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8101
Krai are not organized politically. According to Alexei Nakamura, only 205 Ainu live in Russia (up from just 12 people who self-identified as Ainu in 2008) and they along with the Kurile Kamchadals (Itelmen of Kuril islands) are fighting for official recognition. Since the Ainu are not recognized in the official list of the peoples living in Russia, they are counted as people without nationality or as ethnic Russians or Kamchadal. The Ainu have emphasized that they were the natives of the Kuril islands and that the Japanese and Russians were both invaders. In 2004, the small Ainu community living
"Ainu people"
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8102
in Russia in Kamchatka Krai wrote a letter to Vladimir Putin, urging him to reconsider any move to award the Southern Kuril Islands to Japan. In the letter they blamed the Japanese, the Tsarist Russians and the Soviets for crimes against the Ainu such as killings and assimilation, and also urged him to recognize the Japanese genocide against the Ainu people—which was turned down by Putin. The Ainu have often been considered to descend from the Jōmon people, who lived in Japan from the Jōmon period ( 14,000 to 300 BCE). One of their "Yukar Upopo", or legends, tells that
"Ainu people"
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8103
"[t]he Ainu lived in this place a hundred thousand years before the Children of the Sun came". Recent research suggests that the historical Ainu culture originated in a merger of the Okhotsk culture with the Satsumon, one of the ancient archaeological cultures that are considered to have derived from the Jōmon-period cultures of the Japanese archipelago. The Ainu economy was based on farming, as well as on hunting, fishing and gathering. Full-blooded Ainu, compared to people of Yamato descent, often have lighter skin and more body hair. Many early investigators proposed a Caucasian ancestry, although recent DNA tests have not
"Ainu people"
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8104
shown any genetic similarity with modern Europeans. Luigi Luca Cavalli-Sforza places the Ainu in his "Northeast and East Asian" genetic cluster. Anthropologist Joseph Powell of the University of New Mexico wrote "...we follow Brace and Hunt (1990) and Turner (1990) in viewing the Ainu as a southeast Asian population derived from early Jomon peoples of Japan, who have their closest biological affinity with south Asians rather than western Eurasia peoples". A autosomal DNA research in 2017 resulted in grouping the Ainu and other Jōmon remnants with northeastern Asians. Mark J. Hudson, Professor of Anthropology at Nishikyushu University, Kanzaki, Saga, Japan,
"Ainu people"
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8105
has stated that Japan was settled by a "Proto-Mongoloid" population in the Pleistocene who became the Jōmon and that their features can be seen in the Ainu and Okinawan people. In 1893, anthropologist Arnold Henry Savage Landor described the Ainu as having deep-set eyes and an eye shape typical of Europeans, with a large and prominent browridge, large ears, hairy and prone to baldness, slightly hook nose with large and broad nostrils, prominent cheek-bones and a medium mouth. Omoto has also shown that the Ainu are far more related to other East Asian groups (previously mentioned as 'Mongoloid') than to
"Ainu people"
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8106
any Caucasian groups, on the basis of fingerprints and dental morphology. A study based on cranial and genetic characteristics suggests an origin of the Ainu in northern Asia. Turner found remains of Jōmon people of Japan to belong to a pattern resembling the Sundadont pattern which is typically found in Southern Mongoloid living populations of Taiwanese aborigines, Filipinos, Vietnamese, Indonesians, Thais, Borneans, Laotians, and Malaysians. A recreation of a map made by William W. Howells, professor of anthropology at Harvard University, shows in the shaded the remnants and populations of non-Mongoloid people, appearing as N (Negrito) or A (Australoids of
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8107
Wallacea, Melanesia and Australia). The latter peoples comprise the present aboriginals of Australia and Melanesia, as shown; the interest here is their presence and remnants. Sundadonts comprise Southeast Asiatics and offshore peoples from northern Japan (Ainu) down to Taiwan and Indonesia. Sinodonts comprise the East Asian populations from Korea, Japan, China, Mongolia and Siberia. Ainu men have abundant wavy hair and often have long beards. The book of "Ainu Life and Legends" by author Kyōsuke Kindaichi (published by the Japanese Tourist Board in 1942) contains a physical description of Ainu: Many have wavy hair, but some straight black hair. Very
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8108
few of them have wavy brownish hair. Their skins are generally reported to be light brown. But this is due to the fact that they labor on the sea and in briny winds all day. Old people who have long desisted from their outdoor work are often found to be as white as western men. The Ainu have broad faces, beetling eyebrows, and large sunken eyes, which are generally horizontal and of the so-called European type. Eyes of the Mongolian type are hardly found among them. Genetic testing has shown that the Ainu belong mainly to Y-haplogroup D-M55. Y-DNA haplogroup
"Ainu people"
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8109
D1b is found throughout the Japanese Archipelago, but with very high frequencies among the Ainu of Hokkaido in the far north, and to a lesser extent among the Ryukyuans in the Ryukyu Islands of the far south. The only places outside Japan in which Y-haplogroup D is common are Tibet in China and the Andaman Islands in the Indian Ocean. A study by Tajima "et al." (2004) found two out of a sample of sixteen (or 12.5%) Ainu men to belong to Haplogroup C-M217, which is the most common Y-chromosome haplogroup among the indigenous populations of Siberia and Mongolia. Hammer
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8110
"et al." (2006) tested a sample of four Ainu men and found that one of them belonged to haplogroup C-M217. Some researchers have speculated that this minority of Haplogroup C-M217 carriers among the Ainu may reflect a certain degree of unidirectional genetic influence from the Nivkhs, a traditionally nomadic people of northern Sakhalin and the adjacent mainland, with whom the Ainu have long-standing cultural interactions. Based on analysis of one sample of 51 modern Ainus, their mtDNA lineages consist mainly of haplogroup Y (11/51 = 21.6% according to Tanaka "et al." 2004, or 10/51 = 19.6% according to Adachi "et
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8111
al." 2009, who have cited Tajima "et al." 2004), haplogroup D (9/51 = 17.6%, particularly D4(xD1)), haplogroup M7a (8/51 = 15.7%), and haplogroup G1 (8/51 = 15.7%). Other mtDNA haplogroups detected in this sample include A (2/51), M7b2 (2/51), N9b (1/51), B4f (1/51), F1b (1/51), and M9a (1/51). Most of the remaining individuals in this sample have been classified definitively only as belonging to macro-haplogroup M. According to Sato "et al." (2009), who have studied the mtDNA of the same sample of modern Ainus (n=51), the major haplogroups of the Ainu are N9 (14/51 = 27.5%, including 10/51 Y and
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8112
4/51 N9(xY)), D (12/51 = 23.5%, including 8/51 D(xD5) and 4/51 D5), M7 (10/51 = 19.6%), and G (10/51 = 19.6%, including 8/51 G1 and 2/51 G2); the minor haplogroups are A (2/51), B (1/51), F (1/51), and M(xM7, M8, CZ, D, G) (1/51). Studies published in 2004 and 2007 show the combined frequency of M7a and N9b were observed in Jomons and which are believed by some to be Jomon maternal contribution at 28% in Okinawans (7/50 M7a1, 6/50 M7a(xM7a1), 1/50 N9b), 17.6% in Ainus (8/51 M7a(xM7a1), 1/51 N9b), and from 10% (97/1312 M7a(xM7a1), 1/1312 M7a1, 28/1312 N9b) to
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8113
17% (15/100 M7a1, 2/100 M7a(xM7a1)) in mainstream Japanese. A recent reevaluation of cranial traits suggests that the Ainu resemble the Okhotsk more than they do the Jōmon. This agrees with the references to the Ainu as a merger of Okhotsk and Satsumon referenced above. A recent genetic study has revealed that the closest genetic relatives of the Ainu are the Ryukyuan people, followed by the Yamato people and Nivkh. The first recruitment of Ainu men into the Japanese military occurred in 1898. Sixty-four Ainu served in the Russo-Japanese War (1904-1905) eight of whom died in battle or from illness contracted
"Ainu people"
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8114
during military service. Two received the Order of the Golden Kite, granted for bravery, leadership or command in battle. During World War II Australian troops engaged in the hard-fought Kokoda Track campaign (July–November 1942) in New Guinea were surprised by the physique and fighting prowess of the first Japanese troops they encountered. Today, it is estimated that fewer than 100 speakers of the language remain, while other research places the number at fewer than 15 speakers. The language has been classified as "endangered". As a result of this the study of the Ainu language is limited and is based largely
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8115
