Mapping the Quebec dental workforce: ranking rural oral health disparities.

INTRODUCTION: Ensuring access to oral health services is crucial for improving the oral health of rural and remote populations. A logical step towards addressing oral health disparities and underutilization of services in rural areas is to ensure the availability of the dental workforce. Geographical information systems are valuable in examining workforce dispersion patterns and identifying priority areas requiring administrative and policy attention. The objective of this study was to examine and map the distribution patterns of the dental workforce in Quebec, Canada. METHODS: Utilizing the membership directory of Quebec Professional Orders (2009-2010), data on practice locations, practice types and license issue date for all active members of the Quebec dental workforce were obtained. This was followed by reverse geocoding of the geographic coordinates using a global positioning system visualizer to reveal textual locations. These locations were classified according to various degrees of rurality as defined by the 2006 Census Metropolitan Area and Census Agglomeration Influenced Zone typology, developed by Statistics Canada. Cartography layers were extracted from a geospatial database provided by Canada Natural Resources using ArcGIS 9.3. Descriptive and bivariate analyses were performed using SPSS v17 for Windows. RESULTS: Data analysis revealed statistically significant differences in the distribution of dental professionals in rural and urban areas (urban 59.4±19.4/100 000 vs rural 39.9±17.6/100 000; p<0.001). Approximately 90.3% of the dental workforce was located in urban zones, 1.3% in the zones strongly influenced by metropolitan area, 4.9% in the moderately influenced zones, while only 0.3% of the dental workforce was located in non-metropolitan-influenced zones. Urban zones such as Montreal, Quebec and Sherbrooke had the highest workforce availability (4-6 dentists for every 5000 inhabitants). Of a total of 447 specialist dentists in Quebec, only five were located in rural areas. CONCLUSIONS: This study concludes that there is a strong relationship between the degree of urbanization and the highest concentration of dental professionals. In addition, there is a lack of dental workforce availability, particularly specialists in rural Quebec. Further research is needed to examine and evaluate to what degree these distribution patterns might contribute to oral health outcomes of the rural population.

Personality and psychological health in persons with mild cognitive impairment.

An increasing number of studies have documented the cognitive profile of individuals with mild cognitive impairment (MCI), but few studies have investigated the individuals' psychological health and personality traits or how these factors interact with cognition. In the present study, 27 healthy older adults and 30 persons with MCI completed questionnaires covering psychological health, morale, personality, self-efficacy, and self-actualization. The results indicated that individuals with MCI are more depressed, anxious, hostile, and have lower morale than matched healthy older adults. Furthermore, our results show a positive association between the level of depression of MCI persons and the severity of their cognitive dysfunctions. In contrast, there were no group differences on measures of personality traits. Thus, while psychological distress is present in persons with MCI, those individuals are not characterized by differences in personality traits relative to older adults who experience no cognitive impairment.

Input and output modes modulate phonological and semantic contributions to immediate serial recall: evidence from a brain-damaged patient.

Psycholinguistic models of short-term retention suggest that performance at verbal short-term memory (STM) tasks relies on the activation of phonological, lexical, and semantic representations, the relative impact of each depending on task variables. This was tested in normal individuals and in I.R., a brain-damaged patient with a phonological deficit. In Experiment 1, the effect of phonological and semantic similarity was assessed under different presentation formats (words, pictures) and recall modes (oral, picture pointing, and picture pointing among distractors). In Experiment 2, effects were compared using reproduction and reconstruction responses. When words were used at input, controls showed robust phonological similarity effects irrespective of response mode. In contrast, I.R. showed a reliable semantic effect. However, both studies indicated that when response mode promoted order recuperation (reconstruction and picture pointing modes), I.R. showed a typical phonological similarity effect with no semantic contribution. The data support current psycholinguistic views suggesting that the short-term retention of verbal items depends on the temporary activation of word representations. In healthy controls, presentation mode appears to modulate the role of those representations but in I.R., it was the output condition--particularly whether order was or was not required--that was found to be crucial with respect to the appearance of semantic or phonological effects. This supports the important role that order information plays in short-term memory tasks.