To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure no-reply@cambridge.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Chapter 4 examines the extent to which artificial intelligence can support entrepreneurial activity at the implementation stage of an entrepreneurial idea. The chapter develops a distinction between Knightian epistemic and ontological uncertainty, arguing that while AI can substantially reduce epistemic uncertainty by leveraging data, models, and predictive capabilities, it cannot eliminate the ontological one. This irreducible uncertainty preserves a crucial space for human entrepreneurial agency, particularly when combined with the generative capabilities of AI discussed in Chapter 3. The chapter emphasizes the enduring importance of human qualities in entrepreneurship, including embodied presence, social interaction, persuasion, and trust-building. Drawing an analogy with theatre rather than cinema, it argues that entrepreneurship relies on performative, relational, and leadership dimensions that cannot be fully automated. Psychological challenges are also highlighted, such as the ‘Not Invented Here’ syndrome, whereby entrepreneurs may feel reduced ownership over AI-generated ideas, with potential implications for motivation and commitment. Against this background, the chapter analyses how AI can nonetheless support the implementation phase of entrepreneurial activity through what are termed ‘AI entrepreneurial buddies’. These (potentially agentic) AI-systems can assist entrepreneurs, supporting decision-making, coordination, and execution, while leaving human agency central in innovative and uncertain contexts.
Chapter 3 marks the point at which the book begins to integrate its two core constructs – entrepreneurship and artificial intelligence – by examining how AI reshapes the first stage of the entrepreneurial process, that is, innovative entrepreneurial ideas. The chapter analyses whether and how AI can be considered creative, and whether its increasing predictive power may (or may not) commoditize creativity and narrow the space for genuinely novel ideas. In fact, the analysis examines how AI affects different modes of human thinking, distinguishing between convergent and divergent creativity. In this context, the chapter argues for the continued relevance of human divergent thinking and for the importance of hybrid or symbiotic forms of human-AI intelligence. A central distinction is subsequently drawn between Kirznerian entrepreneurial ideas, which stem from market inefficiencies and unmet needs, and Schumpeterian ideas, which are more radical and disruptive. The chapter argues that the scope for Kirznerian ideas may shrink as incumbents acquire predictive advantages through AI, while the space for Schumpeterian ideas may expand due to the generative capabilities of AI systems. Importantly, the chapter highlights that creativity is not confined to generative AI alone: predictive AI can also display creative potential by identifying non-obvious patterns.
This chapter focuses on impairments in inhibitory control and executive function in addiction. It reviews the role of prefrontal cortical circuits in regulating impulses, evaluating consequences, and guiding goal-directed behavior. Behavioral tasks and neuroimaging studies illustrate how weakened top-down control contributes to compulsive use and relapse. Importantly, the chapter also highlights evidence for neural plasticity and the recovery of control functions with sustained abstinence and intervention.
Effective conservation of rare species requires approaches that extend beyond protected areas and integrate the perspectives of diverse landowners. We synthesized results from rare plant assessments with landowner perceptions and conservation values in landscapes with a mix of ownership and management types to produce an integrated framework for maximizing stewardship effectiveness. We combined field surveys of rare plant species across five landownership types (private, provincial, federal, non-profit and leaseholder) with semi-structured interviews of representatives of these groups in the Redberry Lake Biosphere Region of Canada to identify conservation values, landowner attitudes, perceived challenges, preferred incentives and legislative awareness across ownership types. Derived from the results, our framework drew attention to ecological priority and social feasibility as key elements of integrated conservation management. The framework provided operational definitions for each element and highlighted that even regional conservation strategies must account for variation in landownership and values. This framework therefore serves as a cohesive approach to applying both ecological and social evidence to inform decision-making for biodiversity conservation in mosaic landscapes. Our experience suggests that bringing together evidence from the natural and social sciences offers novel insights, and the framework we propose may be transferable across a range of conservation contexts.
The relationship between “policy tools” and “policy styles” in literature is often implicit, resting on the assumption that governments’ characteristic ways of doing business shape their tool choices, without clarifying what a “style” is or how it connects to those choices. Resolving this ambiguity requires distinguishing two conceptions of policy style: a process-oriented one, describing how governments make decisions, and an output-oriented one, describing what kinds of instruments they characteristically deploy. Building on this distinction, the article introduces a three-level typology comprising a tool’s “genre,” “variation,” and “calibration” to specify at which level of abstraction a policy style exerts its influence on tool choice. Governance modes generate durable preferences primarily at the genre level – for broad categories such as regulation, public enterprises, or treasury-based instruments – rather than for specific design variations or finer calibrations. Making these linkages explicit advances understanding of policy continuity and improves prediction of future instrument choices.