on historical research. Although there have been attempts to show that the Ainu language and the Japanese language are related, modern scholars have rejected that the relationship goes beyond contact, such as the mutual borrowing of words between Japanese and Ainu. No attempt to show a relationship with Ainu to any other language has gained wide acceptance, and Ainu is currently considered to be a language isolate. Words used as prepositions in English (such as "to", "from", "by", "in", and "at") are postpositional in Ainu; they come after the word that they modify. A single sentence in Ainu can be
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8116
made up of many added or agglutinated sounds or affixes that represent nouns or ideas. The Ainu language has had no system of writing, and has historically been transliterated by the Japanese kana or Russian Cyrillic. Today, it is typically written in either katakana or Latin alphabet. The unwieldy nature of the Japanese kana with its inability to accurately represent coda consonants has contributed to the degradation of the original Ainu. For example, some words, such as "Kor" (meaning "to hold"), are now pronounced with a paragoge, as in "Koro". Many of the Ainu dialects, even from one end of
"Ainu people"
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8117
Hokkaido to the other, were not mutually intelligible; however, the classic Ainu language of the Yukar, or Ainu epic stories, was understood by all. Without a writing system, the Ainu were masters of narration, with the Yukar and other forms of narration such as the Uepeker (Uwepeker) tales, being committed to memory and related at gatherings, often lasting many hours or even days. Traditional Ainu culture was quite different from Japanese culture. Never shaving after a certain age, the men had full beards and moustaches. Men and women alike cut their hair level with the shoulders at the sides of
"Ainu people"
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8118
the head, trimmed semicircularly behind. The women tattooed their mouths, and sometimes the forearms. The mouth tattoos were started at a young age with a small spot on the upper lip, gradually increasing with size. The soot deposited on a pot hung over a fire of birch bark was used for colour. Their traditional dress was a robe spun from the inner bark of the elm tree, called "attusi" or "attush". Various styles were made, and consisted generally of a simple short robe with straight sleeves, which was folded around the body, and tied with a band about the waist.
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8119
The sleeves ended at the wrist or forearm and the length generally was to the calves. Women also wore an undergarment of Japanese cloth. Modern craftswomen weave and embroider traditional garments that command very high prices. In winter the skins of animals were worn, with leggings of deerskin and in Sakhalin, boots were made from the skin of dogs or salmon. Ainu culture considers earrings, traditionally made from grapevines, to be gender neutral. Women also wear a beaded necklace called a tamasay. Their traditional cuisine consists of the flesh of bear, fox, wolf, badger, ox, or horse, as well as
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8120
fish, fowl, millet, vegetables, herbs, and roots. They never ate raw fish or flesh; it was always boiled or roasted. Their traditional habitations were reed-thatched huts, the largest square, without partitions and having a fireplace in the center. There was no chimney, only a hole at the angle of the roof; there was one window on the eastern side and there were two doors. The house of the village head was used as a public meeting place when one was needed. Another kind of traditional Ainu house was called "chise". Instead of using furniture, they sat on the floor, which
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8121
was covered with two layers of mats, one of rush, the other of a water plant with long sword shaped leaves ("Iris pseudacorus"); and for beds they spread planks, hanging mats around them on poles, and employing skins for coverlets. The men used chopsticks when eating; the women had wooden spoons. Ainu cuisine is not commonly eaten outside Ainu communities; there are only a few Ainu-run restaurants in Japan, all located in Tokyo or Hokkaido, serving primarily Japanese fare. The functions of judgeship were not entrusted to chiefs; an indefinite number of a community's members sat in judgment upon its
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8122
criminals. Capital punishment did not exist, nor did the community resort to imprisonment. Beating was considered a sufficient and final penalty. However, in the case of murder, the nose and ears of the culprit were cut off or the tendons of his feet severed. The Ainu hunted from late autumn to early summer. The reasons for this were, among others, that in late autumn, plant gathering, salmon fishing and other activities of securing food came to an end, and hunters readily found game in fields and mountains in which plants had withered. A village possessed a hunting ground of its
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8123
own or several villages used a joint hunting territory (iwor). Heavy penalties were imposed on any outsiders trespassing on such hunting grounds or joint hunting territory. The Ainu hunted bear, Ezo deer (a subspecies of sika deer), rabbit, fox, raccoon dog, and other animals. Ezo deer were a particularly important food resource for the Ainu, as were salmon. They also hunted sea eagles such as white-tailed sea eagles, raven and other birds. The Ainu hunted eagles to obtain their tail feathers, which they used in trade with the Japanese. The Ainu hunted with arrows and spears with poison-coated points. They
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8124
obtained the poison, called "surku", from the roots and stalks of aconites. The recipe for this poison was a household secret that differed from family to family. They enhanced the poison with mixtures of roots and stalks of dog's bane, boiled juice of Mekuragumo, Matsumomushi, tobacco and other ingredients. They also used stingray stingers or skin covering stingers. They hunted in groups with dogs. Before the Ainu went hunting, for animals like bear in particular, they prayed to the god of fire and the house guardian god to convey their wishes for a large catch, and safe hunting to the
"Ainu people"
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8125
god of mountains. The Ainu usually hunted bear during the time of the spring thaw. At that time, bears were weak because they had not fed at all during long hibernation. Ainu hunters caught hibernating bears or bears that had just left hibernation dens. When they hunted bear in summer, they used a spring trap loaded with an arrow, called an "amappo". The Ainu usually used arrows to hunt deer. Also, they drove deer into a river or sea and shot them with arrows. For a large catch, a whole village would drive a herd of deer off a cliff
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8126
and club them to death. Men wore a crown called "sapanpe" for important ceremonies. "Sapanpe" was made from wood fibre with bundles of partially shaved wood. This crown had wooden figures of animal gods and other ornaments on its centre. Men carried an "emush" (ceremonial sword) secured by an "emush at" strap to their shoulders. Women wore "matanpushi", embroidered headbands, and "ninkari", earrings. "Ninkari" was a metal ring with a ball. Women wore it through a hole in the ear. "Matanpushi" and "ninkari" were originally worn by men. However, women wear them now. Furthermore, aprons called "maidari" now are a
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8127
part of women's formal clothes. However, some old documents say that men wore "maidari". Women sometimes wore a bracelet called "tekunkani". Women wore a necklace called "rektunpe", a long, narrow strip of cloth with metal plaques. They wore a necklace that reached the breast called a "tamasay" or "shitoki", usually made from glass balls. Some glass balls came from trade with the Asian continent. The Ainu also obtained glass balls secretly made by the Matsumae clan. A village is called a "kotan" in the Ainu language. Kotan were located in river basins and seashores where food was readily available, particularly
"Ainu people"
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8128
in the basins of rivers through which salmon went upstream. A village consisted basically of a paternal clan. The average number of families was four to seven, rarely reaching more than ten. In the early modern times, the Ainu people were forced to labor at the fishing grounds of the Japanese. Ainu kotan were also forced to move near fishing grounds so that the Japanese could secure a labor force. When the Japanese moved to other fishing grounds, Ainu kotan were also forced to accompany them. As a result, the traditional kotan disappeared and large villages of several dozen families
"Ainu people"
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8129
were formed around the fishing grounds. "Cise" or "cisey" (houses) in a kotan were made of cogon grasses, bamboo grass, barks, etc. The length lay east to west or parallel to a river. A house was about seven meters by five with an entrance at the west end that also served as a storeroom. The house had three windows, including the "rorun-puyar," a window located on the side facing the entrance (at the east side), through which gods entered and left and ceremonial tools were taken in and out. The Ainu have regarded this window as sacred and have been
"Ainu people"
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8130
