The Marine chapter of the 2016 State of the Environment (SoE) report incorporates multiple expert templates developed from streams of marine data. This metadata record describes the Expert Assessment "The state and trends of quality of species and groups – seabirds". The full Expert Assessment, including figures and tables (where provided), is attached to this record. Where available, the Data Stream(s) used to generate this Expert Assessment are accessible through the "On-line Resources" section of this record. DESCRIPTION OF TAXONOMIC GROUP FOR EXPERT ASSESSMENT There are presently 57 species of seabirds known to breed in and around Australia and the external territories of Cocos (Keeling) and Christmas Island, Lord Howe and Norfolk Islands, Ashmore and Cartier Islands, and the Coral Sea islands. These 57 species are comprised of penguins (1 species), albatrosses (1 species), petrels, shearwaters and storm-petrels (19 species), boobies, tropicbirds, frigatebirds, cormorants and pelican (16 species) and gulls, tern, and noddies (20 species). Another 130 species of seabirds have been recorded in Australia, either as non-breeding or vagrant. Shorebirds are not considered here, nor are issues associated with nesting or onshore breeding colonies as these are assessed under the Coasts chapter. Species breeding on subantarctic islands and the Antarctic continent are assessed under the Antarctic chapter. DATA STREAM(S) USED IN EXPERT ASSESSMENT The assessment was based on data and analyses published in the peer reviewed literature and agency reports. Details on the specific data products used in this assessment have not been provided. 2016 SOE ASSESSMENT SUMMARY [see attached Expert Assessment for full details] • 2016 • Assessment grade: Good Assessment trend: Unclear Confidence grade: Limited evidence or limited consensus Confidence trend: Limited evidence or limited consensus Comparability: Grade and trend are somewhat comparable to the 2011 assessment • 2011 • Assessment grade: Good Assessment trend: Stable Confidence grade: Limited evidence or limited consensus Confidence trend: Limited evidence or limited consensus CHANGES SINCE 2011 SOE ASSESSMENT Unclear how the 2011 assessment was carried out and on what data. There is very little data on trends in populations available and so the trend cannot be regarded as stable but rather unclear.

The Marine chapter of the 2016 State of the Environment (SoE) report incorporates multiple expert templates developed from streams of marine data. This metadata record describes the Expert Assessment "The state and trends of ecological processes – trophic structures and relationships". The full Expert Assessment, including figures and tables (where provided), is attached to this record. Where available, the Data Stream(s) used to generate this Expert Assessment are accessible through the "On-line Resources" section of this record. DESCRIPTION OF ECOLOGICAL PROCESS FOR EXPERT ASSESSMENT For this assessment, food web structure and function as defined by diet and modelling studies (which synthesis much of the available information) have been used to evaluate the status and trends for trophic structures and relationships. The status and outlook for the structure of Australian marine ecosystems is highly variable. Food webs are naturally dynamic, through time and space (e.g. Griffiths et al. 2009), and human pressure on them has varied around Australia over the past two centuries, altering trophic structures to differing degrees (Dell et al. 2013, GBRMPA 2014). Food webs studies have primarily focused on coastal and shelf waters (e.g. Salini et al 1998, Bulman et al. 2001, DofWWA 2009), with much less coverage of deep water food webs. Diet studies have only occurred intermittently and few studies have been subsequently repeated (e.g. recent resampling of fish diets on the shelf of SE Australia; CSIRO unpublished). Consequently, understanding the true magnitude of inter-annual variation in diets is low and there is little capacity to be sure of dietary changes through time. Modelling studies (Fulton et al. 2005, Klaer 2005) suggest there has been trophic restructuring of food webs in south-eastern Australia over the last century, particularly as a result of the intensification of