The PreFord Study is a multicenter prospective cohort study to evaluate guideline based risk management on primary prevention of cardiovascular diseases. Furthermore a randomised controlled trial (RCT) will be designed to analyse the effect of a special intervention program. 40,000 employees of the Ford Motor Company, Visteon Company and Deutz Company in Germany will be included, monitored for ten years and the following primary endpoints will be investigated: 1. evaluation and comparison of established and newly developed risk-scores, 2. the relative impact of single and combined cardiovascular risk factors on cardiovascular diseases, 3. the influence of a novel occupationally integrated ambulant rehabilitation program in combination with a guideline oriented optimal drug therapy within a high risk group on the primary endpoint: risk reduction by, 4. the influence of this intervention on secondary endpoints: death, myocardial infarction and stroke, combined appearance of angina pectoris and hospitalisation, occurrence of cerebral circulatory disorder and hospitalisation, occurrence of peripheral occlusive arterial disease and hospitalisation and single cardiovascular risk factors and cost-benefit-analysis. Beginning with an cross sectional study there will be a systemic screening of cardiovascular risk profiles, of anthropometric data and different lifestyle-factors. Based on these data participants will be differentiated into three risk-groups according to the risk score of the European Society of Cardiology (risk of a lethal primary acute cardiovascular event: I < or = 1%; II > 1-< 5% and III > or = 5%). In the following longitudinal study different strategies will be applied: Group I: low risk (< 0.5% per year): repetition of the investigation after five and ten years. Group II: middle risk, (0.6% to 1.4% per year), repetition of the investigation every two years, instruction of the patients general practitioner (GP) with respect to a risk factor oriented and evidence based treatment. Group III: high risk, (> 1.5% per year or >15% within the next 10 years) will be randomised into two interventional groups. The first one, the intervention-group "PreFord" will perform an occupational integrated rehabilitation program (2,5-3 hours twice a week, for 15 weeks according to the BAR guidelines) with a following engagement in heart-groups and an annual repetition of the check-ups. The second group, the "classic" intervention-group will be treated evidence based in cooperation with their GP. As a result of this long term interventional study efficient, area wide implementable and economically feasible prevention concepts with special regards to operational healthcare will be developed and evaluated. Core elements will be exercise- and lifestyle-oriented concepts as well as guideline-based pharmacotherapy.

Zusammenfassung Fragestellung: Humeruskopffrakturen geh?ren zu den h?ufigsten Frakturen. Die Evidenzlage zur Nachbehandlung ist schlecht. Ziel der Studie war die Identifikation von Einflussfaktoren auf das Behandlungsergebnis. Material und Methoden: Untersucht wurden 62 Patienten mit proximalen Humerusfrakturen nach 6, 12 und 52 Wochen sowie 10 gesunde Probanden. Mittels Oberfl?chen-EMG erfolgte beidseitig die Ableitung von 16 Schultermuskeln in verschiedenen Untersuchungssituationen in der Scapulaebene. Zus?tzlich wurden Constant-Murley-, DASH-Score sowie patientenspezifische Daten erhoben. Ergebnisse: Die Ergebnisse haben gezeigt, dass die Schwere der Fraktur und die Behandlungsart wichtige Einflussfaktoren sind. Alter, Geschlecht und H?ndigkeit spielten eine untergeordnete Rolle. Eine konservative Behandlung sollte nach M?glichkeit favorisiert werden. Die Funktion des M. deltoideus ist durch die Fraktur beeintr?chtigt und beeinflusst das Ergebnis entscheidend. EMG-Verfahren liefern zus?tzliche Erkenntnisse zur Erkl?rung von Pathomechanismen. Eine fr?hzeitige Nachbehandlung erscheint notwendig. Schlussfolgerung: Wichtig f?r den Behandlungserfolg ist ein begr?ndeter Entscheidungsalgorhythmus des erstbehandelnden Arztes.

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