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We aimed to explore the levels of agreement about the diagnoses of Autistic Spectrum Conditions between the referrer, CAMHS practitioner and a research diagnosis, as well as the stability of the practitioner's diagnosis over time in a secondary analysis of data from 302 children attending two Child and Adolescent Mental Health Services over two years. Kappa coefficient was used to assess the agreement between the referrer and research diagnosis. Kendall's tau b coefficient was used to assess the agreement between the practitioner and the research diagnosis assigned using the Development and Well-Being Assessment, as well as the agreement between the referrer's indication of presenting problems and the practitioner diagnosis. Diagnostic stability was explored in children with and without a research diagnosis of Autistic Spectrum Condition. There was a moderate level of agreement between the referrer and research diagnosis (Kappa = 0.51) and between practitioner's and research diagnosis (Kendall's tau = 0.60) at baseline, which reduced over the subsequent two years. Agreement between the referrer and practitioner's diagnosis at baseline was fair (Kendall's tau = 0.36).The greatest diagnostic instability occurred among children who practitioners considered to have possible Autistic Spectrum Conditions but who did not meet research diagnostic criteria. Further studies could explore the approaches used by practitioners to reach diagnoses and the impact these may have on diagnostic stability in Autistic Spectrum Conditions. Standardised assessment using a clinically rated diagnostic framework has a potential role as an adjunct to standard clinical care and might be particularly useful where practitioners are uncertain.

Increasing accessibility of coral reefs from the latter third of the 20th century led quickly to recognition of the vulnerability of coral reef communities to a combination of direct and indirect human impacts. Coral reefs are confronted by the stark threats of climate and ocean changes from the increasing number, intensity and forms of human use impacting global and marine systems. Management, particularly of accessible coral reefs, occurs in the context of multiple scale transboundary water column linkages of lifecycle processes and increasing human use of coastal and marine space. Four decades of experience have demonstrated the combined importance of biophysical and socio-economic sciences and sharing knowledge with communities for developing implementing effective management. In the face of environmental and socio-economic change the challenge for science and management is to develop knowledge and management responses that can better understand and increase resilience to improve he outlook for coral reef communities., (Copyright © 2018. Published by Elsevier Ltd.)

Humans derive many tangible and intangible benefits from coastal areas, providing essential components for social and economic development especially of less developed coastal states and island states. At the same time, growing human and environmental pressures in coastal areas have significant impacts on coastal systems, requiring urgent attention in many coastal areas globally. Sustainable development goal (SDG) 14 of the 2030 Agenda for Sustainable Development (henceforth the 2030 Agenda) aims for conservation and sustainable use of the oceans, seas, and marine resources, explicitly considering coastal areas in two of its targets (14.2 and 14.5). These promote, as we argue in this article, a strong sustainability concept by addressing protection, conservation, and management of coastal ecosystems and resources. The 2030 Agenda adopts the so-called "three-pillar-model" but does not specify how to balance the economic, social, and environmental dimensions in cases of trade-offs or conflicts. By analysing SDG 14 for the underlying sustainability concept, we derive decisive arguments for a strong sustainability concept and for the integration of constraint functions to avoid depletion of natural capital of coastal areas beyond safe minimum standards. In potential negotiations, targets 14.2 and 14.5 ought to serve as constraints to such depletion. However, such a rule-based framework has challenges and pitfalls which need to be addressed in the implementation and policy process. We discuss these for coastal areas in the context of SDG 14 and provide recommendations for coastal governance and for the process ahead.

In recent years, several sets of legislation worldwide (Oceans Act in USA, Australia or Canada; Water Framework Directive or Marine Strategy in Europe, National Water Act in South Africa, etc.) have been developed in order to address ecological quality or integrity, within estuarine and coastal systems. Most such legislation seeks to define quality in an integrative way, by using several biological elements, together with physico-chemical and pollution elements. Such an approach allows assessment of ecological status at the ecosystem level ('ecosystem approach' or 'holistic approach' methodologies), rather than at species level (e.g. mussel biomonitoring or Mussel Watch) or just at chemical level (i.e. quality objectives) alone. Increasing attention has been paid to the development of tools for different physico-chemical or biological (phytoplankton, zooplankton, benthos, algae, phanerogams, fishes) elements of the ecosystems. However, few methodologies integrate all the elements into a single evaluation of a water body. The need for such integrative tools to assess ecosystem quality is very important, both from a scientific and stakeholder point of view. Politicians and managers need information from simple and pragmatic, but scientifically sound methodologies, in order to show to society the evolution of a zone (estuary, coastal area, etc.), taking into account human pressures or recovery processes. These approaches include: (i) multidisciplinarity, inherent in the teams involved in their implementation; (ii) integration of biotic and abiotic factors; (iii) accurate and validated methods in determining ecological integrity; and (iv) adequate indicators to follow the evolution of the monitored ecosystems. While some countries increasingly use the establishment of marine parks to conserve marine biodiversity and ecological integrity, there is awareness (e.g. in Australia) that conservation and management of marine ecosystems cannot be restricted to Marine Protected Areas but must include areas outside such reserves. This contribution reviews the current situation of integrative ecological assessment worldwide, by presenting several examples from each of the continents: Africa, Asia, Australia, Europe and North America.