written transcription is created from the recording. The transcription document is then analysed by reading and re-reading to fracture the data and develop initial codes, as in grounded theory methodology. However, this method has disadvantages. Aim: To report on how the authors used the process of generating initial codes during their analysis in a research study. Discussion: The authors compare the rigour and efficiency of generating initial codes from reading written transcripts with generating initial codes from listening to recordings. The most notable difference between the two methods is the length of time needed to transcribe the recording before coding can start. The authors discuss the lessons they learned from their pragmatic decision to expedite initial coding by listening to rather than reading the interview data. Conclusion: Grounded theory requires concurrent data generation and analysis. Audio analysis is efficient in developing initial codes from interview recordings. Implications for practice: Nurse researchers can use the audio method of analysing interview data [ABSTRACT FROM AUTHOR]

The aim of this text is to offer a literature review around the main aspects that involve the construction of the dissensual scene in Jacques Rancière, showing how the fabulative power of fiction produce any moments that disturb the consensual chains of actions, gestures, existences and experiences. Firstly, it is provided evidence on how the method of the scene is defined by Rancière as the elaboration of a web or assembly of a complex plot around a singularity, through an operation of dismantling hegemonic and asymmetric legibilities. In a second step, it is argued that this montage operation involves the construction of a writing and a singular lexicon, articulated around the intersection and coexistence between the “random moment” and the “measureless moment”, which are temporalities that Rancière uses to name political emancipation. Finally, it is highlighted how fabulation alters the sensitive map of experiences by producing scenes of dissent that function as a machine that interrupts the winners’ time, refuses the causal continuity of narrative organization and reconfigures appearances and their forms of readability. The measureless moment, reappropriated by a non-explanatory writing, works as a basis for the creation of scenes that reconfigure the spaces and times previously destined to the subjects, failing to meet expectations and, thus, altering the landscape of what is thinkable and possible. [ABSTRACT FROM AUTHOR]

Age of acquisition (AoA) is a measure of word complexity which refers to the age at which a word is typically learned. AoA measures have shown strong correlations with reading comprehension, lexical decision times, and writing quality. AoA scores based on both adult and child data have limitations that allow for error in measurement, and increase the cost and effort to produce. In this paper, we introduce Age of Exposure (AoE) version 2, a proxy for human exposure to new vocabulary terms that expands AoA word lists through training regressors to predict AoA scores. Word2vec word embeddings are trained on cumulatively increasing corpora of texts, word exposure trajectories are generated by aligning the word2vec vector spaces, and features of words are derived for modeling AoA scores. Our prediction models achieve low errors (from 13% with a corresponding R2 of.35 up to 7% with an R2 of.74), can be uniformly applied to different AoA word lists, and generalize to the entire vocabulary of a language. Our method benefits from using existing readability indices to define the order of texts in the corpora, while the performed analyses confirm that the generated AoA scores accurately predicted the difficulty of texts (R2 of.84, surpassing related previous work). Further, we provide evidence of the internal reliability of our word trajectory features, demonstrate the effectiveness of the word trajectory features when contrasted with simple lexical features, and show that the exclusion of features that rely on external resources does not significantly impact performance. [ABSTRACT FROM AUTHOR]

Background: Modern patients use the internet more frequently for their health information. Our aim was to assess the quality and readability of online patient education materials relating to revision knee arthroplasty. We hypothesised that this information would be too difficult to read for the average patient and of a lesser quality than desired.Method: A search of the top 50 results on 3 search engines (Google, Bing, Yahoo) was completed (MeSH "revision knee arthroplasty", "revision knee replacement"). Readability of these websites was calculated using a specialised website, www.readable.com to produce 3 scores (Gunning-Fog (GF), Flesch Reading Ease (FRE), Flesch-Kincaid Grade (FKG). Quality was assessed using the Journal of American Medical Association (JAMA) benchmark criteria and the Health On the Net (HON) code toolbar extension.Results: 89 unique websites were identified. Mean FRE was 44.01 ± 11.05. The mean GF was 12.01 ± 2.94. The mean FKG level was 10.06 ± 1.95. As per the FRE score, no webpage was pitched at or below a sixth grade reading level. The GF index identified only 3 websites (3.4%) at 6th grade reading level. As per FKG score, most webpages (n = 58, 65.2%) found themselves in the 10th grade reading level and above. Four websites (4.5%) displayed a HONcode certificate. However, all had expired. Most websites (n = 34, 38.2%) didn't meet any of the JAMA criteria.Conclusion: The reading level of these materials is too high for the average patient and of a low quality. Given what we know about levels of health literacy and their relationship with patient outcomes, it is vital that we address these deficiencies promptly. [ABSTRACT FROM AUTHOR]

