august 2019 VisibleLanguage the journal of visual communication research 2

53 .

Visible Language 53 . 2 august 2019 ISSN 0022-2224 continuously Published 1967. since Before there was reading there was seeing.

Visible Language has been concerned with ideas that help define the unique role and properties of visual communication. A basic premise of the journal has been that created visual form is an autonomous system of expression that must be defined and explored on its own terms. Today more than ever people navigate the world and probe life’s meaning through visual language. This journal is devoted to enhancing people’s experience through the advancement of research and practice of visual communication.

Published tri-annually in April, August, and December website: http://visiblelanguagejournal.com send correspondence to:

Mike Zender, Editor College of Design, Architecture, Art, and Planning University of Cincinnati PO Box 210016 Cincinnati, OH 45221-0016

Mike Zender, Editor Dr. Maria dos Santos Lonsdale, Associate Editor- Typography University of Cincinnati, School of Design, Publisher Mike Zender, Publication Manager Merald Wrolstad, Founder Sharon Poggenpohl, Editor Emeritus

© Copyright 2019 by University of Cincinnati Visible Language 53 . 2 .

Visible Language

the journal of visual communication research

August 2019 1 Visible Language 53 . 2 . Visible Language

Contents

Dynamic Visual Identities: from a survey of the Tiago Martins 04 — 35 state-of-the-art João M. Cunha João Bicker to a model of features Penousal Machado and mechanisms

Visualizing the terror threat: The impact of Maria dos Santos Lonsdale 36 — 71 communicating David J. Lonsdale Matthew Baxter Advisory Board security information Ryan Graham Aya Kanafani Naomi Baron – The American University, Washington, D.C. to the general public Michael Bierut – Pentagram, New York, NY Anqi Li Charles Bigelow – Type designer using infographics Chunxinzi Peng Matthew Carter – Carter & Cone Type, Cambridge, MA and motion graphics. Keith Crutcher – Cincinnati, OH Mary Dyson – University of Reading, UK Legibility of Jorge Frascara – University of Alberta, Canada Pharmaceutical Ken Friedman – Swinburne University of Technology, Melbourne, Australia Michael Golec – School of the Art Institute of Chicago, Chicago, IL Pictograms: Towards defining a Pia Pedersen 72 — 99 Judith Gregory – University of California-Irvine, Irvine, CA paradigm Kevin Larson – Microsoft Advanced Reading Technologies Aaron Marcus – Aaron Marcus & Associates, Berkeley, CA Per Mollerup – Swinburne University of Technology, Melbourne, Australia For Visual Tom Ockerse – Rhode Island School of Design, Providence, RI Sharon Poggenpohl – Estes Park, CO Attention, are there any Jinsook Kim 100 — 111 Michael H Fritsch Michael Renner – The Basel School of Design – Visual Communication Institute, Tendencies Academy of Art and Design, HGK FHNW Stan Ruecker – IIT, Chicago, IL in Form Katie Salen – DePaul University, Chicago, IL Interpretation Peter Storkerson – Champaign, IL Karl van der Waarde – Avans University, Breda, The Netherlands Book Review Mike Zender – University of Cincinnati, Cincinnati, OH

2 3 Pedersen Legibility of Pharmaceutical Pictograms: - - -

- While we have abundant information about the comprehen information abundant have we While strates that legibility is not prioritized either in theory that strates or in practice. 53 . 2 . . 2 53 Towards Towards defining a paradigm demon­ in, for of pictograms with the use and implementation proceed In to order to we need more know labels, leaflets and information patient example, founda a research create To legibility. constitute that about the features on knowledge of visibility related and legibilitytion, this paper draws from research future the basis of a discussion of the need for forms This domains. knowl design incorporating amongst others by on legibility issues, focus to experiments. edge into The design of medicinal information in leaflets and labels is often criticized of medicinal information design The focus is an increasing there reason, that For needs. not meeting patients’ for on patients benefit may such as pictograms, the use of pictures, on how it can be comprehended a pictogram before However, their medical journey. informa be a challenge when pharmaceutical which may must be legible, visual details need to many space a limited Within be conveyed. tion has to meaning. clarify the intended to be included in order know very we little about the legibilitysion of pictograms, – the ability to By objects lookingvisually identify – of pictograms. legibility research at this paper perspective, a design from pictograms pharmaceutical into Visible Language Language Visible Pia Pedersen Pia 7 3 Legibility of of Legibility Pharmaceutical Pictograms: 72 Pedersen Legibility of Pharmaceutical Pictograms: - see Figure see Figure contextual contextual are you breastfeeding? you are are you breastfeeding? you are There are many research-based guidelines for the guidelines for research-based many are There While some research fails to confirm the benefits of adding of adding the benefits confirm to fails research some While its convey should clearly pictogram an effective Ideally, female toilet female female toilet female must be shown to further understand and differentiate their meanings their meanings further to must be shown understand and differentiate 53 . 2 . . 2 53 ). Second, space is an important space ). Second, aspect of pharma of the implementation the breast must be displayed. When showing side effects such as headache showing When must be displayed. the breast of in the form and some detailed variations a face, and dizziness, clues 2013). It a show et al. is not enough to and Mejía Lesch 2013, (see Zender ( toilet pictogram we see in the woman like of a simple filled icon 1 leaflets and labels (Dowse information patient on e.g. pictograms ceutical 2, visual details as in Figure in size reduced if and Ehlers 1998, 114). However, older the growing Considering legibility. and reduce blend together may clear that it becomes vision, impaired from who oftenpopulation, suffers is important.solving legibility pictograms issues in pharmaceutical pharmaceutical pictograms to labels and PILs (Hwang, Tram, and Knarr and Tram, (Hwang, and PILs labels to pictograms pharmaceutical 2014, 1990, Chan and Hassali and Poon Park, 2010, Morrell, al. et Wolf 2005, improve they can that agreed 2004); it is generally et al. Hämeen-Anttila information to and adhere recall understand, ability notice, to patients’ Alcântara, 2016, Barros, Del Re by et al. (see reviews medication about their Weiss Katz, 2006, Houts et al. 2014, Kripalani, et al. and Mesquita, Santos, could pictograms Pharmaceutical and Ehlers 1998). 2006, Choi 2011, Dowse pharmacists and other healthcare and for patients for tool thus be a valuable take their to patients helping for a responsibility who have professionals 2018). medicine correctly and Cavaco (Kanji, Xu, language literacy, age, across of patients all groups meaning to intended to achieve, this is difficult While and Ehlers 1998, 109). (Dowse and culture not be pictograms pharmaceutical that and although it is recommended 2006, Katz, (Houts et al. explanation or verbal used without some written 2014), et al. Mesquita, Santos, Alcântara, Barros, 2006, Weiss Kripalani, and avoid to as unambiguous as possible in order they are it is crucial that In addition, errors. serious medication lead to could misunderstandings that (Boersema and it must be legible can be understood a pictogram before 2002), which, from and Smith-Jackson Conzola, Wogalter, 2017, 306, Adams First, reasons. two for be challenging may perspective, a visual perception because they represent often complex, are pictograms pharmaceutical details thus, or closely related; complicated are objects that or concepts and comprehensible pictograms make the different be added to need to and the baby instance, for woman, a breastfeeding show To distinguishable. Visible Language Language Visible Figure 1 often require more more often require contextual clues and their convey details to (left): Pictogram message. toilet.(right): female for pictogram Pharmaceutical breastfeeding?’. you ‘are for USPC Source: 7 5 Pharmaceutical pictograms pictograms Pharmaceutical ------USP (TheUSP States United . Their purpose is to help people see, under help people see, purpose is to Their . , which was initiated by The United States Pharmacopeia Pharmacopeia States United The by initiated , which was According to the European Commission’s guidelines symbols Commission’s the European to According One way of improving the efficacy of improving and clarityOne way medical of Meanwhile, an increasing number of people are taking are number of people an increasing Meanwhile, Xu, and Cavaco 2018, 1) but should be considered seriously (Mansoor and but should be considered 2018, 1) and Cavaco Xu, 2003, 1008). Dowse Pharmacopeia) ago. 30 years over (USP-DI) Dispensing Information to under easy as long as they are allowed in leaflets are and pictograms the replace way and do not in any stand and not of an advertising nature no visual guide are there 8). However, 1, Point text (EC 2009, see Annex The pictograms. or implement to design on how lines or exemplifications for tested on labels and leaflets has been of pictograms implementation Chan and Hassali (e.g. and adherence comprehension preference, patient Chan, and Ho 2003, Ng, and Ehlers 2005, Mansoor and Dowse 2014, Dowse than stand-alone a lesser degree to 2016), however et al. 2017, Shiyanbola help people understand to of their potential in spite Moreover, pictograms. (Kanji, is still limited pictograms the use of pharmaceutical their treatment, exacerbated in some groups, like the older population, which is growing which is growing like the older population, in some groups, exacerbated (UN 2017). worldwide The symbols such as pictograms. graphic be through could information a simple and stylized draw to often pictogram refers the term use of current et al. Tijus (see convey to it is meant the idea or concept resembles ing that wayfinding, such as contexts, different used in many are 2007). Pictograms to are employed When they product and instructions. information traffic usually called they are their medicine treatment, understand help patients pictograms pharmaceutical about medicines such as instruc information to and adhere recall stand, well-researched A side effects. warnings and precautions, symptoms, tions, library is the so-called pictograms of pharmaceutical and guidelines within the EU as well as nationally. Research into pharma into Research as nationally. the EU as well and guidelines within including pharmacology, disciplines, several embraces information ceutical and information design graphic science, language business communication, the EU that indicate findings the research these disciplines Across design. of and development the design – prevent good intentions rules – despite 2010, 2008a, Maat needs 2017, 2008b, (Waarde fits users’ that information and Spinillo 2015, Waarde 2014, and Zethsen 2010, Askehave and Lentz Dickinson and Gallina 2017). medicines. our use of for responsibility more given are and we medicines, (WHO errors because of medication people die Still patients 2017). Many state mental because of their information to absorb medical find it difficult are problems These 2006, 174). (Houts et al. terminology and the technical Medicines, as well as regulations regarding ways to inform and educate educate and inform to ways regarding as regulations as well Medicines, in For mass-produced. become increasingly have about medicines, patients in the information drug printed that the EU has required 1992, since stance 2017). Waarde medicines (see with all dispensed of leaflets be enclosed form packaging subject and the pharmaceutical leaflets to legislation These are 74 Introduction Pedersen Legibility of Pharmaceutical Pictograms: - ). Graphemes ). Graphemes pictogram pictogram see Figure 3 see Figure ( signifies. The proper use and The proper signifies. pictograms pictograms pictogram and icons ,