told never to look in through it. A house had a fireplace near the entrance. The husband and wife sat on the fireplace's left side (called "shiso") . Children and guests sat facing them on the fireplace's right side (called "harkiso"). The house had a platform for valuables called "iyoykir" behind the shiso. The Ainu placed "sintoko" (hokai) and "ikayop" (quivers) there. Outbuildings included separate lavatories for men called "ashinru" and for women called "menokoru", a "pu" (storehouse) for food, a "heper set" (cage for young bear), and drying-racks for fish and wild plants. An altar ("nusasan") faced the east
"Ainu people"
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8131
side of the house ("rorunpuyar"). The Ainu held such ceremonies there as "Iyomante", a ceremony to send the spirit of a bear to the gods. The Ainu people had various types of marriage. A child was promised in marriage by arrangement between his or her parents and the parents of his or her betrothed or by a go-between. When the betrothed reached a marriageable age, they were told who their spouse was to be. There were also marriages based on mutual consent of both sexes. In some areas, when a daughter reached a marriageable age, her parents let her live
"Ainu people"
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8132
in a small room called "tunpu" annexed to the southern wall of her house. The parents chose her spouse from men who visited her. The age of marriage was 17 to 18 years of age for men and 15 to 16 years of age for women, who were tattooed. At these ages, both sexes were regarded as adults. When a man proposed to a woman, he visited her house, ate half a full bowl of rice handed to him by her, and returned the rest to her. If the woman ate the rest, she accepted his proposal. If she did
"Ainu people"
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8133
not and put it beside her, she rejected his proposal. When a man became engaged to a woman or they learned that their engagement had been arranged, they exchanged gifts. He sent her a small engraved knife, a workbox, a spool, and other gifts. She sent him embroidered clothes, coverings for the back of the hand, leggings and other handmade clothes. According to some books, many "yomeiri" marriages, in which a bride went to the house of a bridegroom with her belongings to become a member of his family, were conducted in the old days. For a "yomeiri" marriage, a
"Ainu people"
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8134
man and his father would bring betrothal gifts to the house of a woman, including a sword, a treasured sword, an ornamental quiver, a sword guard, and a woven basket ("hokai"). If the man and woman agreed to marry, the man and his father would bring her to their house or the man would stay at her house for a while and then bring her to his house. At the wedding ceremony, participants prayed to the god of fire. Bride and bridegroom respectively ate half of the rice served in a bowl, and other participants were entertained. The worn-out fabric
"Ainu people"
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8135
of old clothing was used for baby clothes because soft cloth was good for the skin of babies and worn-out material protected babies from gods of illness and demons due to these gods' abhorrence of dirty things. Before a baby was breast-fed, he/she was given a decoction of the endodermis of alder and the roots of butterburs to discharge impurities. Children were raised almost naked until about the ages of four to five. Even when they wore clothes, they did not wear belts and left the front of their clothes open. Subsequently, they wore bark clothes without patterns, such as
"Ainu people"
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8136
"attush", until coming of age. Newborn babies were named "ayay" (a baby's crying), "shipo", "poyshi" (small excrement), and "shion" (old excrement). Children were called by these "temporary" names until the ages of two to three. They were not given permanent names when they were born. Their tentative names had a portion meaning "excrement" or "old things" to ward off the demon of ill-health. Some children were named based on their behaviour or habits. Other children were named after impressive events or after parents' wishes for the future of the children. When children were named, they were never given the same
"Ainu people"
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8137
names as others. Men wore loincloths and had their hair dressed properly for the first time at age 15–16. Women were also considered adults at the age of 15–16. They wore underclothes called "mour" and had their hair dressed properly and wound waistcloths called "raunkut" and "ponkut" around their bodies. When women reached age 12–13, the lips, hands and arms were tattooed. When they reached age 15–16, their tattoos were completed. Thus were they qualified for marriage. The Ainu are traditionally animists, believing that everything in nature has a "kamuy" (spirit or god) on the inside. The most important include
"Ainu people"
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8138
Kamuy Fuchi, goddess of the hearth, Kim-un Kamuy, god of bears and mountains, and Repun Kamuy, god of the sea, fishing, and marine animals. The Ainu have no priests by profession; instead the village chief performs whatever religious ceremonies are necessary. Ceremonies are confined to making libations of sake, saying prayers, and offering willow sticks with wooden shavings attached to them. These sticks are called "inaw" (singular) and "nusa" (plural). They are placed on an altar used to "send back" the spirits of killed animals. Ainu ceremonies for sending back bears are called "Iyomante". The Ainu people give thanks to
"Ainu people"
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8139
the gods before eating and pray to the deity of fire in time of sickness. They believe their spirits are immortal, and that their spirits will be rewarded hereafter by ascending to "kamuy mosir" (Land of the Gods). The Ainu are part of a larger collective of indigenous people who practice "arctolatry" or bear worship. The Ainu believe the bear is very special because they think the bear is Kim-un Kamuy's way of delivering the gift of bear hide and meat to humans. John Batchelor reported that the Ainu view the world as being a spherical ocean on which float
"Ainu people"
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8140
many islands, a view based on the fact that the sun rises in the east and sets in the west. He wrote that they believe the world rests on the back of a large fish, which when it moves causes earthquakes. Ainu assimilated into mainstream Japanese society have adopted Buddhism and Shinto, while some northern Ainu are members of the Russian Orthodox Church. Most Hokkaido Ainu and some other Ainu are members of an umbrella group called the Hokkaido Utari Association. It was originally controlled by the government to speed Ainu assimilation and integration into the Japanese nation-state. It now
"Ainu people"
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8141
is run exclusively by Ainu and operates mostly independently of the government. Other key institutions include "The Foundation for Research and Promotion of Ainu Culture (FRPAC)", set up by the Japanese government after enactment of the Ainu Culture Law in 1997, the Hokkaido University Center for Ainu and Indigenous Studies established in 2007, as well as museums and cultural centers. Ainu people living in Tokyo have also developed a vibrant political and cultural community. On March 27, 1997, the Sapporo District Court decided a landmark case that, for the first time in Japanese history, recognized the right of the Ainu
"Ainu people"
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8142
people to enjoy their distinct culture and traditions. The case arose because of a 1978 government plan to build two dams in the Saru River watershed in southern Hokkaido. The dams were part of a series of development projects under the Second National Development Plan that were intended to industrialize the north of Japan. The planned location for one of the dams was across the valley floor close to Nibutani village, the home of a large community of Ainu people and an important center of Ainu culture and history. In the early 1980s when the government commenced construction on the
"Ainu people"
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8143
dam, two Ainu landowners refused to agree to the expropriation of their land. These landowners were Kaizawa Tadashi and Kayano Shigeru—well-known and important leaders in the Ainu community. After Kaizawa and Kayano declined to sell their land, the Hokkaido Development Bureau applied for and was subsequently granted a Project Authorization, which required the men to vacate their land. When their appeal of the Authorization was denied, Kayano and Kaizawa's son Koichii (Kaizawa died in 1992), filed suit against the Hokkaido Development Bureau. The final decision denied the relief sought by the plaintiffs for pragmatic reasons—the dam was already standing—but the
"Ainu people"
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8144
decision was nonetheless heralded as a landmark victory for the Ainu people. In short, nearly all of the plaintiffs' claims were recognized. Moreover, the decision marked the first time Japanese case law acknowledged the Ainu as an indigenous people and contemplated the responsibility of the Japanese nation to the indigenous people within its borders. The decision included broad fact-finding that underscored the long history of the oppression of the Ainu people by Japan's majority, referred to as Wajin in the case and discussions about the case. The legal roots of the decision can be found in Article 13 of Japan's
