[Objective]This study was performed to clarify the benefits and challenges of the acupuncture clinic at the university hospital.
[Methodology]In May, 2012 information on acupuncture clinics from the websites of 80 university hospitals in Japan was analyzed. Information on the experience of the acupuncture clinic at Mie University Hospital was provided by the department of anesthesia at that hospital.
[Results]The number of university hospitals which operate acupuncture clinics was 16. Three types of acupuncture clinics were observed, first was an independent center separated from the university hospital, second was a department specific to oriental medicine within the hospital, and third was a certain medical department such as anesthesia or rehabilitation. In the case of Mie University Hospital, establishment of the acupuncture clinic was proposed in 2007 as a part of collaborative works under the partnership agreement between Mie University and Suzuka University of Medical Science. The acupuncture clinic was then established as the outpatient clinic of anesthesia from 2010. The staff of the acupuncture clinic consists of three acupuncturists belonging to Mie University Hospital, and three faculty members from Suzuka University of Medical Science. A total of 2,749 medical treatments were carried out in the past two years. Through case conferences between physicians and acupuncturists, the level of acupuncture care has improved. For example, electronic medical records were shared, and medical safety management was intensified. However, the number of referrals of hospitalized patients to the acupuncture clinic fell sharply in the second year of the establishment. The main reason was thought to be that the patients who required pain management were referred to the palliative care team which had started full-fledged operation during the second year. An effort to promote cooperation between acupuncturists and the palliative care team is now in progress.
[Discussion]Although there are some challenges to be overcome, establishment of the acupuncture clinic at the university hospital may help promote acupuncture based on scientific evidence, and improve the understanding of acupuncture in the entire medical community. Active proposals of treatments by acupuncturists and promotion of mutual understanding and cooperation between acupuncturists, physicians, and other health care professionals are essential for the successful establishment of acupuncture clinics.
[Conclusion]Although there are several challenges to be overcome, establishment of the acupuncture clinic at the university hospital has a great significance for the promotion and development of acupuncture in Japan.

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‘Integrative medicine’is heard everywhere in Japan. Because the definition of integrative medicine has been misunderstood in various ways, in 2010 the Japanese Government launched an integrative medicine project team. Confusion and misinterpretation of the conceptual distinction between ‘integrative medicine’and ‘complementary and alternative medicine’is a serious problem. The goal of ‘integrative medicine’is not to promote or establish evidence of the effects of particular practices of complementary and alternative medicine. In order to develop integrative medicine in Japan, acupuncture and moxibustion are indispensable, because they are already certified by the national license system, and there are many acupuncture and moxibustion clinics everywhere in Japan. This means that acupuncture and moxibustion treatments are assured of quality, accessibility, and availability. The goal of this proposal is to clearly describe the philosophy and concept of integrative medicine, and especially, the role of acupuncture and moxibustion within the movement toward integrative medicine.

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Apart from development of medical technology, how we prevent disease has been an important issue.
Moreover, it has become clear that the diseases, such as cancer, diabetes, myocardial infarction, cerebral infarction and cerebral hemorrhage, which lead to the cause of death for a great portion of Japanese, are often caused by lifestyle factors and the outbreak of such diseases could possibly be prevented by changing lifestyle.
At this seminar, the lecturers discuss developments in lifestyle especially paying attention to food.
First a lecture was given from a viewpoint of caloric restriction and balance in relevance to healthy eating habits, next the effects of acupuncture and moxibustion on nutrition absorption, and finally oriental holistic foods concepts and the relationship between diet and disease.
We held a discussion based on this lecture. and we reviewed the relation between diet and disease, the affect of acupuncture and moxibustion on nutrition absorption, and the view of the holistic meal as part of oriental medicine. Finally a useful possibility for combining diet with acupuncture and moxibustion therapy was suggested.

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[Objective]The aim of this study was to survey the current status of adverse events (malpractice and side-effects) in clinical practices of acupuncture (Acp) and moxibustion (Mox), to discuss the problems, and to suggest corrective strategies.
[Methods]The survey was sent by mail in October 2009 to 6,000 Acp clinics (including Mox) selected at random from the i-Town-Page telephone directory. The questions addressed the following issues:(1) respondent profile;(2) Acp adverse events;(3) Mox adverse events;(4) complaints and litigation;(5) informed consent regarding these adverse events;(6) subscriptions to publications that address the safety issues of Acp and Mox;and (7) access to free safety resources. Note that we inquired about the experiences of adverse events but did not inquire about their frequency.
[Results]The response rate was 21.6%. The top three adverse events for Acp were subcutaneous hemorrhage (65.8%), micro-hemorrhage (62.0%), and needle pain (52.9%). The top malpractice event was forgotten needles (32.7%). Needle breakage and pneumothorax, which are severe malpractice events, were reported by 2.2%and 2.0%of the clinics, respectively. The top three adverse events for Mox were accidental and unintentional burn injury (24.0%), singed hair (15.5%), and singed clothes (15.0%). The most severe malpractice event was suppuration of the Mox point (10.8%). The top adverse events associated with complaints and litigation were symptom exacerbation (21.8%) and pneumothorax (36.4%). Only 74.8%of respondents obtained informed consent, but of those, 61.0%reported providing adverse affect warnings orally. Subscriptions to books and periodicals on the safety of Acp and Mox were reported by less than 30.0%of the respondents.
[Conclusion]The most common adverse events associated with Acp were side effects caused by excessive stimulation. With Mox adverse events were more commonly attributable to negligence. The low subscription rate to safety periodicals suggests that safety information is not presently widely distributed. It is necessary to transmit safety information via the Internet as well as in books and other periodicals.

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The American Academy of Medical Acupuncture’s 24th Annual Symposium for Medical Acupuncture was held in Atlanta, Georgia, USA on April 27-29, 2012. The American Academy of Medical Acupuncture (AAMA) is an academic society made up mostly of doctors who are interested in acupuncture. This symposium had 11 lectures, 8workshops, 6oral presentations and 7 poster sessions. The contents of almost all presentations concerned acupuncture. There were 300 participants in the symposium. 20 companies took part in the exhibitions at this symposium, and the Japan Society of Acupuncture and Moxibustion (JSAM) was introduced with a large vertical banner in its exhibition booth, and leaflets from JSAM were distributed. I attended the symposium as a representative of the Department of International Affairs in JSAM.

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