Methods: Hospitalized patients with acute VFs underwent assessment of vertebral morphology and paraspinal muscles. Two weeks post-admission, patients were evaluated for pain intensity (using the Verbal Rating Scale [VRS]), pain sensitivity (Pressure Pain Threshold [PPT] and Conditioned Pain Modulation), psychological factors, physical function, and activity levels. At 12 weeks, patients were categorized into CP and non-CP (NCP) groups based on VRS scores. Between-group comparisons and logistic regression analysis were performed to identify predictors of CP development. Results: The CP group exhibited significantly lower remote PPT and reduced low-intensity physical activity time, but higher Pain Catastrophizing Scale rumination scores and prolonged 5-Times Sit-to-Stand Test (5SST) compared to the NCP group. Logistic regression identified prolonged 5SST and reduced low-intensity physical activity as independent predictors of CP development. Conclusions Prolonged 5SST and reduced low-intensity physical activity may predict CP development after VFs. Early assessment of these factors may facilitate CP risk screening in hospitalized patients with VFs.

The clinical competence needed by every beginning resident and the present status of such competencewere examined in August 1998 through questionnaires distributed to clinical educators and the nursing staff of university hospitals and clinical training hospitals designated by the Ministry of Health and Welfare. Completed questionnaires were returned by 576 (65.9%) of clinical educators and nursing staff. With a cluster analysis of the necessity and the present status of clinical competence, 21 items for clinical competence were identified as those most requiring evaluation by the national examination. These 21 items included 11 items for clinical competence in the cognitive domain, 8 items in the psychomotor domain, and 2 in the affective domain. In about half of the direct answers obtained from clinical educators, evaluations were considered necessary for 15 items of clinical competence, of which 13 belonged to the cognitive domain. These results were consistent with the present status. However, practical examinations have also attracted increasing attention, as the results included strong demands that the national examination evaluate some basic clinical skills, such as physical examination and measurement of vital signs. However, about 30 % of authorities governing the national examination thought no changes are needed in the national examination.