icon icon In this paper, ‘pictogram’, is used in accordance with Strauss with Strauss is used in accordance ‘pictogram’, In this paper, The consequence is that we do not know we which variables is that consequence The graphemes 53 . 2 . . 2 53 grapheme grapheme design and cognitive psychology. The taxonomy formulated by Strauss and Strauss by formulated taxonomy The psychology. and cognitive design upon the because it draws a helpful explanation, (2017) provides Zender between differentiates Their taxonomy disciplines and categories. different terms: three mean an inherent have do not necessarily that visual elements small, are or items. simpler concepts represent to made of graphemes are Icons ing. of because they consist character, the most complex then, have Pictograms, and Zender ideas (Strauss complex more help express to icons one or more because it 2017, 8). Such a distinction talking is useful when legibility, about parts of a pictogram. different isolating for a framework forms or assessing the quality of the pictograms before testing them (for example example (for them testing the qualityor assessing before of the pictograms and Knarr of the 2005). Other the design ignore studies Tram, in Hwang, that and use pictograms 2004) et al. in Hämeen-Anttila example (for material example in Hill (for group either of poor quality not fit the target or do are 2006, Kripalani 2007). et al. to startaffect performance. paper this In order these questions, answering within the area establish legibilityindispensable focus as an wishes to the importance of legibility is First pictograms. of pharmaceutical research and selected pictograms of pharmaceutical examples through highlighted review a literature Secondly knowledge typeface legibility research. from knowthe legibility little we about of pharmaceutical how demonstrates domains is brought knowledge related from relevant hence pictograms; on focus to research future the need for the paper discusses Finally forward. bring new could a design-oriented that approach proposing these matters, knowledge the field. to is important it pictograms, pharmaceutical first of examine In to order the term what determine all to confusion. term and has been subject of the classification to much debate and have contexts and places different indeed used in many are Pictograms graphic such as semiotics, disciplines, of different a range been studied over Visible Language Language Visible Figure 3 through the USP pictogram the USP pictogram through ‘Read the label’. USPC Source: 7 7 Pharmaceutical pictograms between difference The icons and graphemes, illustrated pictograms - - - 1 cm 1cm 1cm disregard design design disregard 3 cm 3cm 3cm as the ISO design guidelines, as will be exemplified with a as will be exemplified guidelines, as the ISO design Within letterform research – a field with increasing focus on – a field with increasing letterform research Within 9 cm 9cm 9cm knowledge such It in pictograms some studies include USP pictograms. also appears that few in Chan and Hassali 2014) example (for the layout labels without considering al. 2014, Hill 2006) and age-related problems (e.g. Choi 2011, Ng, Chan, and Choi 2011, Ng, 2014, Hill (e.g. al. 2006) and age-related problems to when it comes 2013). However, et al. Ho 2017, Knapp 2005, Lesch et al. exists. legibility very little research percep to aspectas an isolated legibility in relation legibility – is understood the and identify tion and is defined as the abilityto visually differentiate characters of a typeface (see Beier 2016, Beier Legibility and Larson 2010). size, crowding, instance for are in letterform itemized research features often neglected re Such issues are thickness in existing stroke and contrast. is a tendency either because there to pictograms, on pharmaceutical search or understanding legibility as comprehensibil prioritize comprehensibility 1995, 2018, Ringseis and Caird 2013, Kanji, and Cavaco Soares Xu, ity (e.g. tendency 2016). Another is to and Cavaco Vigário, Pires, comprehensibility of pharmaceutical and other health-related pictograms pictograms and other health-related of pharmaceutical comprehensibility 2013, et al. Korenevsky (e.g. selecting to when it comes content the right and Mejía sensitivity 2013), cultural (e.g. 2017, Zender and Zender Strauss and Cassidy 2004, Zender 2018, Mansoor and Dowse Kanji, and Cavaco Xu, Sharif et 2004), health literacy (e.g. and Collins Vaillancourt, 2014, Kassam, Figure 2 76 Source: USPC Source: are reduced in size. In this In this in size. reduced are example the pill could as easily be misinterpreted and thus confuse a tongue, the reader. Essential details may be be Essential details may when pictograms blurred Pedersen Legibility of Pharmaceutical Pictograms:

