Search

This study explores how undergraduates, as historical thinkers, learn to interact with history and construct their understanding of the past, and examines the role that primary and secondary sources play in narrative construction and revision. Using the African American civil rights movement as a content focus, participants used images to create initial narratives that reflected their understanding of the movement. Half the participants then read an essay on the movement written by a prominent historian, and the other half examined 18 primary sources that reflected the historian's interpretation of the movement. Participants then each created a second narrative, again selecting images to depict their understanding of the movement. The results of the study suggest that even as students work with primary sources, they need an effective narrative framework based on recent scholarship to forge powerful counter-narratives that transcend outdated interpretations and historical myths. In terms of teaching and learning about the lengthy struggle for racial justice in the United States, simply encouraging teachers and students to 'do history' and conduct their own online research is unlikely to change persistent narrative structures that continue to enable and excuse systemic racism.

Background and objectivesTo report safety of ocrelizumab (OCR) up to 7 years in patients with relapsing multiple sclerosis (RMS) and primary progressive multiple sclerosis (PPMS) enrolled in clinical trials or treated in real-world postmarketing settings.MethodsSafety analyses are based on integrated clinical and laboratory data for all patients who received OCR in 11 clinical trials, including the controlled treatment and open-label extension (OLE) periods of the phase 2 and 3 trials, plus the phase 3b trials VELOCE, CHORDS, CASTING, OBOE, ENSEMBLE, CONSONANCE, and LIBERTO. For selected adverse events (AEs), additional postmarketing data were used. Incidence rates of serious infections (SIs) and malignancies were contextualized using multiple epidemiologic sources.ResultsAt data cutoff (January 2020), 5,680 patients with multiple sclerosis (MS) received OCR (18,218 patient-years [PY] of exposure) in clinical trials. Rates per 100 PY (95% confidence interval) of AEs (248; 246-251), serious AEs (7.3; 7.0-7.7), infusion-related reactions (25.9; 25.1-26.6), and infections (76.2; 74.9-77.4) were similar to those within the controlled treatment period of the phase 3 trials. Rates of the most common serious AEs, including SIs (2.01; 1.81-2.23) and malignancies (0.46; 0.37-0.57), were consistent with the ranges reported in epidemiologic data.DiscussionContinuous administration of OCR for up to 7 years in clinical trials, as well as its broader use for more than 3 years in the real-world setting, are associated with a favorable and manageable safety profile, without emerging safety concerns, in a heterogeneous MS population.Classification of evidenceThis analysis provides Class III evidence that long-term, continuous treatment with OCR has a consistent and favorable safety profile in patients with RMS and PPMS. This study is rated Class III because of the use of OLE data and historical controls.