Three patient education texts from the National Cancer Institute (NCI) were subjected to a Coh-Metrix analysis, then further analyzed to obtain Gist Inference Scores (GIS), a new measure of the likelihood that readers will make appropriate inferences about a text's bottom-line meaning. In the GIS formula, the Coh-Metrix psycholinguistic variables referential cohesion, deep cohesion, and latent semantic analysis (LSA) verb overlap increase GIS because cohesive texts that describe related actions are likely to induce gist representations. The Coh-Metrix variables word concreteness, imagability for content words, and hypernymy for nouns and verbs are negatively weighted because they tend to promote verbatim mental representations. NCI texts were modified for a cloze procedure with every tenth word replaced by a blank starting with the second sentence. Participants in two studies received all three cloze-modified texts. Fuzzy-Trace Theory suggests that people are more likely to comprehend high GIS texts "in their own words," and thus fill-the-blanks with multiple words that differ from those omitted by the cloze procedure expressing comparable meaning. In Study One, non-native English speakers appropriately filled blanks with different words at the same rate for all three texts of low-, medium-, and high-GIS. In Study Two, replicating previous findings, for high GIS texts, native English speakers filled blanks appropriately with words other than those removed significantly more often than for medium- or low-GIS texts. High GIS texts apparently afford readers more semantic and lexical flexibility, but non-native English speakers may be ill-equipped to capitalize on this characteristic of high GIS texts. [ABSTRACT FROM AUTHOR]

Patients are becoming increasingly reliant on online platforms for obtaining health information. Previous research has shown that the quality of information available on the internet regarding novel medical therapies is generally poor and frequently misleading. Shock wave therapy represents a novel restorative therapy for erectile dysfunction (ED) that has recently gained attention. We hypothesised that online sources regarding shock wave therapy for ED would be fraught with misleading claims and unreliable health information. Our objective was to evaluate the quality and readability of online medical information on shock wave therapy as a treatment for ED. Websites were generated using a Google search of 'shock wave therapy for erectile dysfunction' with location filters disabled. Readability was analysed using the Readable software (Readable.com, Horsham, United Kingdom). Quality was assessed independently by three reviewers using the DISCERN tool. Articles were subdivided into those from private clinic websites and those from universities or news media websites. Statistical analysis was conducted using the Student's t test. Nine articles that resulted from the Google search had mean readability scores as follows: Flesch–Kincaid grade level (10.8), Gunning–Fog Index (13.67), Coleman–Liau Index (12.74), Simple Measure of Gobbledygook (SMOG) Index (13.33), FORCAST Grade Level (11.33), and Automated Readability Index (11.08). The mean Flesch Reading Ease score was 46.4. The articles had a mean DISCERN score of 3.1, suggesting 'moderate quality' content. Articles from universities (n = 2) or news sources (n = 3) had significantly higher DISCERN scores than articles from private medical practices (n = 4). There was no difference in readability scores between the groups. Articles from private clinics are just as readable as those from universities or news media, but they are significantly more biased and misleading. The current online material relating to shock wave therapy for ED may not adequately inform patients in their medical decisions making, thereby necessitating closer collaboration between the sources disseminating information and urologists. [ABSTRACT FROM AUTHOR]

In an eye-tracking-while-reading study, we investigated adult monolinguals' (N = 80) processing of two-clause sentences embedded in short narratives. Three principles theorised to guide comprehension of complex sentences were contrasted: one operating at the clause level, namely clause structure (main clause – subordinate clause or vice versa), and two operating at the discourse-level, namely givenness (given-new vs. new-given) and event order (chronological vs. reverse order). The results indicate that clause structure mainly affects early stages of processing, whereas the two principles operating at the discourse level are more important during later stages and for reading times of the entire sentence. Event order was found to operate relatively independently of the other principles. Givenness was found to overrule clause structure, a phenomenon that can be related to the grounding function of preposed subordinate clauses. We propose a new principle to reflect this interaction effect: the grounding principle. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to examine the ease of reading cochlear implant (CI) brochures provided to parents and caregivers who are making informed decisions about the management of their child's hearing loss. Method: CI brochures from three Food and Drug Administration--approved CI manufacturers were examined: Advanced Bionics, Cochlear Americas, and MED-EL. Reading grade levels and ease of reading were analyzed using a commercially available computer software program, applying six readability formulas commonly used to examine hearing-related patient education materials (PEMs). Results: The readability of the CI brochures exceeds the fifth- to sixth-grade reading-level guidelines. The CI brochures may be difficult for the average English-speaking adult to read with ease and requires at least a 10th-grade comparable reading level. Conclusions: Despite health literacy initiatives, audiology-focused PEMs continue to be created without full consideration of the burden for the reader. Authors of PEMs should consider the average reading level of the reader as a variable potentially influencing the decision-making process. Likewise, clinicians should consider the average reading level needed to understand PEMs when presenting information and resources to parents and caregivers for informed and shared decision making. [ABSTRACT FROM AUTHOR]