- - - also . In the OBP there are . In are the OBP there dissolve under the tongue under the dissolve dissolve under the tongue dissolve 1 Boersema and Adams chew chew The majority of comprehension studies base studies majorityThe of comprehension there are still many pharmaceutical pictograms that fail to fail to that pictograms pharmaceutical still many are there ISO provides an Online Browsing Platform (OBP) with graphi (OBP) Platform an Online Browsing ISO provides for whether they are different guidelines are ISO design The To date, date, To take by mouth take by taken mouth by American National Standard Criteria for Safety Symbols). As stated stated As Symbols). Safety for Criteria Standard American National For an overview of the ISO standards for graphic symbols, see Boersema and Adams (2017). see Boersema and Adams symbols, graphic an overview for of the ISO standards For 53 . 2 . . 2 53 (ANSI). (ANSI). criteria (see Kanji, and Cavaco meet the ISO or ANSI comprehension Xu, 2015, Merks et Waarde 2014, et al. Mesquita, Bispo, Alcântara, 2018, Barros, 2013). 2018, Montagne al. guidelines methods and design testing cal symbols, Symbols’, Information ‘Public symbols dispersed in 4000 graphical over for ‘Symbols and on Equipment’ Use ‘For Signs’, Safety ‘Water Signs’, ‘Safety symbols in the all graphic not that however, One should notice, Diagrams’. be used and should therefore comprehension for been tested have database 2017, 308). with caution (Boersema and Adams one should look a new symbol or pictogram designing before that argue ‘medical’, on A quick search (ibid.). the platform in version a standardized for apart that an ambu reveals from however, ‘pharmaceutical’, and ‘medicine’ in the standard. pictograms no pharmaceutical are there lance parts symbols (three symbols (ISO 22727:2007) or safety public information for instance, ISO 22727:2007, rules apply. which different of ISO 3864) for of details minimal size such as line widths, visual features rules for provides The guideline also en and human figures. water illustrating and rules for symbols within which one can account designing for a template compasses 1 Today, there are several international as well as national standards for for standards as national as well international several are there Today, perceptual to it comes also when symbols, graphic and testing designing the ones probably are most importantThe standards international quality. for ISO (International Organization mentioned the already by developed by the ones developed perspective, a national from and, Standardization), ANSI ( of many cover ANSI standards (2017, 304) the Boersema and Adams by test to employed frequently are and both standards as ISO, the same areas pictograms. pharmaceutical safety criterion on either the ISO or the ANSI or both, hence their evaluation and 85% of 67% (ISO) level a minimum comprehension symbols must reach Visible Language Language Visible 7 9 Standards (above) The The (above) USP designed pictograms care health primarily for give to professionals medical instructions. Danish icons (below) use. web for designed DLI and USPC Source: - - as

Dansk raphic raphic pictogram fami pictogram last update: 7 7 last update: and even apply to the apply to and even According to the FIP to According

(Sorfleet 2009, Grenier et al. pharmaceutical was initiated in 2004 to support in 2004 to initiated was (Bansolta 2012), Pakistan (Yasmin et al. et al. (Yasmin (Bansolta 2012), Pakistan Pictograms Project Pictograms (Ng, Chan, and Ho 2017), UK (Knapp et al. 2005), and Chan, and Ho 2017), UK (Knapp et al. (Ng, Their Their . he two most comprehensive comprehensive most he two Apart from the FIP and USP, there are also smaller local pic are there Apart the FIP and USP, from in the same instructions visualized how are 4 illustrates Figure The FIP-pictogram family has been developed as a pictogram as a pictogram family has been developed FIP-pictogram The T have been developed under the United States Pharmacopeia Pharmacopeia States under the United developed been have The approximately 100 pictograms are grouped into different different into grouped are 100 pictograms approximately The , then, more broadly denotes – as in the ISO guideline – a “visually ISO guideline – a – as in the denotes broadly , then, more meant for two different media, their differences in shape, style, contrast etc. contrast style, in shape, media, their differences different two for meant pictograms. pharmaceutical in designing is no standard there that indicate website, all pictograms have been designed in a consistent style to avoid style avoid to in a consistent been designed have all pictograms website, on and validated been tested they have (FIP). Furthermore, confusions any of education ages and levels cultures, different 2016) and Pouliot Vaillancourt, 2011, Berthenet,et al. (FIP). visually impaired Risk/BenefitThe by developed such as the Japanese pictograms tograms, and Response (RAD-AR) of Japan, of Drugs Analysis Assessment Council Office Pharmaceutical the (seeal. 2018), Dutch Merks et Patent the Polish Society by (Waarde developed 2015) or the Danish medicine icons A/S (DLI A/S). Lægemiddel Information are and the Danish DLI icons though the USP pictograms Even ways. different and Dowse 2004), Iran (Zargarzadeh and Ahmadi 2017), United Arab Arab 2004), Iran 2017), United (Zargarzadeh and Ahmadi and Dowse 2014), India (Sharif et al. Emirates 2014), Hong Kong 2013). (Soares Portugal ( the FIP website from software can be downloaded that 2017) February their purposepharmacists is in their daily work. Like the USP pictograms, (pharmacists) and professionals between language a common create to patients. ‘Side and ‘Precautions’ ‘Indications’, purposes ‘Frequency’, (‘Dose and Route’, for cultural to account been designed have additional pictograms Effects’); Asia. countries in East Gabon or e.g. in differences lies that have been tested, validated and disseminated are the United States States the United are and disseminated validated tested, been have lies that by software and the pictogram developed (USP) pictograms Pharmacopeia USP pictograms, The (FIP). Federation Pharmaceutical the International mentioned, and Ehlers back in 1987 (Dowse initiated was a project that Convention, of medicines across use proper assist in the purpose is to Their 1998, 113). be can that pictograms 81 are literacy In and language barriers. there total second, instructions’, ‘prescription First, types: different three into grouped USP (WhitakerThe 2015). statements’ ‘cautionary and third, use’, for ‘purpose – States use in the United for and – although designed free are pictograms such countries in other comprehension for and validated tested been have and Ehlers 2001, Mansoor Ehlers 2004, Dowse and as South (Dowse Africa and Zender’s taxonomy to indicate a type of graphic symbol that bears a bears a symbol that type a of graphic indicate to taxonomy and Zender’s g term The object the to or idea it represents. resemblance visual symbol of language” independently information to transmit used figure perceptible V). signs pictures or icon Other such as symbols, p. (ISO 22727:2007(E) terms, source. with their original in accordance employed are etc. Figure 4 78 Pedersen Legibility of Pharmaceutical Pictograms: - - ­ - - - - . , contrast and , contrast . Hence, from from . Hence, legibility While this assump While

