[Accessibility of organ cancer centres: is there already nation-wide coverage in Germany?]. / Erreichbarkeit von Organkrebszentren: Existiert bereits ein flächendeckendes Angebot in Deutschland?

INTRODUCTION: For several years, health care providers and health policy have been establishing certified cancer treatment centres. Although certification is not required by law, a comprehensive and close to home medical care in certified centres is required for all patients with cancer. We analysed whether Germany already provides a spatially inclusive and comprehensive supply with certified centres for the most common cancers for women and men. METHODS: Based on the central place concept "coverage" is defined as accessibility within 30 min by car for over 90% of the population. Using a software-supported route searching procedure we calculated 30- and 60-minutes-driving time zones around all breast and prostate cancre centers. We aggregated the population shares of all 5 digit postcode areas within the defined driving time zone and compared these areas to those outside the radius. The results are depicted as cartographic information. RESULTS: Nationwide 84% of the female populations over 18 years can reach the next breast centre within 30 min by car. In particular in the states of Mecklenburg-Western Pomerania and Brandenburg several areas do not provide sufficient access to breast centres. Using a travel time threshold of 60 min leads to an accessibility rate of 99%. 56% of the male population have access to a prostate cancer centre within half an hour by car. Again, the biggest coverage problems exist especially in eastern Germany. Within a radius of 60 min, the accessibility of prostate cancer centres increases to 94%. CONCLUSIONS: In Germany, some regions do not provide a spatially inclusive and comprehensive supply with organ cancer centers. However, it must be remembered that comprehensive access to care cannot be pursued as the only goal of health policy. Instead, the trade-off between justice, health and patients' interests and economic performance and adequate funding must be considered.

Transcutaneous electrical nerve stimulation in the relief of primary dysmenorrhea.

The purpose of this study was to replicate a previous study to determine the effectiveness of acupuncture-like transcutaneous electrical nerve stimulation in treating primary dysmenorrhea. Twenty-one women with dysmenorrhea received a placebo pill or 30 minutes of acupuncture-like TENS. All subjects completed two pain questionnaires before treatment; immediately posttreatment; 30, 60, 120, and 180 minutes posttreatment; and the next morning upon awakening. Each woman also participated in a separate study measuring electrical resistance at four auricular acupuncture points before and immediately after treatment. The data were analyzed with a two-factor repeated-measures analysis of variance, which revealed statistical significance over time but not for group or interaction between group and time. Results revealed an average pain relief of at least 50% immediately posttreatment, indicating that acupuncture-like TENS may be useful for dysmenorrheic pain. This study also suggests that auriculotherapy via acupressure may relieve the pain of primary dysmenorrhea.