commercial fisheries up to the 1990s. The reduction in fishing pressure, particularly over the last 5-10 years (Flood et al. 2014, Patterson et al. 2015) will likely, eventually, allow the recovery of trophic structures. However, a complete recovery is unlikely given the multitude of on-going pressures (e.g. remaining fishing pressure, both recreational and commercial, shipping, coastal habitat modification, pollution, etc.) and because some highly depleted species (e.g. eastern gemfish) have failed to recover from past overexploitation; which itself may be related to shifts in trophic connections with predators and prey (TSSC 2009). In addition, climate change is reshaping south eastern ecosystems, with shifts in species ranges (Sunday et al. 2015) and the realisation of new trophic interactions (e.g. shifts in octopus diets; Briceno et al. 2015), as omnivorous species appear to shift more rapidly than carnivores (Sunday et al. 2015). Eastern Australian ecosystems, including the Great Barrier Reef are highly modified (Butler and Jernakoff 1999, GBRMPA 2014). Amongst the most obviously shifted systems are around population centres and in the southern Great Barrier Reef (GBRMPA 2014). As elsewhere, fishing pressure has eased over the past 5 years, but other pressures (e.g. from increasing development) have increased (AIMS 2014). Overall trophic structures likely remain highly modified, both by past and present removal of predatory species and shifts in abundance of basal species, due to eutrophication or habitat removal (GBRMPA 2014, Fulton and Gorton 2014). The ecosystems of northern, western, southwestern and southern Australia see less direct, and spatially more variable, pressure than those in the east and south east. Over the past 3 decades, fishing pressure in the region has significantly declined, and has continued to do so (though at a reduced rate) over the past 5 years (Prince et al. 2008, Patterson et al. 2014, Fletcher and Santoro 2015). Development of other sectors (e.g. shipping) has grown, but largely concentrated on specific locations (AIMS

The Marine chapter of the 2016 State of the Environment (SoE) report incorporates multiple expert templates developed from streams of marine data. This metadata record describes the Expert Assessment "The state and trends of quality of species and groups – demersal and benthopelagic fish species, outer shelf (25 m - 250 m)". The full Expert Assessment, including figures and tables (where provided), is attached to this record. Where available, the Data Stream(s) used to generate this Expert Assessment are accessible through the "On-line Resources" section of this record. DESCRIPTION OF ECOLOGICAL SPECIES/COMMUNITY FOR EXPERT ASSESSMENT Most information on demersal and benthopelagic fish species is derived from fisheries catches. Fishing is predominately concentrated in the south-east (Southern and Eastern Scalefish and Shark Fishery; SESSF) and in the north-east (Queensland State fisheries). The demersal and benthopelagic fished species and populations over the shelf of Australian waters are influenced by changes in the physical environment (warming waters on the east coast, and episodic thermal events on the west coast), by terrestrial sources of pollution, and the effects of extractive industries such as fishing and mining. DATA STREAM(S) USED IN EXPERT ASSESSMENT This assessment is based on fisheries assessments of commercial species. Data on state and trends and associated spatial and temporal coverage are detailed in the publications provided in the reference list. 2016 SOE ASSESSMENT SUMMARY [see attached Expert Assessment for full details] • 2016 • Assessment grade: Poor Assessment trend: Improving Confidence grade: Adequate high-quality evidence or high level of consensus Confidence trend: Limited evidence or limited consensus Comparability: Grade and trend are somewhat comparable to the 2011 assessment • 2011 • Assessment grade: Very good Assessment trend: Stable Confidence grade: Adequate high-quality evidence or high level of consensus Confidence trend: Limited evidence or limited consensus CHANGES SINCE 2011 SOE ASSESSMENT It is not clear how the assessment in 2011 was derived. The 2016 is based on the most recent commercial fisheries assessments.

