Whether the process of lexical access in silent reading is mediated by an internal phonological representation or only by visual representations has been a topic of empirical investigation since before the turn of the century. To date, research has generated contradictory findings. More recent evidence suggests that factors such as difficulty of material, frequency of occurrence of items, subjects' fluency, and task demands-which are seldom manipulated in typical studies of word recognition-play important roles in determining the type of mediation used. As a result, interest has shifted to a family of dual access models in which both phonological mediation and visual mediation are ordinarily used in parallel. The data point to a dual access model in which high-frequency words enjoy highspeed access via a visually based representation, whereas low-frequency words are accessed using a slower, phonological receding process.

Objective: To develop and test the prototype of a serious digital game for improving community-dwelling older adults' heart failure (HF) knowledge and self-management behaviors. The serious game innovatively incorporates evidence-based HF guidelines with contemporary game technology. Materials and Methods: The study included three phases: development of the game prototype, its usability assessment, and evaluation of the game's functionality. Usability testing included researchers' usability assessment, followed by research personnel's observations of participants playing the game, and participants' completion of a usability survey. Next, in a pretest-post-test design, validated instruments-the Atlanta Heart Failure Knowledge Test and the Self Care for Heart Failure Index-were used to measure improvement in HF self-management knowledge and behaviors related to HF self-maintenance, self-management, and self-efficacy, respectively. A postgame survey assessed participants' perceptions of the game. Results: During usability testing, with seven participants, 100%, 100%, and 86% found the game easy to play, enjoyable, and helpful for learning about HF, respectively. In the subsequent functionality testing, with 19 participants, 89% found the game interesting, enjoyable, and easy to play. Playing the game resulted in a significant improvement in HF self-management knowledge, a nonsignificant improvement in self-reported behaviors related to HF self-maintenance, and no difference in HF self-efficacy scores. Participants with lower education level and age preferred games to any other medium for receiving information. Conclusion: It is feasible to develop a serious digital game that community-dwelling older adults with HF find both satisfying and acceptable and that can improve their self-management knowledge.

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Predictions for word recognition latencies were generated for the independent parallel model of word recognition based on letter-naming latencies in two display conditions. In one condition, the inside two letters of four-letter words were presented 50 msec in advance of the presentation of the whole word, whereas in the other condition, the outside two letters were presented 50 msec in advance. The model predicts that the two conditions should yield roughly equal recognition latencies, but in each of four experiments the prior presentation of the outside letters led to faster recognition. The implications of these results for the family of parallel models (nonindependent as well as independent) are discussed.

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