This article analyses performance consumptions among young people. The theme is explored along two main axes. The first concerns the social heterogeneity in this field, considered on two levels: the different purposes for those investments - cognitive/mental and physical performance; and the different social contexts - university and work - where performance practices and dispositions may be fostered. The second axis explores the roles of pharmacological and natural consumptions, and their interrelationship, in the dissemination of these practices. The empirical data for this analysis were drawn from an ongoing research project on performance consumptions among young people (aged 18-29 years) in Portugal, including both university students and young workers without university education. The results correspond to the stage of extensive research, for which a questionnaire was organised at a national level, using non-proportional quota sampling. On the one hand, they show that (a) there is a hierarchy of acceptance of consumptions according to their purposes, with cognitive/mental performance showing higher acceptance and (b) both pharmaceuticals and natural products are consumed for every type of performance investment. On the other, the comparison between students and workers introduces a certain heterogeneity in this general backdrop, both in terms of the purposes for their consumptions and their opting for natural or pharmacological resources. These threads of heterogeneity will prompt a discussion of the dynamics of pharmaceuticalisation within the field of performance, in particular how therapeutic cultures may be changing in terms of the way individuals relate to medications, expanding their uses in social life.

BACKGROUND Hereditary nonpolyposis colorectal carcinoma (HNPCC) significantly raises the risk of developing colorectal carcinoma (CRC) and other extracolonic tumors. It is defined by the Amsterdam Criteria and is associated with germline mutations in mismatch repair genes, primarily MLH1 and MSH2. The objectives of the current study were to evaluate the presence of CRC (Type I) and other extracolonic tumors (Type II) in families with HNPCC and to analyze the findings for correlations with germline mutations in the MLH1 and MSH2 genes. METHODS Seventy families with an HNPCC diagnosis were analyzed. Denaturing gradient gel electrophoresis and direct sequencing were used for germline mutation analysis in the MLH1 and MSH2 genes. RESULTS Forty‐three of 70 families (61%) presented with HNPCC Type II. In 21 of 30 families that had a complete genetic diagnosis, 16 pathogenic germline mutations (7 MLH1 mutations and 9 MSH2 mutations) and 5 mutations of unknown pathogenecity (all MLH1 mutations) were found. In the remaining nine families, no mutations were detected. Unequivocally pathogenic mutations were far more common in families with HNPCC Type II compared with families that had CRC only (P = 0.01). Families with endometrial carcinoma presented with the greatest probability of mutational detection (P = 0.005). MLH1 was only gene affected in families with HNPCC Type I, whereas mutations in both MLH1 and MSH2 were found in families with HNPCC Type II (P = 0.04). However, the MSH2 gene was more frequently involved in families with HNPCC in which endometrial carcinoma was present (P = 0.005). CONCLUSIONS CRC and endometrial carcinoma were associated with a greater probability of detecting pathogenic mutations in mismatch repair genes, with MSH2 involvement predominating. The results support specific mutational screening strategies, based on observed phenotypes, for families with HNPCC. Cancer 2004. © 2004 American Cancer Society.

This paper presents a sociological approach to coffee consumption as a performance management strategy in work contexts, particularly in professions with intense work rhythms and highly responsive demands. Focusing on the daily work of three professional groups (nurses, police officers, and journalists), we analyze the social expression of coffee and how it is mobilized to deal with sleep problems, fatigue, concentration, or stress. For this purpose, three intertwined dimensions are explored: (1) the nature of these professionals’ work and the pressures for certain forms and levels of performance; (2) sleep problems as both a result of those work characteristics and a constraint on performance; and (3) the role of coffee in managing professional imperatives. The use of coffee appears as a legitimate practice in everyday working routines, due to its socializing markers, whereas additional benefits are attributed to the pharmacological properties of caffeine, given the perceived improvement in performance. The empirical data derive from a study carried out in Portugal on the use of medicines and food supplements for performance management, following a mixed methods approach. In particular, data from a questionnaire survey in a sample of 539 workers and information collected through seven focus groups with a total of 33 participants were used.

No atual enquadramento regulatório das políticas públicas de saúde verifica-se um maior escrutínio público sobre a medicina, pelo que os atores institucionais se têm empenhado na implementação de medidas que procuram reduzir a variação das práticas médicas, concretamente através das chamadas normas de orientação clínica (NOC). Considerando o processo formal da sua implementação em Portugal, o objetivo específico deste artigo é explorar as razões que explicam a adesão a esta lógica de padronização por parte da medicina geral e familiar (MGF). No quadro de uma metodologia qualitativa-intensiva mais ampla, são aqui mobilizados os resultados empíricos decorrentes da aplicação de um conjunto de entrevistas semiestruturadas junto de um número restrito de informantes privilegiados acerca do envolvimento da MGF neste processo, bem como um suporte documental específico enquadrador da sua implementação em Portugal. Constata-se que a vulnerabilidade deste segmento profissional às interferências regulatórias que foram desencadeadas acabou por ser contingente, dado que a concretização do processo de implementação das NOC implicou uma lógica de negociação que assegurou a participação dos profissionais na própria modulação desta iniciativa e constituiu-se como uma oportunidade de reforço da afirmação profissional desta especialidade médica.

Coffee is a socially rooted drink with pharmacological properties. It is embedded in different everyday rituals, including ‘coffee breaks’ during working hours. This paper analyzes the role of coffee at workplace. Focusing on three professional areas associated with high pressure and responsive demands, we explore the social expression of coffee use at work, and how it is mobilized as a tool for managing sleepiness, fatigue, stress, and concentration problems, amongst other work-related issues.

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Resumo: Tomando como ponto de partida uma experiência de colaboração numa comissão de ética de saúde, a presente proposta procura constituir-se como um exercício reflexivo sobre o percurso de participação decorrente do vínculo formal a uma estrutura desta natureza. No entanto, mais do que apenas apresentar um testemunho pessoal que ponha em evidência a visão de um sociólogo relativamente à integração e participação num órgão colegial e multidisciplinar orientado para as questões da saúde, ensaio um exercício analítico orientado para a compreensão e discussão das particularidades do papel e da acção desta estrutura em matéria de apreciação e deliberação ética de projectos de investigação. Palavras-chave: Comissões de ética, multidisciplinariedade, investigação em saúde, ciências sociais.Ethical appraisal of health research projects: A situated reflection on the ethics of research in the social sciences Abstract: Taking as its starting point a collaborative experience in health ethics committee, this proposal aims to establish itself as a reflexive exercise about the formal participation in this kind of structure.However, more than just present a personal testimony that highlights the vision of a sociologist regarding his integration and participation in a collegiate and multidisciplinary body that is oriented to health issues, Idevelop an analytical exercise oriented to understanding and discussing the particularities of the role of this structure in terms of appreciation and ethical deliberation of research projects.

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