Purpose: Complications related to parotidectomy can cause significant morbidity, and thus, the decision to pursue this surgery needs to be well-informed. Given that information available online plays a critical role in patient education, this study aimed to evaluate the readability and quality of online patient education materials (PEMs) regarding parotidectomy. Methods: A Google search was performed using the term "parotidectomy" and the first 10 pages of the search were analyzed. Quality and reliability of the online information was assessed using the DISCERN instrument. Flesch-Kincaid Grade Level (FKGL) and Flesch-Reading Ease Score (FRE) were used to evaluate readability. Results: Thirty-five PEMs met the inclusion criteria. The average FRE score was 59.3 and 16 (46%) of the online PEMs had FRE scores below 60 indicating that they were fairly difficult to very difficult to read. The average grade level of the PEMs was above the eighth grade when evaluated with the FKGL. The average DISCERN score was 41.7, which is indicative of fair quality. There were no significant differences between PEMs originating from medical institutions and PEMs originating from other sources in terms of quality or readability. Conclusion: Online PEMs on parotidectomy may not be comprehensible to the average individual. This study highlights the need for the development of more appropriate PEMs to inform patients about parotidectomy. [ABSTRACT FROM AUTHOR]

Background: It is challenging to reliably assess the language comprehension of children with severe motor and speech impairments using traditional assessment tools. The Computer Based instrument for Low motor Language Testing (C-BiLLT) aims to reduce barriers to evidence-based assessment for this population by allowing children to access the test using non-traditional methods such as eye gaze so they can independently respond to test items. The purpose of this study is to develop a contextualized understanding of the factors that influenced clinicians' implementation of the C-BILLT in practice in the Netherlands and Norway.Materials and Methods: A qualitative approach including semi-structured individual interviews with 15 clinicians (speech-language pathologists, neuropsychologists, and one teacher, counsellor, and vision specialist) was used. Data analysis was conducted in two rounds. First, a deductive approach including a codebook was used to code data within the COM-B components describing clinicians' capability, opportunity, and motivation for behaviour change. Then, an abductive approach applying thematic analysis was used to identify meaningful patterns within the COM-B components.Results: Several meaningful barriers and facilitators were identified across the data. Clinicians used the C-BiLLT with two distinct groups of clients: (1) the population it was originally developed for, and (2) clients that could have also been assessed using a traditional language test. Clinicians working with the first group experienced more, and more complex barriers across all COM-B components, to successful C-BiLLT use than the latter.Conclusion: This study provides timely insights into the capability, opportunity, and motivation factors important for creating and sustaining assessment behaviour change in clinicians who used or attempted to use the C-BiLLT. Potential tailored intervention strategies aimed at improving implementation of novel assessment tools are discussed and may be helpful for others working to improve service delivery for children with complex needs. [ABSTRACT FROM AUTHOR]