How do we turn theory into practice? Chapter 10 will guide you through two related practical processes: (i) interpreting or making sense of a change case; and (ii) advancing or developing our own instances of change. These processes don’t just help us understand change; they help make it actionable. More than a conclusion, this chapter is a guide for applying the book’s ideas in your own work, turning abstract models into grounded tools for navigating complexity. It’s a practical invitation: take what you’ve learnt, test it out, and make it your own.
How the odds of winning a casino game are presented impacts whether individuals understand and how they perceive those odds. When framed in terms of what the player will win (return to player), younger and middle-aged adults have lower comprehension and higher perceived chances of winning than when the same odds are framed in terms of what the casino will keep (house edge), suggesting a classic framing effect. In the current study, we tested whether older (mean age = 69.01, SD = 3.02) and younger adults (mean age = 23.50, SD = 3.02) differ in their susceptibility to this framing effect and how measures of positivity, risk propensity, and financial exploitation vulnerability impact understanding and perceptions. Across both age groups, comprehension was lower and perceived chances of winning were higher in the return-to-player condition. Age alone did not predict comprehension, but older adults were less optimistic about coming out ahead, were less risk seeking, and self-reported lower financial exploitation vulnerability than younger adults. Exploratory mediation analyses revealed that lower financial exploitation vulnerability partially explained older adults’ reduced belief that they would win, particularly in the return-to-player frame. Together, these findings suggest that age differences in gambling perceptions reflect trait-level differences in financial vigilance and affective outlook rather than chronological age alone .
The mathematisation of economics took place in three different ways, each based on an image of mathematics that was endorsed by a practice of mathematisation and which remained the dominant image until another image became dominant. The first dominant image was that of mathematics as a science of forms, which was embraced in the 1920s by the early econometric programme of scientisation. The resulting methodology was the modelling style developed at MIT in the 1940s and 1950s. The next dominant image was that of mathematics as a science of structure. It was introduced into economics by von Neumann and opened the door for Bourbaki mathematics which set the standards for mathematical rigour. The image of algorithms entered economics through research into decision making under uncertainty. By turning the decisionmaker into a 'representative agent' who takes decisions at a macro-level, this approach reshaped macroeconomic analysis in the 1970s and 1980s.
Health technology assessment (HTA) has become an essential tool for supporting evidence-based decision making in health care systems worldwide. Comprehensive HTA reports, however, are resource-intensive and time-consuming, making them impractical for many decisions that need to be made at the local or institutional level. This gap has led to the development of more pragmatic approaches that aim to balance methodological rigor with feasibility. In Norway, this challenge was addressed through the introduction of mini-HTA, which is a structured, simplified, and context-specific decision-support tool to inform local or institutional decisions about introducing new technologies, procedures, or organizational innovations. Mini-HTA provides a standardized framework for evaluating clinical effectiveness, safety, organizational impact, ethical considerations, and economic consequences while remaining feasible for clinicians and managers to apply in practice. Several key insights emerge from our experience with developing and implementing mini-HTA in Norway. First, adapting HTA approaches to local decision-making contexts increases feasibility and uptake, particularly where time and resources are limited. Second, governance structures, including clear allocation of responsibilities and leadership engagement, are crucial for the consistent use of mini-HTA in practice. Third, the Norwegian experience illustrates how a shared but flexible tool can be applied across different levels of care, including both hospitals and municipalities, while still allowing for contextual adaptation. Finally, the use of mini-HTA as a platform for collaboration across sectors highlights its potential not only as a decision-support tool, but also as a mechanism for coordinating priorities and responsibilities across organizational boundaries.
