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Travel times to hospitals in Australia.

ABSTRACT: Travel time to hospital is a key measure of health service accessibility, and impacts patients' experiences of care and health outcomes. Methods used to estimate travel time vary across studies. In Australia the smallest geographical areas defined by the Australian Bureau of Statistics for the release of population counts are mesh blocks (MBs) and the smallest geographical areas for the release of health-related statistics are statistical areas level 2 (SA2). SA2s are built up from whole MBs. This project used the Open Source Routing Machine (OSRM) HTTP server to compute estimated travel times between the centroid of each inhabited MB and each hospital in Australia, as well as the shortest travel times between MBs and any hospital. By computing population-weighted averages across MBs, the average travel times to hospitals and the shortest travel time to any hospital were estimated for each SA2. This dataset will promote consistency across studies investigating geographic influences on health care in Australia, and the methods are applicable to generating similar datasets for other countries.

SUBMITTER: Barbieri S

PROVIDER: S-EPMC6825170 | biostudies-literature | 2019 Nov

REPOSITORIES: biostudies-literature

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Travel times to hospitals in Australia.

Barbieri Sebastiano S Jorm Louisa L

Scientific data 20191101 1

Travel time to hospital is a key measure of health service accessibility, and impacts patients' experiences of care and health outcomes. Methods used to estimate travel time vary across studies. In Australia the smallest geographical areas defined by the Australian Bureau of Statistics for the release of population counts are mesh blocks (MBs) and the smallest geographical areas for the release of health-related statistics are statistical areas level 2 (SA2). SA2s are built up from whole MBs. Th ...[more]

PMID: 31676758

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Project description:BackgroundHepatitis E virus (HEV) is a common cause of acute viral hepatitis with significant morbidity and mortality, particularly in pregnant women. There are four major genotypes which can cause disease in humans. Genotypes 1 and 2 are usually associated with outbreaks and spread via facal/oral route or contaminated water. Genotypes 3 and 4 are zoonotic and usually associated with handling of pigs or consumption of contaminated pork. The strains circulating in Australia have never been characterized.Rationale/aimsThe aims for this project are to identify the HEV genotypes found in Australia and link them to possible sources of transmission by phylogenetic analysis.Materials and methodsBetween 2015 and 2020, 91 HEV isolates were sequenced and genotyped using an in-house PCR. Sixty-six of these were also sequenced by using the international HEVnet primers. Genotypes were determined using the BLASTn program. Relatedness to other strains in Australia was determined by phylogenetic analyses of the HEVnet sequences. Isolates were also stratified by state of origin, gender, age, predisposing factors and travel history (if known).ResultsOf the 91 HEV isolates sequenced, 55 (60.4%) were genotype 1. There were 34 (37.4%) genotype 3 strains and two genotype 4 (2.2%). At least 20 of the genotype 1 strains have been linked to travel in India, and another three with Pakistan. Five of the "Indian" strains were closely related and are suspected to have originated in Gujarat. Phylogenetic analysis also showed that 12 genotype 3 strains were genetically related and potentially acquired in/from New South Wales, Australia. The two genotype 4 strains may have originated in China.DiscussionThis is the first study to describe the HEV isolates identified in Australia. The results infer that HEV may be acquired during overseas travel as well as locally, presumably from consumption of pork or pork-related products. The phylogenetic analyses also reveal clusters of infection originating from India and Pakistan. This study provides some insight into the source and epidemiology of HEV infection in Australia which may be used to guide public health procedure and enable the implementation of measures to deal with potential outbreaks of infection.

Project description:BACKGROUND: The genus Rattus is highly speciose and has a complex taxonomy that is not fully resolved. As shown previously there are two major groups within the genus, an Asian and an Australo-Papuan group. This study focuses on the Australo-Papuan group and particularly on the Australian rats. There are uncertainties regarding the number of species within the group and the relationships among them. We analysed 16 mitochondrial genomes, including seven novel genomes from six species, to help elucidate the evolutionary history of the Australian rats. We also demonstrate, from a larger dataset, the usefulness of short regions of the mitochondrial genome in identifying these rats at the species level. RESULTS: Analyses of 16 mitochondrial genomes representing species sampled from Australo-Papuan and Asian clades of Rattus indicate divergence of these two groups ~2.7 million years ago (Mya). Subsequent diversification of at least 4 lineages within the Australo-Papuan clade was rapid and occurred over the period from ~ 0.9-1.7 Mya, a finding that explains the difficulty in resolving some relationships within this clade. Phylogenetic analyses of our 126 taxon, but shorter sequence (1952 nucleotides long), Rattus database generally give well supported species clades. CONCLUSIONS: Our whole mitochondrial genome analyses are concordant with a taxonomic division that places the native Australian rats into the Rattus fuscipes species group. We suggest the following order of divergence of the Australian species. R. fuscipes is the oldest lineage among the Australian rats and is not part of a New Guinean radiation. R. lutreolus is also within this Australian clade and shallower than R. tunneyi while the R. sordidus group is the shallowest lineage in the clade. The divergences within the R. sordidus and R. leucopus lineages occurring about half a million years ago support the hypotheses of more recent interchanges of rats between Australia and New Guinea. While problematic for inference of deeper divergences, we report that the analysis of shorter mitochondrial sequences is very useful for species identification in rats.

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Travel times to hospitals in Australia.

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Travel times to hospitals in Australia.

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