Objective : To evaluate the cost - effectiveness of an educational booklet and an exercise program as preventive interventions against back pain (BP) in Japanese health examinees.
  Methods : The number of people with BP in Japanese health examinees was estimated using the prevalence rates of BP in the questionnaire survey at five Japanese healthcare facilities. The loss of quality adjusted life years (QALY) associated with BP was calculated as the estimated number of people with BP multiplied by the mean differences of EQ - 5D scores between those who reported BP and those who reported no musculoskeletal pain in the questionnaire survey. The incremental cost - effectiveness ratios (ICER) were estimated based on the assumption that 4% and 25% reductions in the number of people with BP are achievable by an educational booklet and an exercise program, respectively.
  Results : Among a total of 91,594,000 health examinees aged 20 - 74 years in Japan, 13,169,000 (14.4% ) were estimated to have BP. The loss of QALY associated with BP was estimated at 776,000 years. If all the people with BP receive an educational booklet, the ICER will be 263,000 Japanese YEN/QALY. If all the people with BP receive an exercise program, the ICER will be 1,656,000 - 4,141,000 Japanese YEN/QALY. The ICER will increase with increasing ratio of participants in an exercise program to participants in an educational booklet.
  Conclusion : The estimated ICER suggested that the cost - effectiveness of both interventions was socially acceptable, but an educational booklet was more cost- effective than an educational booklet.

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  We developed a new style of physical checkup system “ the anti - aging dock” in our clinic, several years ago. The aims of the new style dock are to improve the quality of human life and to prevent the age - related diseases. The anti - aging medicine will delay the onset of chronic diseases and cancers, and will reduce its severity by the changes of life style including nutritional therapy, calorie restriction, physical therapy, hormone replacement therapy and several medications. We also developed a custom - made supplement just for the patient with data from the anti - aging dock.
  Finally we believe that this new type dock will contribute to the preventative medicine in our out patient clinic.

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  Zinc, copper, iron and chromium are essential trace elements. The daily intake of these trace elements is insufficient. It is most likely that the deficiency of zinc, copper, iron and chromium is associated with life - style related diseases and aging. Actually, an increase in free radicals, a decrease in immunocompetence, an increase in blood pressure, the disorder of lipid metabolism, a reduction in glucose tolerance and a rise in carcinogenesis etc. are observed in both aging and the deficiency of the essential trace elements. Thus, the measurements of serum zinc, copper, iron and chromium in health examinations are available for the prevention of life - style related diseases and aging.

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