"Ainu people"
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8145
Constitution, which protects the rights of the individual, and in the International Covenant on Civil and Political Rights. The decision was issued on March 27, 1997, and because of the broad implications for Ainu rights, the plaintiffs decided not to appeal the decision, which became final two weeks later. After the decision was issued, on May 8, 1997, the Diet passed the Ainu Culture Law and repealed the Ainu Protection Act—the 1899 law that had been the vehicle of Ainu oppression for almost one hundred years. While the Ainu Culture Law has been widely criticized for its shortcomings, the shift
"Ainu people"
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8146
that it represents in Japan's view of the Ainu people is a testament to the importance of the Nibutani decision. In 2007 the 'Cultural Landscape along the Sarugawa River resulting from Ainu Tradition and Modern Settlement' was designated an Important Cultural Landscape. A later action seeking restoration of Ainu assets held in trust by the Japanese Government was dismissed in 2008. Much national policy in Japan has been developed out of the action of governmental advisory boards, known as in Japanese. One such committee operated in the late 1990s, and its work resulted in the 1997 Ainu Culture Law. This
"Ainu people"
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8147
panel's circumstances were criticized for including not even a single Ainu person among its members. More recently, a panel was established in 2006, which notably was the first time an Ainu person was included. It completed its work in 2008 issuing a major report that included an extensive historical record and called for substantial government policy changes towards the Ainu. The was founded on January 21, 2012, after a group of Ainu activists in Hokkaido announced the formation of a political party for the Ainu on October 30, 2011. The Ainu Association of Hokkaido reported that Kayano Shiro, the son
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8148
of the former Ainu leader Kayano Shigeru, will head the party. Their aim is to contribute to the realization of a multicultural and multiethnic society in Japan, along with rights for the Ainu. The Ainu have historically suffered from economic and social discrimination throughout Japan that continues to this day. The Japanese Government as well as people since contact with the Ainu, have in large part regarded them as a dirty, backwards and a primitive people. The majority of Ainu were forced to be petty laborers during the Meiji Restoration, which saw the introduction of Hokkaido into the Japanese Empire
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8149
and the privatization of traditional Ainu lands. The Japanese government during the 19th and 20th centuries denied the rights of the Ainu to their traditional cultural practices, most notably the right to speak their language, as well as their right to hunt and gather. These policies were designed to fully integrate the Ainu into Japanese society with the cost of erasing Ainu culture and identity. The Ainu's position as manual laborers and their forced integration into larger Japanese society have led to discriminatory practices by the Japanese government that can still be felt today. This discrimination and negative stereotypes assigned
"Ainu people"
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8150
to the Ainu have manifested in the Ainu's lower levels of education, income levels and participation in the economy as compared to their ethnically Japanese counterparts. The Ainu community in Hokkaido in 1993 received welfare payments at a 2.3 times higher rate, had an 8.9% lower enrollment rate from junior high school to high school and a 15.7% lower enrollment into college from high school than that of Hokkaido as a whole. The Japanese government has been lobbied by activists to research the Ainu's standard of living nationwide due to this noticeable and growing gap. The Japanese government will provide
"Ainu people"
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8151
¥7 million beginning in 2015, to conduct surveys nationwide on this matter. Ainu people The Ainu or the Aynu (Ainu アィヌ "Aynu"; Japanese: "Ainu"; Russian: "Ajny"), in the historical Japanese texts the Ezo (), are an indigenous people of Japan (Hokkaido, and formerly northeastern Honshu) and Russia (Sakhalin, the Kuril Islands, and formerly the Kamchatka Peninsula). The official number of the Ainu is 25,000, but unofficially is estimated at 200,000, due to many Ainu having been completely assimilated into Japanese society and, as a result, having no knowledge of their ancestry. Recent research suggests that Ainu culture originated from a
"Ainu people"
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8152
Acropolis An acropolis (Ancient Greek: ἀκρόπολις, "akropolis"; from "akros" (άκρος) or "akron" (άκρον), "highest, topmost, outermost" and "polis" (πόλις), "city"; plural in English: "acropoles", "acropoleis" or "acropolises") was in ancient Greece a settlement, especially a citadel, built upon an area of elevated ground—frequently a hill with precipitous sides, chosen for purposes of defense. Acropoleis became the nuclei of large cities of classical antiquity, such as ancient Athens, and for this reason they are sometimes prominent landmarks in modern cities with ancient pasts, such as modern Athens. The word "acropolis" literally means in Greek "upper city," and though associated primarily with
Acropolis
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8153
the Greek cities Athens, Argos (with Larissa), Thebes (with Cadmea), and Corinth (with its Acrocorinth), may be applied generically to all such citadels, including Rome, Jerusalem, Celtic Bratislava, many in Asia Minor, or even Castle Rock in Edinburgh. An example in Ireland is the Rock of Cashel. Acropolis is also the term used by archaeologists and historians for the urban Castro culture settlements located in Northwestern Iberian hilltops. The most famous example is the Acropolis of Athens, which, by reason of its historical associations and the several famous buildings erected upon it (most notably the Parthenon), is known without qualification
Acropolis
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8154
as "the Acropolis". Although originating in the mainland of Greece, use of the acropolis model quickly spread to Greek colonies such as the Dorian Lato on Crete during the Archaic Period. Because of its classical Hellenistic style, the ruins of Mission San Juan Capistrano's Great Stone Church in California, United States has been called the "American Acropolis". Other parts of the world developed other names for the high citadel or alcázar, which often reinforced a naturally strong site. In Central Italy, many small rural communes still cluster at the base of a fortified habitation known as "La Rocca" of the
Acropolis
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8155
commune. The term "acropolis" is also used to describe the central complex of overlapping structures, such as plazas and pyramids, in many Maya cities, including Tikal and Copán. Acropolis An acropolis (Ancient Greek: ἀκρόπολις, "akropolis"; from "akros" (άκρος) or "akron" (άκρον), "highest, topmost, outermost" and "polis" (πόλις), "city"; plural in English: "acropoles", "acropoleis" or "acropolises") was in ancient Greece a settlement, especially a citadel, built upon an area of elevated ground—frequently a hill with precipitous sides, chosen for purposes of defense. Acropoleis became the nuclei of large cities of classical antiquity, such as ancient Athens, and for this reason they
Acropolis
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8156
Acupuncture Acupuncture is a form of alternative medicine in which thin needles are inserted into the body. It is a key component of traditional Chinese medicine (TCM). The theories and practices of TCM are not based upon scientific knowledge, and acupuncture is a pseudoscience. There are a diverse range of acupuncture theories based on different philosophies, and techniques vary depending on the country in which it is performed. The method used in TCM is probably the most widespread in the United States. It is most often used for pain relief, though it is also used for a wide range of
Acupuncture
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8157
other conditions. Acupuncture is generally used only in combination with other forms of treatment. The conclusions of many trials and numerous systematic reviews of acupuncture are largely inconsistent, which suggests that it is not effective. An overview of Cochrane reviews found that acupuncture is not effective for a wide range of conditions. A systematic review found little evidence of acupuncture's effectiveness in treating pain. The evidence suggests that short-term treatment with acupuncture does not produce long-term benefits. Some research results suggest acupuncture can alleviate pain, though the majority of research suggests that acupuncture's effects are mainly due to the placebo
Acupuncture
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8158
effect. A systematic review concluded that the analgesic effect of acupuncture seemed to lack clinical relevance and could not be clearly distinguished from bias. A meta-analysis found that acupuncture for chronic low back pain was cost-effective as an adjunct to standard care, while a systematic review found insufficient evidence for the cost-effectiveness of acupuncture in the treatment of chronic low back pain. Acupuncture is generally safe when done by an appropriately trained practitioner using clean needle technique and single-use needles. When properly delivered, it has a low rate of mostly minor adverse effects. Accidents and infections are associated with infractions
