Cancer is the leading cause of death in Japan, which boasts one of the longest life expectancies in the world. Some types of cancer cause excruciating pain. Measures are actively being taken to establish palliative care units as specialized facilities to mitigate pain and set up palliative care teams in core hospitals for cancer care. In accordance with the guidelines of the WHO, a method using narcotic drugs as a means of pain relief has been established in Japan, but for patients at the middle to late stages of cancer, sufficient pain control cannot be ensured for many cases. Although various alternative therapies, including acupuncture, moxibustion, and haut care (hand and foot massages) are used to alleviate pain, the effectiveness of these methods is still unclear. Accordingly, we examined the actual conditions of palliative care together with evidence of acupuncture and moxibustion therapies and haut care as a means of pain relief.

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The effects of acupuncture and moxibustion on headache in clinical trials were reviewed. First, the effects of Western medicine on headache for patients with primary headache and secondary headache were systematically reviewed based on online data, and possible mechanisms were discussed. Second, the role and potential use of acupuncture and moxibustion on headache were considered based on a review of research literature. Finally, the effectiveness of acupuncture and moxibustion on migraine and tension type headache was systematically examined based on online data. These results suggest that acupuncture and moxibustion may be most effective on recurring headache.

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[Objective]To investigate if "Japanese acupuncture treatment"is effective for "Japanese patients with lower back pain"by reviewing randomized controlled trials (RCTs) of acupuncture conducted in Japan.
[Methods]Using several databases in Japan, such as Igaku Chuo Zasshi (Japana Centra Revuo Medicina) and PubMed, we searched for RCTs conducted in Japan. In addition, we collected RCTs by a manual search of 5 journals published in Japan. These included the Journal of the JSAM, Kampo Medicine, etc. Then, we examined the abstracts of all RCTs and sorted them according to inclusion and exclusion criteria. After that, we evaluated the quality of extracted RCTs by calculating Modified Jadad Quality Scores and Modified Charmers Scores. Lastly, we performed meta-analysis (MA) using Cochrane Review Manager 5.
[Results]We extracted 19 RCTs. For the Modified Jadad Quality Score 2012, the highest score was 5, the lowest was 1, and the average was 3.5. For the Modified Charmers Score, RCTs with scores over 50 numbered only two, and the average score was 34. In addition, we performed three subgroup meta-analyses:(1) MA of five RCTs, to compare the effect of a retained needle technique with that of sham acupuncture evaluated by a visual analogue scale;VAS (standardized mean difference:SMD -1.79 [95%CI -2.89, -0.69];P = 0.001), (2) MA of three RCTs to compare the effect of retained needle with that of sham acupuncture, evaluated with the Roland Morris Disability Questionnaire;RMDQ (SMD -1.23[95%CI -2.07, -0.38];P = 0.004), and (3) MA of three RCTs to compare the effect of a sparrow-pecking technique with that of sham acupuncture, evaluated by VAS (SMD -0.49 [95%CI -0.98, -0.00];P = 0.05). The results revealed the superiority of real over sham acupuncture for all three subgroup MA.
[Conclusion]Our results demonstrated that evaluations with Modified Jadad Scores were relatively high, but those with an advanced method using Modified Charmers Scores were not satisfactory, indicating a need for further improvement regarding the quality of clinical trials. Although MA revealed that real acupuncture was more effective than sham acupuncture, the RCTs that we extracted in this study were conducted by very few researchers, suggesting the possibility of bias. Therefore, more clinical trials by a variety of researchers are needed to confirm the effectiveness of acupuncture for LBP in Japan.

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[Objective]The purpose of this study was to gain a clear understanding of adverse events associated with acupuncture (Acp) and moxibustion (Mox) therapies. Thus, we administered questionnaires to orthopedists in order to understand the clinical experience of patients who suffered adverse events.
[Materials and Methods]For this study, 6,000 orthopedic hospitals and clinics were randomly selected from 13,225 hospitals and clinics listed in the telephone directory iTown Page (http://itp.ne.jp). In October 2011 and July 2012, 3,500 and 2,500 questionnaires, respectively, were sent by mail. The questions addressed the following:(1) the respondent's profile (e.g., years of experience as a licensed orthopedist);(2) adverse events associated with Acp, including electroacupuncture;(3) adverse events associated with Mox;(4) use of Acp and Mox therapies in the orthopedist's hospital or clinic;(5) comments on the safety of Acp and Mox therapies. The identity of respondents remained secret.
[Results]The questionnaire response rate was 10.7%. The respondents were licensed orthopedists for 30 ± 11 years (mean ±standard deviation). Adverse events associated with Acp included retained needles and needle breakage (n ≥148), hemorrhages (n ≥ 64), infections (n ≥ 40), organ injuries (n = 28), and so on. Retained needles (≥ 145 out of 148), subcutaneous hemorrhages (63out of 64), arthritis (17 out of 40), and pneumothorax injuries (27 out of 28) occurred most frequently. The adverse events associated with Mox were burn injuries (n ≥ 121), infections (n ≥ 16), and other adverse events (n = 2). Second-degree burn injuries (n ≥ 48 out of 121) and suppuration infections (11 out of 16) occurred most frequently. These were the most common adverse events associated with Acp and Mox. The usage rate of Acp and Mox therapies in the orthopaedist's hospital or clinic was 18.6%. There were many comments on infection control by acupuncturists (n = 27), education and technical levels of Acp and Mox (n = 13), and retained needles and needle breakages (n = 13).
[Conclusion]These survey results reveal that the occurrence of severe adverse events associated with Acp and Mox was higher than our expectation. In order to improve the safety of Acp and Mox therapies, various educational activities to disseminate information about existing safety measures to acupuncturists are needed. Further studies on new preventive measures, continuous surveys, and feedback to acupuncturists are also required.

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Executive members of the World Federation of Acupuncture and Moxibustion Societies (WFAS) are elected in the general assembly (GA), which is held once every four years. In addition, member societies that will host the upcoming WFAS conferences over the next 4 years are determined in the GA.
Japan hosted the 3rd World Congress of Acupuncture and Moxibustion in 1993, but has not been invited to host the WFAS annual conference for the past 20 years. In the 8 th WFAS GA held in the Sydney Convention Centre Darling Harbour, Sydney, Australia on 1 November 2013, Japan was elected as the host country for the 2016 WFAS Annual Conference. Thus, the 2016 WFAS Annual Conference will be held in Tokyo, and hosted by the Japan Society of Acupuncture and Moxibustion (JSAM) and Japanese Traditional Acupuncture and Moxibustion Society (JTAMS).
In the election of Executive Members, Shuichi Katai was elected as vice-president of WFAS and Ikuro Wakayama and Naoto Ishizaki were elected as executive members. The term for executive members is four years. In addition, Kiichiro Tsutani, former vice-president of WFAS, was appointed as honorable vice-president, and Yukio Kurosu, former honorable vice-president, was appointed as advisor.
Academic programs were carried out for three days from 2 November 2013. In the WFAS conferences usually more than half of the papers are presented in Chinese, but in Sydney, most papers were presented in English. There were one invited lecture and 13presentations from Japan.

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