128 resultados para Spice


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O livro de Jó pertence à literatura sapiencial de Israel. Seu conteúdo é um grande debate entre sábios. Estes formavam um segmento educado da população: sabiam ler e escrever. A sabedoria era demasiadamente valorizada e concebida como orientação prudente para a vida. O texto 24,1-12 de Jó pertence à parte poética do livro. O poema foi escrito na primeira metade do século V a.C., no período do pós exílio, durante a dominação dos persas. Este império trouxe profundas modificações para a vida do povo em Judá. Apesar da aparente tolerância por parte de seus governantes, eles criaram métodos muito eficazes para alcançar seus objetivos de controle sobre os povos submetidos. Através de um forte aparelho burocrático, fiscal e militar controlavam e garantiam a ordem e o pagamento de tributos. O templo tornou-se o intermediário entre o império e o povo. A economia e a sociedade se estruturaram conforme o regime imposto pelos persas. Essa política econômica e administrativa favorecia o enriquecimento dos setores dominantes, e conseqüentemente o empobrecimento cada vez maior dos camponeses. Os sacerdotes eram os líderes do povo e a teologia da retribuição se fortaleceu muito nessa época. No entanto, a justiça de Deus explicada pela teologia da retribuição deparava-se com o problema do mal e do sofrimento do justo. É a partir da experiência e da observação da realidade que se origina um movimento de resistência à teologia da retribuição. No capítulo 24,1-12, Jó se lança numa contemplação sobre a sociedade dividida entre opressores e oprimidos. Desmonta o funcionamento da sociedade mostrando suas rupturas e conflitos graves. Sua intenção nesse texto é mostrar através da realidade, porque não concorda com as afirmações dos sábios que defendem a teologia da retribuição, sobre o castigo infalível para os ímpios ricos e sobre o sofrimento do pobre como indicação de castigo.(AU)

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O livro de Jó pertence à literatura sapiencial de Israel. Seu conteúdo é um grande debate entre sábios. Estes formavam um segmento educado da população: sabiam ler e escrever. A sabedoria era demasiadamente valorizada e concebida como orientação prudente para a vida. O texto 24,1-12 de Jó pertence à parte poética do livro. O poema foi escrito na primeira metade do século V a.C., no período do pós exílio, durante a dominação dos persas. Este império trouxe profundas modificações para a vida do povo em Judá. Apesar da aparente tolerância por parte de seus governantes, eles criaram métodos muito eficazes para alcançar seus objetivos de controle sobre os povos submetidos. Através de um forte aparelho burocrático, fiscal e militar controlavam e garantiam a ordem e o pagamento de tributos. O templo tornou-se o intermediário entre o império e o povo. A economia e a sociedade se estruturaram conforme o regime imposto pelos persas. Essa política econômica e administrativa favorecia o enriquecimento dos setores dominantes, e conseqüentemente o empobrecimento cada vez maior dos camponeses. Os sacerdotes eram os líderes do povo e a teologia da retribuição se fortaleceu muito nessa época. No entanto, a justiça de Deus explicada pela teologia da retribuição deparava-se com o problema do mal e do sofrimento do justo. É a partir da experiência e da observação da realidade que se origina um movimento de resistência à teologia da retribuição. No capítulo 24,1-12, Jó se lança numa contemplação sobre a sociedade dividida entre opressores e oprimidos. Desmonta o funcionamento da sociedade mostrando suas rupturas e conflitos graves. Sua intenção nesse texto é mostrar através da realidade, porque não concorda com as afirmações dos sábios que defendem a teologia da retribuição, sobre o castigo infalível para os ímpios ricos e sobre o sofrimento do pobre como indicação de castigo.(AU)

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Seven wild and cultivated Salvia species and two Phlomis species, used traditionally in Valencian medicine to treat a variety of external and internal ailments, were studied. New ethnobotanical data are provided, obtained from semistructured interviews with 34 people in the Valencian area. A seasonal characterization of the essential oil of a wild sage, Salvia blancoana Webb & Heldr. subsp. mariolensis Figuerola, by GC-FID and GC-MS was carried out as a means to ensure quality control of endemic traditional species such as this one, which has been commercialized by local industries. A comparison with the essential oil of Salvia lavandulifolia Vahl subsp.lavandulifolia allowed inclusion of the wild sage within the commercial 'Spanish sage' oil.