Introduction: Fibroadenomas are benign lesions found in the breast tissue. Widespread access to and use of the internet has resulted in more individuals using online resources to better understand health conditions, their prognosis and treatment. The aim of this study was to investigate the readability and visual appearance of online patient resources for fibroadenoma. Methods: We searched GoogleTM, BingTM and YahooTM on 6 July 2022 using the search terms "fibroadenoma", "breast lumps", "non-cancerous breast lumps", "benign breast lumps" and "benign breast lesions" to identify the top ten websites that appeared on each of the search engines. We excluded advertised websites, links to individual pdf documents and links to blogs/chats. We compiled a complete list of websites identified using the three search engines and the search terms and analysed the content. We only selected pages that were relevant to fibroadenoma. We excluded pages which only contained contact details and no narrative information relating to the condition. We did not assess information where links were directed to alternative websites. We undertook a qualitative visual assessment of each of the websites using a framework of pre-determined key criteria based on the Centers for Medicare and Medicaid Services toolkit. This involved assessing characteristics such as overall design, page layout, font size and colour. Each criterion was scored as: +1- criterion achieved; -1- criterion not achieved; and 0- no evidence, unclear or not applicable (maximum total score 43). We then assessed the readability of each website to determine the UK and US reading age using five different readability tests: Flesch Kincaid, Gunning Fog, Coleman Liau, SMOG, and the Automated Readability Index. We compared the readability scores to determine if there were any significant differences across the websites identified. We also generated scores for the Flesh Reading Ease as well as information about sentence structure (number of syllables per sentence and proportion of words with a high number of syllables) and proportion of people the text was readable to. Results: We identified 39 websites for readability and visual assessment. The visual assessment scores for the 39 websites identified ranged from -19 to 31 points out of a possible score of 43. The median readability score for the identified websites was 8.58 (age 14–15), with a range of 6.69–12.22 (age 12–13 to university level). There was a statistically significant difference between the readability scores obtained across websites (p<0.001). Almost half of the websites (18/39; 46.2%) were classified as very difficult by the Flesch Reading Ease score, with only 13/39 (33.33%) classified as being fairly easy or plain English. Conclusion: We found wide differences in the general appearance, layout and focus of the fibroadenoma websites identified. The readability of most of the websites was also much higher than the recommended level for the public to understand. Fibroadenoma website information needs to be simplified to reduce the use of jargon and specificity to the condition for individuals to better comprehend it. In addition, their visual appearance could be improved by changing the layout and including images and diagrams. [ABSTRACT FROM AUTHOR]

There is vigorous debate as to whether influential social media platforms like Twitter and Facebook should censor objectionable posts by prominent individuals in the United States and elsewhere. A tentative middle ground is employing content moderation to signal to social media audiences that certain posts may contain objectionable information through the mechanism of flagging. Existing studies have mainly examined the effect of flagging regular users' content. To add to this emerging literature stream, we examine the effect of flagging when the underlying content is produced by a prominent individual. Leveraging Twitter's moderation activities on former U.S. President Donald Trump's tweets as our empirical setting, we employ three machine learning algorithms to estimate the effect of flagging Trump's tweets. We explore preliminary evidence as to whether these posts were retweeted less or more than expected. Our results indicate that the flagged tweets were retweeted at higher rates than expected. Our findings suggest that flagging content of prominent individuals on social media might be ineffective or even counterproductive in curbing the spread of content deemed objectionable by social media companies. [ABSTRACT FROM AUTHOR]

Background: Many people with aphasia (PWA) want to read books. Text-to-speech (TTS) technology sometimes provides comprehension and processing time benefits when PWA read short, multisentence passages. Currently, no research examines the effect of TTS support when PWA read books. Aims: This study’s primary purpose was to examine comprehension accuracy and total processing time of PWA and neurotypical healthy adults (NHAs) when reading book sections in read-only versus TTS-supported conditions. A secondary aim was to examine condition preference and perceived degree of understanding by people in both participant groups. Method and Procedure: Ten PWA and 10 NHAs alternated between read-only and TTS-supported conditions to read a book. Participants answered comprehension questions and provided feedback about their reading experience, condition preference, and desire to use TTS technology for future book reading. Outcomes and Result: Overall, PWA exhibited less accurate comprehension and slower processing times compared to NHAs in both conditions. No significant comprehension accuracy difference occurred between conditions for either group. However, four PWA exhibited a 10% or greater increase in comprehension accuracy when receiving TTS support. A significant processing time difference occurred with PWA processing text faster with TTS support, whereas NHAs did not demonstrate processing time differences. Most PWA preferred the TTS condition and expressed a desire to use TTS technology in the future. Most NHAs expressed the opposite preference. Conclusions: TTS support during book reading promotes faster processing without compromising comprehension for PWA. Clinicians should discuss with PWA the relative importance of comprehension accuracy, processing time, and comfort with technology when determining whether using TTS support during book reading is desirable. [ABSTRACT FROM AUTHOR]