The Marine chapter of the 2016 State of the Environment (SoE) report incorporates multiple expert templates developed from streams of marine data. This metadata record describes the Expert Assessment "The state and trends of quality of species and groups – mesopelagic fish species". The full Expert Assessment, including figures and tables (where provided), is attached to this record. Where available, the Data Stream(s) used to generate this Expert Assessment are accessible through the "On-line Resources" section of this record. DESCRIPTION OF ECOLOGICAL SPECIES/COMMUNITY FOR EXPERT ASSESSMENT Mesopeolagic fish species (200 to 1000 m depths) of the Australian region are thought to be in very good condition as there is limited direct impact by human activities (e.g. no targeted commercial fishing, and limited seismic surveys). Therefore factors affecting the mesopelagic fishes and their habitats will most likely be due to overall changes in environmental conditions associated with climate change and variability influencing factors such as primary production, ocean acidification and changing oxygen levels (Hobday and Pecl, 2014). This estimate of mesopelagic fish status and trend is uncertain due to the low amount of monitoring that is done, but monitoring has increased since the last assessment in 2011. Monitoring of mesopelagic fishes has recently been included in Australia’s Integrated Marine Observing System (IMOS) through a bio-acoustics sub-facility in 2010 with one focus being the Tasman Sea (www.imos.org.au). Mesopelagic fishes are very diverse in Australian waters where in a recent field guide of the southern Tasman Sea 143 species in 43 families were identified (Flynn and Pogonoski, 2012). Using the IMOS bioacoustics Tasman Sea transect along 40oS there has been no detectable change in the annual acoustic index of mesopelagic fish biomass off the east coast of Tasmania between 2004 and 2013 (Kloser et al pers comms, www.imos.org.au). This region has a diverse range of fishes that have complex depth distributions and trophic interactions (Flynn and Kloser, 2012). Ecosystem models and observational studies of mesopelagic fishes highlight their importance to ecosystem structure and function where they transfer energy to higher order predators such as commercial fish species in Australian waters (Fulton et al., 2005; Lehodey et al., 2010; Young et al., 2011). This is particularly important for Australia’s continental slope commercial species and other top predators for ecosystem based management (Smith et al., 2011). The importance of mesopelagic fishes to ecosystem services has been shown yet their biomass and production is uncertain with several recent net and acoustic estimates differing by 2 orders of magnitude in Tasman Sea Australian waters (Kloser et al., 2009; Irigoien et al., 2014). This difference is based on using different sampling gear and methods to interpret the data. The outlook for mesopelagic fish in the Australian region is very good given the low direct impact of human activities (e.g. fishing) and increased monitoring through the IMOS bioacoustics program. Spatial and temporal shifts in mesopelagic fishes are expected to occur due to climate change and variability which will influence the distribution of their predators (Ridgway et al., 2008; Hobday and Pecl, 2014). To understand shifts in higher order predators and their ecological and human impact monitoring and ecosystem modelling of mesopelagic fish status and future trends is necessary. DATA STREAM(S) USED IN EXPERT ASSESSMENT Data from the IMOS bio-acoustics sub-facility, data from surveys along a transect line in the Tasman Sea repeated across 2004-2013. 2016 SOE ASSESSMENT SUMMARY [see attached Expert Assessment for full details] • 2016 • Assessment grade: Very good Assessment trend: Stable Confidence grade: Limited evidence or limited consensus Confidence trend: Limited evidence or limited consensus Comparability: Grade and trend are comparable

The Marine chapter of the 2016 State of the Environment (SoE) report incorporates multiple expert templates developed from streams of marine data. This metadata record describes the Expert Assessment "The state and trends of non-indigenous/non-endemic species – number and abundance of introduced species". The full Expert Assessment, including figures and tables (where provided), is attached to this record. Where available, the Data Stream(s) used to generate this Expert Assessment are accessible through the "On-line Resources" section of this record. DESCRIPTION OF ECOLOGICAL PROCESS FOR EXPERT ASSESSMENT There are over 250 introduced marine plants and animals established in Australian waters (see marine pests.gov.au). Some have hitch-hiked to Australian waters on the hulls of vessels of all types from yachts to commercial ships, or in their ballast water. Others have been introduced to support local aquaculture, with the aquarium industry another vector. Some species are listed on the National Introduced Marine Pest Information System and are assessed under the ‘Number and abundance of NIMPIS-listed species’ assessment. This assessment covers those species not currently on the list. DATA STREAM(S) USED IN EXPERT ASSESSMENT This assessment is based on peer-review papers and reports as well as information on the marine pests website: see http://www.marinepests.gov.au. 2016 SOE ASSESSMENT SUMMARY [see attached Expert Assessment for full details] • 2016 • Assessment grade: Good Assessment trend: Unclear Confidence grade: Limited evidence or limited consensus Confidence trend: Evidence or consensus too low to make an assessment Comparability: Grade and trend are comparable to the 2011 assessment • 2011 • Assessment grade: Good Assessment trend: Unclear Confidence grade: Limited evidence or limited consensus Confidence trend: Evidence or consensus too low to make an assessment CHANGES SINCE 2011 SOE ASSESSMENT The 2016 assessment is similar to the 2011 assessment. With very little information on most species abundances and no long-term monitoring of populations with which clear trends could be determined it was considered appropriate to assign a trend of ‘unclear’.

