This is the largest reported series of CDH1 mutation carriers, providing more precise estimates of age-associated risks of gastric and breast cancer that will improve counseling of unaffected carriers. In HDGC families lacking CDH1 mutations, testing of CTNNA1 and other tumor suppressor genes should be considered. Clinically defined HDGC families can harbor mutations in genes (ie, BRCA2) with different clinical ramifications from CDH1. Therefore, we propose that HDGC syndrome may be best defined by mutations in CDH1 and closely related genes, rather than through clinical criteria that capture families with heterogeneous susceptibility profiles.

Partnership working has emerged as a key feature of New Labour's approach to social policy. However, although the theoretical benefits of partnership have been well rehearsed, agencies charged with fostering partnerships lack "evidence" about how best to proceed in bringing about organizational change. This paper describes the development and implementation of a practical approach to capturing the strategies that can be used to establish, strengthen and sustain local partnerships. To this end, it presents a conceptual framework for the evaluation of partnership working and demonstrates the application of the framework to an investigation of partnership working in

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