Providing care in the perinatal period brings medical practice to the essence of what it means to be human: fertility, birth, death, dignity, personhood, parenthood, and beyond. Such a shifting technological and moral landscape necessitates practitioners to develop an adaptable ethical framework to address complex, emotionally charged, value-laden decisions. As the border of viability is pushed earlier in gestational life and we improve treatment of conditions that were once considered untreatable, areas for ethical inquiry and potential moral distress grow. Our ethical examinations of such advances often lag, evolving as the shortcomings of those leaps become apparent. Projected neurologic function often lies at the heart of ethical questions that emerge in the neonatal period. Despite rigorous efforts in research, reliable, evidence-based guidance is lacking. We must investigate many elements of the decision-making process concerning medical practitioners, families, and the courts. We must balance the rights of the patient and surrogate decision-makers, the duties of the physician and care team, legal precedent, and questions revolving around quality and quantity of life. Recent controversies highlight the challenge of communicating with desperate parents, the delicate balance involved in respecting family preferences today, and research that yields valuable evidence for superior care tomorrow.
Although closely linked in typically developing children, cognitive and language development may diverge in IA children – particularly when they arrive already speaking their birth language. In such cases, cognitive growth may outpace language acquisition in the new linguistic environment. This chapter examines the relevant literature, synthesizing findings from studies that illuminate these dynamics. Special attention is given to the contributions of IA individuals – especially those who enter their new homes with relative proficiency in their mother tongue – to our understanding of the interplay between language and cognition. Assessing the extent to which cognitive deficits resulting from institutional care can be mitigated, and whether such improvements are sustained over time, is essential not only for advancing theoretical knowledge of cognitive development but also for informing effective policies regarding the care of children without parental support.
Real-world evidence (RWE) is reshaping how health technology assessment (HTA) bodies evaluate therapies, yet a critical gap persists: while transportability methods enable researchers to adapt treatment effect estimates from RWE studies in another jurisdiction to local contexts, the field remains unclear on when these analyses impact decision-making. This article synthesizes insights from HTA bodies, health technology developers (HTDs), and methodologists to clarify what is missing from today’s transportability conversation. We find that methodological progress has outpaced guidance on its utility; HTDs risk investing in transportability analyses without clear evidence that they reduce key uncertainties or affect recommendations. We identify three fundamental gaps: the absence of objective thresholds for determining whether transportability assumptions are adequately met; limited guidance on when quantitative transportability is needed versus qualitative assessment; and variation in HTA bodies’ evaluation and application of transported evidence. These gaps create a critical impasse where HTDs must decide whether to invest in such analyses, while HTA bodies lack standardized frameworks for their assessment. We argue that transportability cannot transition from academic exercise to a decision-making tool without explicit early dialogue between stakeholders, transparent reporting standards, and capacity building within HTA bodies. We present actionable recommendations to build HTA expertise, create a case study repository, and define contexts where transported RWE demonstrably impacts patient access. As evidence dossiers increasingly rely on nonlocal data, addressing these strategic and operational gaps becomes essential to help patients.
To identify and characterise active national illicit drug use sentinel surveillance systems worldwide.
Methods:
We conducted a scoping review to identify and characterise active sentinel surveillance systems for illicit drug use worldwide. Inclusion criteria: 1) articles describing or analysing data from sentinel networks with an established national scope, 2) supported by public agencies, and 3) data accessible via online repositories. We excluded articles on networks which did not have drug surveillance as their main designated objective.
Results:
Ten sentinel surveillance systems targeting recreational drug use at the national level were identified. Even though each has its own structure and functionality, they are often integrated in larger surveillance programmes. Although health professionals in emergency departments are the main informants, some systems also include information directly from people who use drugs or from community stakeholders. Systems also varied in their operational characteristics, including reporting frequency and methods used to disseminate findings.
Conclusion:
Having similarities, awareness of these different characteristics makes it possible to improve the design of surveillance systems directed towards illicit drug use monitoring and surveillance.
When searching for information before making a decision, one faces a fundamental trade-off. On the one hand, more information will almost always improve the decision outcome. On the other hand, spending more time, money, or effort on further information search may be more costly than that improvement is beneficial. If decision makers are adaptive, they should use their resources in information searches efficiently. Using a sampling-based decision paradigm with financial costs for each observation, we conducted five experiments to investigate whether and how participants adapt their information amount to relevant aspects of the environment. Experiment 1a (N = 67) and 1b (N = 79) focused on changes in response to different ratios of information cost and decision payoffs, revealing that participants are capable of adapting, but seem to do so mainly based on a priori planning. Experiment 2 (N = 131) assessed the role of a second process, online adjustment, by varying whether participants received feedback. Surprisingly, participants changed their behavior to the same extent irrespective of whether they received feedback. To further improve the opportunities for metacognitive monitoring and control, Experiments 3a and 3b (N = 160 and N = 318) implemented different feedback types across more decision trials for three different ratios of information cost and decision outcomes, which stayed constant per participant. Whether participants changed their sample size and efficiency across trials depended on that ratio, but not on the type of feedback. This provides crucial insights into how participants adapt and what challenges might befall the necessary metacognitive monitoring, serving as a valuable prompt for future research.