and visibility is a matter of how often we have have often we how of is a matter , then, refers to both visibility to and familiar , then, refers familiarity is the “clarity of letters isolated from the influence the influence from isolated of letters “clarity is the Legibility visibility This form of knowledge, which is based on practical of knowledge, experi form This Whilst lookingWhilst the impact Beier into of familiarity on reading, in both typography has its roots legibility research Typeface 53 . 2 . . 2 53 between the two fields (Dyson 2013, Beier and Dyson 2014). While there While there fields (Dyson the two between 2013, Beier and 2014). Dyson typefaces the impacthas been a tendency of different simply compare to of the importance of incorpor awareness a greater is now there on reading, (Beier and Dyson material 2014, the test knowledge typographic ating into Beier 2016). to 2005 (1958)), can add (Polanyi ‘tacit knowledge’ and also knownence as ability understand to because of the designer’s material of test the creation different when simply comparing Hence, of new shapes. and conceive form proportions in weight, variances many too are there typefaces, one isolate knowing to by how Instead, another. one typefacestyles to from particular this how it and determine can easier control we visual feature, comparing let For instance, legibility affects (Beier and 2014). Dyson feature their weight but only altering and style, with similar proportion,ters contrast this particular of how us with evidence affects legibility, variable provides to understand this clarifies in order that context, 6. In the present see Figure variables that the different recognize must first the principle of legibility we stake. at are The test method also accounts for symbols that must function that symbols sizes in small for accounts method also test The 311). 2017, (Boersema and Adams body of knowledge on type is a growing there letterform research Within et al. Legge 1998, Sawyer Mansfield and Chung, example legibility (for face form could that 2015) et al. Thiessen 2018, and Castet Bernard 2017, Beier, legibility pictogram constitutes what the basis of determining because both can be compared, and letters some visual aspects, pictograms and strokes. counters shapes, of black and white consist I purpose, the present discussion, for comprehensive a more tion requires to help determine some definitions will borrow visibility each other. that and familiarity from (2009) argued can be isolated Beier, to According whereas of typeface familiarity,” letter between similar the features a typeface and how to been exposed (Beier 2009, 23). are forms of the individual characters ity and differentiation and is about the design as it is the first context, distinctionThis is useful in the present in a typeface. legibility. variables specific improve understanding what towards step collaboration has been scant there historically and psychology; however, Visible Language Language Visible 8 1 Legibility - - - ≥ 2,0 mm ≥ 0,5 mm < 0,5 mm Recommended Exceptional Underweight Three different test methods have been developed by ISO been developed test methods have different Three the different elements of a symbol. Respondents may use all the time they may Respondents of a symbol. elements the different can either be an A correct answer see and describe the symbol. need to or the actual description of the shape, object name of the depicted. accurate for graphical symbols: first, a method for testing comprehensibility (ISO comprehensibility testing for a method symbols: first, graphical for quality (ISO 9186- perceptual testing a method for 9186-1:2014); second, (ISO association symbol referent testing a method for 2:2008) and third, earlier ISO 9186 -2:2008, mentioned in this article, second, The 9186-3:2014). in a elements problematic identify as it helps to in this context, is relevant includes guidelines for standard This perspective. a visual from pictogram level lighting viewing distance, quality, print i.e. material, and test apparatus least two in at should be tested Symbols and color. symbol size room, in test – helps decide 2 m viewing distance one – 8x8 cm at the large where sizes, deter and the small size named as intended, whether depicted are elements in a normal setting of viewing recognizable are mines whether elements and describe identify asked to are In respondents the method, conditions. USP pictograms are drawn with lines the majority of which are below the with lines the majority below of which are drawn are USP pictograms in some of the FIP pictograms, issue is evident This 2 mm. recommended thin strokes. also make use of that here) (not displayed too, for specific line thicknesses. Hence, lines should be at least 2 mm thick (in 2 mm thick at least be should lines line thicknesses. specific Hence, for be and spacing 0.5 mm) to can go down they special circumstances some recom ISO standard again, the Then 1 mm. should be minimum lines tween (ISO outlines to compared legibility improve they because areas filled mends however, majorityThe FIP pictograms, of the USP and 13). p. 22727:2007, of the the visual recommendations not follow in outline and do drawn are two how 5 illustrates Figure mark etc.). line width, negation guidelines (e.g. Figure 5 80 exceptionally. exceptionally. and Author USPC Source: in red widen to ca. 0.5 ca. 0.5 widen to in red to mm, which according the ISO recommendation should only be used and 2 mm, the red for lines lines for and 2 mm, the red When the 0.5 mm. below so scaled are pictograms that the frame extends the the thinnest lines margin, standard recommendation recommendation standard pink The line width. for parts lines represent that between 0.5 below are broad margin), it becomes it becomes margin), broad clear that the standards black The not followed. are those that fit the are areas When inserting a USP in the ISO pictogram (within a 66 mm template Pedersen Legibility of Pharmaceutical Pictograms: - - the details the details Lesch et al. (2013, 1278) who argue that when that (2013, 1278) who argue et al. Lesch n Figure 7 it becomes clear that while that clear becomes 7 it n Figure

In summary, legibility concerns both visibility legibility concerns and familiarityIn summary, 53 . 2 . . 2 53 This issue was also noticed by by also noticed issue was This is reduced or pictogram and the symbol and complexity, add details we which is an important issue particularly decrease, legibility may in size, for older people. visual The comprehensibility. from as a distinctand should be tested feature size, color, example for legibilityproperties are pictogram influence that furthermore Legibility shape and style. depends on the con stroke, contrast, reflection) and the luminance, distance, (medium, text in which it is shown and Bota Brozović, maturity and vision) (Kovačević, person who sees it (eye 2002, Megalakaki and Smith-Jackson 2016). Conzola, et al. Wogalter, 2014, in Majaj et al. 2002, 1166). I 1166). 2002, in Majaj et al. sizes in small blend together to tend the USP pictograms in strokes and thin in larg comprehend easier to be – they may instance – looking for the pill, at on the Danish icons, The visible. clues are all the contextual where er sizes however, in smaller sizes; thus clearer visually less detailed, are other hand, with interfere – may a hand and a face clues – such as the lack of contextual comprehension. Visible Language Language Visible Figure 7 8 3 A way of locating potential of locating potential A way visibility issues can be blurring by achieved Inpictograms. the the pill example above, at in the USP pictogram left is indistinguishable the pill in the to compared Danish icon at right which is clearer. DLI and USPC Source: ------

Pictogram Pictogram as “a type of graphic type of graphic “a as pictogram , defines a Pictogram Design Pictogram The way the eye decodes the information it sees can be the information decodes the eye way The Finally, in the design field, too, there is an equivalent under is an equivalent there too, field, in the design Finally, Beier’s definition of visibility resembles the resembles definition of visibility International Beier’s on in research can be perceived A similar understanding in his definition, the importance,comprehen not only of Ota stresses way we see small-sized pictograms, whereas for large-sized the for pictograms whereas pictograms, see small-sized we way important although with letters, more details become (see also the example, form Carla Similarly, sion, but also of issues such as visual clarity and legibility. does not only depend of pictograms the effectiveness that Spinillo argues is what perceive we also on how but comprehended they are well on how depicted (Spinillo 2012, 3400). selects the eye only read, we When frequency channels. modelled through 2014, 29). Hence, and Mugikura (Ahrens one channel depending on the size on high frequency ele draws system visual angles our perceptual large at on the draws at small visual angles the system while of finer details, ments thickness frequency of stroke low elements and proportions. By blurring the as the identifica frequencyimage one can see the effect of low channels, is thus important for the This information tion of finer details is disturbed. warning can be understood it must be legible. Hence, Wogalter, Conzola, Conzola, Wogalter, Hence, it must be legible. warning can be understood the earlyFirst, stages: between two (2002) differentiate and Smith-Jackson legibility; the later i.e. of a shape, second, implies the recognition stage that implies the understanding of the mean that comprehensibility, i.e. stage, figure-background viewing distance, size, (or text).ing of a pictogram Color, ap are conditions and lighting environment print quality, shape, contrast, and Bota Brozović, as influencing factors of legibility (see Kovačević, proved 2002). and Smith-Jackson Conzola, Wogalter, 2014, Ota, who au Yukio designer, notable Japanese pictogram The standing. the classic thored understand its meaning through “people make whose purpose is to symbol” (Ota 1987, 18). By emphasizing its meaning” expressing the use of a form Organization for Standardization (ISO) definition for graphic symbols. ISO symbols. graphic for definition (ISO) Standardization for Organization properties“the visual of a character or a visibility(9241-3, 1992) defines as (as quot facility the determine symbol that recognized” with which it can be testing Megalakaki the ISO method for ed by Furthermore, 2016, 1632). al. et the meaning before quality that (ISO 9186-2:2008(E)) emphasizes perceptual must be identifiable. its elements of a symbol can be understood a and of comprehension visibility distinct as a is thus understood feature independently. be tested should that comprehension for precondition the legibility of pictorial where symbols is comprehended warning design, and Conzola, (Wogalter, of initial clarity“the of the warning” degree as a before that it is stressed in this context, 2002, 223). Also Smith-Jackson

