We created a new medical interview form which is called chronological analysis for East Asian Traditional Medicine (EATM).
I would like to focus on our medical interview in EATM. Our patient comes to see a doctor with his or her life and medical histories.
When we interview and write them on CHRONOLOGICAL ANALYSIS CHART, we can give them into several groups. Each group is characterized as a chronic health problem (CHP) and named by the traditional major pattern diagnosis and the symptom-to-medicine pattern diagnosis. The former base on TCM (Traditional Chinese Medicine) and the latter Japanese Kampo Medicine.
On this chart the patient's life events are written in the left side and his or her active symptoms are written in right side. We write them to make in the same longitudinal time line. Comparison with light life events and right illnesses makes us understand the structure consisting of several groups. We already saw more than three hundred thousand patients in 30 years. A 52 year-old women came to see us. We interviewed by our chronological analysis. Her history consist of several groups:The 1 st group is Detoxication pattern, the 2 nd is heat in intestine blood, the 3rd is congestion in blood, and the 4 th is Liver "CHI"congestive dysfunction and finally we diagnosed as Toukakujyoukitou decoction for climacteric dysfunction.
The most significance is we could guess that she had a stressful time in the blue colored part.
After observing each patient's chronic health problems, we relate them chronologically to their life events and develop a graphic structure for each patient comprehensively. To see a patient from this kind of this view, we call emphasize them in both modern and traditional medicine. We show a new interview way using chronological chart to understand patients more deeply.
Amid the growing medical needs of an aging society this chronological analysis is significant to understand our patients comprehensively.
Through these medical approach we understand patients and give them traditional healing of mind and body.

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[Objective]The purpose of this study was to clarify the current status of cooperation between acupuncturists and physicians providing palliative care at home care support clinics.
[Methods]We studied 297 home care support clinics that provide cancer palliative care in the home. We mailed a self-administered questionnaire to the physicians belonging to the clinics. The questionnaire was created to clarify the number of clinics that provide home palliative care, current status of cooperation with acupuncturists, and methods of information-sharing.
[Results]We received responses from 98 clinics (33.3%response rate). Of these, 14 clinics (14.3%) currently provide care for terminal cancer patients in cooperation with acupuncturists, 9clinics (9.2%) reported having done so in the past. Patient's conditions treated in cooperation with acupuncturists were things such as pain, hiccups, edema, ascites, and constipation. The benefits attributed to cooperation with acupuncturists included "relief of symptoms,""improved patient satisfaction,"and "improved patient motivation."Regarding the presence or absence of information-sharing with acupuncturists, 7clinics (50%) responded that they "always share," 7clinics (50%) responded that they "share depending on the situation,"and no clinic reported "does not share information."Regarding the prospect for cooperation with acupuncturists in providing home palliative care in the future, 9clinics (9.2%) responded that they "actively want to cooperate,"and 65 clinics (66.3%) stated that they would "think about cooperation in some circumstances."
[Conclusion]From this study, it was concluded that cooperation exists between acupuncturists and physicians in 14.3%of home care support clinics providing palliative care. In addition, the possibility that cooperative patient care provides not only symptom relief but also other benefits has been suggested. On the other hand, it is necessary for acupuncturists, as part of a healthcare team, to have access to patient information and the status of other treatments, so that the acupuncturists can be involved in the field of home palliative care. Furthermore, management should promote an environment for cooperating with professionals in other medical occupations, including physicians.

