Yuta Takahashi

Social capital is a fundamental social determinant of health for older adults in rapidly aging societies; however, existing comprehensive instruments often impose high cognitive friction through complex recall tasks, potentially leading to systematically excluding vulnerable populations. This study validated the factor structure of the Fujisawa Social Capital Scale (FSCS) - an independent, brief tool designed for inclusive community-based practice - among community-dwelling Japanese older adults participating in "Kayoi-no-ba" (neighborhood social participation hubs). Data were analyzed from 587 participants in the Gunma Aging Cohort (mean age 79.2 ± 6.0 years; 87.1% female; 29.6% living alone). Exploratory factor analysis using the Weighted Least Squares Mean- and Variance-adjusted estimator was prioritized to ensure statistical stability for this specific cohort. A robust two-factor structure emerged: Factor 1, "Sense of Security and Attachment to the Community," and Factor 2, "Mutual Aid Among Neighbors." These findings underscore the conceptual distinction between psychological belonging and functional support within community settings. The model demonstrated favorable fit indices, with a Root Mean Square Error of Approximation of 0.071 and a Tucker-Lewis Index of 0.96. High internal consistency was confirmed using McDonald's omega (ω) for the total scale (ωt = 0.85), Factor 1 (ω = 0.77), and Factor 2 (ω = 0.74). Overall, these results indicate that the FSCS is a "practice-first" instrument that minimizes respondent burden while maintaining data reliability. By distinguishing psychological attachment from functional support, it provides a "common language" for interdisciplinary teams to guide social prescribing and prioritize targeted community-based support for socially vulnerable older adults.

The prevalence of chronic pain in patients with cancer ranges from 23% to 36%. Opioids are effective in relieving severe pain; however, they also cause side effects, such as physical dependence, tolerance, sedation, and hyperalgesia. The prevalence of opioid-induced constipation (OIC) increases with a rise in the duration of opioid analgesic use. When OIC develops, opioid treatment satisfaction decreases, and many patients tend to discontinue treatment. Naldemedine is an opioid receptor antagonist that improves OIC in patients with cancer by acting on the gastrointestinal tract. It does not inhibit opioid analgesia or cause withdrawal symptoms. Therefore, this review aims to provide a comprehensive overview of OIC management in patients with cancer pain, with a focus on naldemedine. This narrative review also reports recent findings on the efficacy and safety of naldemedine and provides comparisons based on cancer type. A comprehensive search was conducted to identify primary articles on the clinical effectiveness and adverse effects of naldemedine in patients with cancer with OIC. Naldemedine is a well-tolerated and effective drug for treatment of OIC in patients with cancer, and its use is expected to increase.

Objectives Lenalidomide, a hazardous drug, has strict distribution controls. However, the risk of contamination with lenalidomide when patients take the drug has not been studied and the risk of drug exposure to people in the patient’s living environment is unknown. Thus, we investigated the amount of lenalidomide that could be dispersed during the period between removal of the capsule and returning the used blister packages, and we considered the conditions under which lenalidomide could be dispersed and countermeasures. Methods The amount of lenalidomide contamination was measured on the outside of the unused blister packages returned by the patients, on the surface of the capsule, and on the inside of the package immediately after removal of the capsule. In addition, the amount of contamination was measured on the blister packages used by the patients and on the gloves worn by the pharmacists on receipt of the packages. Lenalidomide was analysed by liquid chromatography–tandem mass spectrometry. Results Lenalidomide amounts on the outside of the unused blister packages returned by the three patients were Conclusions The amount of lenalidomide contamination per package was found to be at least 100 ng less after collection by the pharmacist than immediately after removal of the capsules. Therefore, it is recommended to clean the surrounding area and wash one’s hands after taking the capsules.

Background: Frailty is a clinical condition characterized by increased vulnerability to adverse health outcomes. Elderly people are screened for frailty as part of preventative care. However, the risk factors for frailty among older adults who undergo Ningen Dock, a comprehensive medical checkup, remain unclear. Thus, this cross-sectional study aims to identify the risk factors for frailty in older adults who received Ningen Dock. The study included 372 participants over 65 years of age who underwent Ningen Dock at the Health Care Center of Gunma Chuo Hospital between April 2019 and March 2020. Frailty was defined using the Kihon Checklist, a basic checklist. Clinical variables were obtained from Ningen Dock records, a vascular function test, and a questionnaire on medication, among others. Multivariate ordinal logistic regression models were used to assess risk factors. Results: Prevalence for frailty and pre-frailty was 12.6% and 26.6%, respectively. The mean age of participants was 72.0 ± 5.1 years old, and 43.5% were female. Compared with systolic blood pressure (SBP) ≥ 130 mmHg, the odds ratios for the 100–129 mmHg and < 100 mmHg groups were 2.43 (P = 0.020) and 8.95 (P 0.6 mg/dL. Compared with an exercise habit of ≥ 4 metabolic equivalents (METs), the odds ratio for < 2 METs/week was 2.45 (P < 0.001). The odds ratio for the cardio-ankle vascular index (CAVI) ≥ 9 group was 1.84 (P = 0.020) compared to < 9. Conclusions: In older adults who received Ningen Dock, SBP < 100 mmHg, medications ≥ 7, serum iron ≤ 85 μg/dL, total bilirubin ≤ 0.6 mg/dL, exercise habits < 2 METs, and CAVI ≥ 9 were associated with frailty.