Background: Developmental language disorder (DLD) has clear functional ramifications in the areas of social competency, emotion recognition, emotional well‐being and literacy skill, which have been found to persist from childhood to adolescence. These domains are important factors during the transition from primary to secondary school in typical development (TD). Nevertheless, there is a paucity of research on the transition from primary to secondary school for adolescents with DLD and low language (LL) ability. Aims: To investigate the association between psychosocial domains, literacy skill and concerns about school during the transition to secondary school for adolescents with DLD, LL and their TD peers. The first research question examined whether levels of social competency, emotion recognition, emotional well‐being and literacy skill predicted school concern for the three groups. The second research question explored the longitudinal relationship between school concern and psychosocial and literacy indicators over the transition. Methods & Procedures: Participants (aged 10–11 years) with DLD (n = 30), LL ((n = 29) and TD (n = 42) were recruited for this longitudinal study from eight UK primary schools. Standardized language and psychosocial assessments were administered in the spring and summer terms of the final year of primary school, and the autumn and summer terms of the first year in secondary school. Outcomes & Results: Regression analyses showed pre‐transition school concern to be predicted by emotion recognition for the DLD group, by social competence and emotional well‐being for the LL group, and by social competence for the TD group. Post‐transition concern was predicted by emotional well‐being for the LL group; with no significant predictors for the DLD/TD groups. Path analyses revealed an association between literacy skill and emotion recognition for the DLD group. A developmental cascade illustrated a relationship between social competence and emotional well‐being for the TD group. Conclusions & Implications: This study concludes that transition interventions must be differentiated according to language ability; support for DLD adolescents should focus on emotion recognition skill, provision for LL adolescents should centre on emotional well‐being, and TD participants should be particularly supported in the domain of social competence in advance of the move to secondary school. Additionally, this study emphasizes the importance of the inclusion of a LL group, as their outcomes cannot be predicted using DLD/TD research. WHAT THIS PAPER ADDS: What is already known on the subject: There is limited research exploring the transition from primary school to secondary for adolescents with DLD or LL ability. Research on TD has highlighted vulnerable domains at this time. As these key areas are evidenced spheres of difficulty in DLD and LL, there was a strong impetus for this study. What this paper adds to existing knowledge: This study reveals differences between language ability groups in the predictors of school concern both pre‐ and post‐transition. Concerns of adolescents with DLD were predicted by emotion recognition, those of adolescents with LL were predicted by emotional well‐being, and a longitudinal link between social competence and emotional well‐being was evidenced for TD adolescents. What are the potential or actual clinical implications of this work?: This study has implications for researchers and clinicians, as a need has been identified for a new clinical group. It also has practical implications for transition support planning for educational practitioners, families and adolescents. [ABSTRACT FROM AUTHOR]

Aim: Although fibromyalgia patients frequently use the internet to get information about their diseases, there is no comprehensive and strong study investigating the quality and reliability of websites offering online information in Turkish. The aim of this study was to examine the content, readability, and reliability levels of the information published on Turkish websites about fibromyalgia. Methods: In May 2022, the words "fibromyalgia" and "muscle rheumatism" were scanned on a Google search, and the websites in the first 20 pages were investigated. The websites were divided into three groups according to the creator: Group 1= hospitals, associations, and official institutions; group 2= health professionals; and group 3= others (news sites, blogs, etc.). The readability level was evaluated according to the Ateşman and Bezirci-Yılmaz formula; the reliability was evaluated according to the Journal of the American Medical Association (JAMA) score; and the information content was evaluated by referring to the subject headings in the patient information booklet prepared by the Turkish Physical Medicine and Rehabilitation Association. The grouping of the websites and evaluation of the JAMA score were rated by two independent researchers. Results: One hundred and seven websites were included in the study; 48 (44.8%) were in group 1, 28 (26.2%) were in group 2, and 31 (29.0%) were in group 3. The median Ateşman value of all websites was 47.3 [minimum (min.)=21.6, maximum (max.)=80.2]; the median Bezirci-Yılmaz value was 13.1 (min.=4.8, max.=22.7). The JAMA median score was 2.0 (min.=0, max.=4), and 102 (95.2%) websites were classified as low-reliable (JAMA score≤2). The information content of 12 (11.2%) websites was complete. There was no difference between the groups in terms of the JAMA score, Ateşman, and Bezirci-Yılmaz values (p=0.705, 0.801, and 0.697, respectively). Websites on the first two pages (n=16) had a slightly lower JAMA score than the next pages (p=0.011). Inter-rater consistency was excellent (Cohen's=0.89 and 0.823, respectively; p<0.001). Conclusion: Turkish websites are far from providing sufficient and quality information on fibromyalgia. Physicians and patients should be aware of this situation; relevant institutions should develop the necessary health policies to solve the problem. [ABSTRACT FROM AUTHOR]

