An Integrated Approach to Developing Japanese Students' English Presentation and Discussion Skills

We examined the types of difficulties that Japanese high school students have in English presentation and discussion activities. We conducted factor analysis (principal factor method with promax rotation) on the survey data, which was divided into four stages: (1) the presentation preparation stage; (2) the presentation stage; (3) the listening stage; and (4) the discussion stage. The results showed that students had difficulty with the following skills during each of the four stages: (1) "effective ways of providing information," "revision," and "collaborative work" during the presentation preparation stage; (2) "basic presentation skills," "handling questions," and "audience management" during the presentation stage ; (3) "active interaction" and "active understanding" during the listening stage; and (4) "overcoming communication anxiety," "adaptation to classroom activities," "problem solving approach," and "self-relativization" during the discussion stage

An Integrated Approach to Developing Japanese Students' English Presentation and Discussion Skills

We examined the types of difficulties that Japanese high school students have in English presentation and discussion activities. We conducted factor analysis (principal factor method with promax rotation) on the survey data, which was divided into four stages: (1) the presentation preparation stage; (2) the presentation stage; (3) the listening stage; and (4) the discussion stage. The results showed that students had difficulty with the following skills during each of the four stages: (1) "effective ways of providing information," "revision," and "collaborative work" during the presentation preparation stage; (2) "basic presentation skills," "handling questions," and "audience management" during the presentation stage ; (3) "active interaction" and "active understanding' during the listening stage; and (4) "overcoming communication anxiety," "adaptation to classroom activities," "problem solving approach," and "self-relativization" during the discussion stage

Speaking Practices Designed to Improve Presentation Skills and Their Effect on High School Students’ Oral Performance

この研究は，口頭発表活動に必要な技術を身につける実践を通じて，発話力の伸びを検証することを目的とした実証的研究である。高校１年生の実験クラスを対象に，物語の紹介を目的とする，パターン化された構成で行うプレゼンテーション形式の活動を一定期間行い，ポストテストにおける発話を統制クラスと比較した結果，流暢さの面で向上が見られた。実験クラスの経験した発表活動では，パターン化された情報構造で発話内容を考えるため，活動時の発話過程において，概念化の段階で受ける認知的負荷が軽減され，言語化に向ける認知資源を増やすことができ，流暢さが高まったと考えられる。The present study takes an empirical approach to assessing the effect of speaking practice designed to improve presentation skills. First-year high-school students repeatedly engaged in book-talk activities for a certain period of time. During the activities, they were given a speaking format to facilitate their performance. At the end of the instruction period, students’ speaking fluency was measured, analyzed, and compared with that of a control group. The comparative analysis demonstrates that the students’ fluency improves substantially when they are provided with a speaking format. The result supports the hypothesis that this format helps to lessen the students’ cognitive load at the initial conceptualization stage and instead helps to save cognitive resources for successive stages of speech production, which consequently enhances the students’ speaking performance

Effects of Small-Group Facilitators on Speaking Performance of Junior High School Students

本研究は，中学生のスピーキング活動におけるファシリテーターの働きに注目し，その発話の特徴とそれが学習者の発話にどのように影響するかについて，日本人英語教員，外国人英語話者および学習者がファシリテーター役を担う小集団を設定し，調査結果を量的・質的に分析することにより，今後のスピーキング指導の在り方の方向性を提案することを目的とした。結果として，日本人英語教員，外国人英語話者ともに学習者への発話量の多さはあるものの，ディスカッションで求められる学習者の思考の深まりを促す働きは確認できなかった。しかし，会話分析から，ファシリテーターの発話の量と質のバランスを工夫することにより，学習者から発話を引き出し，思考の深まりを促すきっかけを与えることができる可能性があることは確認できた。今後は，今回の調査において，発話回数が少なかった「学習者に自信を与える発話」や「思考を深める発話」に焦点を当てた調査・分析を課題としたい。The aim of this research is to propose how the instruction on speaking activities can be effective by focusing on the role of a facilitator. In this research, a Japanese teacher, a foreign language speaker and a junior high school student played the role of the facilitator in a group of junior-high students. The facilitators’ utterances produced in the groups were analyzed by both qualitative and quantitative ways. As a result, the majority of the facilitators succeeded in letting the students speak out, but their work wasn’t sufficient enough to deepen the students’ thoughts. However, this research suggests that the facilitators can help students to speak out and deepen their thoughts by using adequate types of facilitation, which encourages the students to speak out and allows them to deepen their thoughts

Why Are Outcomes Different for Registry Patients Enrolled Prospectively and Retrospectively? Insights from the Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF).

Background: Retrospective and prospective observational studies are designed to reflect real-world evidence on clinical practice, but can yield conflicting results. The GARFIELD-AF Registry includes both methods of enrolment and allows analysis of differences in patient characteristics and outcomes that may result. Methods and Results: Patients with atrial fibrillation (AF) and ≥1 risk factor for stroke at diagnosis of AF were recruited either retrospectively (n = 5069) or prospectively (n = 5501) from 19 countries and then followed prospectively. The retrospectively enrolled cohort comprised patients with established AF (for a least 6, and up to 24 months before enrolment), who were identified retrospectively (and baseline and partial follow-up data were collected from the emedical records) and then followed prospectively between 0-18 months (such that the total time of follow-up was 24 months; data collection Dec-2009 and Oct-2010). In the prospectively enrolled cohort, patients with newly diagnosed AF (≤6 weeks after diagnosis) were recruited between Mar-2010 and Oct-2011 and were followed for 24 months after enrolment. Differences between the cohorts were observed in clinical characteristics, including type of AF, stroke prevention strategies, and event rates. More patients in the retrospectively identified cohort received vitamin K antagonists (62.1% vs. 53.2%) and fewer received non-vitamin K oral anticoagulants (1.8% vs . 4.2%). All-cause mortality rates per 100 person-years during the prospective follow-up (starting the first study visit up to 1 year) were significantly lower in the retrospective than prospectively identified cohort (3.04 [95% CI 2.51 to 3.67] vs . 4.05 [95% CI 3.53 to 4.63]; p = 0.016). Conclusions: Interpretations of data from registries that aim to evaluate the characteristics and outcomes of patients with AF must take account of differences in registry design and the impact of recall bias and survivorship bias that is incurred with retrospective enrolment. Clinical Trial Registration: - URL: http://www.clinicaltrials.gov . Unique identifier for GARFIELD-AF (NCT01090362)

Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights from the GARFIELD-AF Registry.