The Marine chapter of the 2016 State of the Environment (SoE) report incorporates multiple expert templates developed from streams of marine data. This metadata record describes the Expert Assessment "The state and trends of quality of species and groups – demersal and benthopelagic fish species, slope (>250 m)". The full Expert Assessment, including figures and tables (where provided), is attached to this record. Where available, the Data Stream(s) used to generate this Expert Assessment are accessible through the "On-line Resources" section of this record. DESCRIPTION OF ECOLOGICAL SPECIES/COMMUNITY FOR EXPERT ASSESSMENT Most information available on the state and trends of demersal and benthopelagic fish species is derived from fisheries catches (note that sharks are also included in a separate assessment on sharks). The demersal and benthopelagic fish species and populations over the slope of Australian waters greater than 250 m depth are considered to be in good condition except in the South East Region (SER) where stocks are considered in poorer but improving condition. This assessment will focus particularly on commercial stocks in the SER, the most impacted by fishing and the region with the most comprehensive studies of stock status of key commercial populations. Attempts have also been made to be consistent in scope with the 2011 State of the Environment report. Within the slope waters of the Southern and Eastern Scalefish and Shark Fishery (SESSF) commercial fish stocks have been managed under agreed harvest strategies to set catch limits, Commonwealth marine reserves have been established, and a closure to deepwater fishing greater than 700 m was declared since 2006. These measures as well as a structural adjustment scheme which resulted in a reduction in active licenses operating in the fishery have assisted in the improvement of the status of some over exploited stocks and by reducing over-fishing. Of the 13 slope species (groups) representing 22 distinct managed populations, there has been an improvement in the overall fish biomass of populations; 10 populations were considered as not overfished in 2010, while 13 populations were considered as not overfished in 2015. The clearest example of this improving trend is the recovery of the deep-water eastern zone stock of orange roughy (Hoplostethus atlanticus). Since closure due to concerns regarding stock status in 2006, the eastern zone stock is now believed to have recovered sufficiently to have allowed a commercial fishery to recommence in 2015. Several indicators for the eastern zone orange roughy fishery support this assessment with improvements in the biomass, age distribution and fish fecundity. Five populations, representing three species, are considered to be overfished. The southern and western zone populations of orange roughy, eastern gemfish (Rexea solandri) and gulper sharks (Centrophorus spp.) are currently classified as overfished. Despite efforts to rebuild the stock of eastern gemfish, there have been no signs of recovery to date. Changing environmental conditions due to the strengthening and southern movement of the East Australian Current may be a component of this non-recovery. Gulper Sharks have been subject to increasing research, a recovery plan, and spatial closures. Recovery of these populations however has been estimated to take more than 60 years. Based on current management and monitoring practices, the outlook for commercial deep-water demersal and benthopelagic fish species in Australian waters is improving. DATA STREAM(S) USED IN EXPERT ASSESSMENT This assessment is based on fisheries assessments of commercial species in the south-east region. Data on state and trends and associated spatial and temporal coverage are detailed in the publications provided in the reference list. 2016 SOE ASSESSMENT SUMMARY [see attached Expert Assessment for full details] • 2016 • Assessment grade: Good Assessment trend: Improving Confidence grade:

The Marine chapter of the 2016 State of the Environment (SoE) report incorporates multiple expert templates developed from streams of marine data. This metadata record describes the Expert Assessment "The state and trends of habitats and communities - water column, inner shelf (0 - 25 m)". The full Expert Assessment, including figures and tables (where provided), is attached to this record. Where available, the Data Stream(s) used to generate this Expert Assessment are accessible through the "On-line Resources" section of this record. DESCRIPTION OF HABITAT/COMMUNITY FOR EXPERT ASSESSMENT Based on biomass the major communities found in the water column are phytoplankton>bacteria>zooplankton>fish (Marchant 2002). The water column is the habitat and the major determinants of quality for most pelagic organisms can be considered to be temperature (T), salinity (S), light, nutrients, dissolved oxygen (DO), pH, and food availability. The inner shelf waters around Australia are generally warm, mostly saline, well illuminated, low in nutrients, and phytoplankton, zooplankton and fish abundance. The inner shelf is also the pelagic marine habitat most exposed to human induced pressures and has local habitats that range from heavily disturbed to pristine. The capability of this habitat to support the existing flora and fauna can be considered to be under threat (e.g. Game et al. 2009) from: inputs