Acupuncture
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8159
of sterile technique or neglect on the part of the practitioner. A review stated that the reports of infection transmission increased significantly in the previous decade. The most frequently reported adverse events were pneumothorax and infections. Since serious adverse events continue to be reported, it is recommended that acupuncturists be trained sufficiently to reduce the risk. Scientific investigation has not found any histological or physiological evidence for traditional Chinese concepts such as "qi", meridians, and acupuncture points, and many modern practitioners no longer support the existence of life force energy ("qi") flowing through meridians, which was a major part of
Acupuncture
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8160
early belief systems. Acupuncture is believed to have originated around 100 BC in China, around the time "The Yellow Emperor's Classic of Internal Medicine" (Huangdi Neijing) was published, though some experts suggest it could have been practiced earlier. Over time, conflicting claims and belief systems emerged about the effect of lunar, celestial and earthly cycles, yin and yang energies, and a body's "rhythm" on the effectiveness of treatment. Acupuncture fluctuated in popularity in China during changes in the country's political leadership and the preferential use of rationalism or Western medicine. Acupuncture spread first to Korea in the 6th century AD,
Acupuncture
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8161
then to Japan through medical missionaries, and then to Europe, beginning with France. In the 20th century, as it spread to the United States and Western countries, spiritual elements of acupuncture that conflict with Western beliefs were sometimes abandoned in favor of simply tapping needles into acupuncture points. Acupuncture is a form of alternative medicine. It is used most commonly for pain relief, though it is also used to treat a wide range of conditions. The majority of people who seek out acupuncture do so for musculoskeletal problems, including low back pain, shoulder stiffness, and knee pain. Acupuncture is generally
Acupuncture
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8162
only used in combination with other forms of treatment. For example, American Society of Anesthesiologists states it may be considered in the treatment for nonspecific, noninflammatory low back pain only in conjunction with conventional therapy. Acupuncture is the insertion of thin needles into the skin. According to the Mayo Foundation for Medical Education and Research (Mayo Clinic), a typical session entails lying still while approximately five to twenty needles are inserted; for the majority of cases, the needles will be left in place for ten to twenty minutes. It can be associated with the application of heat, pressure, or laser
Acupuncture
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8163
light. Classically, acupuncture is individualized and based on philosophy and intuition, and not on scientific research. There is also a non-invasive therapy developed in early 20th century Japan using an elaborate set of "needles" for the treatment of children ("shōnishin" or "shōnihari"). Clinical practice varies depending on the country. A comparison of the average number of patients treated per hour found significant differences between China (10) and the United States (1.2). Chinese herbs are often used. There is a diverse range of acupuncture approaches, involving different philosophies. Although various different techniques of acupuncture practice have emerged, the method used in
Acupuncture
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8164
traditional Chinese medicine (TCM) seems to be the most widely adopted in the US. Traditional acupuncture involves needle insertion, moxibustion, and cupping therapy, and may be accompanied by other procedures such as feeling the pulse and other parts of the body and examining the tongue. Traditional acupuncture involves the belief that a "life force" ("qi") circulates within the body in lines called meridians. The main methods practiced in the UK are TCM and Western medical acupuncture. The term Western medical acupuncture is used to indicate an adaptation of TCM-based acupuncture which focuses less on TCM. The Western medical acupuncture approach
Acupuncture
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8165
involves using acupuncture after a medical diagnosis. Limited research has compared the contrasting acupuncture systems used in various countries for determining different acupuncture points and thus there is no defined standard for acupuncture points. In traditional acupuncture, the acupuncturist decides which points to treat by observing and questioning the patient to make a diagnosis according to the tradition used. In TCM, the four diagnostic methods are: inspection, auscultation and olfaction, inquiring, and palpation. Inspection focuses on the face and particularly on the tongue, including analysis of the tongue size, shape, tension, color and coating, and the absence or presence of
Acupuncture
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8166
teeth marks around the edge. Auscultation and olfaction involve listening for particular sounds such as wheezing, and observing body odor. Inquiring involves focusing on the "seven inquiries": chills and fever; perspiration; appetite, thirst and taste; defecation and urination; pain; sleep; and menses and leukorrhea. Palpation is focusing on feeling the body for tender ""A-shi"" points and feeling the pulse. The most common mechanism of stimulation of acupuncture points employs penetration of the skin by thin metal needles, which are manipulated manually or the needle may be further stimulated by electrical stimulation (electroacupuncture). Acupuncture needles are typically made of stainless steel,
Acupuncture
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8167
making them flexible and preventing them from rusting or breaking. Needles are usually disposed of after each use to prevent contamination. Reusable needles when used should be sterilized between applications. Needles vary in length between , with shorter needles used near the face and eyes, and longer needles in areas with thicker tissues; needle diameters vary from 0 to 0, with thicker needles used on more robust patients. Thinner needles may be flexible and require tubes for insertion. The tip of the needle should not be made too sharp to prevent breakage, although blunt needles cause more pain. Apart from
Acupuncture
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8168
the usual filiform needle, other needle types include three-edged needles and the Nine Ancient Needles. Japanese acupuncturists use extremely thin needles that are used superficially, sometimes without penetrating the skin, and surrounded by a guide tube (a 17th-century invention adopted in China and the West). Korean acupuncture uses copper needles and has a greater focus on the hand. The skin is sterilized and needles are inserted, frequently with a plastic guide tube. Needles may be manipulated in various ways, including spinning, flicking, or moving up and down relative to the skin. Since most pain is felt in the superficial layers
Acupuncture
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8169
of the skin, a quick insertion of the needle is recommended. Often the needles are stimulated by hand in order to cause a dull, localized, aching sensation that is called "de qi", as well as "needle grasp," a tugging feeling felt by the acupuncturist and generated by a mechanical interaction between the needle and skin. Acupuncture can be painful. The skill level of the acupuncturist may influence how painful the needle insertion is, and a sufficiently skilled practitioner may be able to insert the needles without causing any pain. "De-qi" (; "arrival of qi") refers to a sensation of numbness,
Acupuncture
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8170
distension, or electrical tingling at the needling site which might radiate along the corresponding meridian. If "de-qi" can not be generated, then inaccurate location of the acupoint, improper depth of needle insertion, inadequate manual manipulation, or a very weak constitution of the patient can be considered, all of which are thought to decrease the likelihood of successful treatment. If the "de-qi" sensation does not immediately occur upon needle insertion, various manual manipulation techniques can be applied to promote it (such as "plucking", "shaking" or "trembling"). Once "de-qi" is achieved, further techniques might be utilized which aim to "influence" the "de-qi";
Acupuncture
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8171
for example, by certain manipulation the "de-qi" sensation allegedly can be conducted from the needling site towards more distant sites of the body. Other techniques aim at "tonifying" () or "sedating" () "qi". The former techniques are used in deficiency patterns, the latter in excess patterns. "De qi" is more important in Chinese acupuncture, while Western and Japanese patients may not consider it a necessary part of the treatment. Acupuncture has been researched extensively; as of 2013, there were almost 1,500 randomized controlled trials on PubMed with "acupuncture" in the title. The results of reviews of reviews of acupuncture's effectiveness,
