Ulrike Zier
University of Mainz
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BMC Medical Education | 2011
Elke Ochsmann; Ulrike Zier; Hans Drexler; Klaus Schmid
BackgroundApart from objective exam results, the overall feeling of preparedness is important for a successful transition process from being a student to becoming a qualified doctor. This study examines the association between self-assessed deficits in medical skills and knowledge and the feeling of preparedness of junior doctors in order to determine which aspects of medical education need to be addressed in more detail in order to improve the quality of this transition phase and in order to increase patient safety.MethodsA cohort of 637 doctors with up to two years of clinical work experience was included in this analysis and was asked about the overall feeling of preparedness and self-assessed deficits with regard to clinical knowledge and skills. Three logistic regression models were used to identify medical skills which predict the feeling of preparedness.ResultsAll in all, about 60% of the participating doctors felt poorly prepared for post-graduate training. Self-assessed deficits in ECG interpretation (aOR: 4.39; 95% CI: 2.012-9.578), treatment and therapy planning (aOR: 3.42; 95% CI: 1.366-8.555), and intubation (aOR: 2.10; 95% CI: 1.092-4.049) were found to be independently associated with the overall feeling of preparedness in the final regression model.ConclusionsMany junior doctors in Germany felt inadequately prepared for being a doctor. With regard to the contents of medical curricula, our results show that more emphasis on ECG-interpretation, treatment and therapy planning and intubation is required to improve the feeling of preparedness of medical graduates.
Social Work in Health Care | 2011
Heiko Rueger; Norbert F. Schneider; Ulrike Zier; Stephan Letzel; Eva Muenster
The study examines over-indebted fathers after separation/divorce with respect to health-related lifestyles/state of health. A cross-sectional survey was conducted among over-indebted persons in Germany 2006/2007 (response rate 39.7%). Fathers in complete families (n = 73; M = 37 years) and single mothers (n = 72; M = 33.5 years) served as comparison groups to the separated fathers (n = 59; M = 37 years). Risks of depressive mood, unhealthy nutrition, and hypertension were higher compared to fathers in complete families. Tobacco use and low health awareness proved to be higher than among both comparison groups. The findings indicate problematic health-related behavior and health status among separated over-indebted fathers, and suggest recognizing them as a high risk group within social work.
Annals of Agricultural and Environmental Medicine | 2014
Bernd Roßbach; Peter Kegel; Ulrike Zier; Adrian Niemietz; Stephan Letzel
INTRODUCTION AND OBJECTIVE Prevention of tick borne diseases in forestry workers is essentially based on the use of appropriate clothing. The objective of this pragmatic, randomized, controlled trial was to assess the potential benefit of permethrin-treated working trousers for the prevention of tick infestation during forestry work. MATERIALS AND METHODS N=164 male forestry workers were equipped for a period of 16 weeks with permethrin-treated (intervention group-I) or untreated work trousers (control group-II). Subgroups, according to the use of trousers with (I-1, II-1) or without cut protection lining (I-2, II-2) were constituted. Tick infestation (quantity of ticks on the body surface) was assessed by questionnaire after 16 workdays. Control and intervention groups were compared by calculating the infestation rate (percentage of subjects with ticks) and the average number of ticks per workday. RESULTS The infestation rate in the intervention group was significantly lower than in the control group (36.6 vs. 63.4%, p=0.001; Fisher-test). Further analysis revealed a significant reduction of tick infestation by permethrin treatment only for subjects wearing trousers without the cut protection lining (I-2: 34.2 vs. II-2: 80.0%, p<0.001), while users of cut protection trousers did not benefit from such treated trousers (I-1: 38.6 vs. II-1: 47.6%, n.s.). Similar results were found for comparisons based on the average number of ticks per workday. CONCLUSIONS The use of permethrin-treated trousers does not completely prevent tick infestations. Improvement of tick protection has been shown only for some applications, but not in general. Additional prevention measures are therefore still indispensable.