from the terrestrial environment (e.g. sediments in runoff or due to increased erosion, nutrients, wastes), harvesting of biota, invasive species, infrastructure development (e.g. impoundments, harbours, hardening), mariculture, mining, oil and gas extraction, climate change (warming, falling DO, decreasing pH). There are many areas of local habitat degradation, with the most impacted areas tending to be embayments and estuaries with significant population pressures and limited exchange (e.g. Alyazichi et al., 2015; Mckinley et al., 2011). In spite of improvements in the management of these types of pressures the magnitude of the growth in mineral exports, agriculture exports and population growth would suggest that development impacts will have risen. At the same time across many jurisdictions improvements in sewage treatment and disposal mean that potentially dangerous pathogens are increasingly rare. For example in 2015 96% of NSW open beaches with high rates of recreational use were rated good or very good (NSW EPA, 2015). At a larger geographic scale our shelf waters are experiencing increasing impacts from global pressures such as warming. Shelf waters from Port Hedland to Cape Howe have risen ~ 1°C from 1993 to 2013 (Foster et al., 2014), and portions of the SW region were 3°C warmer during February 2011 than normal (Pearce and Feng 2013). There is evidence that dissolved oxygen has declined (Thompson et al. 2009) and will continue to decline due to warming (Talley et al., 2016). This is likely to lead to more losses of marine fauna due to low oxygen; such as the unprecedented event during 2015 in Cockburn Sound (Pattiaratchi 2016). Recent blooms of toxic phytoplankton in regions where they never bloomed before (Campbell et al., 2013) and the SE shellfish that have suffered badly from disease outbreaks (Hooper et al., 2007; Lewis et al., 2012). There is evidence of widespread responses to climate related pressures across the major types of biota, phytoplankton, zooplankton and fish (e.g. Johnson et al. 2011, Thompson et al. 2016) as well as our coral reefs under increased stress from rising temperatures and declining pH (Mongin et al., 2016). DATA STREAM(S) USED IN EXPERT ASSESSMENT Data are computed from the level 3 (L3) daily global products using one merging method following Maritorena and Siegel, (2005). Details can be found at http://www.globcolour.info/products_description.html Phytoplankton and zooplankton data are from Australia’s National Reference Stations operated by the Integrated Marine Observing System. 2016 SOE ASSESSMENT

The Marine chapter of the 2016 State of the Environment (SoE) report incorporates multiple expert templates developed from streams of marine data. This metadata record describes the Expert Assessment "Pressures on the marine environment associated with commercial fishing". The full Expert Assessment, including figures and tables (where provided), is attached to this record. Where available, the Data Stream(s) used to generate this Expert Assessment are accessible through the "On-line Resources" section of this record. DESCRIPTION OF THE PRESSURE Australia’s wild-caught marine fisheries are highly diverse and contribute significantly to the economy. These fisheries catch scallops, prawns, crabs, squid, coastal fish such as whiting and flathead, reef fish such as coral trout, shelf and deepwater fish such as ling and blue-eye trevally, and oceanic tuna and billfish Although fisheries operate across all states and the Northern Territory and out to the limit of the Australian EEZ, fishing effort is not evenly distributed across Australian marine waters with the majority of fishing effort occurring in the North, Temperate East, South-East, and South-West Marine Regions. The impact of fisheries on the marine environment also varies with differing gears having differing impacts on species that might be caught as bycatch, and the habitats where fishing takes place. Methods used to capture those species are highly varied ranging from small-scale netting to large-scale pelagic long-line fishing and trawling (Flood et al. 2014). There is currently extensive effort occurring the Coral Sea bioregion using pelagic long – line gear. There have been extensive reductions in the footprint of the trawl fishery in the South West, South East and Temperate Eastern Bioregions. There is also an extensive trawl fishery in the North Bioregion, associated with the Northern Prawn Fishery, which remains relatively constant through time. DATA STREAM(S) USED IN EXPERT ASSESSMENT The metadata record for the fisheries data can be found at http://www.marlin.csiro.au/geonetwork/srv/eng/search?uuid=aa53a4df-7fe6-46d1-93b7-2d3732f4883e. 2016 SOE ASSESSMENT SUMMARY [see attached Expert Assessment for full details] • 2016 • Assessment grade: Low-High Assessment trend: Improving Confidence grade: Adequate high quality evidence and high level of consensus Confidence trend: Adequate high quality evidence and high level of consensus Comparability: Grade and trend are not comparable to the 2011 assessment • 2011 • Assessment grade: Not directly comparable Assessment trend: Not directly comparable Confidence grade: Not directly comparable Confidence trend: Not directly comparable CHANGES SINCE 2011 SOE ASSESSMENT Commercial fishing was separated from recreational fishing and traditional use of resources.

