[Barriers and Potential Improvements in the Diagnosis and Treatment of Asylum Seekers with Tuberculosis in Germany: A Qualitative Study]. / Hemmnisse und Verbesserungspotenziale bei der Diagnose und der Therapie asylsuchender Tuberkulosepatienten in Deutschland: Ergebnisse einer qualitativen Untersuchung.

Since 2014, the number of new cases of tuberculosis (TB) has risen in Germany by about 20%. This coincides with a large number of people applying for asylum in Germany. Some of them are from countries in which TB is much more prevalent than in Germany. The objectives of this contribution are to identify and explain barriers in the diagnosis and treatment of asylum seekers with TB and potential improvements in those fields. Data are derived from 14 problem-centred interviews that were carried out with doctors and staff from public health offices, representing the views of experts in the field of health care. On the one hand, the results suggest that structural factors are responsible for some of the barriers mentioned by the experts. For example, the restricted access to health care for asylum seekers leads to a delayed diagnosis since they visit the doctor too late (if at all). Accordingly, a nationwide implementation of an electronic health card for asylum seekers was proposed. On the other hand, individual and cultural factors play important roles as well. To those belong language barriers: they not only complicate history taking and diagnosis, but also educating patients about their disease and therapy. Moreover, the lack of knowledge concerning the German health care system increases the risk of treatment interruptions. To alleviate those problems, experts propose to carry out train-the-trainer-programmes and to install "guides" who pilot asylum seekers with TB through the German health care system.

The Nuisance Mosquito Anopheles plumbeus (Stephens, 1828) in Germany-A Questionnaire Survey May Help Support Surveillance and Control.

The mosquito species Anopheles plumbeus is an aggressive biter and a potential vector of malaria parasites and West Nile virus. It occurs naturally at low population densities, as its larval development is adapted to the specific water qualities found in tree holes. However, probably owing to environmental changes, it has recently been observed in several European countries to use increasingly often artificial breeding habitats that may lead to mass development and severe annoyance to humans living close by. The perception of mosquito nuisance, however, is very subjective, and breeding habitats are not always known, thus impeding targeted surveillance and control. To relate nuisance by An. plumbeus to specific environmental conditions, a questionnaire survey was carried out addressing persons who had submitted specimens of this particular mosquito species to the German citizen science project "Mueckenatlas", an instrument of passive mosquito surveillance. The questionnaire was intended to find out whether a nuisance situation linked to An. plumbeus had existed, whether mosquito breeding habitats could be identified and whether control measures had been conducted. Despite some efforts, the participants who claimed to suffer from an An. plumbeus nuisance problem had rarely identified the source of the mosquitoes. Once control measures had been performed on abandoned manure pits, however, the nuisance problem disappeared or mosquito abundance was at least significantly reduced. Nevertheless, no significant effect of abandoned manure pits on the probability of an An. plumbeus nuisance could be demonstrated in a multivariate logistic regression model testing various variables. Instead, a significant positive effect of a disused farm nearby was found. The reason is probably that manure pits as the most frequent source of An. plumbeus mass development are often located on disused farms, without most people's knowledge about their existence. Disused farms are therefore appropriate candidates to consider when it comes to public health issues connected to An. plumbeus such as surveillance of mass development and implementation of control measures.

Does Sexual Satisfaction Change With Relationship Duration?

Despite a large body of empirical literature on sexual satisfaction, its development over the course of a relationship is still unclear. Only a small number of studies, most of which have relied on cross-sectional data of convenience samples, have explicitly focused on relationship duration, and empirical evidence is mixed. We analyzed how sexual satisfaction changes over the course of a relationship using three waves of the German Family Panel study (pairfam). We concentrated our analyses on young and middle-aged heterosexual individuals in committed relationships (N = 2,814) and applied fixed effects regression models, which have the advantage of estimations based on changes within individuals over time. We found a positive development of sexual satisfaction in the first year of a relationship, followed by a steady decline. This pattern persisted even when controlling for the frequency of intercourse, although the effects were, in part, mediated by intercourse frequency. We explained the non-linear effect of relationship duration on sexual satisfaction with an initial learning effect regarding partner-specific sexual skills, which is then outweighed by a decline in passion at later stages of a relationship. Moreover, we found significant effects for the control variables of health status, intimacy in couple communication, and conflict style, as expected. In contrast to past research, however, cohabitation and marriage were not found to play a role for sexual satisfaction in our data. Further research is required to deepen the understanding of the reasons why sexual satisfaction changes with relationship duration.

Effects of relationship duration, cohabitation, and marriage on the frequency of intercourse in couples: Findings from German panel data.

Research into the changes in the frequency of sexual intercourse is (with few exceptions) limited to cross-sectional analyses of marital duration. We investigate the frequency of intercourse while taking into account relationship duration as well as the duration of cohabitation and marriage, effects of parenthood, and relationship quality. For the analysis we apply fixed effects regression models using data from the German Family Panel (pairfam), a nationwide randomly sampled German panel survey. Our findings imply that the drop in sex frequency occurs early in the relationship, whereas neither cohabitation nor marriage affects the frequency of intercourse to a significant extent. Sex frequency is reduced during pregnancy and as long as the couple has small children, but becomes revived later on. Relationship quality is found to play a role as well. These results are contrary to the honeymoon effect found in earlier research, but indicate that in times of postponed marriage an analogous effect may be at work in the initial period of the relationship.