Environmental impact assessment reports meant for proposed development actions can be evaluated to reveal their quality and fitness for the purpose of environmental decision-making. Therefore, this study evaluated the quality and identified strengths and weaknesses in environmental impact assessment reports of telecommunications infrastructure proposed for Plateau State in Nigeria. To this end, 80 reports were evaluated using the modified version of the Lee and Colley review package. The results revealed the following points. In Review Area 1.0 (Description of the proposed telecommunications facilities) and Review Area 5.0 (Communication of results), the quality of environmental impact assessment reports was found to be generally satisfactory. However, the quality of all reports was considered \'very unsatisfactory\' (\'F\') regarding their overall legal compliance with the requirements stipulated in the remaining three Review Areas, namely, Review Area 2.0 (Terrain susceptibility in the proposed project areas), Review Area 3.0 (Associated and potential environmental impacts), and Review Area 4.0 (Mitigation measures/alternatives). This \'F\' rating was assigned to 65% (52/80) of reports regarding Review Area 3.0 because the information provided was \'very unsatisfactory\'; important tasks were poorly carried out or not attempted at all. Moreover, in review areas such as Review Area 2.0 and Review Area 4.0, all reports in the evaluation were assigned an \'F\' quality. Such an unsatisfactory quality rating is ascribable to the very unsatisfactory manner in which the reports were populated, especially as important task(s) were poorly performed or not attempted at all. Historically, only Review Area 1.0 and Review Area 5.0 indicated improvements in quality over time, whereas the remaining three review areas (Review Area 2.0, Review Area 3.0 and Review Area 4.0) did not improve. Based on the results obtained from the study, we recommend that there should be periodic reviews of environmental impact assessment reports by independent reviewers and environmental consultants should adhere to the sectoral guidelines for telecommunication infrastructure during the production of these reports. Moreover, in order to build technical capacity, more studies on report quality must be conducted in all sectors in Nigeria.

Background: Customer churn is a term that refers to the rate at which customers leave the business. Churn could be due to various factors, including switching to a competitor, cancelling their subscription because of poor customer service, or discontinuing all contact with a brand due to insufficient touchpoints. Long-term relationships with customers are more effective than trying to attract new customers. A rise of 5% in customer satisfaction is followed by a 95% increase in sales. By analysing past behaviour, companies can anticipate future revenue. This article will look at which variables in the Net Promoter Score (NPS) dataset influence customer churn in Malaysia\'s telecommunications industry.  The aim of This study was to identify the factors behind customer churn and propose a churn prediction framework currently lacking in the telecommunications industry.   Methods: This study applied data mining techniques to the NPS dataset from a Malaysian telecommunications company in September 2019 and September 2020, analysing 7776 records with 30 fields to determine which variables were significant for the churn prediction model. We developed a propensity for customer churn using the Logistic Regression, Linear Discriminant Analysis, K-Nearest Neighbours Classifier, Classification and Regression Trees (CART), Gaussian Naïve Bayes, and Support Vector Machine using 33 variables.   Results: Customer churn is elevated for customers with a low NPS. However, an immediate helpdesk can act as a neutral party to ensure that the customer needs are met and to determine an employee\'s ability to obtain customer satisfaction.   Conclusions: It can be concluded that CART has the most accurate churn prediction (98%). However, the research is prohibited from accessing personal customer information under Malaysia\'s data protection policy. Results are expected for other businesses to measure potential customer churn using NPS scores to gather customer feedback.

Obsessive-compulsive disorder (OCD), a disabling psychiatric illness, creates substantial societal burden. Evidence-based treatments, including psychopharmacology and exposure with response/ritual prevention (EX/RP), are often inaccessible. Digital health technologies, including videoconferencing, may increase access, but the best way to integrate them with current treatments remains unclear. This column describes the experiences of faculty at the Center for OCD and Related Disorders with videoconferencing-assisted treatment. Through a case series, the authors describe five ways to incorporate videoconferencing into OCD treatment: hybrid in-person/remote EX/RP; fully remote EX/RP; and videoconferencing-assisted psychopharmacology, support groups, and clinical supervision. For each strategy, the authors highlight advantages, challenges, clinical considerations, and avenues needing further research.