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Back Row: Director Philip Bartelme, Wheaton Cole, George Thomson, Thomas Bogle, George Lawton, Clement Quinn, trainer Kranzlein

2nd Row: Coach Fielding Yost, Stanfield Wells, Fredric Conklin, Captain Albert Benbrook, William Edmunds, Joe Magidsohn, Student Mangr. C.G. Spice

Front Row: Stanley Borleski, Vic Pattengill, Neil McMillan, Arthur Cornwell

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Thesis (Master's)--University of Washington, 2016-06

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Ginger (Zingiber officinale, Roscoe), a monocotyledonous, sterile cultigen, is widely used as a spice, flavoring agent, and herbal medicine. The pungency of fresh ginger is due to a series of homologous phenolic ketones of which [6]-gingerol is the major one. The gingerols are thermally unstable and can be converted to their corresponding shogaols, which are present in dried ginger, Fresh rhizomes of 17 clones of Australian ginger, including commercial cultivars and experimental tetraploid clones, were assayed by HPLC for gingerols and shogaols. [6]-Gingerol was identified as the major pungent phenolic compound in all samples, while [8]- and [10]-gingerol occurred in lower concentrations. One cultivar known as Jamaican contained the highest concentrations of all three gingerols and was the most pungent of the clones analyzed. Gingerols were stable in ethanolic solution over a 5-month period when stored at 4 degrees C. Shogaols were not identified in the extracts prepared from fresh rhizomes at ambient temperature, confirming that these compounds are not native constituents of fresh ginger, In contrast to previous findings, this study did not find significant differences in gingerol concentrations between the tetraploid clones and their parent diploid cultivar.

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O livro de Jó pertence à literatura sapiencial de Israel. Seu conteúdo é um grande debate entre sábios. Estes formavam um segmento educado da população: sabiam ler e escrever. A sabedoria era demasiadamente valorizada e concebida como orientação prudente para a vida. O texto 24,1-12 de Jó pertence à parte poética do livro. O poema foi escrito na primeira metade do século V a.C., no período do pós exílio, durante a dominação dos persas. Este império trouxe profundas modificações para a vida do povo em Judá. Apesar da aparente tolerância por parte de seus governantes, eles criaram métodos muito eficazes para alcançar seus objetivos de controle sobre os povos submetidos. Através de um forte aparelho burocrático, fiscal e militar controlavam e garantiam a ordem e o pagamento de tributos. O templo tornou-se o intermediário entre o império e o povo. A economia e a sociedade se estruturaram conforme o regime imposto pelos persas. Essa política econômica e administrativa favorecia o enriquecimento dos setores dominantes, e conseqüentemente o empobrecimento cada vez maior dos camponeses. Os sacerdotes eram os líderes do povo e a teologia da retribuição se fortaleceu muito nessa época. No entanto, a justiça de Deus explicada pela teologia da retribuição deparava-se com o problema do mal e do sofrimento do justo. É a partir da experiência e da observação da realidade que se origina um movimento de resistência à teologia da retribuição. No capítulo 24,1-12, Jó se lança numa contemplação sobre a sociedade dividida entre opressores e oprimidos. Desmonta o funcionamento da sociedade mostrando suas rupturas e conflitos graves. Sua intenção nesse texto é mostrar através da realidade, porque não concorda com as afirmações dos sábios que defendem a teologia da retribuição, sobre o castigo infalível para os ímpios ricos e sobre o sofrimento do pobre como indicação de castigo.(AU)

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A microcap SPICE circuit-level model of a 12-pulse autotransformer based rectifier for an aircraft fuel-pump motor drive is described. The importance of including the nonlinear magnetising inductance of the interphase transformers is illustrated. Small supply voltage distortions are seen to result in current imbalance in the interphase transformers, degrading the rectifier input current, and may lead to infringement of the power quality specification. The model has been validated for various operating supply voltages, frequencies and output powers, against measurements from a 3.75 kW unit.

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To examine the detailed operation of the power distribution network in a future more electric aircraft that employs electric actuation systems, a Micro-Cap SPICE simulation is developed for one of the essential buses. Particular attention is paid to model accurately the most important effects that influence system power quality. Representative system and flight data are used to illustrate the operation of the simulation and to assess the power quality conditions within the network as the flight control surfaces are deployed. The results illustrate the importance of correct cable sizing to ensure stable operation of actuators during transient conditions.

