This place of death study includes more populations than any other known. In many populations, residential aged care was an important site of death for older people, indicating the need to optimise models of end-of-life care in this setting. For many countries, more standardised reporting of place of death would inform policies and planning of services to support end-of-life care.

Mobile phones are becoming increasingly important in monitoring and delivery of healthcare interventions. They are often considered as pocket computers, due to their advanced computing features, enhanced preferences and diverse capabilities. Their sophisticated sensors and complex software applications make the mobile healthcare (m-health) based applications more feasible and innovative. In a number of scenarios user-friendliness, convenience and effectiveness of these systems have been acknowledged by both patients as well as healthcare providers. M-health technology employs advanced concepts and techniques from multidisciplinary fields of electrical engineering, computer science, biomedical engineering and medicine which benefit the innovations of these fields towards healthcare systems. This paper deals with two important aspects of current mobile phone based sensor applications in healthcare. Firstly, critical review of advanced applications such as; vital sign monitoring, blood glucose monitoring and in-built camera based smartphone sensor applications. Secondly, investigating challenges and critical issues related to the use of smartphones in healthcare including; reliability, efficiency, mobile phone platform variability, cost effectiveness, energy usage, user interface, quality of medical data, and security and privacy. It was found that the mobile based applications have been widely developed in recent years with fast growing deployment by healthcare professionals and patients. However, despite the advantages of smartphones in patient monitoring, education, and management there are some critical issues and challenges related to security and privacy of data, acceptability, reliability and cost that need to be addressed.

L ong-term residential aged care (RAC) is used at any one time by about 4-6% of those aged 65 years or over in many developed countries, including NZ. [1][2][3] This figure -usually derived from research adopting cross-sectional methods such as censuses and surveys -sometimes leads to the erroneous assumption that only few people use RAC during their lifetimes. 4 Inappropriate use of cross-sectional figures for estimating the likelihood of use of RACwhich Kastenbaum and Candy referred to as "the four per cent fallacy" 5,6 -may suggest that the sector is small and affects few people. To avoid such misunderstandings, and for policy and planning purposes, estimates are needed of the likelihood people aged 65 and over will use residential care at any time before they die, hereafter termed 'lifetime use' .Studies of place of death have been used to answer this question. 5,[7][8][9] Deaths in RAC are widely available, based on death certificate information. For example, a large international comparison of 21 populations aged 65+ years showed RAC was the place of death for a median of 18% (inter-quartile range 14-29 %) of decedents 10 . In the US the proportion was 29% and in Australia and Canada 32%, but in Iceland and NZ the proportion was higher at 38%. However, deaths in RAC underestimate total RAC use wherever a proportion of RAC residents die in an acute hospital.Other than place of death, three methodologies have previously been used to assess lifetime use. These include 1) assembling a population-representative cohort and following it either prospectively until death or from death retrospectively; 2) using the lifetable method as used in demographic projections; and 3) modelling transition probabilities between residence at home, residence in RAC and death, and then simulating lifetime risk. All these methods require the assembly of large or long cohorts. In countries where there are no such cohorts, including NZ, another method of estimation is required. The need for simple methods to estimate lifetime use has previously been recognised. 9 This paper describes a simple method of estimation of lifetime use of RAC for people who reach the age of 65 years. Administrative data for place of death obtained from death certificates are obtained first for the NZ population, derived from all death certificates over a five-year period. To that figure is added an estimate of the number of RAC residents who die, not in RAC, but in acute hospital. It then compares NZ estimates to published reports for other countries. Methods: Deaths of RAC residents in acute hospitals were estimated for NZ from four separate studies and added to deaths occurring in RAC, to derive the likelihood of using RAC after age 65 years. Academic and other sources were searched for comparative reports. Likelihood of residential agedResults: An estimated 18% of RAC residents died in acute hospital in NZ. When added to those who died in RAC, the proportion using RAC for late-life care was estimated at over 47% (66% if aged 85+ years). Of 12 US reports,...

The soluble cleaved urokinase plasminogen activator receptor (scuPAR) is a circulating protein detected in multiple diseases, including various cancers, cardiovascular disease, and kidney disease, where elevated levels of scuPAR have been associated with worsening prognosis and increased disease aggressiveness. We aimed to identify novel genetic and biomolecular mechanisms regulating scuPAR levels. Elevated serum scuPAR levels were identified in asthma (n=514) and chronic obstructive pulmonary disease (COPD; n=219) cohorts when compared to controls (n=96). In these cohorts, a genome-wide association study of serum scuPAR levels identified a human plasma kallikrein gene (KLKB1) promoter polymorphism (rs4253238) associated with serum scuPAR levels in a control/asthma population (P=1.17×10−7), which was also observed in a COPD population (combined P=5.04×10−12). Using a fluorescent assay, we demonstrated that serum KLKB1 enzymatic activity was driven by rs4253238 and is inverse to scuPAR levels. Biochemical analysis identified that KLKB1 cleaves scuPAR and negates scuPAR's effects on primary human bronchial epithelial cells (HBECs) in vitro. Chymotrypsin was used as a proproteolytic control, while basal HBECs were used as a control to define scuPAR-driven effects. In summary, we reveal a novel post-translational regulatory mechanism for scuPAR using a hypothesis-free approach with implications for multiple human diseases.—Portelli, M. A., Siedlinski, M., Stewart, C. E., Postma, D. S., Nieuwenhuis, M. A., Vonk, J. M., Nurnberg, P., Altmuller, J., Moffatt, M. F., Wardlaw, A. J., Parker, S. G., Connolly, M. J., Koppelman, G. H., Sayers, I. Genome-wide protein QTL mapping identifies human plasma kallikrein as a post-translational regulator of serum uPAR levels.