Research on the use of speed, as an indicator of motor handwriting problems, is controversial and the legibility of the text is the measure mostly examined in children. This case-control study compared handwriting legibility and speed in 25 children with Developmental Coordination Disorder (DCD) and 75 typically developing peers matched by school grade (third and fourth grade). Children with DCD achieved significantly lower scores than their peers in both legibility and speed measures, overall and in the third and in the fourth grade independently. These measures represent a good insight into children's writing abilities and could be both used to screen and monitor. [ABSTRACT FROM AUTHOR]

What Is Known and Objective: The technique of highlighted capital letters, Tall Man lettering, is a tool that allows differentiating the names of similar drugs in a way that contributes to reduce medication errors related to the drug identification. The objective was to implement and monitor the application protocol of the Tall Man lettering tool in drug information systems in the healthcare environment to improve the quality of care and patient safety in the pharmacy service and the medical institution. Methods: Scope: Tertiary general hospital with 1000 beds in which a Tall Man lettering application protocol was approved in the pharmacy service information systems. Design: Retrospective observational study. Period: 2019–2021. Population: Information systems and databases used in the pharmacy service. Working group: Made up of people in charge of information areas and systems. Implementation: Five phases were defined: organization of the working group, selection of drug names and information systems, establishment of actions, their execution, and results monitoring. Variables: Number of pharmaceutical specialties, names of active ingredient and brands incorporated in the information systems. Results and Discussion: The application of Tall Man lettering was authorized in 13/13 information systems, six have been fully implemented and seven are in the database update phase. Of the implanted systems, a total of 210 drug names have been modified (168/210 active ingredient and 42/210 brand names), corresponding to 659 pharmaceutical specialties. What Is New and Conclusion: The application of Tall Man lettering in hospital information systems is a tool for improving the quality of the pharmacy service and guarantees the safety of medicines in the hospital. [ABSTRACT FROM AUTHOR]

In less than a decade, the western world has witnessed an unprecedented rise in the numbers of children and adolescents seeking gender transition. Despite the precedent of years of gender-affirmative care, the social, medical and surgical interventions are still based on very low-quality evidence. The many risks of these interventions, including medicalizing a temporary adolescent identity, have come into a clearer focus through an awareness of detransitioners. The risks of gender-affirmative care are ethically managed through a properly conducted informed consent process. Its elements-deliberate sharing of the hoped-for benefits, known risks and long-term outcomes, and alternative treatments-must be delivered in a manner that promotes comprehension. The process is limited by: erroneous professional assumptions; poor quality of the initial evaluations; and inaccurate and incomplete information shared with patients and their parents. We discuss data on suicide and present the limitations of the Dutch studies that have been the basis for interventions. Beliefs about gender-affirmative care need to be separated from the established facts. A proper informed consent process can both prepare parents and patients for the difficult choices that they must make and can ease professionals' ethical tensions. Even when properly accomplished, however, some clinical circumstances exist that remain quite uncertain. [ABSTRACT FROM AUTHOR]

The purpose of this investigation was to evaluate the content, quality, and readability of orthodontic information contained on the websites of general dental practices located in Australia. An online search strategy was adopted to identify practice websites for evaluation. Websites satisfying inclusion/exclusion criteria were checked for the presence of pre-determined orthodontic treatment-related items. Three validated quality of health information and readability tools were applied for website content assessment. A total of 231 websites satisfied inclusion/exclusion criteria. The mean overall [SD] DISCERN score was 29.87 (6.03)/80, [95%CI: 29.09–30.65]. The majority of the websites (88.3%) recorded poor or very poor DISCERN quality of information scores. Most websites described orthodontic clear aligner treatment (91.3%). Information regarding Invisalign® was provided by 69.3% and myofunctional therapy by 22.5%. Only 7 (3%) websites indicated that orthodontic retention was indefinite. The mean [SD] Simple Measure of Gobbledygook (SMOG) score was 10.10 [1.31], (95%CI: 9.95–10.25). The SMOG and Flesch Reading Ease scores were closely correlated (r = −0.9041; 95%CI: −0.93 to −0.88; p < 0.0001) and signified difficult-to-read information. The content authors should consider the use of quality information and readability tools to ensure that readers access high-quality and readable information. [ABSTRACT FROM AUTHOR]