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Commercial process simulators are increasing interest in the chemical engineer education. In this paper, the use of commercial dynamic simulation software, D-SPICE® and K-Spice®, for three different chemical engineering courses is described and discussed. The courses cover the following topics: basic chemical engineering, operability and safety analysis and process control. User experiences from both teachers and students are presented. The benefits of dynamic simulation as an additional teaching tool are discussed and summarized. The experiences confirm that commercial dynamic simulators provide realistic training and can be successfully integrated into undergraduate and graduate teaching, laboratory courses and research. © 2012 The Institution of Chemical Engineers.

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An integrated, high-resolution chemostratigraphic (C, O and Sr isotopes) and magnetostratigraphic study through the upper Middle Cambrian - lowermost Ordovician shallow-marine carbonates of the northwestern margin of the Siberian Platform is reported. The interval was analysed at the Kulyumbe section, which is exposed along the Kulyumbe River: an eastern tributary of the Enisej River. It comprises the upper Ust'-Brus, Labaz, Orakta, Kulyumbe, Ujgur, and lower Iltyk formations and includes the Steptoean positive carbon isotopic excursion (SPICE) studied here in detail from upper Cambrian carbonates of the Siberian Platform for the first time. The peak of the excursion, showing d13C positive values as high as +4.6? and least-altered 87Sr/86Sr ratios of 0.70909, is reported herein from the Yurakhian Horizon of the Kulyumbe Formation. The stratigraphic position of the SPICE excursion does not support traditional correlation of the boundary between the Orakta and Labaz formations at Kulyumbe River with its supposedly equivalent level in Australia, Laurentia, South China, and Kazakhstan, where the Glyptagnostus stolidotus and G. reticulatus biozones are known to immediately precede the SPICE excursion and span the Middle-Upper Cambrian boundary. The Cambrian-Ordovician boundary is probably situated in the middle Nyajan Horizon of the Iltyk Formation, in which carbon isotope values show a local maximum below a decrease in the upper part of the Nyajan Horizon, attributed herein to the Tremadocian. A refined magnetic polarity sequence shows that the geomagnetic reversal frequency was very high during the Middle Cambrian at 5-10 reversals per Ma, assuming a total duration of ~10 Ma and up to 100 magnetic intervals in the Middle Cambrian. By contrast, the sequence attributed herein to the Upper Cambrian on chemostratigraphic grounds contains only 10-11 magnetic intervals. Preprint in Open Access hdl:10013/epic.30209.d001

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This deliverable is software, as such this document is abridged to be as succinct as possible, the extended descriptions and detailed documentation for the software are online. The document consists of two parts, part one describes the first bundle of social gamification assets developed in WP3, part two presents mock-ups of the RAGE ecosystem gamification. In addition to the software outline, included in part one is a short market analysis of existing gamification solutions, outline rationale for combining the three social gamification assets into one unified asset, and the branding exercise to make the assets more developer friendly.Online links to the source code, binaries, demo and documentation for the assets are provided. The combined assets offer game developers as well as a wide range of software developers the opportunity to readily enhance existing games or digital platforms with multiplayer gamification functionalities, catering for both competitive and cooperative game dynamics. The solution consist of a flexible client-server solution which can run either as a cloud-based service, serving many games or have specific instances for individual games as necessary.

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We present new methodologies to generate rational function approximations of broadband electromagnetic responses of linear and passive networks of high-speed interconnects, and to construct SPICE-compatible, equivalent circuit representations of the generated rational functions. These new methodologies are driven by the desire to improve the computational efficiency of the rational function fitting process, and to ensure enhanced accuracy of the generated rational function interpolation and its equivalent circuit representation. Toward this goal, we propose two new methodologies for rational function approximation of high-speed interconnect network responses. The first one relies on the use of both time-domain and frequency-domain data, obtained either through measurement or numerical simulation, to generate a rational function representation that extrapolates the input, early-time transient response data to late-time response while at the same time providing a means to both interpolate and extrapolate the used frequency-domain data. The aforementioned hybrid methodology can be considered as a generalization of the frequency-domain rational function fitting utilizing frequency-domain response data only, and the time-domain rational function fitting utilizing transient response data only. In this context, a guideline is proposed for estimating the order of the rational function approximation from transient data. The availability of such an estimate expedites the time-domain rational function fitting process. The second approach relies on the extraction of the delay associated with causal electromagnetic responses of interconnect systems to provide for a more stable rational function process utilizing a lower-order rational function interpolation. A distinctive feature of the proposed methodology is its utilization of scattering parameters. For both methodologies, the approach of fitting the electromagnetic network matrix one element at a time is applied. It is shown that, with regard to the computational cost of the rational function fitting process, such an element-by-element rational function fitting is more advantageous than full matrix fitting for systems with a large number of ports. Despite the disadvantage that different sets of poles are used in the rational function of different elements in the network matrix, such an approach provides for improved accuracy in the fitting of network matrices of systems characterized by both strongly coupled and weakly coupled ports. Finally, in order to provide a means for enforcing passivity in the adopted element-by-element rational function fitting approach, the methodology for passivity enforcement via quadratic programming is modified appropriately for this purpose and demonstrated in the context of element-by-element rational function fitting of the admittance matrix of an electromagnetic multiport.

