Luce Irigaray: Back to the Beginning

In 2014 it will be 40 years since Luce Irigaray’s (second) doctoral thesis Speculum de l'autre femme was first published. That book, widely recognized as the most important text in feminist philosophy, was to introduce Irigaray’s critique of western philosophy and psychoanalysis and her ethics of sexual difference for which she was to become so well known. Irigaray, well into her eighties now, has published continuously since Speculum, despite her exclusion from French academic life after her expulsion in 1974 from the Université de Paris VIII Vincennes. That her latest book In the Beginning, She Was, released on the eve of Speculum’s anniversary, is perhaps the most personally revelatory of her works and revisits many of the same themes and issues that concerned her in Speculum cannot be coincidental. In this critical notice we examine Irigaray’s latest offering arguing that her contribution is twofold as she combines with new clarity her longstanding critique of phallocratic culture and her transformative vision of humanity as a culture of sexuate difference. There are a number of important themes addressed in the six chapters of the book, but for the purposes of this discussion our analysis will focus mostly on elaborating her critique of Western culture, on the usefulness of her work for rethinking masculine subject formation and on the figure of Antigone, as a feminine subject on her own terms, as a way of imagining a possible relation between two subjects within a culture of sexuate difference. We argue that this book continues to illustrate Irigaray’s importance as one of the most radical and prophetic philosophers of our time.

Mantle flow, volatiles, slab-surface temperatures and melting dynamics in the north Tonga arc-Lau back-arc basin

The Fonualei Spreading Center affords an excellent opportunity to evaluate geochemical changes with increasing depth to the slab in the Lau back-arc basin. We present H2O and CO2 concentrations and Sr, Nd, Pb, Hf and U-Th-Ra isotope data for selected glasses as well as new Hf isotope data from boninites and seamounts to the north of the Tonga arc. The Pb and Hf isotope data are used to show that mantle flow is oriented to the southwest and that the tear in the northern end of the slab may not extend east as far as the boninite locality. Along the Fonualei Spreading Center, key geochemical parameters change smoothly with increasing distance from the arc front and increasing slab surface temperatures. The latter may range from 720 to 866 degrees C, based on decreasing H2O/Ce ratios. Consistent with experimental data, the geochemical trends are interpreted to reflect changes in the amount and composition of wet pelite melts or super-critical fluids and aqueous fluids derived from the slab. With one exception, all of the lavas preserve both U-238 excesses and Ra-226 excesses. We suggest that lavas from the Fonualei Spreading Center and Valu Fa Ridge are dominated by fluid-fluxed melting whereas those from the East and Central Lau Spreading Centers, where slab surface temperatures exceed similar to 850-900 degrees C, are largely derived through decompression. A similar observation is found for the Manus and East Scotia back-arc basins and may reflect the expiry of a key phase such as lawsonite in the subducted basaltic crust.

Days in the Bay

A short performance devised by the Tiger’s Bay Men’s Group and inspired by the disappearing streetscape of North Belfast

Different frequencies of acupuncture for treatment for chronic low back pain: an-assessor blinded pilot randomised controlled trial.

OBJECTIVES:
To examine the feasibility of a main RCT to compare the effectiveness of two frequencies (2 versus 5 times/week) of acupuncture treatment for chronic low back pain (LBP).
METHODS:
Participants (n=30) with chronic LBP were randomised into two groups to receive 10 acupuncture treatments: Low Frequency Group, 2 times/week for five weeks (n=15); High Frequency Group, 5 times/week for two weeks (n=15). The following outcomes were measured blindly at baseline, 2 weeks, 5 weeks, 3 months and 1 year: pain on a VAS, functional disability using the RMDQ, quality of life using the Measure Yourself Medical Outcome Profile (MYMOP-2), psychological impact with the Coping Strategies Questionnaire (CSQ) and Pain Locus of Control (PLC) questionnaire. Two objective outcomes, the Shuttle Walk Test (SWT) and Lateral Trunk Flexibility (LTF), were also measured.
RESULTS:
The compliance rate was 100% for each group. Some of the measurements were shown to be sensitive (VAS, RMDQ, MYMOP-2 Wellbeing). 66-330 participants would be required for a fully powered non-inferiority trial. The groups were balanced at baseline for LBP and demographic characteristics. There were no significant differences between the groups in terms of any of the outcomes, at each follow-up time point. It was notable however that the clinically important improvement in terms of pain, functional disability, quality of life, and SWT in both groups was achieved within the first two weeks, which was maintained at one year follow-up.
CONCLUSIONS:
It is feasible to conduct a main RCT, to compare different frequencies of acupuncture for LBP, using sensitive measurements. Also the trend for early clinically important improvement within a minimum of four measurements is worthy of further study.