The Marine chapter of the 2016 State of the Environment (SoE) report incorporates multiple expert templates developed from streams of marine data. This metadata record describes the Expert Assessment "The state and trends of quality of species and groups – dolphins and porpoises". The full Expert Assessment, including figures and tables (where provided), is attached to this record. Where available, the Data Stream(s) used to generate this Expert Assessment are accessible through the "On-line Resources" section of this record. DESCRIPTION OF TAXONOMIC GROUP FOR EXPERT ASSESSMENT Following taxonomic standards, 20 dolphin species in the Family Delphinidae and one species in the Family Phocoenidae occur in Australian waters. A number of these species (e.g. common bottlenose dolphins) are distributed nationally, others are restricted to particular latitudes (e.g. dusky dolphin) and others consist of populations that are highly restricted to embayments and tributaries within particular regions (e.g. the endemic snub-fin dolphin). DATA STREAM(S) USED IN EXPERT ASSESSMENT This assessment is based on peer-review papers and reports provided by a series of researchers working on dolphin and porpoises in Australia. Data on state and trends and associated spatial and temporal coverage are detailed in the publications provided in the reference list. Specific data products used to generate the assessment are not listed. 2016 SOE ASSESSMENT SUMMARY [see attached Expert Assessment for full details] • 2016 • Assessment grade: Good Assessment trend: Unclear Confidence grade: Limited evidence or limited consensus Confidence trend: Limited evidence or limited consensus Comparability: Grade and trend are somewhat comparable to the 2011 assessment • 2011 • Assessment grade: Good Assessment trend: Stable Confidence grade: Limited evidence or limited consensus Confidence trend: Limited evidence or limited consensus CHANGES SINCE 2011 SOE ASSESSMENT The 2016 assessment is similar to the 2011 assessment. With very little information on most species abundances and no long-term monitoring of populations with which clear trends could be determined it was considered appropriate to alter the trend assignment to ‘unclear’ rather than ‘stable’.

The Marine chapter of the 2016 State of the Environment (SoE) report incorporates multiple expert templates developed from streams of marine data. This metadata record describes the Expert Assessment "Pressures on the marine environment associated with recreational fishing". The full Expert Assessment, including figures and tables (where provided), is attached to this record. Where available, the Data Stream(s) used to generate this Expert Assessment are accessible through the "On-line Resources" section of this record. DESCRIPTION OF THE PRESSURE Australia’s marine recreational fishery applies substantial pressure to specific species and taxa. For some targeted species harvest can exceed the take of the commercial fishery. For instance recreational tonnage of southern sand flathead in Tasmania in 2012/13 was six times that of the commercial fishery (Lyle et al., 2014), while the estimated recreational harvest of King George whiting in South Australia in 2013/14 was 1.46 million fish or 367 tonnes, which was more than half (58%) of the total harvest (Hall and Giti, 2015). While participation rates remain high in absolute terms for WA, NSW, QLD and TAS there has been a trend of declines in effort, participation and harvest. In contrast in South Australia there was an increase in participation but a decline in effort and harvest. For VIC expert opinion suggests an increase across all fishery metrics while for NT effort and participation has increased but harvest has declined. DATA STREAM(S) USED IN EXPERT ASSESSMENT Expert opinion and state assessment reports were sourced from all states. 14 interviews were conducted with experts based in all states. While more interviews would have been useful to better gauge perception the high level picture was easily discernible. 2016 SOE ASSESSMENT SUMMARY [see attached Expert Assessment for full details] • 2016 • Assessment grade: High impact Assessment trend: Stable Confidence grade: Adequate high quality evidence and high level of consensus Confidence trend: Limited evidence or limited consensus Comparability: Grade and trend are not comparable to the 2011 assessment • 2011 • Assessment grade: Low impact Assessment trend: Improving Confidence grade: Adequate high quality evidence and high level of consensus Confidence trend: Limited evidence or limited consensus CHANGES SINCE 2011 SOE ASSESSMENT N/A