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OBJECTIVES:The present study aimed to assess the influence of dental occlusion on body posture and the competitive performance of young elite rowers.METHOD:Dental occlusion disturbance devices were used to simulate dental malocclusions. We assessed the influence of malocclusion on the body balance, paravertebral muscle contraction symmetry, and muscular power of young elite rowers. A nonparametric permutation test for repeated measures ANOVA, a Cochran's Q test for paired data and a paired Student's t-test were used in order to statistically evaluate the influence of artificial occlusal disturbance on each factor. A force platform and a Dyno Concept 2 machine were used as measuring instruments.RESULTS:A total of 7 members of the “Pôle France Aviron” (age range of 15-17 years) were enrolled in the study. None of the body balance parameters was significantly influenced by the artificial occlusal disturbance. The interposition of an occlusal silicone splint significantly increased the proportion of athletes presenting asymmetric muscular contractions from 14.3% to 85.7% (p=0.025) and induced a significant 17.7% decrease in the athletes' muscular power (p=0.030).CONCLUSIONS:This study shows the negative impacts of an occlusal disturbance on the athletic performance of young elite rowers. The detection of malocclusion traits by regular occlusal monitoring would be of great interest in this population.

Objective To determine the association of reductions in price of antiretroviral drugs and foreign assistance for HIV with coverage of antiretroviral treatment.Design Retrospective study.Setting Africa.Participants 13 African countries, 2003-8.Main outcome measures A price index of first line antiretroviral therapy with data on foreign assistance for HIV was used to estimate the associations of prices and foreign assistance with antiretroviral coverage (percentage of people with advanced HIV infection receiving antiretroviral therapy), controlling for national public health spending, HIV prevalence, governance, and fixed effects for countries and years.Results Between 2003 and 2008 the annual price of first line antiretroviral therapy decreased from $1177 (£733; €844) to $96 and foreign assistance for HIV per capita increased from $0.4 to $13.8. At an annual price of $100, a $10 decrease was associated with a 0.16% adjusted increase in coverage (95% confidence interval 0.11% to 0.20%; 0.19% unadjusted, 0.14% to 0.24%). Each additional $1 per capita in foreign assistance for HIV was associated with a 1.0% adjusted increase in coverage (0.7% to 1.2%; 1.4% unadjusted, 1.1% to 1.6%). If the annual price of antiretroviral therapy stayed at $100, foreign assistance would need to quadruple to $64 per capita to be associated with universal coverage. Government effectiveness and national public health expenditures were also positively associated with increasing coverage.Conclusions Reductions in price of antiretroviral drugs were important in broadening coverage of HIV treatment in Africa from 2003 to 2008, but their future role may be limited. Foreign assistance and national public health expenditures for HIV seem more important in expanding future coverage.

Les théories de l'agence et des stakeholders apportent un éclairage nouveau sur la gestion de l'Education Nationale caractérisée par l'emboîtement de trois niveaux de décision que sont le ministère, les académies et les établissements d'enseignement. Leurs dirigeants élaborent leur stratégie en fonction des demandes parfois contradictoires du mandant et des autres parties prenantes que sont le personnel, les usagers et les collectivités territoriales. Le formalisme contractuel, mécanisme de régulation privilégié entre les trois niveaux de décision, présente certaines insuffisances en raison du contexte éducatif et de la nature des contrats. Ce mécanisme de gouvernance est complété dans le cadre de ces relations et de celles avec les autres parties prenantes par des mécanismes de type relationnel au service de la coopération. Une analyse des discours stratégiques du ministère démontre que le rôle et l'autonomie de l'académie sont pour partie occultés. Le ministère est ambigu face à l'autonomie des établissements, il incite les chefs d'établissement à coopérer avec l'ensemble des acteurs locaux pour élaborer la politique de leur établissement mais en même temps il souhaite développer un formalisme contractuel au service d'objectifs nationaux. L'analyse des projets académiques montre que sont surtout pris en compte les objectifs nationaux. Leur élaboration n'est pas le résultat d'une large démarche participative. L'absence de planification stratégique empêche les parties prenantes de surveiller les actions académiques et d'évaluer leurs résultats. En revanche les recteurs semblent recourir à des mécanismes relationnels et mettent au centre de leur gestion un certain nombre de valeurs (mission de service public, égalité des chances, équité) partagées par l'ensemble des parties prenantes.