Acupuncture
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8172
however, have been inconclusive. It is difficult but not impossible to design rigorous research trials for acupuncture. Due to acupuncture's invasive nature, one of the major challenges in efficacy research is in the design of an appropriate placebo control group. For efficacy studies to determine whether acupuncture has specific effects, "sham" forms of acupuncture where the patient, practitioner, and analyst are blinded seem the most acceptable approach. Sham acupuncture uses non-penetrating needles or needling at non-acupuncture points, e.g. inserting needles on meridians not related to the specific condition being studied, or in places not associated with meridians. The under-performance of
Acupuncture
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8173
acupuncture in such trials may indicate that therapeutic effects are due entirely to non-specific effects, or that the sham treatments are not inert, or that systematic protocols yield less than optimal treatment. A 2014 review in "Nature Reviews Cancer" found that "contrary to the claimed mechanism of redirecting the flow of "qi" through meridians, researchers usually find that it generally does not matter where the needles are inserted, how often (that is, no dose-response effect is observed), or even if needles are actually inserted. In other words, 'sham' or 'placebo' acupuncture generally produces the same effects as 'real' acupuncture and,
Acupuncture
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8174
in some cases, does better." A 2013 meta-analysis found little evidence that the effectiveness of acupuncture on pain (compared to sham) was modified by the location of the needles, the number of needles used, the experience or technique of the practitioner, or by the circumstances of the sessions. The same analysis also suggested that the number of needles and sessions is important, as greater numbers improved the outcomes of acupuncture compared to non-acupuncture controls. There has been little systematic investigation of which components of an acupuncture session may be important for any therapeutic effect, including needle placement and depth, type
Acupuncture
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8175
and intensity of stimulation, and number of needles used. The research seems to suggest that needles do not need to stimulate the traditionally specified acupuncture points or penetrate the skin to attain an anticipated effect (e.g. psychosocial factors). A response to "sham" acupuncture in osteoarthritis may be used in the elderly, but placebos have usually been regarded as deception and thus unethical. However, some physicians and ethicists have suggested circumstances for applicable uses for placebos such as it might present a theoretical advantage of an inexpensive treatment without adverse reactions or interactions with drugs or other medications. As the evidence
Acupuncture
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8176
for most types of alternative medicine such as acupuncture is far from strong, the use of alternative medicine in regular healthcare can present an ethical question. Using the principles of evidence-based medicine to research acupuncture is controversial, and has produced different results. Some research suggests acupuncture can alleviate pain but the majority of research suggests that acupuncture's effects are mainly due to placebo. Evidence suggests that any benefits of acupuncture are short-lasting. There is insufficient evidence to support use of acupuncture compared to mainstream medical treatments. Acupuncture is not better than mainstream treatment in the long term. The use of
Acupuncture
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8177
acupuncture has been criticized owing to there being little scientific evidence for explicit effects, or the mechanisms for its supposed effectiveness, for any condition that is discernible from placebo. Acupuncture has been called 'theatrical placebo', and David Gorski argues that when acupuncture proponents advocate 'harnessing of placebo effects' or work on developing 'meaningful placebos', they essentially concede it is little more than that. Publication bias is cited as a concern in the reviews of randomized controlled trials (RCTs) of acupuncture. A 1998 review of studies on acupuncture found that trials originating in China, Japan, Hong Kong, and Taiwan were uniformly
Acupuncture
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8178
favourable to acupuncture, as were ten out of eleven studies conducted in Russia. A 2011 assessment of the quality of RCTs on TCM, including acupuncture, concluded that the methodological quality of most such trials (including randomization, experimental control, and blinding) was generally poor, particularly for trials published in Chinese journals (though the quality of acupuncture trials was better than the trials testing TCM remedies). The study also found that trials published in non-Chinese journals tended to be of higher quality. Chinese authors use more Chinese studies, which have been demonstrated to be uniformly positive. A 2012 review of 88 systematic
Acupuncture
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8179
reviews of acupuncture published in Chinese journals found that less than half of these reviews reported testing for publication bias, and that the majority of these reviews were published in journals with impact factors of zero. A 2015 study comparing pre-registered records of acupuncture trials with their published results found that it was uncommon for such trials to be registered before the trial began. This study also found that selective reporting of results and changing outcome measures to obtain statistically significant results was common in this literature. Scientist and journalist Steven Salzberg identifies acupuncture and Chinese medicine generally as a
Acupuncture
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8180
focus for "fake medical journals" such as the "Journal of Acupuncture and Meridian Studies" and "Acupuncture in Medicine". The conclusions of many trials and numerous systematic reviews of acupuncture are largely inconsistent with each other. A 2011 systematic review of systematic reviews found that for reducing pain, real acupuncture was no better than sham acupuncture, and concluded that numerous reviews have shown little convincing evidence that acupuncture is an effective treatment for reducing pain. The same review found that neck pain was one of only four types of pain for which a positive effect was suggested, but cautioned that the
Acupuncture
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8181
primary studies used carried a considerable risk of bias. A 2009 overview of Cochrane reviews found acupuncture is not effective for a wide range of conditions. A 2014 systematic review suggests that the nocebo effect of acupuncture is clinically relevant and that the rate of adverse events may be a gauge of the nocebo effect. According to the 2014 "Miller's Anesthesia" book, "when compared with placebo, acupuncture treatment has proven efficacy for relieving pain". A 2012 meta-analysis conducted by the Acupuncture Trialists' Collaboration found "relatively modest" efficiency of acupuncture (in comparison to sham) for the treatment of four different types
Acupuncture
[ -0.04443465173244476, 0.21728546917438507, -0.07178770005702972, -0.1804981231689453, -0.14485590159893036, -0.008353829383850098, 0.27129146456718445, -0.2884136140346527, 0.3876972198486328, -0.11906404793262482, 0.2730214595794678, 0.80998295545578, -0.015033342875540257, -0.26622581481...
8182
of chronic pain (back and neck pain, knee osteoarthritis, chronic headache, and shoulder pain) and on that basis concluded that it "is more than a placebo" and a reasonable referral option. Commenting on this meta-analysis, both Edzard Ernst and David Colquhoun said the results were of negligible clinical significance. Edzard Ernst later stated that "I fear that, once we manage to eliminate this bias [that operators are not blind] … we might find that the effects of acupuncture exclusively are a placebo response." In 2017, the same research group updated their previous meta-analysis and again found acupuncture to be superior
Acupuncture
[ -0.027443407103419304, 0.24185171723365784, 0.3581332564353943, -0.24596166610717773, -0.29544803500175476, 0.20707541704177856, 0.3086923360824585, -0.2117713987827301, 0.3712582588195801, -0.1355685144662857, 0.11136770248413086, 0.7961705327033997, 0.2109045386314392, -0.152988940477371...
8183
to sham acupuncture for non-specific musculoskeletal pain, osteoarthritis, chronic headache, and shoulder pain. They also found that the effects of acupuncture decreased by about 15% after one year. A 2010 systematic review suggested that acupuncture is more than a placebo for commonly occurring chronic pain conditions, but the authors acknowledged that it is still unknown if the overall benefit is clinically meaningful or cost-effective. A 2010 review found real acupuncture and sham acupuncture produce similar improvements, which can only be accepted as evidence against the efficacy of acupuncture. The same review found limited evidence that real acupuncture and sham acupuncture
Acupuncture
[ -0.02831723913550377, 0.24867257475852966, 0.12945911288261414, -0.0979456976056099, -0.2344515323638916, 0.1123076006770134, 0.34049996733665466, -0.05410032346844673, 0.46607258915901184, -0.2663210928440094, 0.30960172414779663, 0.8164124488830566, 0.0974121019244194, -0.296619355678558...