To investigate whether the authoritative COVID-19 consumer health information provided by the Centers for Disease Control and Prevention (CDC) in the United States (U.S.) and the World Health Organization (WHO) is at low readability levels (i.e., at or below a sixth-grade reading level). Major public health organizations, such as these have quickly distributed authoritative COVID-19 health information on the Internet during the pandemic. However, scant research has assessed whether the information disseminated by these two major public health organizations enables access by adults from the general public. This study examines the Flesch-Kincaid grade levels of the COVID-19 health information in English distributed by the CDC and the WHO. The study is guided by communication and information science frameworks. It examines the reading level of the resources to see if they are compatible with the guidelines of the American Medical Association for patient education materials. The methodology used centered on content and document analyses. The samples analyzed were identified through accessing the COVID-19 health information shared on the websites of the public library systems of the twenty largest cities in the U.S. The results show that the documents reviewed in the study are not compatible with the sixth-grade reading level recommended by the American Medical Association for patient education materials. [ABSTRACT FROM AUTHOR]

Background: The HOPE Scale by Gowri Anandarajah is a qualitative tool for examining and assessing the spiritual needs of sick people, which can be used by health care professionals, but also other personnel whose purpose is to support the patient during illness. Aim: The aim of this study was the cultural adaptation and validation of a qualitative tool for examining the spiritual needs of patients. Methods: A six-step procedure was adopted with the inclusion of four independent forward and two backward translations and cognitive debriefing of the Polish version with experts (n = 11) and chronically ill patients (n = 15). These methods were used to verify a semantic validation and comprehensibility of the HOPE scale according to the standards of cultural measure validation and adaptation. Bioethics Committee approval No KE-0254/222/2020. Results: No major problems were encountered during the process of straightforward and backward translation, and the suggested minor linguistic corrections were made. The HOPE scale was found to be comprehensible and readable by experts and patients, and the instructions were clear and did not pose any difficulties for the respondents. Following the six steps of the validation, the final Polish version of the HOPE scale was obtained, adapted stylistically and culturally to Polish conditions. Conclusions: The Polish version of the HOPE scale is culturally and linguistically adapted and is ready to be used for assessing patients' spiritual needs. The scale can be used both for research and in practice when working with chronically ill people. [ABSTRACT FROM AUTHOR]

The aim of this study was to assess text generation and text transcription of children and youth with Autism Spectrum Disorder (ASD, n = 67) and Typically Developing (TD) peers (n = 67). Participants (80.6% male, ages 9–14) produced a free-style handwriting task analysed for written content and handwriting legibility and speed. Findings showed children and youth with ASD perform significantly poorer than TD peers for written content and handwriting legibility and speed. For children and youth with ASD, poor handwriting legibility predicted poor written content. For TD peers, fast handwriting predicted good written content. Collapsing both groups, ASD group membership negatively predicted written content, after controlling for handwriting legibility and speed. Practical implementations for the educational context are provided. [ABSTRACT FROM AUTHOR]

The notorious length of Karl Ove Knausgaard's My Struggle is the result of an ever-increasing preoccupation with speed: as much time went into the first few pages as went into all of the final volume's 1,248 pages. Not surprisingly, critics' appraisals were inversely related to this speed, beginning with nearly unanimous praise and ending with nearly unanimous condemnation. But it is the final volume that reveals the kind of work the novel really is: Against an innate, nearly automatic inclination to produce "what people liked," Knausgaard wanted to write how "he really [thought] things [were]." This desire is one Michael Fried would call "antitheatrical," in that Knausgaard did not want the novel to be for the audience. Yet Knausgaard felt that form and the meaning form produces, which for Fried were the primary means of antitheatricality, might actually have been what people liked about My Struggle. Writing quickly, then, was a way of not giving the audience what they wanted – meaning – by making the text an object – by making it meaningless. My Struggle, despite appearances, is not the epitome of readability; it is a text that wants to mean nothing so that it might truly reject any appeal to the audience. [ABSTRACT FROM AUTHOR]

