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The purpose of this paper is to provide an up‐to‐date overview of Tajikistan's health system, focusing on the main factors affecting health systems development. The wider contextual environment is to be explored, focusing on political, social and economic issues. Different elements of the health system including health policy, governance, service delivery, human resources and health financing are reviewed in the light of their development over the past decade.

The paper shows that the Republic of Tajikistan is in transition. Formerly one of the most neglected republics within the USSR, the country became independent in 1990 and faced the civil conflict shortly thereafter. In the last few years there have been major public sector reforms with health reforms formally launched in the late 1990s. Little information about current Tajikistan is widely available.

The paper finds that the progress of health reforms in Tajikistan has been relatively slow compared with neighbouring Kazakhstan and Kyrgyzstan. This is largely due to the effects of civil war in the mid‐1990s and significant out‐migration of qualified experts, but it can also be attributed to an inability of central government to adequately adapt to the requirements of transition.

The paper shows that many problems are still to be overcome by the health system, ranging from operational issues related to service delivery to strategic issues such as formulating an explicit privatisation policy, reducing fragmentation of, and aligning, external aid. However, some recent developments, such as adoption of a country health reform conception, a health financing strategy, and willingness of central government to improve coordination, suggest that improvements are possible.

A business organization should consistently meet the needs of its stakeholders. Any sub‐optimal position suggests that enhancement of business performance is possible in at least two areas: the effectiveness of the routes to achieving those stakeholder needs, and the efficiency of those routes. The support activities constitute an environment created by the integration and co‐ordination of people, processes and places. The challenge is to create the support environment that consistently meets the needs of the business, and then to manage it through the optimum use of resources. An organization that has created, sustained and managed a business‐aligned support environment is likely to have a competitive advantage over those that have not done so. If the author is able to confirm this assertion through his research, then the desired outcome would be a framework for achieving such alignment. This paper briefly describes the concept of Business Support Optimisation as an approach to improving such alignment at a moment in time, and suggests how it can be operationalised using value mapping to realise stakeholder expectations.

The purpose of this study is to explore the causal link between procurement route and ongoing buyer‐supplier relationship.

The research draws on literature in the areas of: facilities management (FM) outsourcing; purchasing and supply chain strategy; and collaborative business relationship management. The research methodology is qualitative, and comprised semi‐structured interviews with buyers and suppliers of FM services.

Findings suggest that in general clients are seeking more collaborative relationships and this may determine a more relational procurement process. Some organisations appear more practiced than others in defining the level of collaboration and business benefits sought. Results support the view that a relational procurement process provides greater clarity of service requirements and facilitates cultural alignment between the buyer and supplier. However, additional time, effort, and cost are incurred, and concerns arise regarding the maturity of the supplier‐market and the sincerity of client intentions to collaborate.

A major practical implication is that facilities managers should recognise the importance of determining relationship objectives and the benefits sought within the context of FM procurement activity and select a purchasing route which supports the achievement of those objectives.

Originality exists in the qualitative approach used to inquire into the causality between relationships and procurement routes. The study offers potential value to both buyers and suppliers of FM services through describing the attributes of a successful collaborative relationship and how they link to a given procurement process, and identifying the potential risks and rewards involved.

State and national standards compel teachers to introduce historical topics through multiple diverse texts, emphasizing the use of informational texts. Trade books allow teachers to meet these standards while also meeting the needs of diverse students. Primary sources serve as an additional curricular resource filling the gaps in information not covered by textbooks and trade books and allowing students to gain a more complete and accurate understanding of historical figures and events. Standards leave the selection and implementation of appropriate trade books, primary sources, and other curricular resources to the classroom teacher. In this research, I qualify and quantify how President Andrew Jackson, a very controversial historical figure, is portrayed in trade books. Misrepresentations within trade books concerning Jackson are reported and analyzed. Suggestions and a rationale for trade book and primary source selection and implementation in elementary, middle, and secondary school are addressed.

The purpose of this study is to mirror the late guitarist Peter Green’s life experiences through insights from Andrew Voyce, who recovered from mental illness, and expertise from Peter Bryngelsson, a Swedish professional musician and author.

The authors used a mixed method of collaborative autoethnography, psychobiography and digital team ethnography.

Despite having not previously attracted academic interest, Peter Green’s experiences of mental health problems and his return to recording and performance provide a rich data source when mirrored and compared to the lives and experiences of Andrew Voyce and Peter Bryngelsson.

The main limitation of this piece of work is that Peter Green died in 2020. During the process of writing, the authors have had to follow different, mostly unacademic, sources that have described various parts of Peter Green’s life. The authors have given examples and drawn conclusions from their own lives as well as from academic sources, which they have found appropriate.

Both Andrew Voyce and Peter Bryngelsson’s stories would be helpful when it comes to a deeper understanding as to why Peter Green “took a left turn”, i.e., turned his back on an accepted lifestyle.

Acid casualty is a problem connected to both mental distress and to the music industry. Peter Bryngelsson’s story tells us that one can remain sane and drug free and still be an influential and creative musician.

The analysis has brought together two stories of mental distress in combination with insights.

This study examines a general education, hands-on and 100 per cent online laboratory course to better understand the prospects for fostering green building literacy through experiential online education.

The mixed-methods research design included pre- and post-course surveys (n = 42) together with semi-structured interviews mid-semester (n = 10) and four to six months post-course (n = 5). Data were collected for two semesters.