8184
appear to produce biological differences despite similar effects. A 2009 systematic review and meta-analysis found that acupuncture had a small analgesic effect, which appeared to lack any clinical importance and could not be discerned from bias. The same review found that it remains unclear whether acupuncture reduces pain independent of a psychological impact of the needling ritual. A 2017 systematic review and meta-analysis found that ear acupuncture may be effective at reducing pain within 48 hours of its use, but the mean difference between the acupuncture and control groups was small. A 2013 systematic review found that acupuncture may be
Acupuncture
[ 0.3661881685256958, 0.3617858290672302, 0.21437378227710724, -0.08354733139276505, -0.28066301345825195, -0.12266678363084793, 0.5394604206085205, -0.34172073006629944, 0.6119532585144043, -0.1744810789823532, 0.20839223265647888, 1.0798784494400024, 0.22813096642494202, -0.441200286149978...
8185
effective for nonspecific lower back pain, but the authors noted there were limitations in the studies examined, such as heterogeneity in study characteristics and low methodological quality in many studies. A 2012 systematic review found some supporting evidence that acupuncture was more effective than no treatment for chronic non-specific low back pain; the evidence was conflicting comparing the effectiveness over other treatment approaches. A 2011 systematic review of systematic reviews found that "for chronic low back pain, individualized acupuncture is not better in reducing symptoms than formula acupuncture or sham acupuncture with a toothpick that does not penetrate the skin."
Acupuncture
[ 0.08391716331243515, 0.13737815618515015, -0.14872799813747406, 0.0848093256354332, -0.3391727805137634, 0.23285600543022156, 0.23838375508785248, -0.1406605988740921, 0.3194582164287567, -0.2833821177482605, 0.2625478506088257, 0.9798607230186462, 0.1689520627260208, -0.2782440483570099, ...
8186
A 2010 review found that sham acupuncture was as effective as real acupuncture for chronic low back pain. The specific therapeutic effects of acupuncture were small, whereas its clinically relevant benefits were mostly due to contextual and psychosocial circumstances. Brain imaging studies have shown that traditional acupuncture and sham acupuncture differ in their effect on limbic structures, while at the same time showed equivalent analgesic effects. A 2005 Cochrane review found insufficient evidence to recommend for or against either acupuncture or dry needling for acute low back pain. The same review found low quality evidence for pain relief and improvement
Acupuncture
[ -0.05091489106416702, 0.006230673287063837, -0.1272559016942978, 0.0838567391037941, -0.31281986832618713, 0.3358989357948303, 0.17247603833675385, -0.08071305602788925, 0.4397980272769928, -0.15839934349060059, 0.21998922526836395, 0.9874657988548279, 0.021026697009801865, -0.258905053138...
8187
compared to no treatment or sham therapy for chronic low back pain only in the short term immediately after treatment. The same review also found that acupuncture is not more effective than conventional therapy and other alternative medicine treatments. A 2017 systematic review and meta-analysis concluded that, for neck pain, acupuncture was comparable in effectiveness to conventional treatment, while electroacupuncture was even more effective in reducing pain than was conventional acupuncture. The same review noted that "It is difficult to draw conclusion [sic] because the included studies have a high risk of bias and imprecision." A 2015 overview of systematic
Acupuncture
[ 0.04886573180556297, 0.07147644460201263, 0.07047788053750992, -0.034222543239593506, -0.2519969046115875, 0.182228222489357, 0.21933826804161072, -0.27049586176872253, 0.3289923369884491, -0.10510673373937607, 0.15371564030647278, 0.9420954585075378, 0.2281065583229065, -0.399385184049606...
8188
reviews of variable quality showed that acupuncture can provide short-term improvements to people with chronic Low Back Pain. The overview said this was true when acupuncture was used either in isolation or in addition to conventional therapy. A 2017 systematic review for an American College of Physicians clinical practice guideline found low to moderate evidence that acupuncture was effective for chronic low back pain, and limited evidence that it was effective for acute low back pain. The same review found that the strength of the evidence for both conditions was low to moderate. Another 2017 clinical practice guideline, this one
Acupuncture
[ 0.02416914328932762, 0.004054885357618332, -0.12185686826705933, -0.12946096062660217, -0.06833825260400772, 0.09358271956443787, 0.312382310628891, -0.16316649317741394, 0.3675719201564789, -0.0833105519413948, 0.21508125960826874, 0.6518057584762573, 0.12181209772825241, -0.3708952367305...
8189
produced by the Danish Health Authority, recommended against acupuncture for both recent-onset low back pain and lumbar radiculopathy. Two separate 2016 Cochrane reviews found that acupuncture could be useful in the prophylaxis of tension-type headaches and episodic migraines. The 2016 Cochrane review evaluating acupuncture for episodic migraine prevention concluded that true acupuncture had a small effect beyond sham acupuncture and found moderate-quality evidence to suggest that acupuncture is at least similarly effective to prophylactic medications for this purpose. A 2012 review found that acupuncture has demonstrated benefit for the treatment of headaches, but that safety needed to be more fully
Acupuncture
[ 0.10542982071638107, 0.10978429764509201, 0.04879830777645111, 0.06815389543771744, -0.1861790269613266, -0.06272182613611221, 0.2531379759311676, 0.006681542843580246, 0.26962190866470337, 0.04272269457578659, 0.2557021379470825, 0.8319936394691467, 0.04285462573170662, -0.416497468948364...
8190
documented in order to make any strong recommendations in support of its use. A 2014 review concluded that "current evidence supports the use of acupuncture as an alternative to traditional analgesics in osteoarthritis patients." , a meta-analysis showed that acupuncture may help osteoarthritis pain but it was noted that the effects were insignificant in comparison to sham needles. A 2013 systematic review and network meta-analysis found that the evidence suggests that acupuncture may be considered one of the more effective physical treatments for alleviating pain due to knee osteoarthritis in the short-term compared to other relevant physical treatments, though much
Acupuncture
[ 0.06829582154750824, -0.012653030455112457, 0.012069127522408962, 0.23934222757816315, -0.11464998126029968, 0.10376708209514618, 0.24802693724632263, 0.09607309848070145, 0.40269362926483154, -0.27517169713974, 0.3114599585533142, 0.7382470965385437, 0.264475017786026, -0.3328405022621155...
8191
of the evidence in the topic is of poor quality and there is uncertainty about the efficacy of many of the treatments. A 2012 review found "the potential beneficial action of acupuncture on osteoarthritis pain does not appear to be clinically relevant." A 2010 Cochrane review found that acupuncture shows statistically significant benefit over sham acupuncture in the treatment of peripheral joint osteoarthritis; however, these benefits were found to be so small that their clinical significance was doubtful, and "probably due at least partially to placebo effects from incomplete blinding". A 2013 Cochrane review found low to moderate evidence that
Acupuncture
[ 0.12833359837532043, 0.26913711428642273, -0.03210848569869995, -0.016958242282271385, -0.09481759369373322, 0.10623817890882492, 0.3271633982658386, 0.10634738206863403, 0.3613912761211395, -0.1376831978559494, 0.2406950145959854, 0.7573363184928894, 0.19396281242370605, -0.15210932493209...
8192
acupuncture improves pain and stiffness in treating people with fibromyalgia compared with no treatment and standard care. A 2012 review found "there is insufficient evidence to recommend acupuncture for the treatment of fibromyalgia." A 2010 systematic review found a small pain relief effect that was not apparently discernible from bias; acupuncture is not a recommendable treatment for the management of fibromyalgia on the basis of this review. A 2012 review found that the effectiveness of acupuncture to treat rheumatoid arthritis is "sparse and inconclusive." A 2005 Cochrane review concluded that acupuncture use to treat rheumatoid arthritis "has no effect on
Acupuncture
[ 0.002175325760617852, 0.16341117024421692, -0.07069586962461472, -0.006382863502949476, -0.1344400942325592, 0.1339861899614334, 0.19464433193206787, 0.02606980688869953, 0.4620245099067688, -0.3369213938713074, 0.18720000982284546, 0.7922605872154236, 0.035877082496881485, -0.293655157089...
