Strategies for Dealing with Uncertainties in Strategic Environmental Assessment: An Analytical Framework Illustrated with Case Studies from The Netherlands

Strategic environmental assessment (SEA) is a widely applied policy tool that aims to aid decision-makers in making informed, higher-quality decisions that minimize negative environmental impacts. However, different types of uncertainties complicate the ex ante assessment of environmental impacts. Literature suggests uncertainties are often not well addressed, resulting in inaccurate and even unreliable SEAs. At the same time, SEA literature offers limited guidance in how to systematically identify and deal with uncertainties. Therefore, in this paper, we present an analytical framework for characterizing and classifying different forms of uncertainty in SEA, and for identifying strategies for dealing with these uncertainties. The framework is based on literature on uncertainties in other subdomains of the environmental sciences. The framework is applied to five case studies of SEAs for spatial planning in The Netherlands in order to illustrate and critically reflect on our framework, and to bridge the gap between theory and practice. Based on these case studies we concluded the following: (1) The framework is useful for identifying uncertainties in SEA in a systematic way; (2) There is a discrepancy between how uncertainties are dealt with in theory and in practice; (3) In practice, uncertainties seem to be dealt with in a rather implicit way. The framework may help dealing with uncertainties more systematically and more proactively; (4) The most successful way of coping with uncertainties seems to be the application of multiple strategies

Strategies for Dealing with Uncertainties in Strategic Environmental Assessment : An Analytical Framework Illustrated with Case Studies from The Netherlands

Strategic environmental assessment (SEA) is a widely applied policy tool that aims to aid decision-makers in making informed, higher-quality decisions that minimize negative environmental impacts. However, different types of uncertainties complicate the ex ante assessment of environmental impacts. Literature suggests uncertainties are often not well addressed, resulting in inaccurate and even unreliable SEAs. At the same time, SEA literature offers limited guidance in how to systematically identify and deal with uncertainties. Therefore, in this paper, we present an analytical framework for characterizing and classifying different forms of uncertainty in SEA, and for identifying strategies for dealing with these uncertainties. The framework is based on literature on uncertainties in other subdomains of the environmental sciences. The framework is applied to five case studies of SEAs for spatial planning in The Netherlands in order to illustrate and critically reflect on our framework, and to bridge the gap between theory and practice. Based on these case studies we concluded the following: (1) The framework is useful for identifying uncertainties in SEA in a systematic way; (2) There is a discrepancy between how uncertainties are dealt with in theory and in practice; (3) In practice, uncertainties seem to be dealt with in a rather implicit way. The framework may help dealing with uncertainties more systematically and more proactively; (4) The most successful way of coping with uncertainties seems to be the application of multiple strategies

Strategies for dealing with uncertainties in strategic environmental assessment : An analytical framework illustrated with case studies from The Netherlands

Strategic environmental assessment (SEA) is a widely applied policy tool that aims to aid decision-makers in making informed, higher-quality decisions that minimize negative environmental impacts. However, different types of uncertainties complicate the ex ante assessment of environmental impacts. Literature suggests uncertainties are often not well addressed, resulting in inaccurate and even unreliable SEAs. At the same time, SEA literature offers limited guidance in how to systematically identify and deal with uncertainties. Therefore, in this paper, we present an analytical framework for characterizing and classifying different forms of uncertainty in SEA, and for identifying strategies for dealing with these uncertainties. The framework is based on literature on uncertainties in other subdomains of the environmental sciences. The framework is applied to five case studies of SEAs for spatial planning in The Netherlands in order to illustrate and critically reflect on our framework, and to bridge the gap between theory and practice. Based on these case studies we concluded the following: (1) The framework is useful for identifying uncertainties in SEA in a systematic way; (2) There is a discrepancy between how uncertainties are dealt with in theory and in practice; (3) In practice, uncertainties seem to be dealt with in a rather implicit way. The framework may help dealing with uncertainties more systematically and more proactively; (4) The most successful way of coping with uncertainties seems to be the application of multiple strategies.</p

Prognostic Value of Thrombus Volume and Interaction With First-Line Endovascular Treatment Device Choice

BACKGROUND: A larger thrombus in patients with acute ischemic stroke might result in more complex endovascular treatment procedures, resulting in poorer patient outcomes. Current evidence on thrombus volume and length related to procedural and functional outcomes remains contradicting. This study aimed to assess the prognostic value of thrombus volume and thrombus length and whether this relationship differs between first-line stent retrievers and aspiration devices for endovascular treatment.METHODS: In this multicenter retrospective cohort study, 670 of 3279 patients from the MR CLEAN Registry (Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands) for endovascularly treated large vessel occlusions were included. Thrombus volume (0.1 mL) and length (0.1 mm) based on manual segmentations and measurements were related to reperfusion grade (expanded Treatment in Cerebral Infarction score) after endovascular treatment, the number of retrieval attempts, symptomatic intracranial hemorrhage, and a shift for functional outcome at 90 days measured with the reverted ordinal modified Rankin Scale (odds ratio &gt;1 implies a favorable outcome). Univariable and multivariable linear and logistic regression were used to report common odds ratios (cORs)/adjusted cOR and regression coefficients (B/aB) with 95% CIs. Furthermore, a multiplicative interaction term was used to analyze the relationship between first-line device choice, stent retrievers versus aspiration device, thrombus volume, and outcomes.RESULTS: Thrombus volume was associated with functional outcome (adjusted cOR, 0.83 [95% CI, 0.71-0.97]) and number of retrieval attempts (aB, 0.16 [95% CI, 0.16-0.28]) but not with the other outcome measures. Thrombus length was only associated with functional independence (adjusted cOR, 0.45 [95% CI, 0.24-0.85]). Patients with more voluminous thrombi had worse functional outcomes if endovascular treatment was based on first-line stent retrievers (interaction cOR, 0.67 [95% CI, 0.50-0.89]; P=0.005; adjusted cOR, 0.74 [95% CI, 0.55-1.0]; P=0.04). CONCLUSIONS: In this study, patients with a more voluminous thrombus required more endovascular thrombus retrieval attempts and had a worse functional outcome. Patients with a lengthier thrombus were less likely to achieve functional independence at 90 days. For more voluminous thrombi, first-line stent retrieval compared with first-line aspiration might be associated with worse functional outcome.</p