Dialectic and dialogue in the hermeneutics of Paul Ricœur and H.G. Gadamer

The present paper uses the theme of dialectic and dialogue to begin unraveling the similarities and differences between the hermeneutics of Paul Ricoeur and H.G. Gadamer. Ricoeur is shown to distance himself from Heidegger by insisting on a dimension of explanation and distanciation (which he sometimes identifies with Plato's `descending dialectic') that cannot be reduced to, or absorbed by, understanding and appropriation. This same move, however, leads him to reject Platonic dialogue, with the attendant prioritizing of oral conversation over the written text, as a model for hermeneutics. Ricoeur therefore sees in Gadamer's recourse to such a model a regression to the problematic position of Heidegger. Yet the conception of philosophy as dialectical and dialogical which Gadamer finds in Plato is capable of responding to Ricoeur's objections. Where the fundamental difference between the hermeneutics of Ricoeur and Gadamer emerges is in the question of whether experience is fundamentally dialectical and whether language is inherently dialogical.     

Lactate threshold prediction by blood glucose and rating of perceived exertion in people with type 2 diabetes

The validity of rating of perceived exertion (RPE) in predicting lactate threshold during an incremental test was analyzed in 15 men with type 2 diabetes (M age = 53.4 yr., SD = 12.9). Blood glucose, lactate, and minute ventilation (VE)/VO2 responses identified the lactate, ventilatory, and glucose thresholds. Workloads (W) corresponding to RPEs 12, 13, 14, and 15 were determined. Second-order polynomials fit to VE/W and [lac]/W ratios corresponding to RPEs of 9-10, 12-13, and 16-17 also identified workloads above which there was an overproportional increase in VE and [lac]. These workload breakpoints did not differ, although at RPE 12 underestimated and at RPE 15 overestimated lactate threshold. RPE 13 and 14 and the responses of VE/W and [lac]/W to submaximal exercise accurately predicted lactate threshold.     

Using empowerment theory in collaborative partnerships for community health and development

Models of community empowerment help us understand the process of gaining influence over conditions that matter to people who share neighborhoods, workplaces, experiences, or concerns. Such frameworks can help improve collaborative partnerships for community health and development. First, we outline an interactive model of community empowerment that describes reciprocal influences between personal or group factors and environmental factors in an empowerment process. Second, we describe an iterative framework for the process of empowerment in community partnerships that includes collaborative planning, community action, community change, capacity building, and outcomes, and adaptation, renewal, and institutionalization. Third, we outline activities that are used by community leadership and support organizations to facilitate the process of community empowerment. Fourth, we present case stories of collaborative partnerships for prevention of substance abuse among adolescents to illustrate selected enabling activities. We conclude with a discussion of the challenges and opportunities of facilitating empowerment with collaborative partnerships for community health and development. This work was supported by Kansas Health Foundation Grants 9206032B and 9206032A to support and evaluate community partnerships to prevent adolescent substance abuse. Thanks to Tom Wolff for sharing his wisdom about community coalitions so generously, and to Bill Berkowitz and anonymous reviewers for thoughtful comments on an earlier version of this manuscrpt. We also thank our colleagues from the Kansas Health Foundation, Mary K. Campuzano, Steve Coen, and Marni Vliet, and those from collaborating communities, who continue to teach us about ways to enhance community capacities to address local concerns.     

Association Between Gait and Dual Task With Cognitive Domains in Older People With Cognitive Impairment

The authors investigated whether impaired gait and dual-task performances are associated with specific cognitive domains among older people with preserved cognition (PC), mild cognitive impairment (MCI), and mild Alzheimer's disease (AD). The sample comprised 40 older adults with PC, 40 with MCI, and 38 with mild AD. The assessment consisted of gait (measured by 10-m walk test and Timed Up and Go Test [TUGT]), dual task (measured by TUGT associated with a cognitive-motor task of calling a phone number), and cognition (domains of the Addenbrooke Cognitive Examination–Revised and Frontal Assessment Battery [FAB]). For data analysis, the Pearson product-moment correlation and the backward stepwise linear regression were conducted. Language, fluency, and visuospatial domains predicted the 10-m walk test measure specifically in PC, MCI, and AD groups. Only the visuospatial domain was independently associated with the TUGT measure in the MCI and AD groups. FAB score, language domain, and FAB score and fluency domain were the strongest predictors for the isolated cognitive-motor task measure in the PC, MCI, and AD groups, respectively. The visuospatial domain was independently associated with the dual-task test measure in all 3 groups. The study findings demonstrate the influence of specific cognitive domains in daily mobility tasks in people with different cognitive profiles.