Students experienced significant increases in green building knowledge and skills, environmental sensitivity and pro-environmental behaviors from the beginning to the end of the course. Qualitative results indicate that the hands-on laboratory assignments were the primary pedagogical interventions affecting change. Interviews four to six months after the course revealed that motivation, convenience and supportiveness of the context were key factors impacting the pro-environmental behaviors that were maintained versus those that were discontinued by students when the course was over.

This paper shares effective approaches used to deliver an online course with hands-on laboratories that lead to positive increases in sustainability knowledge and behaviors stretching beyond the semester.

While online and experiential learning are both well-studied themes in higher education, very little empirical work examines experiential online learning, and this is particularly the case for online laboratory courses. The work here contributes to the understanding of general education online laboratories that are designed to increase knowledge and behavior change through hands-on experiential learning techniques.

Aarhus Kommunes Biblioteker (Teknisk Bibliotek), Ingerslevs Plads 7, Aarhus, Denmark. Representative: V. NEDERGAARD PEDERSEN (Librarian).

This paper aims to assess agri-environment (AE) scheme options on cultivated agricultural land in England for their impact on agricultural greenhouse gas (GHG) emissions. It considers both absolute emissions reduction and reduction incorporating yield decrease and potential production displacement. Similarities with Ecological Focus Areas (EFAs) introduced in 2015 as part of the post-2014 Common Agricultural Policy reform, and their potential impact, are considered.

A life-cycle analysis approach derives GHG emissions for 18 key representative options. Meta-modelling is used to account for spatial environmental variables (annual precipitation, soil type and erosion risk), supplementing the Intergovernmental Panel on Climate Change methodology.

Most options achieve an absolute reduction in GHG emissions compared to an existing arable crop baseline but at the expense of removing land from production, risking production displacement. Soil and water protection options designed to reduce soil erosion and nitrate leaching decrease GHG emissions without loss of crop yield. Undersown spring cereals support decreased inputs and emissions per unit of crop yield. The most valuable AE options identified are included in the proposed EFAs, although lower priority is afforded to some.

Recommendations are made where applicable to modify option management prescriptions and to further reduce GHG emissions.

This research is relevant and of value to land managers and policy makers. A dichotomous key summarises AE option prioritisation and supports GHG mitigation on cultivated land in England. The results are also applicable to other European countries.

Intellectual disability (ID) is prevalent in 1 per cent of the population. Premenstrual syndrome (PMS) affects up to 5 per cent of the general population of adult women. Identification of PMS is challenging in women with ID due to differences in communication. Management of PMS in the ID population requires careful consideration of baseline function, co-existing mental and physical health problems, drug interactions as well as complex ethical considerations. The paper aims to discuss this issue.

Prospero-registered systematic review (CRD42019119398) of papers exploring the diagnosis and management of patients with PMS and ID (n=414). In total, 35 relevant titles were identified and 27 full text papers were assessed for eligibility, resulting in 10 studies for final qualitative analysis.

Ten original research papers were included. There are no standardised symptom criteria for diagnosis of PMS in women with ID. Studies relied on observer-reported data. All papers demonstrated higher rates of PMS in women with ID compared with the general adult population. Management was not standardised and varied between centres. Mainstays of treatment included non-steroidal anti-inflammatories, combined oral contraceptive pills and intramuscular progesterone. Newer evidence suggests levonorgestrel intrauterine systems may be appropriate. There was no quantitative method of establishing success of management.

A modified symptom diary should be used for diagnosis in this population. Differentiation between cyclical behavioural change due to pain vs mood disturbance remains challenging. Conservative, psychological and medical management should be the mainstay of treatment, with surgery considered in exceptional cases.

This paper demonstrates the current limited evidence for the management of PMS in women with a diagnosis of ID and offers an overview of the current options for managing these patients’ symptoms.

Several studies have shown that climate change is a threat to sustainable human living and high consumption of energy by buildings is a contributory factor. However, green practices in buildings have been proved as one of the successful technologies to mitigate global warming. Previous studies have shown lax green practices in developing countries’ buildings, but how far concerning green certification of buildings in Nigeria is yet to be explored. Therefore, this paper investigated the barriers to green certification of buildings (GCB). Also, the paper proposed a model for promoting GCB in Nigeria.

Eighteen experts with green building certification knowledge were engaged across three of Nigeria’s cities (Benin City, Abuja and Lagos) via scheduled WhatsApp video and teams calls. Collated interview data were analysed and presented in themes.

Findings show that there is an absence of a framework to promote GCB in Nigeria. Hence, GCB is low across the states. Twelve main sub-themes emerged as the barriers to GCB in Nigeria. Also, eight key sub-themes emerged as the possible concepts that can be used to improve GCB in Nigeria and formulated into a proposed framework to promote GCB in Nigeria.

This paper is limited to GCB in Nigeria and only 18 participants were engaged. Thus, this paper suggests that a mixed-methods approach should be conducted in future studies with wider coverage. This may assist to validate the paper’s findings.

Findings from this paper will stir up practitioners in green building and influence the promotion of GCB in the sector. As part of this study’s implications, suggestions through the paper’s proposed framework will benefit Nigeria’s policymakers to make decisions towards achieving GCB. This can be achieved via the proposed framework to promote the concept across Nigeria.

This paper is probably the first that attempted to investigate the barriers and proffer policy solutions via a framework to promote GCB in Nigeria and by extension in other developing countries.