BMC Medicine | 2018
Jenny Jesuthasan; Ekin Sönmez; Ingar Abels; Christine Kurmeyer; Jana Gutermann; Renate Kimbel; Antje Krüger; Guenter Niklewski; Kneginja Richter; Ulrich Stangier; Anja Wollny; Ulrike Zier; Sabine Oertelt-Prigione; Meryam Shouler-Ocak
BackgroundThe year 2016 has marked the highest number of displaced people worldwide on record. A large number of these refugees are women, yet little is known about their specific situation and the hurdles they have to face during their journey. Herein, we investigated whether sociodemographic characteristics and traumatic experiences in the home country and during the flight affected the quality of life of refugee women arriving in Germany in 2015–2016.MethodsSix hundred sixty-three women from six countries (Afghanistan, Syria, Iran, Iraq, Somalia, and Eritrea) living in shared reception facilities in five distinct German regions were interviewed by native speakers using a structured questionnaire. Sociodemographic data and information about reasons for fleeing, traumatic experiences, symptoms, quality of life, and expectations towards their future were elicited. All information was stored in a central database in Berlin. Descriptive analyses, correlations, and multivariate analyses were performed.ResultsThe most frequent reasons cited for fleeing were war, terror, and threat to one’s life or the life of a family member. Eighty-seven percent of women resorted to smugglers to make the journey to Europe, and this significantly correlated to residence in a war zone (odds ratio (OR) = 2.5, 95% confidence interval (CI) = 1.4–4.6, p = 0.003) and homelessness prior to fleeing (OR = 2.1, 95% CI = 1–4.3, p = 0.04). Overall the described quality of life by the women was moderate (overall mean = 3.23, range of 1–5) and slightly worse than that of European populations (overall mean = 3.68, p < 0.0001). The main reasons correlating with lower quality of life were older age, having had a near-death experience, having been attacked by a family member, and absence of health care in case of illness.ConclusionsRefugee women experience multiple traumatic experiences before and/or during their journey, some of which are gender-specific. These experiences affect the quality of life in their current country of residence and might impact their integration. We encourage the early investigation of these traumatic experiences to rapidly identify women at higher risk and to improve health care for somatic and mental illness.
BMC Pregnancy and Childbirth | 2018
Eva Münster; Stephan Letzel; Jasmin Passet-Wittig; Norbert F. Schneider; Bettina Schuhrke; Rudolf Seufert; Ulrike Zier
BackgroundIt is estimated that 5-15% of all couples in industrialised nations are infertile. A perceived unfulfilled desire for a child or self-identification as infertile can lead to psychological strain and social isolation. About 53.000 women underwent assisted reproduction treatments in Germany in 2014. Little is known about the first medical consultation and patient needs prior to the first visit in a fertility clinic in Germany. The baseline survey of the prospective cohort study on couples undergoing fertility treatment in Germany (PinK Study) provides first results on this topic for Germany.MethodsThe baseline survey was conducted between 2012 and 2013. Self-administered questionnaires were handed out to patients of six fertility clinics at the beginning of treatment by clinic staff. At a participation rate of 31.0%, we were able to analyse data on 323 women and 242 men.Results92.6% of the women had their initial medical consultation on their unfulfilled desire for a child with a gynaecologist. After the urologist (44.2%), the general practitioner (12.0%) was the second most approached initial contact person for men. 36.4% of all men had no medical consultation on the unfulfilled desire for a child before visiting a fertility clinic. 46.9% of the respondents expressed the wish that the conversation about infertility should be initiated by a physician. Prior to their first visit to a fertility clinic, 11.2% of the men and 24.8% of the women were informed by a physician that infertility treatment can cause emotional strain.ConclusionWhile almost all women consult a gynaecologist prior to the first visit in a fertility centre, one out of three men do not consult any physician at that stage. For the remaining group of men, urologists and general practitioners are the most important contact persons. Gender-specific health care needs are evident. In order to close the health care gap for men in Germany, more opportunities for discreet access to consultation should be offered. Due to its low threshold and family-oriented approach, general practice could make an important contribution to this effect.
Social Work in Health Care | 2011
Eva Muenster; Ulrike Zier; Stephan Letzel; Elke Ochsmann; Horst Weirich; André Michael Toschke
The health hazards of tobacco consumption are well known; numerous prevention programs exist, but knowledge of risk factors for starting to smoke is scarce. This study addressed the question if school-related factors influence smoking behavior in 7–17-year-old pupils. A cross-sectional study including 2459 pupils of schools in Rhineland-Palatinate, Germany, was conducted. Roughly every twentieth child (n = 135, 4.5%) had smoked at least once. In the multivariate model the probability of smoking was associated with older age, being male, not being content, and having inadequate family support, as well as with feeling unfairly treated at school. These findings suggest the imposition of gender- and age-adequate prevention with a focus on social support from school and parents to decrease the number of juvenile smokers.
