Training hour requirements to provide acupuncture in the United States.

INTRODUCTION: The National Academy of Medicine recommends, and Joint Commission requires, offering non-pharmacologic approaches to pain management, including acupuncture, to reduce opioid overuse in the United States. This study describes 2019 state training requirements to evaluate how they represent opportunities and barriers to increasing access to acupuncture. METHODS: We searched publicly available databases to identify Acupuncture Practice Acts and additional statutes and regulations pertaining to acupuncture training requirements on state licensure board websites. We then extracted state-specific acupuncture training requirements for individuals with and without a healthcare-related professional license. RESULTS: Thirty-three states allow physicians to provide acupuncture without requiring any additional training requirements, 11 states and the District of Columbia (DC) require 200-300 training hours, and three require physicians to obtain a separate acupuncture license. Three states have no regulatory agency ruling. Forty states require non-healthcare professionals to complete an accredited program of more than 1900 h and pass an examination. Twenty-three states have an Acupuncture Detoxification Specialist designation allowing individuals without a clinical professional license to provide auricular acupuncture for substance use disorder treatment after a 70-h training course. DISCUSSION: State-level training requirements are intended to increase safe and effective care, but variations represent a potential barrier to increasing the number of acupuncture providers in the United States. Allowing non-physician medical professionals to complete reduced training requirements for specific indications could be a model to increase access to acupuncture. The influence of training requirements on acupuncture access and opioid overuse needs examination.

The present state of complementary medicine regulation in Saudi Arabia.

The prevalence of use of traditional and complementary medicine in the Saudi Arabia population has reached 75%. The most used therapies are religious healing, herbal medicine and cupping therapy. The National Center for Complementary and Alternative Medicine is the Saudi national reference for all activities regarding complementary medicine. This article briefly highlights the current state of complementary medicine regulation in Saudi Arabia.

Distribution of licensed acupuncturists and educational institutions in the United States in early 2015.

In recent decades, acupuncture has been used more widely and extensively in the United States (U.S.). However, there have been no national surveys or analyses reported in academic journals on the number of practicing or licensed acupuncturists. This study was conducted to identify the approximate number of licensed acupuncturists active in 2015. The Board of Acupuncture or Board of Medicine in each state or U.S. territory was contacted to collect data. Online license information searching was also performed in order to get accurate numbers of licensed acupuncturists for those states in which a board was unable to be contacted. The study found that the number of licensed acupuncturists in 2015 in the U.S. was 34,481. Of this, more than 50% were licensed in three states alone: California (32.39%), New York (11.89%) and Florida (7.06%). The number of licensed acupuncturists increased 23.30% and 52.09%, compared to the year 2009 (n = 27,965) and 2004 (n = 22,671), respectively; increasing about 1,266 per year. There were 62 and 10 accredited acupuncture institutions providing master and doctoral degrees, respectively. The West Coast comprised 51.39% of degree granting programs, while the East Coast comprised 29.17%; together the coastal states housed more than 80% of all programs, with the remainder sprinkled across the southern (9.72%), northern (8.33%), and the middle/central states (1.39%). Forty-four states and the District of Columbia regulated acupuncture practice by law at the time of data collection. Acupuncture continues to be a quickly growing profession in the U.S.

[Strategy programming for acupuncture development along One-Belt-One-Road countries].

Acupuncture has been applied in 183 countries and regions and gradually become a name card as TCM spreads across the world. The international influence of which plays a significant role in enhancing TCM development. The laws and regulations of TCM acupuncture along One-Belt-One-Road countries were compared and analyzed in this article. With comprehensive research and analysis, the international development strategy of acupuncture was rationally proposed. Combined with the historical background of China's national initiative One-Belt-One-Road, the acupuncture was taken as a breakthrough to lead the global spreading of TCM culture and Chinese herbs, so as to enhance China's soft strength, which could further create a fine cultural environment for the economic prosperity of One-Belt-One-Road countries. In addition, the strategy selection for China regarding TCM acupuncture development along One-Belt-One-Road countries was proposed, and the suggestive solution and implementation strategy for the essential missions and significant issues were provided.

[Current development of acupuncture-moxibustion in India:a case study of West Bengal].

Acupuncture-moxibustion was introduced to India in mid-20th century and has been legislated in two provinces in India where the registration of acupuncture practitioners is implemented at present. In India, the central government recognizes that acupuncture-moxibustion is an approach of treatment and is permitted by the licensed doctor. Because of the weakness of the basic development of acupuncture-moxibustion in India, the go-vernment put great effort to support and protect their national traditional medicine. Acupuncture-moxibustion development is mainly in the folk and in the progression for the provincial and governmental legislation. In the paper, by taking West Bengal as example, the legislation, clinical application, education and scientific research of acupuncture-moxibustion are analyzed so that an approach is explored for the further development of acupuncture-moxibustion in India.