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BACKGROUND: To reduce the spread of coronavirus disease 2019 (COVID-19), many substance use disorder treatment programs have transitioned to telemedicine. Emergency regulatory changes allow buprenorphine initiation without an in-person visit. We describe the use of videoconferencing for buprenorphine initiation combined with street outreach to engage 2 patients experiencing homelessness with severe opioid use disorder (OUD).
METHODS: Patient 1 was a 30-year-old man with severe OUD who had relapsed to injection heroin/fentanyl after incarceration. A community drop-in center outreach harm reduction specialist facilitated a videoconference with an addiction specialist at an OUD bridge clinic. The patient completed a community buprenorphine/naloxone initiation and self-titrated to his prior dose, 8/2 mg twice daily. One week later, he reconnected with the outreach team for a follow-up videoconference visit. Patient 2, a 36-year-old man with severe OUD, connected to the addiction specialist via a syringe service program harm reduction specialist. He had been trying to connect to a community buprenorphine/naloxone provider, but access was limited due to COVID-19, so he was using diverted buprenorphine/naloxone to reduce opioid use. He was restarted on his previous dose of 12/3 mg daily which was continued via phone follow-up 16 days later.
CONCLUSIONS: COVID-19-related regulatory changes allow buprenorphine initiation via telemedicine. We describe 2 cases where telemedicine was combined with street outreach to connect patients experiencing homelessness with OUD to treatment. These cases highlight an important opportunity to provide access to life-saving OUD treatment for vulnerable patients in the setting of a pandemic that mandates reduced face-to-face clinical interactions.

The intent of this paper is to identify and provide insight on key enablers for successful implementation of telehealth services in severely under-resourced and rural populations. The case study presented is in the context of the U.S. Affiliated Pacific Islands that represent resilient and innovative communities who face many challenges of isolation, tiny populations, and developing economies. Long-standing telecommunication hindrances and lack of supporting resources are fundamental barriers to telehealth advancement. New undersea fiber optic developments present opportunities for reliable connectivity needed for telehealth applications. This paper reviews the emergence of telehealth champions in the region and reviews key elements that contribute to rapid and successful implementation of telehealth applications and services.

Rainfall spatio-temporal distribution is of great concern for rainfall-runoff modellers. Standard rainfall observations are, however, often scarce and/or expensive to obtain. Thus, rainfall observations from non-traditional sensors such as commercial microwave links (CMLs) represent a promising alternative. In this paper, rainfall observations from a municipal rain gauge (RG) monitoring network were complemented by CMLs and used as an input to a standard urban drainage model operated by the water utility of the Tabor agglomeration (CZ). Two rainfall datasets were used for runoff predictions: (i) the municipal RG network, i.e. the observation layout used by the water utility, and (ii) CMLs adjusted by the municipal RGs. The performance was evaluated in terms of runoff volumes and hydrograph shapes. The use of CMLs did not lead to distinctively better predictions in terms of runoff volumes; however, CMLs outperformed RGs used alone when reproducing a hydrograph\'s dynamics (peak discharges, Nash-Sutcliffe coefficient and hydrograph\'s rising limb timing). This finding is promising for number of urban drainage tasks working with dynamics of the flow. Moreover, CML data can be obtained from a telecommunication operator\'s data cloud at virtually no cost. That makes their use attractive for cities unable to improve their monitoring infrastructure for economic or organizational reasons.