Introduction: Readability gives information about the characteristics of syllables, words and sentences of that language and whether the text is easily understood by the reader at a certain level by presenting some quantitative data about the texts. The aim of our study is to evaluate the readability of English-language patient education materials related to "Sepsis". Materials and Methods: The first 100 websites in English language were scanned using "Sepsis" as a keyword. Texts included in the study; Flesch Reading Ease Score (FRES), Flesch-Kincaid Grade Level (FKGL), Simple Measure of Gobbledygook (SMOG), Gunning Fog, The Coleman-Liau Index, automatic readability index, and Linsear Write formulas were evaluated. The number of Latin medical words in the text were determined. Results: 48 of the first 100 websites included in the study were sites for patient information about "Sepsis". In the analysis of texts belonging to 48 websites that were evaluated, the mean FRES was 47.31 ± 13.14 (quite difficult), the mean Gunning Fog was 13.63 ± 3.04 (very difficult), the average FKGL and SMOG was 11.36 ± 2.82 and 1031 ± 2.81 years of education, respectively, The Coleman-Liau Index 11.42 ± 1.95 years of education, automatic readability index 11.53 ± 3.46 years of education, Linsear Write Formula 12.36 ± 3.97 years of education was determined. According to all readability formulas, it was evaluated that the readability level was much higher than the 6th grade level. It was determined that there was a positive weak correlation between the WR score average and the FRES average of the texts, and a negative weak correlation between the Google rank and the Latin word average. Conclusion: While the analysis of the texts related to sepsis in our study was found to be quite difficult in terms of FRES and Gunning Fog values, it was determined that the texts addressed individuals with 10-13 years of education according to the values of FKGL, SMOG, Coleman-Liau Index, automatic readability index, and Linsear Write Formula. In our study, the readability level of internet-based patient education materials related to "Sepsis" was found to be quite high. [ABSTRACT FROM AUTHOR]

Background: The role of patient educational materials for paediatric patients is increasing. A reading grade level of eighth‐grade (USA) or year nine (Australia and New Zealand) is recommended as acceptable. The aim of this paper was to assess the reading grade levels of paediatric online patient educational materials, within Australasia. Methods: The online Google® search engine was used with a variety of keyword combinations, filtered to the location of Australia and New Zealand. Suitable websites were explored for webpages related to slipped upper femoral epiphysis, septic arthritis, osteomyelitis, talipes equinovarus and developmental dysplasia of the hip. Readability was assessed using the online readability software WEB FX®. Results: Seventy‐six patient educational webpages were analysed: 66 from Australia and 10 from New Zealand. Only eight of the 76 webpages (10.5%) had reading grade levels below the recommended eighth‐grade (US)/year nine (AUS/NZ) level. Webpages from private healthcare providers and pages related to septic arthritis had the significantly highest reading grades. Conclusions: Australasian families have limited online patient educational materials available to them, which are mostly set at reading grade levels above recommended standards. Healthcare providers should be incentivized to improve the readability of their patient educational materials to reduce health disparities and improve health literacy moving forward. [ABSTRACT FROM AUTHOR]

The article focuses on the study that analyzed the readability of urology publications using established readability metrics. According to the Flesch Reading Ease (FRE) scale, the study discovered that the majority of urology publications are challenging to read, with approximately two-thirds falling into the "difficult to read" category. It highlights that readability scores showed a limited association with author count, word count, and reference count.

Background: Participant information sheets and consent forms (PICFs) used in interventional studies are often criticised for being hard to read and understand. We assessed the readability and its correlates of a broad range of Australian PICFs.Methods: We analysed the participant information sheet portion of 248 PICFs. Readability scores were measured using three formulae: the Flesch Reading Ease, the Flesch-Kincaid Grade Level, and the Simple Measure of Gobbledygook (SMOG). We investigated how various features (including sponsor type and PICF type) correlated with PICF length and readability and examined compliance with other measures known to improve readability.Results: For a sample of 248 PICFs, the mean (standard deviation) Flesch Reading Ease score was 49.3 (5.7) and for the Flesch-Kincaid Grade Level 11.4 (1.1). The mean (SD) SMOG score was 13.2 (0.9). The median document length was 3848 words (8 pages). Commercial PICFs were more than twice as long as non-commercial, but statistically more readable (p = 0.03) when analysed using the SMOG formula. Subgroup analyses indicated that PICFs for self-consenters were statistically more readable than those for proxy consenters. The use of tables, but not the use of illustrations was associated with better readability scores.Conclusions: The PICFs in our sample are long and complex, and only 3 of the 248 achieved the recommended readability score of grade 8 or below. The broader use of best practice principles for writing health information for consumers and the development of more context-sensitive templates could improve their utility. [ABSTRACT FROM AUTHOR]