Recomendação nº 042 de 15 de setembro de 2017: recomenda que a Câmara dos Deputados aprecie, com urgência, o Projeto de Lei nº 1549/2003, que regulamenta o exercício da Acupuntura e que se encontra em fase terminativa na Comissão de Constituição e Justiça e Cidadania (CCJC) da Câmara dos Deputados, acatando na íntegra os termos do Voto em separado apresentado pelo Deputado Ronaldo Fonseca, pois atende os anseios da população, fazendo-se justiça e promovendo a equidade, fortalecendo o SUS e o acesso universal e com segurança para o usuário às Práticas Integrativas em Saúde / Recommendation No. 042 of September 15, 2017: recommends that the Chamber of Deputies urgently consider Bill No. 1549/2003, which regulates the exercise of Acupuncture and which is in its final phase in the Committee on Constitution and Justice and Citizenship (CCJC) of the Chamber of Deputies, fully accepting the terms of the separate vote presented by Deputy Ronaldo Fonseca, as it meets the need

Recomenda que a Câmara dos Deputados aprecie, com urgência, o Projeto de Lei nº 1549/2003, que regulamenta o exercício da Acupuntura e que se encontra em fase terminativa na Comissão de Constituição e Justiça e Cidadania (CCJC) da Câmara dos Deputados, acatando na íntegra os termos do Voto em separado apresentado pelo Deputado Ronaldo Fonseca, pois atende os anseios da população, fazendo-se justiça e promovendo a equidade, fortalecendo o SUS e o acesso universal e com segurança para o usuário às Práticas Integrativas em Saúde; e que, posteriormente, os Senadores da República, em ato contínuo do processo legislativo, no Senado Federal, possam prezar pelo direito constitucional à saúde com qualidade em tempo operacionalizada de modo multi e interprofissional e transdisciplinar com fulcro no que se recomenda como de grande relevância à Câmara Federal.

[The current situation of acupuncture definition in international organizations and legislation of some countries].

Acupuncture is developing rapidly in the world, and more attention is paid on acupuncture in various countries. Because of the cultural differences, there are different views on acupuncture between China and the west, which has brought influence and challenge to the development of acupuncture in the world. Acupuncture-related research is becoming increasingly extensive and complex, but the definition of acupuncture is lack of unified standards. The definition of acupuncture is in urgent need. Based on the analysis of acupuncture definition in the 201 international organizations of 48 countries on five continents and legislation of representative countries, this paper summarized the development status of acupuncture in foreign countries, and put forward that the definition of acupuncture should adopt the model of small connotation and large extension, integrate discipline superiority, expand the scope of acupuncture, and focus on the overall situation.

A Needling Controversy.

Acupuncture licensing requires thousands of hours of training, but the Texas Board of Chiropractic Examiners' (TBCE's) rules allow chiropractors to perform the procedure and to do so with considerably less training. The Texas Association of Acupuncture and Oriental Medicine (TAAOM) is challenging those rules in a lawsuit, saying acupuncture is beyond the chiropractic scope of practice, and TBCE's inclusion of it constitutes a public health risk. The Texas Medical Association filed an amicus curiae brief to support TAAOM's case, citing the limitations on acupuncture practice in the Texas Occupations Code and the large disparity in required training hours between licensed acupuncturists and chiropractors who perform the technique.

[Pneumothorax following dry needling treatment: legal and ethical aspects]. / Pneumotorace successivo a trattamento riabilitativo con tecnica "dry needling": aspetti medico legali e etico-deontologici.

Trigger point "dry needling" is a technique used to treat myofascial pain. It involves using filiform needles which are inserted into muscles to give local pain relief. Few cases of serious adverse events following this treatment have been reported in the literature. In this paper we describe the case of a professional swimmer who developed pneumothorax after dry needling treatment and discuss the medicolegal and ethical aspects related to competencies and responsibilities of medical doctors and physiotherapists performing the procedure.

[Present situation and development of acupuncture in the Netherlands].

The development, present situation, educational institution and association, legislation and application of acupuncture therapy in the Netherlands are introduced. Acupuncture was introduced into the Netherlands about 400 years ago. At present, being one of the complementary and alternative medicine, acupuncture has not passed the national legislation yet. The nongovernmental source is given priority to the development of acupuncture and the educational institution is private. Even though acupuncture has not been listed in the basic medical insurance in the Netherlands, it becomes one of the additional items of the insurance company and its expenditure is reimbursed partially. The field of TCM in the Netherlands now is facing to the issues to be solved, including constructing the official medical institution, educating high-quality acupuncturists, promoting national legislation and adopting acupuncture into the basic medical insurance.

[Development of acupuncture in Israel].

By collecting and analyzing information regarding the history development, current situation, legislation, health insurance, education and academic organizations of acupuncture in Israel, the development characteristics of acupuncture in Israel were summarized. The overall traditional medicine developed well in Israel, yet acupuncture have only appeared in Israel for 18 years. The proposal of Israeli Acupuncture Legislation Act improved the development of health insurance, education and public awareness of acupuncture in Israel. However, improvement in areas of education, legislation and health insurance are still in need. Suggestions are proposed to improve the education quality, acupuncture legislation, international cooperation, volunteer activities and cultural exchanges. In addition, the legislative process of acupuncture in the countries of "the Belt and Road", especially the Middle East countries, are promoted.