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[Objective]In recent years, communication skills have been recognized as an essential competence for acupuncturists. This study proposes to develop a scale for measuring the medical communication skills of acupuncturists.
[Materials and Methods]A questionnaire of 20 items was used to measure medical communication skills. These items were adopted from a concept analysis conducted in a previous study.
Cronbach's alpha was used to examine the scale's reliability. The scale's validity was examined by correlation analysis and multiple regression analysis comparisons with normal communication skills subscale scores (ENDCOREs, Encode, Decode, Control, Regulate) and a Japanese version of characteristic trait anxiety scores (STAI, State-Trait Anxiety Inventory).
[Results]Factor analysis, using a principal extraction method and promax rotation, was conducted on responses from 443students and therapists. As a result, the original 20 items were reduced to 16, and the following three factors were extracted:I. Acceptance of patients and self-control;II. Appropriate explanation to patients;and III. Understanding of patient's feelings. These three factors had high degrees of internal consistency (Cronbach's alpha =.872 -.892).
The scores of the three factors correlated significantly with the scores of the six factors of ENDCORE, and with the anxiety scores. Although the results of multiple regression analysis showed that each factor of ENDCORE explained the three factors, the anxiety scores did not influence medical communication skills. The scores for the three factors correlated significantly with self-evaluation scores of medical interview skill. In addition, these three factors were affected by the degree of clinical experience.
[Conclusion]These results suggest that this scale may be a reliable instrument for assessing medical communication skills among Japanese acupuncturists.

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[Objective]We report herein the use of acupuncture to counteract gait disturbance in a patient with Parkinson's disease (PD). A portable gait rhythmogram was used to objectively demonstrate gait improvements.
[Case]Case:A 72-year-old woman, who a 64 experienced a tremor of the right hand and was diagnosed with PD. Symptoms improved with anti-PD medication, but at 71 years old, she experienced heaviness of the neck and shoulders and stiffness of the anterior thighs, and her step length decreased. Acupuncture therapy was initiated to relieve these symptoms.
Present illness:On examination, she presented a wobbly gait, cold feet, and reported frequent falling. Heaviness in the neck and shoulders extended from the neck to the suprascapular region, and increasing heaviness resulted in a forward-flexed posture and decreased step length. Muscle hypertonia of the quadriceps muscles was bilaterally observed, explaining the perceived stiffness in the thighs. She was at stage III on the Hoehn and Yahr Scale.
Acupuncture therapy:Acupuncture therapy was performed weekly for 12 weeks to alleviate the muscle hypertonia associated with muscular rigidity. Acupuncture points comprised the points in the muscle hypertonia where tenderness was observed, including BL 10, DU 16, ST 32, SP 10 and ST 34.
Evaluation:A portable gait rhythmogram was used to measure the ground reaction force (GRF), velocity and step length. Dynamic balance functions and PD symptoms, were respectively evaluated using the Timed Up and Go Test (TUGT) and Unified Parkinson's Disease Rating Scale (UPDRS). Evaluations were conducted on initial examination and after the 12th therapy session.
[Results]After the fourth session, perceived stiffness in the neck, shoulder region and thighs decreased. all frequency decreased from 5 times/day to 3times/day (4th session) and then once/day (7th session). There were no falls after the 8th session. Reduction in gait disturbance was objectively observed as follows:Increases were observed in GRF (0.15 to 0.17 m/s 2), gait velocity (49 to 53m/min), and step length (47 to 49 cm), while TUGT time decreased (11.8 to 9.5 s). Improvements in PD symptoms were also observed with decreased UPDRS score (41 to 28 points).
[Discussion and Conclusion]The use of acupuncture therapy achieved improvements in Parkinson-related gait disturbance (objectively demonstrated using a portable gait rhythmogram). Acupuncture improved not only gait disorder but also other PD symptoms.

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2014 The American Academy of Medical Acupuncture (26 th Annual Symposium for Medical Acupuncture) was held in Denver, Colorado, USA on April 11-13. The symposium had 11 lectures, 13workshops, 4oral presentations and 6 poster sessions. All presentations were the contents that concerning acupuncture. There were 215 participants in the symposium. The above-mentioned presentations were not only research, but also included clinical practice, basic theory and therapeutic principle of acupuncture. Education of acupuncture for physicians sufficiently was considered in the symposium. Further, 16 companies took part in the exhibition of the symposium.

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