Institutional change and diversity have been two major topics of debate in contemporary social sciences. At the core of this debate are actors’ skills to manage the institutional frame that defines limits and possibilities for their strategies. This article analyses how social movements produce institutional change and diversity in the organic food market. It contrasts the experiences of Participatory Guarantee Systems created by Nature & Progrès (France) and Ecovida Agroecology Network (Brazil) to reframe the institutional order of the organic market. Results demonstrate that, while the conventional third-party certification remains the dominant institutional frame, there is space for competing schemes. However, the relevance of the alternatives depends both on the characteristics of the institutional order historically shaped in each context, and on the skills social movements possess to face the interests of the dominant actors. In this way, the article demonstrates that, in comparison to Nature & Progrès, Ecovida has been a more skillful movement because of its closer connection with other social movements and state actors, compelling Brazil to produce an institutional frame more open to diversity than that found in France.

BACKGROUND: The aim of the present study was to assess the periodontal condition of individuals with Down syndrome and the association with sociodemographic and behavioural characteristics and family perception of oral health. METHODS: This cross-sectional observational study was performed at a referral centre for dental assistance to disabled persons in Aracatuba, Brazil. Parents of the individuals were interviewed, and the visible plaque index, bleeding on probing, probing pocket depth and clinical attachment level were recorded by one periodontist in six sites per tooth of all teeth. The individual was the unit of analysis. The significance level was set at 5%. RESULTS: Sixty-four subjects (23.8 +/- 8.3 years old) were included. Eighteen (28.1%) were diagnosed with gingivitis and 46 (71.9%) with periodontitis. In the multiple logistic regression final model, age and self-reported oral hygiene practices were associated with the occurrence of periodontitis. The chance of having periodontitis was 4.7 times higher among individuals older than 20 years and approximately 4 times higher in patients whose oral hygiene was performed by themselves and their parents, compared with those who performed oral hygiene alone. Sex, follow-up time in the centre, education, degree of participants' dependence, flossing and family history of periodontal disease were not associated with the occurrence of periodontitis. Higher levels of plaque and bleeding were observed for participants with parents reporting bad gingival health (76.2% and 46.9%) and deficient oral hygiene (79.5% and 47.3%). The perception of parents regarding gingival bleeding was correlated with higher bleeding detected clinically (P = 0.01; 50.1%). CONCLUSIONS: The prevalence of periodontitis in individuals with Down syndrome is high and increases with age, even in the face of the parents' perception about their children's oral condition.