Much applied research into musical performance requires a method of quantifying differences and changes between performances; for this purpose, researchers have commonly used performance assessment schemes taken from educational contexts. This article considers some conceptual and practical problems with using judgments of performance quality as a research tool. To illustrate some of these, data are reported from a study in which three experienced evaluators watched performances given by students at the Royal College of Music, London, and assessed them according to a marking scheme based on that of the Associated Board of the Royal Schools of Music. Correlations between evaluators were only moderate, and some evidence of bias according to the evaluators' own instrumental experience was found. Strong positive correlations were found between items on the assessment scheme, indicating an extremely limited range of discrimination between categories. Implications for the use of similar assessment systems as dependent measures in empirical work are discussed, and suggestions are made for developing scales with greater utility in such work.

Treatment of early relapsing-remitting multiple sclerosis with the lymphocyte-depleting humanized monoclonal antibody alemtuzumab (Campath [registered trade mark]) significantly reduced the risk of relapse and accumulation of disability compared with interferon β-1a in a phase 2 trial [Coles et al., (Alemtuzumab vs. interferon β-1a in early multiple sclerosis. N Engl J Med 2008; 359: 1786-801)]. Patients treated with alemtuzumab experienced an improvement in disability at 6 months that was sustained for at least 3 years. In contrast, those treated with interferon β-1a steadily accumulated disability. Here, by post hoc subgroup analyses of the CAMMS223 trial, we show that among participants with no clinical disease activity immediately before treatment, or any clinical or radiological disease activity on-trial, disability improved after alemtuzumab but not following interferon β-1a. This suggests that disability improvement after alemtuzumab is not solely attributable to its anti-inflammatory effect. So we hypothesized that lymphocytes, reconstituting after alemtuzumab, permit or promote brain repair. Here we show that after alemtuzumab, and only when specifically stimulated with myelin basic protein, peripheral blood mononuclear cell cultures produced increased concentrations of brain-derived neurotrophic factor, platelet-derived growth factor and ciliary neurotrophic factor. Analysis by reverse transcriptase polymerase chain reaction of cell separations showed that the increased production of ciliary neurotrophic factor and brain-derived neurotrophic factor after alemtuzumab is attributable to increased production by T cells. Media from these post-alemtuzumab peripheral blood mononuclear cell cultures promoted survival of rat neurones and increased axonal length in vitro, effects that were partially reversed by neutralizing antibodies against brain-derived nerve growth factor and ciliary neurotrophic factor. This conditioned media also enhanced oligodendrocyte precursor cell survival, maturation and myelination. Taken together, the clinical analyses and laboratory findings support the interpretation that improvement in disability after alemtuzumab may result, in part, from neuroprotection associated with increased lymphocytic delivery of neurotrophins to the central nervous system.

A survey of conservatoire students is reported in which information was gathered regarding their awareness and incidence of physical and mental health problems resulting from performing music, as well as places and/or people they would turn to for advice in the event of a future problem. Pain and discomfort relating to posture and excessive practising were reported to be frequent, as was performance anxiety. Students showed a significant inclination to go first to their instrumental teacher for advice about health and psychological problems, before appropriate medical practitioners. These results are discussed in the light of previous research. In addition, a curriculum initiative is described in which a series of seminars have been presented to first-year students at the Royal College of Music with the intention of broadening their awareness of the health issues associated with performing professionally and of the places where they could seek professional help.

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