OBJECTIVE: To describe the collaboration and prospective outcome of challenging human immunodeficiency virus (HIV) cases presented by Board of Prisons (BOP) pharmacists in consultation with Clinician Consultation Center (CCC) clinical pharmacists and physicians to improve correctional patient care.
METHODS: Federal correctional facilities.
METHODS: Pharmacists improve care of incarcerated persons infected with HIV.
METHODS: Pharmacists evaluate, implement, and provide successful oversight of HIV/hepatitis C virus (HCV) care.
RESULTS: Retrospective review of the clinical outcomes of HIV and HCV coinfected cases implemented by BOP pharmacists following CCC clinical consultations from 2010 through 2012.
RESULTS: Most cases focused on selecting optimal antiretroviral therapy (ART) regimens in patients experiencing treatment failure by interpreting resistance tests, limiting ART toxicity, identifying adherence strategies, and managing HIV/HCV coinfection. In 32 of the 34 cases presented, 87.5% (28/32) of CCC recommendations were implemented, resulting in 89% of those patients (25/28) achieving optimal virologic or clinical outcome. Complete virologic suppression occurred in 64% (18/28), and significant viral load reductions in 25% (7/28) of the cases. No changes occurred in 2 patients, and data were not available in 2 others lost to follow-up. BOP participation has increased since its inception from 6 to 12-15 pharmacists per call. Discussions also included updates in antiretroviral guidelines, screening and management of patients coinfected with HIV and HCV, and implications for BOP guidelines.
CONCLUSIONS: BOP clinical consultant pharmacists can successfully implement CCC recommendations to achieve desired clinical outcomes. Consultations and educational efforts from CCC experts assist BOP pharmacists in ensuring excellence in management of complex HIV/HCV issues and medication regimens to achieve desired outcomes. CCC collaboration and BOP pharmacist involvement have improved patient care. Using a team approach to include BOP clinical pharmacists and obtaining expert opinion in management of other chronic illnesses may be a model that can be considered to improve correctional care.

The data regarding the risk and benefits associated with live demonstrations at interventional cardiology congresses are scarce and controversial. We aimed to assess the clinical safety of chronic total occlusion percutaneous coronary intervention (CTO-PCI) procedures during live demonstrations. From January 2008 to December 2013, 739 consecutive patients underwent CTO-PCI at our center, and 199 patients were scheduled to undergo live CTO-PCI demonstrations at cardiology congresses that were globally transmitted to international meetings. The baseline characteristics, procedural complications, and clinical outcomes were compared between the live demonstration group and nonlive demonstration group. The procedural success rates were similar in the live demonstration group than in the nonlive demonstration group (91.5% vs 86.7%, p = 0.076), although the CTO lesions were longer and more tortuous in the live demonstration group (p = 0.029, p = 0.022, respectively). No cases of 30-day mortality were noted in the live demonstration group (0% vs 0.7%, p = 0.28), and no significant differences in procedural complications, such as coronary dissection, coronary perforation, and cardiac tamponade, were observed between the groups (p = 0.53, p = 0.12, and p = 0.40, respectively). The survival rates were similar in the 2 groups at a median follow-up duration of 51.2 ± 28.9 months (log-rank test: p = 0.45). Compared with cases of unsuccessful CTO-PCI, the cases of successful CTO-PCI exhibited improved all-cause survival in both the live and nonlive demonstration groups (log-rank test: p = 0.045, p = 0.0056, respectively). In conclusion, we found that procedural and clinical outcomes of live demonstration CTO-PCI were not significantly different compared with cases undergoing routine CTO-PCI procedures.

OBJECTIVE: To describe the impact of major loss of telecommunications on general practice in a rural region of Australia.
METHODS: A multi-stage qualitative study. Purposively selected participants were invited to contribute to initial data collection using an online survey, followed by interviews with selected participants. Thematic analysis of the data was performed by both research team members.
METHODS: South-western Victoria, Australia.
METHODS: Individuals from organisations involved in Telstra recovery efforts, disaster management, health care and general practice staff.
METHODS: The survey collected freeform responses from participants. Semi-structured interviews further explored a variety of experiences from purposively selected participants.
RESULTS: Organisations and practices in the region were prepared for major disasters, but not for the unusual and \'limited\' disaster of losing telecommunications, including lack of Internet access and loss of telephone services. Although alternative measures were found for telecommunications, there was still a significant impact on many health-care-related activities and general practice functionality during the outage period. In particular, there was an increase in duties for administrative staff to compensate for loss of telecommunications. Patient traffic for many services decreased due to uncertainty about availability and continuation of business.
CONCLUSIONS: The Warrnambool outage could be used as a case study illustrating the dramatic impact of communication loss. Major impacts include changes in patient traffic, increased administrative duties and slowing of patient care. When developing or assessing disaster management plans, general practices should consider the impact of telecommunication loss on functionality and prepare appropriate alternative, accessible and reliable measures.