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En esta Tesis Doctoral se estudian la pasificación de las uvas Pedro Ximénez y Tempranillo, y la obtención de vinos dulces de uvas Tempranillo pasificadas. Durante la pasificación aumentan los azúcares, el pH, la acidez titulable y la acidez volátil. Los compuestos con aroma herbáceo disminuyen y los de aroma a fruta madura aumentan. En Tempranillo también aumentan los aromas especiados y a hierba seca. La nariz electrónica se revela como herramienta de análisis rápida y sencilla para decidir el punto óptimo de pasificación en función de la composición volátil. Parece existir un óptimo de pasificación sobre el 25% de deshidratación. La composición fenólica y la actividad antioxidante de mostos aumentan con la pasificación, mientras que disminuyen en los hollejos. Los valores de ambas variables son superiores en Tempranillo. En Pedro Ximénez la fracción más influyente varía durante la pasificación, siendo al final de la misma la correspondiente a las procianidinas poliméricas. En Tempranillo son los antocianos los que más contribuyen a la actividad antioxidante. Los ensayos in vitro con Pedro Ximénez demuestran que tanto los mostos como sus extractos fenólicos protegen al ADN, a lípidos, azúcares y proteínas de la oxidación provocada por distintos radicales libres. Los ensayos in vivo manifiestan que la incubación de las levadura con los mostos de uvas Pedro Ximénez y Tempranillo pasificadas, les confiere un claro efecto protector frente al estrés oxidativo. Efecto que aumenta con el grado de pasificación. Los hollejos de la variedad Tempranillo se han mostrado más efectivos que los mostos en esta protección. El contenido en compuestos volátiles es mayor en los vinos dulces de uvas Tempranillo pasificadas obtenidos por fermentación parcial que en los elaborados por el método tradicional, siendo también los mejor valorados organolépticamente.