Acupuncture practice acts: a profession's growing pains.

State legislation that authorizes any healthcare profession is known as the Practice Act. In order for a profession to establish a recognizable national presence and be integrated into mainstream medicine, all the state Practice Acts must evidence consistency. The extent to which state Practice Acts fail to exhibit consistency can inhibit the ability of the profession to grow and become successful. We looked at the histories of other health professions, along with the 45 acupuncture Practice Acts in the USA, in order to understand the time worn paths that lead to integration in the mainstream and how the acupuncture profession might benefit.

[The trajectory of the introduction and regulation of acupuncture in Brazil: recollections of the challenges and struggles]. / A trajetória da introdução e regulamentação da acupuntura no Brasil: memórias de desafios e lutas.

Based on the life experiences of acupuncturists, the scope of this study was to examine the struggle to obtain regulation of the practice of acupuncture in Brazil. The method used was Oral Live History, the core issue being the dimension of the human experience involved in this trajectory of struggles and challenges. We conducted ten interviews, following the set of procedures demanded by the Oral History technique. The information contained in the narratives was analyzed and, taking the interpretive approach called immersion/crystallization as a benchmark, the central themes of the work were established, based on which which the discussion was developed. The results indicate the emergence of highly controversial themes involving political, corporate and cultural aspects, which constitute central elements within a historical process still under development.

A trajetória da introdução e regulamentação da acupuntura no Brasil: memórias de desafios e lutas / The trajectory of the introduction and regulation of acupuncture in Brazil: memories of challenges and struggles

O presente estudo objetivou explorar, a partir de relatos de vida de acupunturistas, a luta pela regulamentação da prática da acupuntura no Brasil. Utilizamos a História Oral de Vida como método, tendo como proposta central a dimensão das experiências humanas envolvidas nesta trajetória de lutas e desafios. Realizamos dez entrevistas, seguindo o conjunto de procedimentos exigidos pela História Oral. As informações contidas nas narrativas foram analisadas e, tomando como referencial a abordagem de interpretação denominada imersão/cristalização, foram estabelecidos os temas centrais do trabalho, a partir dos quais a discussão foi desenvolvida. Os resultados apontaram a emergência de temas extremamente controversos que envolvem aspectos políticos, corporativos e de âmbito cultural, que se apresentam como elementos centrais dentro de um processo histórico ainda em desenvolvimento.

[On the interrelationship between standardization and intellectual property rights of acu-moxibustion therapy].

Under the condition of knowledge economy, the acu-moxibustion standardization definitely involves intellectual property rights. Then, what is the relationship between the standardization and the intellectual property rights of acu-moxibustion? The authors of the present paper hold that it is not only exclusive, but also syncretic. If their relationship cannot be handled properly, their own respective development will be affected adversely. Therefore, a proper handling of the relationship between the two is of great practical significance. The present paper makes a comprehensive analysis about their interaction (mutual promotion and mutual inhibition), similarities (systemic composition, dynamic implementation course, standardization-rated order and ultimate targets) and differences (in properties, working components, secret requirement, effectiveness-time limitation, usage cost, etc).

[Problems and solutions on transformation of scientific research achievements of acupuncture].

With more and more attention and investment on acupuncture scientific researches, considerable outcomes and achievements has been acquired, but the shortcoming of low transformation rate of acupuncture research achievements is gradually exposed. Nowadays there is no related report on this problem, so based on achievement translational research in other areas and practical situation of acupuncture, the existing problems and solutions are analyzed. As a result, the existing problems include (1) the research content is mainly basic research and clinical research but less acupuncture device research, leading to limited transformation efficiency; (2) the evaluation system and transformation pattern are still needed to be perfect. The solutions are (1) to properly evaluate the research achievements of acupuncture, (2) to advocate the concept and method of translational medicine, (3) to reform the policy and system, and (4) to establish valid platforms covering research, outcomes and transformation.

[On the necessity of intellectual property rights involving standardization of acupuncture and moxibustion therapies].

In the process of working out and implementing standardization of acupuncture-moxibustion (acu-moxi) therapy, the issue of intellectual property rights has been frequently involved. Whether is the standardization inevitably involved in intellectual property rights? A reasonable answer to this question is definitely of important realistic guiding value and significance for acu-moxi standardization work. For this reason, authors of the present paper sum up historical development of correlation between acu-moxi standardization and intellectual property rights, and fully analyze the related causes under the conditions of knowledge economy from 1) increasing protection of acu-moxi intellectual property rights, 2) intrinsic requirements for raising the standardization level of acu-moxi, 3) profits drive of the intellectual property rights owners, and 4) increasing impetuous international economic trade competition.