The Interactive RadioEpidemiological Program (IREP) is a Web-based, interactive computer code that is used to estimate the probability that a given cancer in an individual was induced by given exposures to ionizing radiation. IREP was developed by a Working Group of the National Cancer Institute and Centers for Disease Control and Prevention, and was adopted and modified by the National Institute for Occupational Safety and Health (NIOSH) for use in adjudicating claims for compensation for cancer under the Energy Employees Occupational Illness Compensation Program Act of 2000. In this paper, the quantity calculated in IREP is referred to as “probability of causation/assigned share” (PC/AS). PC/AS for a given cancer in an individual is calculated on the basis of an estimate of the excess relative risk (ERR) associated with given radiation exposures and the relationship PC/AS = ERR/ERR+1. IREP accounts for uncertainties in calculating probability distributions of ERR and PC/AS. An accounting of uncertainty is necessary when decisions about granting claims for compensation for cancer are made on the basis of an estimate of the upper 99% credibility limit of PC/AS to give claimants the “benefit of the doubt.” This paper discusses models and methods incorporated in IREP to estimate ERR and PC/AS. Approaches to accounting for uncertainty are emphasized, and limitations of IREP are discussed. Although IREP is intended to provide unbiased estimates of ERR and PC/AS and their uncertainties to represent the current state of knowledge, there are situations described in this paper in which NIOSH, as a matter of policy, makes assumptions that give a higher estimate of the upper 99% credibility limit of PC/AS than other plausible alternatives and, thus, are more favorable to claimants.
Dose-rate conversion factors have been calculated for external exposure above ground to monoenergetic photon emitters in soil. These factors give external dose rates per unit source concentration in soil. The calculations are based on the point-kernel integration method and assume that the source concentration at any depth in soil is uniform over an infinite surface parallel to the ground plane. Dose-rate factors in air at a height of 1 m above ground are tabulated for discrete photon energies between 0.01 and 10 MeV and for source depths in soil between 0 and 300 cm. Application of the results for plane sources in soil to the calculation of photon dose rates from distributions of sources with depth in soil is described, and dose-rate factors are tabulated for the particular cases of uniform slab sources of finite thickness and sources which are exponentially distributed with depth. We also demonstrate how dose-rate factors in air for monoenergetic photon sources are used to estimate dose-rate factors for body organs of exposed individuals and for the spectrum of photons from radioactive decay. The calculations in this paper show that allowing for downward migration of radionuclides in soil can result in significant reductions in external dose compared with the usual assumption that radionuclides which are deposited on the ground surface remain there until removal by radioactive decay.
This paper presents so-called radiation effectiveness factors that are intended to represent the biological effectiveness of different radiation types, relative to high-energy Co gamma rays, for the purpose of estimating cancer risks and probability of causation of radiogenic cancers in identified individuals. Radiation effectiveness factors are expressed as subjective probability distributions to represent uncertainty that arises from uncertainties in estimates of relative biological effectiveness obtained from radiobiological studies of stochastic endpoints, limited data on biological effectiveness obtained from human epidemiological studies, and other judgments involved in evaluating the applicability of available information to induction of cancers in humans. Primarily on the basis of reviews and evaluations of available data by experts, probability distributions of radiation effectiveness factors are developed for the following radiation types: neutrons of energy less than 10 keV, 10-100 keV, 0.1-2 MeV (including fission neutrons), 2-20 MeV, and greater than 20 MeV; alpha particles of any energy emitted by radionuclides; photons of energy 30-250 keV and less than 30 keV; and electrons of energy less than 15 keV. Photons of energy greater than 250 keV and electrons of energy greater than 15 keV are assumed to have the same biological effectiveness as reference Co gamma rays and are assigned a radiation effectiveness factor of unity, without uncertainty. For neutrons and alpha particles, separate probability distributions of radiation effectiveness factors are developed for solid tumors and leukemias, and small corrections to represent an inverse dose-rate effect are applied to those distributions in cases of chronic exposure. A radiation effectiveness factor different from unity for 15-60 keV electrons is discussed but is not adopted due to a lack of relevant radiobiological data. Radiation effectiveness factors presented in this paper are incorporated in the Interactive RadioEpidemiological Program and were developed for use by The National Institute for Occupational Safety and Health and U.S. Department of Labor in evaluating claims for compensation for radiogenic cancers by workers at U.S. Department of Energy facilities.
This editorial addresses the age-old service problem, where B2B customers fail to realize value and become dissatisfied, which leads to churn and reduced profitability of the vendor firm. Specifically, we focus on how proactively servicing customers can reduce churn rates by ensuring that customers realize promised, recurring, and sufficient value. The issue of churn is becoming increasingly critical as firms transition to digital-and subscription-based service offerings, which greatly reduces switching costs. In these models, which depend on recurring revenue, reports from industry demonstrate that traditional customer service and support efforts are not sufficient in retaining customers.A primary driver of churn from increased service efforts is the inability of firms to proactively engage with customers to cocreate value. To overcome this problem, customer success management, which we operationally define as "the proactive (versus reactive) relational engagement of customers to ensure the value potential of product offerings is realized by the customer," is becoming a common industry practice. Customer success management is needed because within dynamic relationships (Zhang et al. 2016), customers that aren't properly engaged (i.e., helped in maintaining value as offerings expand and change) can feel neglected and betrayed, which drives migration toward negative relationship states. Given its focus on retaining customers, this new form of B2B relationship management is quickly being adopted across firms that offer full-service solutions, yet the topic is largely absent from the literature. Thus, our editorial is intended to spur new research on customer success management and proactive customer engagement. In the remainder of this editorial, we first review relevant literature that provides a foundation for customer success (CS). We then describe the customer success manager (CSM) role, followed by an agenda for future research that provides an initial starting point for investigation by service scholars. Finally, we close with a mini case study from GE Digital to showcase the potential impact of CS programs within service firms. Basis of the Customer Success Role in Scholarly ResearchThe notion of CS builds upon seminal concepts of services marketing. For example, while not using the CS term, Berry (1995) suggests service providers should take good care of customers via relationship marketing initiatives. Thus, we suggest that the role of CSM is an evolution of the trend toward service-sales interfaces and adoption of ambidextrous approaches to managing dynamic relationships. Dynamic customer relationships have been shown to migrate in both positive and negative directions, leading to better or worse relationship states (Zhang et al. 2016). Migration can occur from firm and frontline efforts that are (un)satisfactory to address increased market, customer, and product needs. The concept of service-sales ambidexterity, where service workers are asked to sell and salespeople offer service, is one way that firms ...
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