Figure 6 6 Figure 82 Futura Bold. Futura UltraLight, Helvetica Light Light UltraLight, Helvetica Regular; and Helvetica right: UltraLight, Helvetica Bodoni 72 Book and as stroke weight, width, width, as stroke weight, skeleton, contrast letter and proportion. The example is based on the typefaces: Helvetica Left: parameter that varies is that variesparameter is in the the stroke weight; several are second there such that vary, parameters In the first example of In first example of the this illustration the only Pedersen Legibility of Pharmaceutical Pictograms: - -

- - - - - compared to outdoor outdoor to compared hieh and Huang (2003) studied the ef in this context to illustrate the different different the illustrate to context in this are still mentioned mentioned still are A number of other studies have concentrated on surround on surround concentrated A number of other studies have One such visual feature is color, which is known help at to is color, feature One such visual confirmed benefits of some have signs of traffic Studies Considering the mentioned research on typeface legibility (i.e. on typeface legibility (i.e. research the mentioned Considering (e.g. Murray et al. 1998). S et al. Murray (e.g. 53 . 2 . . 2 53 they identified difficult details using an optical filtering approach. The high approach. filtering using an optical difficult details they identified with filtered was in each symbol contained frequencyspatial information alter by then redesigned details were These lens. the help of an appropriate In separation. words, other the contour and increasing size ing the contour and their shapes were spaces negative symbols had larger the improved the advan 1993, 28). Interestingly, (see Kline and Fuchs pronounced more of in three older drivers for be greater to proved signs tage of the improved working that with shapes in detail can illustrates This symbols. tested four useful knowledge about visibility. provide 2004) and the Chan, and Salvendy Yu, 2008, and Correia Paulo shapes (e.g. circle-slash slash and thickness orientation circle of the red size, fect of pictorial solidity, Their 581-83). see pp. of these features a review symbols (for prohibitive for pictorial is 75% of the inner diameter the proper size that indicate results those solid pictorials over people prefer that also found They of the slash. in the ISO guideline (ISO recommendation which fits with the in outline, the effects of pictorial same authors examined and The size 22727:2007). condi legibility under degraded glance slash on thickness circle of the red conditions, such that findings indicate Their tions (Shieh and Huang 2004). small pictorial time, exposure or limited contrast reductions of luminance i.e. and the thickness legibility. size slashes affect glance of circle et al. 1998), but 1998), et al. important. considered are that or features elements visual of hazard. and levels concepts different and communicate tract attention illumi different and Bota how (2014) examined Brozović, Kovačević, packagingcolored the legibility affect of pictograms. and different nants to thicknesses, and different with lines in five drawn were Pictograms different many how to according assigned subjectivity were avoid scores proved color Background a time limit. without identified thick lines were legibilityhighest performance the most; the pictogram affect to was on a illuminants Furthermore, on a blue one. lowest and the background yellow legibility typicalsimulating increased home lighting simulations. line thicknesses of levels and with different 6) – using pictograms Figure many because the study included too that be argued – it could complexity results. the they affected decide how not possible to it was visual features, (Kline than text visible signs et more are signs icon that showing pictures by 1990, Schieber and Kearns 1996). Kline and Klineal. et al (1990) 1994, Long ages of different drivers for signs the visibility of highway distance tested no differ were there found that They conditions. lighting under different visible from were signs icon but that comprehension, in age regarding ences further even dusk (Kline 1990). Of than text at signs, distances et al. greater Kline by and is the investigation context particular in the present interest signs the visibility (1993), who studied how of symbolic highway Fuchs 7, in Figure outlined earlier, As their shape. altering by be increased could Visible Language Language Visible 8 5 - - -

The issue of visibility symbols has The and legibility of graphic In the UK, while examining interpretation differences between between In differences the UK, interpretation while examining visibility distance, shape and slashes. Some studies are preference ratings ratings preference Some studies are shape and slashes. visibility distance, Shieh and Huang 2003, Murray (e.g. than studies of visual perception rather Since legibility is undervaluedSince the pictograms, of pharmaceutical in studies In connection that it is foundation. start to a research need is there layering of the influence examined have domains that nessecary related consider to Similarly to shape and complexity. size, such as color, visual features relevant forthcoming to domains mentioned point the research letterform research, assess to clarify how could methods that and research areas focus relevant the legibility pictograms. of pharmaceutical and Bzostek (e.g. design warning to relating domains several in studied been 1998, Shieh and Huang et al. 1999, Shieh and Huang 2004, Murray Wogalter ­ sign and Bota 2014) and traffic Brozović, Kovačević, 2003), packaging (e.g. 2008, and Correia and Kearns 1996, Paulo Kline 1990, Long et al. age (e.g. about color, insights has given research This Siswandari and Xiong 2015). a united feature. feature. a united Knapp (2005) et al. of USP pictograms, American and South versions African Figure (3x3 cm and 9x9 cm). Looking back at of pictograms sizes two tested of 9x9 cm pictograms between 2, one can get a notion of the difference performed pictograms large that and 3x3 cm. Not surprisingly they found cause additional could smaller pictograms and that better, considerable were percentages correct interpretation that Given patients. for problems using very Knapp proposed et al. of the smaller versions, in many halved 1231). p. of small images (ibid, comprehension facilitate simple images to dressed in research into pharmaceutical pictograms. As stated earlier, one earlier, stated As pictograms. pharmaceutical into in research dressed understand legibility as comprehensi some researchers be that may reason 1995, Ringseis 2018, and Caird 2013, Kanji, and Cavaco Soares Xu, bility (e.g. the (2013) investigated Soares instance, 2016). For and Cavaco Vigário, Pires, the pharmacy However, for legibility of USP pictograms in Portugal. clients and understood were the pictograms on how concentrate study appears to these being of legibility, understanding the present to not on factors related early the or other factors – of infor stages influence that and contrast size (1995), Ringseis a study by and Caird same applies to The processing. mation as important as a feature mentioned legibility was where not tested but was In the pre-testingdistinct comprehension. and also the re-testing from of 20 as examined were legibility and comprehension pictograms, pharmaceutical The aforementioned issues of visibility and legibility have hardly been ad hardly issues of visibility legibility and have aforementioned The 84 Other pictogram related domains Other pictogram related Pharmaceutical pictograms Pharmaceutical legibility research legibility Review of pictorial pictorial of Review Pedersen Legibility of Pharmaceutical Pictograms: - - - as - - 1cm 1 cm The concreteness concreteness The

3 cm 3cm

1cm ); however, we need to know more about how this how know about need to more we ); however, 1 cm In contrast, McDougall, Curry, and de Bruijn (1999) examined Bruijn (1999) examined and de Curry, McDougall, In contrast, In this context it is relevant to discuss the relationship between between discuss the relationship to In it is relevant this context 3cm 3 cm 53 . 2 . . 2 53 that are familiar to people (McDougall, de Bruijn, and Curry people (McDougall, familiar to are 2000, 291). that Bruijn, and Curry de McDougall, to (2000, 292) some studies have According the without controlling and complexity, concreteness mistakenly coupled used were were that icons the concrete In these studies, of complexity. level that the conclusion thus leading to than the abstract icons, complex more de details must be added (the studies McDougall, be concrete, to an icon for 1987, Green Wandmacher and Muthig, Arend, are: to Bruijn, and Curry refer 1989). and Carey George, 1990, Stammers, and Barnard meaningful visual complexity, concreteness, icon between the relationship all characteristics that found They familiarity distance. ness, and semantic per which was of visual complexity, with the exception closely related, were whether icon further investigate To characteristic. as an independent ceived user performance, complexity or not for on icon is dependent concreteness de Bruijn, and CurryMcDougall, (2000) conducted a series in of experiments no relation found They and complexity. concreteness which they controlled complex icon concreteness, icon to and compared the two ship between of icons, the design For time. visual search increase strongly to ity proved that conclude de Bruijn, and CurryMcDougall, (2000, 304-305) therefore and simple concrete more make icons adding details does not necessarily also be concrete. may icons in smaller sizes. Finally, the use of a separate frame enlarges the size of the of the size the enlarges frame of a separate the use Finally, sizes. in smaller is space will further which pictogram where legibility situations in lower ( adding details by important. can be achieved comprehension Increased 7 in Figure also shown was hand in hand with legibility. go may forthcom the studies mentioned Although and complexity. concreteness electrical equipment, (e.g. used in various contexts on icons based ing are interfaces) from and computer – very systems different public information because they relevant still considered – they are pictograms pharmaceutical characteristics. between relationship an overall indicate objects represents which an icon to as the degree is understood of icons