Attention-deficit hyperactivity disorder (ADHD) is associated with impairments in real-life decisions, many involving balancing costs and benefits. Increasing dopamine and norepinephrine with stimulant medication improves decision-making in ADHD. However, it is unclear whether stimulant medication affects sensitivity to costs and/or benefits or alters the speed-accuracy tradeoff. Here, we applied the drift diffusion model (DDM) to assess how the stimulant medication methylphenidate (MPH) affects subprocesses of cost-benefit decision-making in ADHD.
Methods
Sixty-one adult participants with ADHD and 63 healthy controls completed a cost-benefit decision-making task in a randomized double-blind placebo-controlled design. ADHD participants were tested once on and once off MPH. Control participants performed the task in two sessions without medication. The task entailed deciding whether to accept or reject a stimulus based on learned cost and benefit value associations. The effect of ADHD and medication on subprocesses of decision-making was disentangled by estimating task performance with DDM parameters drift rate, starting point bias, and decision threshold, representing evidence accumulation, a priori accept/reject bias, and the speed-accuracy tradeoff, respectively. Primary analyses used a modified intention-to-treat sample, including participants with main-phase data from both sessions.
Results
The DDM analysis identified impaired evidence accumulation combined with premature responding in participants with ADHD, indicated by reduced sensitivity to costs and benefits and narrower decision thresholds. MPH altered the cost-benefit balance by improving sensitivity to costs. Lastly, lower cost sensitivity was associated with greater symptom severity and higher prescribed dosage in ADHD.
Conclusions
Methylphenidate alters cost-benefit decision-making in ADHD by increasing sensitivity to costs.
This paper examines how spatial arrangements affect digitally supported individual and group decision-making. In a controlled within-subjects study, 24 participants completed the NASA Moon Survival Task across three spatial conditions: standing at an interactive table, sitting at the same table with personal zones, and using laptops. By analysing decision quality, speed, and perceived collaboration, the study shows that spatial design meaningfully shapes decision performance, interaction dynamics, and user experience.
This study presents a simulation-based framework to analyze resource consumption and cost effects of product family design strategies. Drawing on Extended Axiomatic Design (EAD) and 53 documented design cases, we simulate empirically grounded patterns that reveal denser, more homogeneous resource use than benchmarks from cost accounting literature. The findings (1) provide a reusable dataset; (2) demonstrate the value of EAD for standardized product family design and enhanced cost transparency; and (3) support broader generalization of cost accounting insights.
Mixed Reality (MR) prototyping offers significant design opportunities but introduces complexity in prototype specification. This paper presents a card-based design tool to support designers in this specification process. The tool is based on a comprehensive taxonomy of MR prototype fidelity and foundational research into the interplay between, and value of, different physical and virtual characteristics. A validation study demonstrates that the developed tool supports and guides designer reasoning, resulting in higher quality MR prototypes with stronger rationale for their implementation.
Perpetual innovative products (PIPs) enable the reuse of components from previous generations to create new products with improved functionality and performance, supporting a circular economy. However, the concept entails uncertainties in design due to degradation and functional integration. This paper examines how testing can reveal and reduce these uncertainties through the analysis of testing activities. A four-step process is proposed that integrates testing in PIP development. The process strengthens decision-making by translating heterogeneous testing into actionable design knowledge.
This study presents a structured approach for developing new modular, size-variable product families in small and medium-sized enterprises (SMEs), demonstrated through a case study on air filtration units. Starting from a minimum viable product (MVP), the approach provides a framework for size level definition and systematic generation of alternative modular concepts while considering product-specific design trade-offs. An evaluation combining qualitative criteria assessment with quantitative cost forecasting enables transparent concept comparison.