Supervised walking in comparison with fitness training for chronic back pain in physiotherapy: results of the SWIFT single-blinded randomized controlled trial (ISRCTN17592092)

Effectiveness of brief/minimal contact self-activation interventions that encourage participation in physical activity (PA) for chronic low back pain (CLBP >12 weeks) is unproven. The primary objective of this assessor-blinded randomized controlled trial was to investigate the difference between an individualized walking programme (WP), group exercise class (EC), and usual physiotherapy (UP, control) in mean change in functional disability at 6 months. A sample of 246 participants with CLBP aged 18 to 65 years (79 men and 167 women; mean age ± SD: 45.4 ± 11.4 years) were recruited from 5 outpatient physiotherapy departments in Dublin, Ireland. Consenting participants completed self-report measures of functional disability, pain, quality of life, psychosocial beliefs, and PA were randomly allocated to the WP (n = 82), EC (n = 83), or UP (n = 81) and followed up at 3 (81%; n = 200), 6 (80.1%; n = 197), and 12 months (76.4%; n = 188). Cost diaries were completed at all follow-ups. An intention-to-treat analysis using a mixed between-within repeated-measures analysis of covariance found significant improvements over time on the Oswestry Disability Index (Primary Outcome), the Numerical Rating Scale, Fear Avoidance-PA scale, and the EuroQol EQ-5D-3L Weighted Health Index (P < 0.05), but no significant between-group differences and small between-group effect sizes (WP: mean difference at 6 months, 6.89 Oswestry Disability Index points, 95% confidence interval [CI] -3.64 to -10.15; EC: -5.91, CI: -2.68 to -9.15; UP: -5.09, CI: -1.93 to -8.24). The WP had the lowest mean costs and the highest level of adherence. Supervised walking provides an effective alternative to current forms of CLBP management.

A review of behaviour change theories and techniques used in group based self-management programmes for chronic low back pain and arthritis

Background: Medical Research Council (MRC) guidelines recommend applying theory within complex interventions to explain how behaviour change occurs. Guidelines endorse self-management of chronic low back pain (CLBP) and osteoarthritis (OA), but evidence for its effectiveness is weak. Objective: This literature review aimed to determine the use of behaviour change theory and techniques within randomised controlled trials of group-based self-management programmes for chronic musculoskeletal pain, specifically CLBP and OA. Methods: A two-phase search strategy of electronic databases was used to identify systematic reviews and studies relevant to this area. Articles were coded for their use of behaviour change theory, and the number of behaviour change techniques (BCTs) was identified using a 93-item taxonomy, Taxonomy (v1). Results: 25 articles of 22 studies met the inclusion criteria, of which only three reported having based their intervention on theory, and all used Social Cognitive Theory. A total of 33 BCTs were coded across all articles with the most commonly identified techniques being '. instruction on how to perform the behaviour', '. demonstration of the behaviour', '. behavioural practice', '. credible source', '. graded tasks' and '. body changes'. Conclusion: Results demonstrate that theoretically driven research within group based self-management programmes for chronic musculoskeletal pain is lacking, or is poorly reported. Future research that follows recommended guidelines regarding the use of theory in study design and reporting is warranted.