Visible Language Language Visible FIGURE 8 FIGURE 8 7 comprehension version. version. comprehension with here Displayed the permission of Mike Wogalter. and Wolff USPC and Source: (1993) Wogalter Two versions of the of the versions Two near heat ‘Do not store pictogram. or in sunlight’ USP current The (left) that failed the version test; comprehension (right) Wolf & Wogalter’s and enhanced redesigned ------According According

with fewer clues (Lesch et al. 2013, Zender 2013, Zender et al. (Lesch clues with fewer

An example taken from a comprehension experiment further experiment a comprehension taken from example An In contrast, other studies have found that when complexity is is when complexity that found have other studies In contrast, In short letterforma method often time is research, exposure ). However, the thin white spaces between in window will bleed in window between spaces the thin white ). However, Figure 8 Figure ( lines will clutter the sun beams and the heat Similarly, out in smaller sizes. Based on feedback from low-literate participants, the revised versions were were versions participants, the revised low-literate from Based on feedback less crowded. clues and visually richer in contextual of phar and clues in the context the question of complexity demonstrates test the to the first were (1993) Wogalter and Wolff pictograms. maceutical Back then the collection of which 30 pictograms comprised USP pictograms. asking by participants tested the meaning of the picto write to 28 were or near heat ‘Do not store the failed was that One of the pictograms grams. in successful proved of the pictogram version redesigned The in sunlight’. been imple it has never 1993, 189); however, Wogalter and Wolff (see tests Wogalter’s and Wolff version, the current to Compared in practice. mented clues (pill glass in slash and is richer in contextual has a clearer version test aid comprehension and sun) to window radiator, pictogram frame, separate fectiveness of pictograms (e.g. Spinillo 2012, 3399, Byrne Spinillo 2012, 3399, 1993). (e.g. pictograms of fectiveness and Ehlers (1998), simple Dowse (2006) and by et al. Houts by the reviews to comprehension facilitate details seem to pictures without irrelevant realistic designed icons For pictures. complex and more than photographs more visual interfaces, visual complexity is also known increase computer to for (McDougall, the information process it takes longer to because times, search de Bruijn, and Curry 2000, Byrne 1993). com is improved comprehension clues, of contextual the form in increased symbols graphic simple to pared type of study where in a different also suggested was This and Mejía 2013). different and improve revise participatory used to were approaches design on smart pictograms pharmaceutical existing phones (Wolpin 2016). et al. lower for symbols with more detail. Of the four slash variants, comprehen Of variants, slash detail. the four with more symbols for lower slash. In the under and translucent be higher for to found were sion scores some conflicts are there (2002), et al. Wogalter out by as pointed general, to differ due the findings in these between most probably kinds of studies, the Either way, etc. depiction, circumstances in speed presentations, ences a have complexity may visual (2002) suggest that et al. Wogalter by findings impact on comprehension. legibility on negative and hence aspect of the ef in terms as a negative is often understood Complexity used, when the focus is to measure the legibility of single letters or numbers or numbers legibility the letters of single measure is to the focus when used, (e.g. a glance at is on reading (Beier and Dyson or when the focus 2014, 84), such a short (2002) used al. et visual exposure Wogalter 2014). et al. Dobres slashes: of circle variants legibility of four the glance measure method to proved scores partial slash. Comprehension and translucent under, over, and concepts and concrete familiar symbols representing simple higher for 86 Complexity as opposed to legibility as opposed to legibility Complexity and comprehensibility Pedersen Legibility of Pharmaceutical Pictograms: - -

- - there there In a number Thus Thus As mentioned, mentioned, As

However, before we can start visual we measuring the different before However, According to Beier and Dyson (2014) many typeface Beier legibility and Dyson to (2014) many According medi to an important when it comes Elderly people are group to determine the components that increase legibility in order to to legibility in order increase that the components determine to