BACKGROUND: The Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) is an ongoing prospective noninterventional registry, which is providing important information on the baseline characteristics, treatment patterns, and 1-year outcomes in patients with newly diagnosed non-valvular atrial fibrillation (NVAF). This report describes data from Indian patients recruited in this registry. METHODS AND RESULTS: A total of 52,014 patients with newly diagnosed AF were enrolled globally; of these, 1388 patients were recruited from 26 sites within India (2012-2016). In India, the mean age was 65.8 years at diagnosis of NVAF. Hypertension was the most prevalent risk factor for AF, present in 68.5% of patients from India and in 76.3% of patients globally (P < 0.001). Diabetes and coronary artery disease (CAD) were prevalent in 36.2% and 28.1% of patients as compared with global prevalence of 22.2% and 21.6%, respectively (P < 0.001 for both). Antiplatelet therapy was the most common antithrombotic treatment in India. With increasing stroke risk, however, patients were more likely to receive oral anticoagulant therapy [mainly vitamin K antagonist (VKA)], but average international normalized ratio (INR) was lower among Indian patients [median INR value 1.6 (interquartile range {IQR}: 1.3-2.3) versus 2.3 (IQR 1.8-2.8) (P < 0.001)]. Compared with other countries, patients from India had markedly higher rates of all-cause mortality [7.68 per 100 person-years (95% confidence interval 6.32-9.35) vs 4.34 (4.16-4.53), P < 0.0001], while rates of stroke/systemic embolism and major bleeding were lower after 1 year of follow-up. CONCLUSION: Compared to previously published registries from India, the GARFIELD-AF registry describes clinical profiles and outcomes in Indian patients with AF of a different etiology. The registry data show that compared to the rest of the world, Indian AF patients are younger in age and have more diabetes and CAD. Patients with a higher stroke risk are more likely to receive anticoagulation therapy with VKA but are underdosed compared with the global average in the GARFIELD-AF. CLINICAL TRIAL REGISTRATION-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01090362

Improved risk stratification of patients with atrial fibrillation: an integrated GARFIELD-AF tool for the prediction of mortality, stroke and bleed in patients with and without anticoagulation.

OBJECTIVES: To provide an accurate, web-based tool for stratifying patients with atrial fibrillation to facilitate decisions on the potential benefits/risks of anticoagulation, based on mortality, stroke and bleeding risks. DESIGN: The new tool was developed, using stepwise regression, for all and then applied to lower risk patients. C-statistics were compared with CHA2DS2-VASc using 30-fold cross-validation to control for overfitting. External validation was undertaken in an independent dataset, Outcome Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF). PARTICIPANTS: Data from 39 898 patients enrolled in the prospective GARFIELD-AF registry provided the basis for deriving and validating an integrated risk tool to predict stroke risk, mortality and bleeding risk. RESULTS: The discriminatory value of the GARFIELD-AF risk model was superior to CHA2DS2-VASc for patients with or without anticoagulation. C-statistics (95% CI) for all-cause mortality, ischaemic stroke/systemic embolism and haemorrhagic stroke/major bleeding (treated patients) were: 0.77 (0.76 to 0.78), 0.69 (0.67 to 0.71) and 0.66 (0.62 to 0.69), respectively, for the GARFIELD-AF risk models, and 0.66 (0.64-0.67), 0.64 (0.61-0.66) and 0.64 (0.61-0.68), respectively, for CHA2DS2-VASc (or HAS-BLED for bleeding). In very low to low risk patients (CHA2DS2-VASc 0 or 1 (men) and 1 or 2 (women)), the CHA2DS2-VASc and HAS-BLED (for bleeding) scores offered weak discriminatory value for mortality, stroke/systemic embolism and major bleeding. C-statistics for the GARFIELD-AF risk tool were 0.69 (0.64 to 0.75), 0.65 (0.56 to 0.73) and 0.60 (0.47 to 0.73) for each end point, respectively, versus 0.50 (0.45 to 0.55), 0.59 (0.50 to 0.67) and 0.55 (0.53 to 0.56) for CHA2DS2-VASc (or HAS-BLED for bleeding). Upon validation in the ORBIT-AF population, C-statistics showed that the GARFIELD-AF risk tool was effective for predicting 1-year all-cause mortality using the full and simplified model for all-cause mortality: C-statistics 0.75 (0.73 to 0.77) and 0.75 (0.73 to 0.77), respectively, and for predicting for any stroke or systemic embolism over 1 year, C-statistics 0.68 (0.62 to 0.74). CONCLUSIONS: Performance of the GARFIELD-AF risk tool was superior to CHA2DS2-VASc in predicting stroke and mortality and superior to HAS-BLED for bleeding, overall and in lower risk patients. The GARFIELD-AF tool has the potential for incorporation in routine electronic systems, and for the first time, permits simultaneous evaluation of ischaemic stroke, mortality and bleeding risks. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier for GARFIELD-AF (NCT01090362) and for ORBIT-AF (NCT01165710)