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Abstract and Summary of Thesis: Background: Individuals with Major Mental Illness (such as schizophrenia and bipolar disorder) experience increased rates of physical health comorbidity compared to the general population. They also experience inequalities in access to certain aspects of healthcare. This ultimately leads to premature mortality. Studies detailing patterns of physical health comorbidity are limited by their definitions of comorbidity, single disease approach to comorbidity and by the study of heterogeneous groups. To date the investigation of possible sources of healthcare inequalities experienced by individuals with Major Mental Illness (MMI) is relatively limited. Moreover studies detailing the extent of premature mortality experienced by individuals with MMI vary both in terms of the measure of premature mortality reported and age of the cohort investigated, limiting their generalisability to the wider population. Therefore local and national data can be used to describe patterns of physical health comorbidity, investigate possible reasons for health inequalities and describe mortality rates. These findings will extend existing work in this area. Aims and Objectives: To review the relevant literature regarding: patterns of physical health comorbidity, evidence for inequalities in physical healthcare and evidence for premature mortality for individuals with MMI. To examine the rates of physical health comorbidity in a large primary care database and to assess for evidence for inequalities in access to healthcare using both routine primary care prescribing data and incentivised national Quality and Outcome Framework (QOF) data. Finally to examine the rates of premature mortality in a local context with a particular focus on cause of death across the lifespan and effect of International Classification of Disease Version 10 (ICD 10) diagnosis and socioeconomic status on rates and cause of death. Methods: A narrative review of the literature surrounding patterns of physical health comorbidity, the evidence for inequalities in physical healthcare and premature mortality in MMI was undertaken. Rates of physical health comorbidity and multimorbidity in schizophrenia and bipolar disorder were examined using a large primary care dataset (Scottish Programme for Improving Clinical Effectiveness in Primary Care (SPICE)). Possible inequalities in access to healthcare were investigated by comparing patterns of prescribing in individuals with MMI and comorbid physical health conditions with prescribing rates in individuals with physical health conditions without MMI using SPICE data. Potential inequalities in access to health promotion advice (in the form of smoking cessation) and prescribing of Nicotine Replacement Therapy (NRT) were also investigated using SPICE data. Possible inequalities in access to incentivised primary healthcare were investigated using National Quality and Outcome Framework (QOF) data. Finally a pre-existing case register (Glasgow Psychosis Clinical Information System (PsyCIS)) was linked to Scottish Mortality data (available from the Scottish Government Website) to investigate rates and primary cause of death in individuals with MMI. Rate and primary cause of death were compared to the local population and impact of age, socioeconomic status and ICD 10 diagnosis (schizophrenia vs. bipolar disorder) were investigated. Results: Analysis of the SPICE data found that sixteen out of the thirty two common physical comorbidities assessed, occurred significantly more frequently in individuals with schizophrenia. In individuals with bipolar disorder fourteen occurred more frequently. The most prevalent chronic physical health conditions in individuals with schizophrenia and bipolar disorder were: viral hepatitis (Odds Ratios (OR) 3.99 95% Confidence Interval (CI) 2.82-5.64 and OR 5.90 95% CI 3.16-11.03 respectively), constipation (OR 3.24 95% CI 3.01-3.49 and OR 2.84 95% CI 2.47-3.26 respectively) and Parkinson’s disease (OR 3.07 95% CI 2.43-3.89 and OR 2.52 95% CI 1.60-3.97 respectively). Both groups had significantly increased rates of multimorbidity compared to controls: in the schizophrenia group OR for two comorbidities was 1.37 95% CI 1.29-1.45 and in the bipolar disorder group OR was 1.34 95% CI 1.20-1.49. In the studies investigating inequalities in access to healthcare there was evidence of: under-recording of cardiovascular-related conditions for example in individuals with schizophrenia: OR for Atrial Fibrillation (AF) was 0.62 95% CI 0.52 - 0.73, for hypertension 0.71 95% CI 0.67 - 0.76, for Coronary Heart Disease (CHD) 0.76 95% CI 0.69 - 0.83 and for peripheral vascular disease (PVD) 0.83 95% CI 0.72 - 0.97. Similarly in individuals with bipolar disorder OR for AF was 0.56 95% CI 0.41-0.78, for hypertension 0.69 95% CI 0.62 - 0.77 and for CHD 0.77 95% CI 0.66 - 0.91. There was also evidence of less intensive prescribing for individuals with schizophrenia and bipolar disorder who had comorbid hypertension and CHD compared to individuals with hypertension and CHD who did not have schizophrenia or bipolar disorder. Rate of prescribing of statins for individuals with schizophrenia and CHD occurred significantly less frequently than in individuals with CHD without MMI (OR 0.67 95% CI 0.56-0.80). Rates of prescribing of 2 or more anti-hypertensives were lower in individuals with CHD and schizophrenia and CHD and bipolar disorder compared to individuals with CHD without MMI (OR 0.66 95% CI 0.56-0.78 and OR 0.55 95% CI 0.46-0.67, respectively). Smoking was more common in individuals with MMI compared to individuals without MMI (OR 2.53 95% CI 2.44-2.63) and was particularly increased in men (OR 2.83 95% CI 2.68-2.98). Rates of ex-smoking and non-smoking were lower in individuals with MMI (OR 0.79 95% CI 0.75-0.83 and OR 0.50 95% CI 0.48-0.52 respectively). However recorded rates of smoking cessation advice in smokers