is no focus on this aspect of pharmaceuti and testing in the design is no focus 53 . 2 . . 2 53 cal pictograms. Legibility research is here almost non-existing. is here research Legibility cal pictograms. is a need and based on this pictograms of pharmaceutical the effectiveness improve guidelines. customized formulate of the importance of controlling aware well are we letterform research From a distinction that first, concerned: can be made parameters the different variables visual visibilitybetween and familiarity; the different that second, as to in order must be isolated etc. stroke contrast, stake such as size, at domains related other from on performance. sess their influence Research symbols of graphic elements relevant to attention furthermore draws slash, and circle size versus pictogram shape such as surround specifically, the visibility altering of of pictograms. ways to and points redesigning by signs the visibility of road (1993) improved Kline and Fuchs to found the advantage defined and were that elements the problematic forward of working be a step may way This among older drivers. be greater comprehensive by followed pictograms, of pharmaceutical in the context and testing. prototyping test the to out how figure need to we in detail, dimensions of pictograms outline are not necessarily followed. In be appears to this connection there followed. not necessarily are outline one country from pictograms pharmaceutical of designing way no standard the design these shortcomings be that may for One reason another. to Another character. complex with a more not fit pictograms guidelines do pharma include not does (OBP) platform symbol ISO the that be may reason to date field the design be that may another reason Yet pictograms. ceutical and clear how not always it is that is point The this area. has not entered material. in the test implemented are pictograms pharmaceutical where a but lack typographic background a scientific have appear to researchers same tendency on The can be observed in research understanding. instance, for studies, Some comprehension pictograms. pharmaceutical elderly help the (Knapp pictograms large simple and et al. that indicate we this makes sense, While 2016). and Pouliot Vaillancourt, 2005, Berthenet, we mean do What this means visually. what specifically knowneed to more simplicity talkingby in this particular we about the skeleton Are context? or the white of the image the contour elements, length, the number of reading situations? and sizes in different affected these are how And spaces? factThe ability visual that age (Ng, is known decline by to cine information. legibility as a crucial factor. Chan, and Ho 2017, 168) highlights legibility and design, psychology warning design, typography, e.g. of fields, such features where distinct comprehension, from as a feature is understood these While as important. recognized indeed are etc. contrast size as color, comprehensibility, for legibility is a precondition that shown fields have there Visible Language Language Visible 8 9 Suggestions for future research Suggestions for future ------, visualizing low frequency channels, frequency, visualizing low channels, 7 Moreover, by looking at the ISO design guidelines for graphic graphic looking guidelines for by the ISO design at Moreover, Size is a significant feature in legibility and is even more more in legibilityeven and is feature is a significant Size quality perceptual testing the ISO method for to According symbols (ISO 22727:2007) and analyzing a selection of pictograms, we have have we symbols (ISO 22727:2007) and analyzing a selection of pictograms, and line width, size regarding recommendations the specific seen that (ISO 9186-2:2008), pictograms should be tested in minimum two sizes, the sizes, in minimum two should be tested (ISO 9186-2:2008), pictograms participants whether test determine as in to the elements identify size large whether the elements determine to the smaller size the designer, by tended sizes large in too If is a tendency pictograms test there to recognizable. are of these Knapp 2005, 1228), then the comprehension by et al. (as pointed to reference Furthermore, with by their visibility. is less affected pictograms Figure in the blurring employed filter know see and thus comprehend we veryit means that we little about how In it should be mentioned this context, sizes. in implementable pictograms (2005) is 9x9 cm, which is Knapp by et al. employed size test the large that empha This 8x8 cm). ISO (i.e. by recommended size than the largest larger in smaller sizes. pictograms and test also design the need to sizes ly, before pharmaceutical pictograms can be successfully implemented in implemented can be successfully pictograms pharmaceutical before ly, certainleaflets and labels they must meet there legibility criteria, and here apply to question whether it is feasible even may We go. to is a long way poor quality. of their current because pictograms, pharmaceutical such as pharmaceutical pictograms in detailed and complex pronounced they comprehensibility, heighten meaningful details may While pictograms. particularly implementable to when down-scaled legibility, lower appear to in caused problems have instance, for USP pictograms, current The sizes. examples the through confirmed was This (Knapp 2005). smaller sizes et al. and thus become details bleed out in small sizes 7 and 8 where in Figure to identify. difficult of pictograms. Additionally, the literature review demonstrated that the that demonstrated review the literature Additionally, of pictograms. start to and in order issue of legibility been neglected, has historically creat Through be considered. to have domains related foundation, ing a research legibility must be why summarize I will remarks, concluding the following and letterformresearch from the insights and – benefiting from prioritized, research. future for suggestions domains – I will provide related the clarity and improve help to potentially could pictograms Pharmaceutical ele additional require they However, of medicinal information. effectiveness make their meaning understandable and distinguish and details to ments ­ Additional and culture. language literacy, age groups, people across able for The key purpose of this paper has been to highlight legibility as an indis highlight key purposepaper has been to of this The Based on pensable factor pictograms. of pharmaceutical in the assessment some demonstrating knowledge and by letterform primarily from research legibility issues in a selection been it has pictograms of pharmaceutical legibility is an important that shown aspect effectiveness the determining in 88 Legibility must be prioritized Legibility must Concluding remarks Concluding Pedersen Legibility of Pharmaceutical Pictograms: 21 Visible Visible https://doi. . Visible Visible 8:1493. 18 (2):118-137. 11 (3):209-222. 10 (5):704-719. 2016. “Evaluation, 2016. “Evaluation, 6 (4):411-426. doi: . Size-specificto adjustments type Journal of Health Communication Information Design Journal International Journal of PharmacyInternational & Communication & Medicine Communication Patient Preference and Adherence Preference Patient 3 (3):232-236. : Just Another Foundry. : Just Another 50 (2):64-79. 47 (3):74-95. http://dx.doi.org/10.1016/j.sapharm.2013.11.002 Caroline O Santos, Felipe P Paixão, and Divaldo P Lyra. 2014. P Lyra. and Divaldo P Paixão, Felipe O Santos, Caroline review.” “The A literature in the health care: use of pictograms Pharmacy in SocialResearch and Administrative doi: Royal School of Communication, thesis, PhD of Philosophy of Art.College Language Research of DRS2018, Design Proceedings and visual complexity.” Limerick. Society, Scientific Design-led Research.” Knowledge from Useful Language Letters.” Misrecognized Pictograms Depicting of Medication Validation Modification, and Instructions in the Elderly.” designs: An investigation of the principles guiding the design of guiding the design of the principles designs: Aninvestigation sizes optical superiority selection in menu icons.” global feature by for Behaviour & Information Technology leaflets information of Danish EU patient of the lay-friendliness 2012.” 2000 to from doi: 10.1558/cam.v11i3.20700. Pharmacy in a Pharmacy in Karnataka, Students College India: Study.” A Preliminary Therapeutics P Lyra and Divaldo Moreira, Porto Vagner E Rocha, Chiara Bispo, the United from “Understanding of pictograms 2014. Junior. among (USP-Di) Dispensing Information Pharmacopeia States elderly Brazilians.” org/10.1080/01449298708901853 53 . 2 . . 2 53 Beier, Sofie. 2009. “Typeface Legibility: Towards defining familiarity.” Doctor defining familiarity.” Towards Legibility: “Typeface 2009. Sofie. Beier, academic orphan.” An “Letterform Research: 2016. Sofie. Beier, legibility “Numeral 2018. Castet. and Eric Bernard, Jean-Baptiste Sofie, Beier, ‘i’: and ‘h’ of on “The Influence Serifs and Sofie, Mary C 2014. Dyson. Beier, Frequently for “Design Improvements and Kevin Larson. 2010. Sofie, Beier, Pouliot. and Annie Vaillancourt, Berthenet, Marion, Régis Ahrens, Tim, and Shoko Mugikura. 2014. and Shoko Mugikura. Tim, Ahrens, “Evidence 1987. Wandmacher. and Jens Muthig, Klaus-Peter Udo, Arend, analysis comparative “A 2014. and Karen Korning Zethsen. Inger, Askehave, among the Undergraduate of Pictograms “Awareness 2012. Bansolta, Acish. R Mesquita, Monica Alessandra L S Alcântara, Thaciana Izadora MC, Barros, R Mesquita, Anne Alessandra S Alcântara, Thaciana Izadora MC, Barros, Visible Language Language Visible 9 1 References

- - - -

The alphabet is limit alphabet The Many thanks to Sofie thanks to Many Beier for her important

The same is not necessarily the case for pictures. They varyThey so much pictures. the case for not necessarily same is The This is where the knowledge of the designer becomes relevant and relevant knowledge the becomes is where of the designer This When it comes to variations of shape and form, one should ensure, one should ensure, of shape and form, variations to it comes When n.

