生涯学習と初修外国語 : 面接授業「初歩のフランス語」の教材制作と全体構想

　平成17年度に開設された面接授業「初歩のフランス語」は、まったくフランス語に触れたことのない学習者が5回の授業を通して発音の原則を覚え、簡単な挨拶を交わすことができるようになることを目標としている。また同時に、異文化を内包する市民社会という点において日本にはるかに先んじているフランスおよび広域フランス語圏について馴染んでもらうことで、「社会、文化、歴史に開かれたモティヴェーション教育」を行うことを目指している。実際の授業では、一方向的な放送授業との差異化を図り、教師と学生のふれあいを大切にし、学生の反応に応じて、また時事問題などを取り入れながら、臨機応変に授業を運営する方針をとっている。　こうしたヴィジョンに則って、担当講師たちがオリジナルの共通教材を制作した。「共通教材」とは、すべての教室で共有する最小限のコンテンツであり、各講師はそれをもとに自由に授業を展開することができる。今回制作したのは、カラーの図版やイラストを豊富に用いた6ページのコピー教材と、教材の例文のネイティヴ講師による発音を録音した音声教材である。教材制作は授業計画に沿って行われた。授業計画において、初回と第2回は発音やアルファベットを丁寧に解説し、第3回から第5回までは「パリ」、「フランス諸地方」、「フランス語圏」をテーマにして会話練習等を行うこととした。そこで、それぞれの地域について分担して資料を集め、カラー教材に収めた。　教材の具体的な活用については、平成17年度1学期の担当講師による授業報告を参照していただきたい。　初回と最終回の授業では、フランス語および授業についてのアンケートを実施した。アンケート結果の分析によって、生きた知識を取り入れながらコミュニケーションの手段としてのフランス語の基本を学ぶ「初歩のフランス語」の試みが好スタートを切ったことが窺える

Omecamtiv mecarbil in chronic heart failure with reduced ejection fraction, GALACTIC‐HF: baseline characteristics and comparison with contemporary clinical trials

Aims: The safety and efficacy of the novel selective cardiac myosin activator, omecamtiv mecarbil, in patients with heart failure with reduced ejection fraction (HFrEF) is tested in the Global Approach to Lowering Adverse Cardiac outcomes Through Improving Contractility in Heart Failure (GALACTIC‐HF) trial. Here we describe the baseline characteristics of participants in GALACTIC‐HF and how these compare with other contemporary trials. Methods and Results: Adults with established HFrEF, New York Heart Association functional class (NYHA) ≥ II, EF ≤35%, elevated natriuretic peptides and either current hospitalization for HF or history of hospitalization/ emergency department visit for HF within a year were randomized to either placebo or omecamtiv mecarbil (pharmacokinetic‐guided dosing: 25, 37.5 or 50 mg bid). 8256 patients [male (79%), non‐white (22%), mean age 65 years] were enrolled with a mean EF 27%, ischemic etiology in 54%, NYHA II 53% and III/IV 47%, and median NT‐proBNP 1971 pg/mL. HF therapies at baseline were among the most effectively employed in contemporary HF trials. GALACTIC‐HF randomized patients representative of recent HF registries and trials with substantial numbers of patients also having characteristics understudied in previous trials including more from North America (n = 1386), enrolled as inpatients (n = 2084), systolic blood pressure < 100 mmHg (n = 1127), estimated glomerular filtration rate < 30 mL/min/1.73 m2 (n = 528), and treated with sacubitril‐valsartan at baseline (n = 1594). Conclusions: GALACTIC‐HF enrolled a well‐treated, high‐risk population from both inpatient and outpatient settings, which will provide a definitive evaluation of the efficacy and safety of this novel therapy, as well as informing its potential future implementation

Cardiac myosin activation with omecamtiv mecarbil in systolic heart failure

BACKGROUND The selective cardiac myosin activator omecamtiv mecarbil has been shown to improve cardiac function in patients with heart failure with a reduced ejection fraction. Its effect on cardiovascular outcomes is unknown. METHODS We randomly assigned 8256 patients (inpatients and outpatients) with symptomatic chronic heart failure and an ejection fraction of 35% or less to receive omecamtiv mecarbil (using pharmacokinetic-guided doses of 25 mg, 37.5 mg, or 50 mg twice daily) or placebo, in addition to standard heart-failure therapy. The primary outcome was a composite of a first heart-failure event (hospitalization or urgent visit for heart failure) or death from cardiovascular causes. RESULTS During a median of 21.8 months, a primary-outcome event occurred in 1523 of 4120 patients (37.0%) in the omecamtiv mecarbil group and in 1607 of 4112 patients (39.1%) in the placebo group (hazard ratio, 0.92; 95% confidence interval [CI], 0.86 to 0.99; P = 0.03). A total of 808 patients (19.6%) and 798 patients (19.4%), respectively, died from cardiovascular causes (hazard ratio, 1.01; 95% CI, 0.92 to 1.11). There was no significant difference between groups in the change from baseline on the Kansas City Cardiomyopathy Questionnaire total symptom score. At week 24, the change from baseline for the median N-terminal pro-B-type natriuretic peptide level was 10% lower in the omecamtiv mecarbil group than in the placebo group; the median cardiac troponin I level was 4 ng per liter higher. The frequency of cardiac ischemic and ventricular arrhythmia events was similar in the two groups. CONCLUSIONS Among patients with heart failure and a reduced ejection, those who received omecamtiv mecarbil had a lower incidence of a composite of a heart-failure event or death from cardiovascular causes than those who received placebo. (Funded by Amgen and others; GALACTIC-HF ClinicalTrials.gov number, NCT02929329; EudraCT number, 2016 -002299-28.)