Archive | 2015
Ulrike Zier; Stephan Letzel; Eva Münster
Das Phanomen der Uberschuldung von privaten Haushalten hat in Deutschland eine relevante Verbreitung und beeinflusst die Lebenslage der Betroffenen enorm. Leider sind zuverlassige aktuelle Zahlen zur Verbreitung des Phanomens nicht vorhanden. Eine Schatzung der Pravalenz wird u.a. jahrlich durch Creditreform Wirtschaftsforschung (2013: 3f) durchgefuhrt. Dort wird der Anteil der Uberschuldeten an der Gesamtbevolkerung in den Jahren 2004-2013 auf 9,1 % bis 10,9 % geschatzt.
Archive | 2013
Ulrike Zier; Carsten Homann; Stephan Letzel; Eva Münster
Zur Bewaltigung von Schulden, insbesondere von uberschuldung, sind physische und psychische Gesundheit wichtige Faktoren. Das Abtragen von Schulden oder auch die Einleitung eines Insolvenzverfahrens mit moglicher Restschuldbefreiung gelingt am besten bei voller Handlungskapazitat. Die wichtige Ressource Gesundheit ist jedoch nicht gleich verteilt.
Gesundheitswesen | 2013
Ulrike Zier; B Schuhrke; N Schneider; J Passet
Mit 8,1 Neugeborenen pro 1000 Einwohner im Jahr 2011 ist das Geburtenniveau in der Bundesrepublik Deutschland im europaischen Vergleich sehr niedrig. Einer der Grunde ist die gestiegene Zahl Kinderloser. Dabei kommt das Phanomen vorubergehender ungewollter Kinderlosigkeit relativ haufig vor. Je nach zugrunde gelegter Definition wird die Pravalenz auf 6% bis uber 30% geschatzt. Eine wichtige Moglichkeit dem unerfullten Kinderwunsch zu begegnen, ist die medizinisch assistierte Reproduktion. Im Jahr 2009 wurden 1,9% der lebend Geborenen in Deutschland durch Befruchtung auserhalb des Korpers gezeugt. Dass die Rolle der Reproduktionsmedizin mit verschiedenen gesellschaftlichen Rahmenbedingungen zusammenhangt zeigt sich beispielsweise am starken Ruckgang ihrer Inanspruchnahme infolge der Erhohung der finanziellen Eigenbeteiligung 2003. Auch andere aktuelle Entwicklungen wie die Einfuhrung der Praimplantationsdiagnostik zeugen von dieser Interaktion. Im geplanten Workshop sollen aus verschiedenen Perspektiven aktuelle und kunftige Schwierigkeiten und Entwicklungschancen in der Reproduktionsmedizin fur die Gesellschaft als Ganzes aber auch die Patienten diskutiert werden. Dazu gehoren beispielsweise Hurden und Verzogerungen, aber auch Unterstutzung und Hilfe, die Paare auf dem Weg zur Behandlung und wahrend der Kinderwunschbehandlung erleben.
Archive | 2012
Ulrike Zier; H. Rüger; Eva Münster
Unter dem Begriff der Uberschuldung oder der dauerhaften Zahlungsunfahigkeit ist zu verstehen, dass das Einkommen einer Privatperson nach Abzug der notwendigen Lebenshaltungskosten nicht ausreicht, um alle ausstehenden Zahlungsverpflichtungen in absehbarer Zeit zu erfullen (Wimmer 2006, S. 1682). Selbst bei einer Reduzierung des eigenen Lebensstandards besteht in diesem Fall keine Perspektive, die Rechnungen oder Schulden langfristig abzubezahlen. Betroffene und die zum Haushalt gehorenden Personen und ggf. Haustiere sind damit in ihrem Alltag von akuter Ausgabenarmut betroffen, so dass selbst die Grundversorgung nicht gewahrleistet und soziale Teilhabe eingeschrankt sein konnen.