In Kyoto, we held the first “Palliative care workshop for physicians engaged in clinical practice for cancer treatment” in Japan on June 7-8, 2008 under the directive of the Ministry of Health, Labor and Welfare. There were 163 participants in the workshop, including 56 physicians and 107 voluntarily participating healthcare professionals (77 nurses, 23 pharmacists and 7 other medical professionals). We analyzed the results of tests consisting of 25 questions classified into 7 categories based on their contents. Tests were administered before and after the workshop (pre-test and post-test), and the educational effects of our conference were evaluated by examining changes in test scores. Participants other than physicians, nurses and pharmacists were excluded from analysis of the test scores because comprehensive medical knowledge was required to solve the questions. The mean rates of correct answers on pre- and post-test were 87.9% for physicians (total 78.9%) and 94.6% for physicians (total 89.1%), respectively. The scores were markedly increased after the workshop, showing practical significance of our attempt. However, the percentage of correct answers regarding psychological symptoms was lowest for physicians as well as for other healthcare professionals on both pre- and post-test. These findings strongly suggest that the workshops produced a sufficient educational effect, but improvement in individual training systems is considered necessary, especially in fields related to psychological manifestations. Palliat Care Res 2010; 5(2): 152-161

Purpose：To explore a methodology for evaluating end-of-life （EOL） cancer care using diagnosis procedure combination （DPC） administrative data. Methods： We investigated care provided to inpatients whose deaths were attributed to cancer and occurred between August 2010 and December 2012. We measured the quality of palliative care by dividing the decedents into two groups： those who died in the palliative care unit （PCU） and those who died in the general wards（GW）. Results： A total of 311 inpatient deaths were identified as cancer deaths. Of these, 147 patients were included in the PCU group and 164 in the GW group. We calculated the DPC data as follows： the rates of chemotherapy administered within 30 days before death （PCU 0％, GW 27％） and within 14 days before death （PCU 0％, GW 10％）, admission to the intensive care unit （PCU 0％, GW 2％）, life-sustaining interventions （PCU 0％, GW 3％）, rehabilitation sessions （PCU 10％, GW 26％）, emergency admission （PCU 2％, GW 27％）, and antibiotics （PCU 32％, GW 28％）. In the PCU group, rates of chemotherapy and emergency admission were significantly lower（＜0.0001；＜0.0001, respectively）, and rehabilitation sessions were significantly higher （p＝0.0002） than in the GW group. Conclusion： EOL care in a university hospital can be easily investigated using DPC data. Some limitations are the single-site study design, the health insurance system, and secondary use of administrative data. However, this methodology may be adapted to investigate the entire Japanese claim database and to evaluate EOL cancer care.

To date, there have been limited reports on the efficacy of Kampo medicine in treating obsessive compulsive behaviors. To the best of our knowledge, there have been no previous reports on the efficacy of ryokeijutsukanto for obsessive compulsive behaviors. Here, we describe 2 cases of obsessive-compulsive behavior successfully treated with ryokeijutsukanto. Case 1 involved a 30-year-old female patient who presented with vague anxiety. As a result, she spent significant time engaging in compulsive behavior related to checking and was frequently tardy to work. She met the diagnostic criteria for obsessive compulsive disorder. We prescribed ryokeijutsukanto. Her compulsive behavior then improved from 40 minutes to 5 minutes in 56 days. Case 2 involved 57-year-old female patient who complained of not feeling refreshed in the morning. In addition, she had a feeling of gloom, daytime sleepiness and compulsive behavior of checking about 5 times whether windows were locked. We prescribed ryokeijutsukanto. In 14 days, her checking behavior then improved from 5 times to once. Other troublesome symptoms also improved. Ryokeijutsukanto is usually utilized for patients with fluid retention, dizziness, and qi counterflow. However, these 2 cases have qi stagnation rather than qi counterflow. These results suggested that ryokeijutsukanto could also be utilized to treat compulsive behaviors when patients had fluid retention, dizziness and qi stagnation.

[Objective] This study aimed to investigate the awareness and perceptions of cosmetic acupuncture among ordinary women.[Method] A questionnaire method was adopted, with a target population of 1,000 ordinary women living in Shizuoka prefecture, which is considered a suitable location for test marketing in Japan.Questionnaires were distributed through the Chambers of Commerce in the prefecture by age group, according to the population ratio, and responses were obtained. The items included (1) basic information; (2) presence and type of facial cosmetic concerns; (3) experience of acupuncture, awareness of cosmetic acupuncture, the medium through which they learned of it, perception of effects, and experience of cosmetic acupuncture; (4) effects and types of cosmetic acupuncture, presence or absence of adverse effects, current treatment status, desired treatment outcomes and reasons for seeking treatment, wishes from treatment clinics, and wishes from practitioners; and (5) 1 month's investment in beauty.[Result] The response rate was 56.2%, and 91.8% of the participants perceived that they had facial cosmetic concerns; 28.8% had experience with acupuncture, whereas 42.0% had knowledge regarding cosmetic acupuncture. Television (45.3%) was the primary source of information regarding this. The most prevalent perception of the effects of cosmetic acupuncture was lifting (44.8%), and 43.2% of the 521 participants inexperienced with cosmetic acupuncture consented to treatment. Participants mostly reported being somewhat interested in the procedure as their reason for wanting to receive treatment (45.3%). The most common reason for opting out of treatment was due to pain (52.6%). Of those who experienced cosmetic acupuncture, 60.0% said they experienced positive effects, and lifting (62.5%) is the most frequently perceived outcome, which matched the commonly held perception. However, among the participants, 45.0% reported negative effects, while 47.5% received the treatment two or more times in the past but did not continue. Participants mainly wanted clean treatment centers and skilled practitioners. The most common monthly investment in beauty was between 3,000 yen and 5,000 yen (28.5%).[Discussion/Conclusion] The results suggest that many women have cosmetic concerns regarding their faces and expect lifting from cosmetic acupuncture. The low treatment rate among women and their reasons for not seeking re-treatment were elucidated in this study, despite their degree of awareness. Further, the problems associated with the development of cosmetic acupuncture were clarified.