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The NHS Plan (DoH, 2000), consistent with earlier policy documents, emphasises the need for integrated working between health and social care. However, the path to achieving integration appears to be littered with as many failures of teamworking as successes. This paper reports on an evaluation of the development of a team of practitioners working with clients with severe enduring mental health problems. Soft systems methodology enabled the researchers to inform service development rather than merely describing its process and outcomes. Care management was proactive rather than crisis orientated, with prompt response to subtle changes in clients' needs, facilitated by the employment of Community Support Workers. New care processes and structures enabled client and professional knowledge to be used as a resource to inform decisions about care. The practitioners managed this knowledge through informal trans-disciplinary exchange, promoting access to the fine detail of the relationship between user need and service provision.

To further analyze the VDJ recombination defect in lymphoid pre-B cells from mice with severe combined immune deficiency (scid mice), we have assayed the ability of Abelson murine leukemia virus (A-MuLV) transformed pre-B cells from scid mice to rearrange a recombination substrate in which inverted VH to DJH joins activate a selectable (gpt) gene. In unselected populations, substrate rearrangements occurred frequently, but were aberrant and probably analogous to the aberrant rearrangements observed at endogenous scid Ig gene loci. In contrast, populations of scid pre-B lines selected for gpt activity within the substrate contained mostly "normal" VH to DJH joins within the introduced substrate. These findings demonstrate that scid pre-B cells can make normal joins at low efficiency and are discussed with respect to the potential mechanism of the scid defect and the occurrence of Igs in leaky scid mice.