8193
ESR, CRP, pain, patient's global assessment, number of swollen joints, number of tender joints, general health, disease activity and reduction of analgesics." A 2010 overview of systematic reviews found insufficient evidence to recommend acupuncture in the treatment of most rheumatic conditions, with the exceptions of osteoarthritis, low back pain, and lateral elbow pain. A 2014 systematic review found that although manual acupuncture was effective at relieving short-term pain when used to treat tennis elbow, its long-term effect in relieving pain was "unremarkable". A 2007 review found that acupuncture was significantly better than sham acupuncture at treating chronic knee pain; the
Acupuncture
[ -0.09239393472671509, 0.08388924598693848, 0.11250616610050201, 0.0313723050057888, -0.15359072387218475, 0.2577114701271057, 0.1956223100423813, -0.0850474089384079, 0.4294604957103729, -0.35067644715309143, 0.2565942406654358, 0.932375967502594, 0.31302279233932495, -0.38061997294425964,...
8194
evidence was not conclusive due to the lack of large, high-quality trials. A 2005 Cochrane Review concluded that there is not enough evidence to determine if acupuncture is effective as a method to treat shoulder pain. A 2014 overview of systematic reviews found insufficient evidence to suggest that acupuncture is an effective treatment for postoperative nausea and vomiting (PONV) in a clinical setting. A 2013 systematic review concluded that acupuncture might be beneficial in prevention and treatment of PONV. A 2015 Cochrane review found moderate-quality evidence of no difference between stimulation of the P6 acupoint on the wrist and antiemetic
Acupuncture
[ 0.0636226087808609, 0.09452971816062927, 0.18910466134548187, -0.015912696719169617, -0.25496014952659607, -0.0824233815073967, 0.12360206246376038, 0.1112629622220993, 0.14197389781475067, -0.0750187337398529, 0.20127104222774506, 0.7617314457893372, 0.1781715750694275, -0.440531939268112...
8195
drugs for preventing PONV. A new finding of the review was that further comparative trials are futile, based on the conclusions of a trial sequential analysis. Whether combining PC6 acupoint stimulation with antiemetics is effective was inconclusive. A 2014 overview of systematic reviews found insufficient evidence to suggest that acupuncture is effective for surgical or post-operative pain. For the use of acupuncture for post-operative pain, there was contradictory evidence. A 2014 systematic review found supportive but limited evidence for use of acupuncture for acute post-operative pain after back surgery. A 2014 systematic review found that while the evidence suggested acupuncture
Acupuncture
[ 0.07143024355173111, 0.13902397453784943, 0.13416504859924316, -0.01649203710258007, -0.2365884780883789, 0.020055564120411873, 0.061605118215084076, -0.13117004930973053, 0.24196213483810425, -0.12913724780082703, 0.19202737510204315, 0.9351151585578918, 0.08116523921489716, -0.3683250546...
8196
could be an effective treatment for postoperative gastroparesis, a firm conclusion could not be reached because the trials examined were of low quality. A 2015 Cochrane review found that there is insufficient evidence to determine whether acupuncture is an effective treatment for cancer pain in adults. A 2014 systematic review published in the Chinese Journal of Integrative Medicine found that acupuncture may be effective as an adjunctive treatment to palliative care for cancer patients. A 2013 overview of reviews published in the Journal of Multinational Association for Supportive Care in Cancer found evidence that acupuncture could be beneficial for people
Acupuncture
[ -0.002357437275350094, 0.16907766461372375, -0.026696467772126198, 0.09532266855239868, 0.057247597724199295, 0.04328462854027748, 0.16060428321361542, 0.13195033371448517, 0.43184900283813477, -0.22116735577583313, 0.21064122021198273, 0.5901804566383362, 0.2823285758495331, -0.2128487974...
8197
with cancer-related symptoms, but also identified few rigorous trials and high heterogeneity between trials. A 2012 systematic review of randomised clinical trials published in the same journal found that the number and quality of RCTs for using acupuncture in the treatment of cancer pain was too low to draw definite conclusions. A 2014 systematic review reached inconclusive results with regard to the effectiveness of acupuncture for treating cancer-related fatigue. A 2013 systematic review found that acupuncture is an acceptable adjunctive treatment for chemotherapy-induced nausea and vomiting, but that further research with a low risk of bias is needed. A 2013
Acupuncture
[ -0.011467051692306995, 0.27139148116111755, -0.053231045603752136, -0.16408774256706238, -0.1323847770690918, 0.021527692675590515, 0.24795600771903992, -0.09798974543809891, 0.33869296312332153, 0.03466753289103508, 0.27596649527549744, 0.7528302073478699, 0.17061293125152588, -0.32944512...
8198
systematic review found that the quantity and quality of available RCTs for analysis were too low to draw valid conclusions for the effectiveness of acupuncture for cancer-related fatigue. A 2016 systematic review and meta-analysis found that acupuncture was "associated with a significant reduction in sleep disturbances in women experiencing menopause-related sleep disturbances." For the following conditions, the Cochrane Collaboration or other reviews have concluded there is no strong evidence of benefit: A 2010 overview of systematic reviews found that moxibustion was effective for several conditions but the primary studies were of poor quality, so there persists ample uncertainty, which limits
Acupuncture
[ 0.10180319100618362, 0.1808079183101654, -0.10174833983182907, -0.012926768511533737, -0.11315719038248062, -0.11588411033153534, 0.298458993434906, -0.0723721981048584, 0.2763442397117615, 0.013178599067032337, 0.16523857414722443, 0.931099534034729, 0.09044800698757172, -0.40489289164543...
8199
the conclusiveness of their findings. Acupuncture is generally safe when administered by an experienced, appropriately trained practitioner using clean-needle technique and sterile single-use needles. When improperly delivered it can cause adverse effects. Accidents and infections are associated with infractions of sterile technique or neglect on the part of the practitioner. To reduce the risk of serious adverse events after acupuncture, acupuncturists should be trained sufficiently. People with serious spinal disease, such as cancer or infection, are not good candidates for acupuncture. Contraindications to acupuncture (conditions that should not be treated with acupuncture) include coagulopathy disorders (e.g. hemophilia and advanced liver
Acupuncture
[ 0.39574459195137024, 0.3007715046405792, 0.15234801173210144, 0.15498745441436768, 0.10263732820749283, -0.11937001347541809, 0.4681876599788666, -0.1637386530637741, 0.6189550161361694, -0.3169732391834259, 0.04882879927754402, 0.7511462569236755, 0.11360576748847961, -0.4662051796913147,...
8200
disease), warfarin use, severe psychiatric disorders (e.g. psychosis), and skin infections or skin trauma (e.g. burns). Further, electroacupuncture should be avoided at the spot of implanted electrical devices (such as pacemakers). A 2011 systematic review of systematic reviews (internationally and without language restrictions) found that serious complications following acupuncture continue to be reported. Between 2000 and 2009, ninety-five cases of serious adverse events, including five deaths, were reported. Many such events are not inherent to acupuncture but are due to malpractice of acupuncturists. This might be why such complications have not been reported in surveys of adequately-trained acupuncturists. Most such
Acupuncture
[ 0.31279611587524414, 0.08299965411424637, -0.009662293829023838, -0.3059732913970947, 0.08755923062562943, 0.045820824801921844, 0.3298439383506775, 0.1785162389278412, 0.24774877727031708, 0.0509364977478981, 0.15823860466480255, 0.5912319421768188, -0.1808355748653412, -0.216296032071113...