This paper describes the work of a clinical case management core team (four nurses and an occupational therapist) during the course of a week. Information was gathered through non-participant observation of the team by two independent researchers. Transcripts produced from the data recorded were examined. From this, seven categories of activity were identified: planned client contact; unplanned client contact; family/carer contact; liaison; administration; team information sharing and supervision, training and personal development. These categories were felt to encompass the range of activities practised by the team. The amount of time that case managers spent engaged in these core functions was calculated. Detailed examples are presented. Results are discussed with reference to Kanter's components and principles of clinical case management.

Psychological research in early pubertal development is scant. Much of the directly relevant literature is dated and reflects a tendency to search for 'psychopathology'. Studies have unravelled few long-term effects on psychological functioning but research findings are inconclusive due to methodological flaws. In the absence of a clear understanding of what is important, it may be helpful to ask those with personal experience what for them is salient about experiences of early pubertal development. This paper offers a preliminary analysis based on interviews with five women whose physical sexual development had begun before the age of seven. Transcripts of the interviews were examined for dominant themes and subjected to a preliminary discursive analysis. The women's accounts revealed implicit social rules that govern childhood, physique, adult-child demarcations and sexuality. Discourses of childhood non-sexuality and the conflation of feminine appearance with sexual availability intersect to position our participants as sexual anomalies. Self-perceptions of deviance remained even when peers had caught up in physical development. All of the participants had continued to seek explanations in adulthood, to try and make sense of their 'difference'. Whilst it is too early to draw conclusions from such a small study, our preliminary analysis offers some fresh ideas for formulating future research in the area. Further research is very much needed to clarify how typical the reported experiences are, what factors are associated with them, how these experiences may or may not influence adult sexuality and identity, and how those affected by early pubertal development wish to be supported.

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