is an insights, comments and corrections that have helped to improve this paper. And this paper. improve helped to that have and corrections comments insights, corrections. Raheem for her English to Helle thanks finally, Commission. As such, a better understanding of the visual features that con that understanding of the visual features such, a better As Commission. make legibility and comprehension to forward legibility is a big step stitute In so doing we guidelines. customized create as to as well go hand in hand, further will be able to in pharmaceutical of pictograms the benefits explore criteria. meet ISO and ANSI success to leaflets and labels and supported was the Danish for Independent Research work by This Council DFF – 7013-00039]. number [grant they may increase legibility. increase they may fail to that pictograms still many are there underline the point, to Finally, happens when every criteria and what meet the ISO or ANSI comprehension boundaries where world in a set of pictograms country its own develops be some in fluid? Should there kind of standard increasingly becoming are tendency the can be problematic, though standardizing Even too? this field comprehensive does call for in medical contexts using pictograms towards Such pictograms. pharmaceutical for developed guidelines and customized national and international into guidelines should also be incorporated the European those issued by example guidelines for pharmaceutical therefore account for this in a way that does not interfere with the results. with the results. does not interfere that in a way this for account therefore stimuli be all the chosen familiarity present be to could control to A way or a list of pictograms with assessments and use multiple choice forehand words. are they that such experiments, for or choosing pictograms when designing width, complexity, stroke i.e. their resemblance, determining by comparable etc. size, knowledge design into on incorporating should focus research future why both can a designer with form, Based on his/her experience experiments. to isolate how variablesat stake and understand the different recognize a design-oriented ap Thus material. test when designing these variables and how components bring new knowledge could different about proach visibility of pictograms compared to letters and words. and words. letters to visibility compared of pictograms an that when visible, all agree, we can and of letters, number a specific ed to n which makes the number of pictures and the is unlimited, form in shape and one of the presents probably latter The straightforward. far from comparison alphabet; however, familiar with the people are Educated main challenges. should setting experimental An with all pictures. not familiar all people are 90 Acknowledgements Acknowledgements Some final points Pedersen Legibility of Pharmaceutical Pictograms: 2011. Journal of https://doi. https://doi. https://doi.org/1 https://doi.org/10 . 61 (2):173-190. doi: . 100 (11-12):687-693. 6 (1):26. doi: . . . 58 (1):63-70. 45 (2):87-99. doi: 4 (4):238-245. doi: . 16 (3):271-294. doi: BMC Family Practice Family BMC Patient Education and Counseling Education Patient INTERACT ‘90 – Human-Computer Interaction,‘90 – Human-Computer INTERACT South African Journal of Science South African The DesignThe Journal locations.” locations.” 1990. 27-31 August, U.K, Cambridge, Preston. and Cindy Elena Pascuet, Turpin, Marc Pierre Wade, of culture-specificfor the and development “Design pictograms communities.” first nation for labelling of medication in Healthcare Communication 0.1179/1753807611Y.0000000007 health literacy; with low patients to a information medication de Universidad Mapping Conference, Concept preliminary study.” Rica. 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- 14 Human , edited , edited International International Visible Language Visible 13, (1):197-204. Information design Information 22. 47 (1):66-89. , edited by Jorge Frascara, 185-189. Frascara, Jorge by , edited Information DesignInformation Practice and – Research Visible Language Visible 48 (1):69-95. of individual symbols in the construction of on the role focus meaning.” Comprehension in Different Cultural Contexts.” Contexts.” Cultural in Different Comprehension by Alison Black, Paul Luna, Ole Lund and Sue Walker, 715-730. Walker, and Sue Ole Lund Luna, Black, Alison by Paul Routlege. In medicines in Europe.” about information relevant, as principled action: Making information accessible, and usable understandable, Publishing. Ground Common of Pictograms of Understanding Analysis “Comparative 2014. among Pharmacy and Non-Pharmacy Students.” Journal of Sciences: Basic and Applied Research shapes.” and surround words signal for of implied hazard & Service in Manufacturing and Ergonomics Industries Factors (1):69-80. doi: 10.1002/hfm.10048. illiterate by pictograms Pharmacopeia selected States United in experience II.” first Iran–Part The speakers: Farsi and literate the official journal of Isfahan sciences: in medical Journal research of Sciences University of Medical legislation.” In legislation.” feng, Alan HS Chan, and Gavriel Salvendy. 2004. “Chinese perceptions perceptions “Chinese 2004. Chan, and Gavriel HS Alan Salvendy. feng, ‐ 53 . 2 . . 2 53 Zender, Mike, and G Mauricio Mejía. 2013. “Improving icon design: through through design: icon “Improving Mike, and G Mauricio Mejía. 2013. Zender, her visual commu Since researcher. and designer is a graphic Pedersen Pia SchoolDesign an Kolding in Denmark studies at nication has developed she she Currently, visualization. through in making clearer information interest Danish Royal The at Design Visual Institute of The at professor is an associate and Conservation Design Arts, Schools of Architecture, of Fine Academy her research Through Design. Visibility for the Centre at she works where particularly the legibility of pictograms, to improve ways find she wishes to she where in infographics holds a PhD Pia pictograms. pharmaceutical Education), TYpographic Picture of (International System studied ISOTYPE all sorts design to using pictograms of approach a visual communication She has also been working the layperson. as an information for information Morgenavisen (DR) and at Corporation the Danish Broadcasting at designer in Denmark. newspapers one of the largest Jyllands-Posten, Waarde, Karel van der, and Carla Spinillo. 2015. “The visual of development 2015. Spinillo. Carla and Karel der, van Waarde, Tehseen Quds. and Wajiha Shaima Hasnat, Iffat, Riffat, Sadia Shakeel, Yasmin, Rui Yu, of “Comprehensibility 2017. H, and SaharZargarzadeh, Amir Ahmadi. “(Mis)understanding: Icon 2014. Cassidy. Mike, and Amy Zender, Waarde, Karel van der. 2017. “Chapter 49 Medical information design and its and its design Medical 49 information “Chapter 2017. Karel der. van Waarde, Visible Language Language Visible Author 9 9

44 5 :187-192. Information Design Visible Language Visible . 46 (19):1753-1757. doi: / 46 (19):1753-1757. doi: 14 (2). doi: 10.18549/ Archives of Internal Medicine of Internal Archives Proceedings of the Human Factors of the Human Factors Proceedings 33 (3):219-230. doi: 10.1016/ Proceedings of Interface’93 Proceedings https://qualitymatters.usp.org/ “Measuring in the quality of information Applied Ergonomics Pharmacy Practice (Granada) Pharmacy Practice InfoDesign: Revista Brasileira de Design Informação da InfoDesign: Revista Brasileira 16 (3):216-228. http://www.who.int/news-room/detail/29-03-2017-who- Unpublished Report: Basel School of Design, Fachhochschule Unpublished Report: School Basel Fachhochschule of Design, Nordwestschweiz. PharmPract.2016.02.686 PharmPract.2016.02.686 people.” (3):29-39. medical package leaflets: Harmful or helpful?” Journal Design?” and Benign Assumptions Malignant (1):39-69. Jennifer A Webb, Mary V Bocchini, Stacy Cooper Bailey, and and StacyV Bocchini, Bailey, Mary Cooper Webb, A Jennifer to Warnings Drug Prescription “Improving 2010. Ruth M Parker. Comprehension.” Patient Promote 170 (1):50-56. Pictorials.” of Pharmaceutical 2016. Donna and Berry. L Chu, Adeline Fernando, Lara Morisky, health literacy with low patients for pictographs “Redesigning deliveryand establishing preliminary for via smart steps phones.” launches-global-effort-to-halve-medication-related-errors-in-5- years and warning design guidelines for “Research-based 2002. “ evaluation S0003-6870(02)00009-1. safety types of prohibitive of different “Comprehension 2002. exposure.” symbols with glance Societyand Ergonomics Meeting Annual doi.org/10.1177/154193120204601914. accessed 6 October 2018 accessed improving-health-literacy-usp-pictograms 29 March accessed Health Organization, World in 5 years.” errors 2018. Waarde, Karel van der. 2008a. “Designing information about medicine for medicine for about information “Designing 2008a. Karel der. van Waarde, 2008b. Karel der. van Waarde, Medicines: for “Visual Communication 2010. Karel der. van Waarde, test. symbols: A comprehensibility four Twenty 2015. Karel der. van Waarde, Wolf, Michael S, Terry C Davis, Patrick F Bass, Laura M Curtis, Lee A Lindquist, A Lindquist, M Curtis, Lee Laura F Bass, Patrick C Davis, Terry Michael S, Wolf, and Development “Test 1993. Wogalter. and Michael S. Snow, Jennifer Wolff, Y Lam, Donald E Annie Jason J Parks, Seth Juliet K Nguyen, E, Wolpin, Wogalter, Michael S, Vincent C Conzola, and Tonya L Smith-Jackson. L Smith-Jackson. Tonya and C Conzola, Vincent Michael S, Wogalter, and Eric F Shaver. L Glover, Barbara A La Murray, Tondra Michael S, Wogalter, Whitaker, Will. 2015. “Improving Health Literacy: USP Pictograms.” USP, USP, Literacy: Health “Improving USP Pictograms.” 2015. Will. Whitaker, “WHO medication-related launches global effortto halve 2017. WHO. 98 Subscription Rates United States Individual Institutional 1 year $35.00 $65.00 2 year $65.00 $124.00

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