with MMI were significantly lower than the recorded rates of smoking cessation advice in smokers with diabetes (88.7% vs. 98.0%, p<0.001), smokers with CHD (88.9% vs. 98.7%, p<0.001) and smokers with hypertension (88.3% vs. 98.5%, p<0.001) without MMI. The odds ratio of NRT prescription was also significantly lower in smokers with MMI without diabetes compared to smokers with diabetes without MMI (OR 0.75 95% CI 0.69-0.81). Similar findings were found for smokers with MMI without CHD compared to smokers with CHD without MMI (OR 0.34 95% CI 0.31-0.38) and smokers with MMI without hypertension compared to smokers with hypertension without MMI (OR 0.71 95% CI 0.66-0.76). At a national level, payment and population achievement rates for the recording of body mass index (BMI) in MMI was significantly lower than the payment and population achievement rates for BMI recording in diabetes throughout the whole of the UK combined: payment rate 92.7% (Inter Quartile Range (IQR) 89.3-95.8 vs. 95.5% IQR 93.3-97.2, p<0.001 and population achievement rate 84.0% IQR 76.3-90.0 vs. 92.5% IQR 89.7-94.9, p<0.001 and for each country individually: for example in Scotland payment rate was 94.0% IQR 91.4-97.2 vs. 96.3% IQR 94.3-97.8, p<0.001. Exception rate was significantly higher for the recording of BMI in MMI than the exception rate for BMI recording in diabetes for the UK combined: 7.4% IQR 3.3-15.9 vs. 2.3% IQR 0.9-4.7, p<0.001 and for each country individually. For example in Scotland exception rate in MMI was 11.8% IQR 5.4-19.3 compared to 3.5% IQR 1.9-6.1 in diabetes. Similar findings were found for Blood Pressure (BP) recording: across the whole of the UK payment and population achievement rates for BP recording in MMI were also significantly reduced compared to payment and population achievement rates for the recording of BP in chronic kidney disease (CKD): payment rate: 94.1% IQR 90.9-97.1 vs.97.8% IQR 96.3-98.9 and p<0.001 and population achievement rate 87.0% IQR 81.3-91.7 vs. 97.1% IQR 95.5-98.4, p<0.001. Exception rates again were significantly higher for the recording of BP in MMI compared to CKD (6.4% IQR 3.0-13.1 vs. 0.3% IQR 0.0-1.0, p<0.001). There was also evidence of differences in rates of recording of BMI and BP in MMI across the UK. BMI and BP recording in MMI were significantly lower in Scotland compared to England (BMI:-1.5% 99% CI -2.7 to -0.3%, p<0.001 and BP: -1.8% 99% CI -2.7 to -0.9%, p<0.001). While rates of BMI and BP recording in diabetes and CKD were similar in Scotland compared to England (BMI: -0.5 99% CI -1.0 to 0.05, p=0.004 and BP: 0.02 99% CI -0.2 to 0.3, p=0.797). Data from the PsyCIS cohort showed an increase in Standardised Mortality Ratios (SMR) across the lifespan for individuals with MMI compared to the local Glasgow and wider Scottish populations (Glasgow SMR 1.8 95% CI 1.6-2.0 and Scotland SMR 2.7 95% CI 2.4-3.1). Increasing socioeconomic deprivation was associated with an increased overall rate of death in MMI (350.3 deaths/10,000 population/5 years in the least deprived quintile compared to 794.6 deaths/10,000 population/5 years in the most deprived quintile). No significant difference in rate of death for individuals with schizophrenia compared with bipolar disorder was reported (6.3% vs. 4.9%, p=0.086), but primary cause of death varied: with higher rates of suicide in individuals with bipolar disorder (22.4% vs. 11.7%, p=0.04). Discussion: Local and national datasets can be used for epidemiological study to inform local practice and complement existing national and international studies. While the strengths of this thesis include the large data sets used and therefore their likely representativeness to the wider population, some limitations largely associated with using secondary data sources are acknowledged. While this thesis has confirmed evidence of increased physical health comorbidity and multimorbidity in individuals with MMI, it is likely that these findings represent a significant under reporting and likely under recognition of physical health comorbidity in this population. This is likely due to a combination of patient, health professional and healthcare system factors and requires further investigation. Moreover, evidence of inequality in access to healthcare in terms of: physical health promotion (namely smoking cessation advice), recording of physical health indices (BMI and BP), prescribing of medications for the treatment of physical illness and prescribing of NRT has been found at a national level. While significant premature mortality in individuals with MMI within a Scottish setting has been confirmed, more work is required to further detail and investigate the impact of socioeconomic deprivation on cause and rate of death in this population. It is clear that further education and training is required for all healthcare staff to improve the recognition, diagnosis and treatment of physical health problems in this population with the aim of addressing the significant premature mortality that is seen. Conclusions: Future work lies in the challenge of designing strategies to reduce health inequalities and narrow the gap in premature mortality reported in individuals with MMI. Models of care that allow a much more integrated approach to diagnosing, monitoring and treating both the physical and mental health of individuals with MMI, particularly in areas of social and economic deprivation may be helpful. Strategies to engage this “hard to reach” population also need to be developed. While greater integration of psychiatric services with primary care and with specialist medical services is clearly vital the evidence on how best to achieve this is limited. While the National Health Service (NHS) is currently undergoing major reform, attention needs to be paid to designing better ways to improve the current disconnect between primary and secondary care. This should then help to improve physical, psychological and social outcomes for individuals with MMI.