Staff Publications

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    'Staff publications' contains references to publications authored by Wageningen University staff from 1976 onward.

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User-documented food consumption data from publicly available apps: an analysis of opportunities and challenges for nutrition research
Maringer, Marcus ; Veer, P. van 't; Klepacz, Naomi ; Verain, M.C.D. ; Normann, Anne ; Ekman, Susanne ; Timotijevic, Lada ; Raats, Monique M. ; Geelen, M.M.E.E. - \ 2018
food consumption data - dietary intake assessment - diet apps - user-documented data - contextual data - technological innovations - data management - legal and ethical governance - research infrastructure
Background The need for a better understanding of food consumption behaviour within its behavioural context has sparked the interest of nutrition researchers for user-documented food consumption data collected outside the research context using publicly available nutrition apps. The study aims to characterize the scientific, technical, legal and ethical features of this data in order to identify the opportunities and challenges associated with using this data for nutrition research. Method A search for apps collecting food consumption data was conducted in October 2016 against UK Google Play and iTunes storefronts. 176 apps were selected based on user ratings and English language support. Publicly available information from the app stores and app-related websites was investigated and relevant data extracted and summarized. Our focus was on characteristics related to scientific relevance, data management and legal and ethical governance of user-documented food consumption data. Results Food diaries are the most common form of data collection, allowing for multiple inputs including generic food items, packaged products, or images. Standards and procedures for compiling food databases used for estimating energy and nutrient intakes remain largely undisclosed. Food consumption data is interlinked with various types of contextual data related to behavioural motivation, physical activity, health, and fitness. While exchange of data between apps is common practise, the majority of apps lack technical documentation regarding data export. There is a similar lack of documentation regarding the implemented terms of use and privacy policies. While users are usually the owners of their data, vendors are granted irrevocable and royalty free licenses to commercially exploit the data. Conclusion Due to its magnitude, diversity, and interconnectedness, user-documented food consumption data offers promising opportunities for a better understanding of habitual food consumption behaviour and its determinants. Non-standardized or non-documented food data compilation procedures, data exchange protocols and formats, terms of use and privacy statements, however, limit possibilities to integrate, process and share user-documented food consumption data. An ongoing research effort is required, to keep pace with the technical advancements of food consumption apps, their evolving data networks and the legal and ethical regulations related to protecting app users and their personal data.
Paper on quality criteria and overview of criteria applied to available data/methods - WP6 : deliverable D6.4
Raats, Monique ; Bartos, Sebastian ; Timotijevic, Lada ; Peacock, Matthew ; Hodgkins, Charo ; Touray, Morro ; Geelen, Anouk ; Maringer, Marcus ; Normann, Anne ; Verain, M.C.D. ; Zimmermann, K.L. ; Veer, P. van 't; Engberg Mikkelson, Bent - \ 2018
EU - 54 p.
Paper on quality criteria and overview of criteria applied to available data/methods - WP7 - User-documented food consumption data from publicly available apps: an analysis of opportunities and challenges for nutrition research : deliverable D7.4
Maringer, Marcus ; Veer, P. van 't; Klepacz, Naomi ; Verain, M.C.D. ; Normann, Anne ; Ekman, Susanne ; Timotijevic, Lada ; Raats, Monique ; Geelen, M.M.E.E. ; Zimmermann, K.L. - \ 2018
EU - 16 p.
Report on the Synthesis of the findings for WP5-7 : deliverable D4.2
Hodgkins, Charo ; Timotijevic, Lada ; Raats, Monique ; Normann, Anne ; Maringer, Marcus ; Klepacz, Naomi ; Zimmermann, K.L. ; Veer, P. van 't - \ 2018
EU - 25 p.
Report on the synthesis of the findings for WP8-10 : deliverable D4.3
Hodgkins, Charo ; Timotijevic, Lada ; Finglas, Paul ; Hieke, Sophie ; Mikkelsen, Bent Egberg ; Zimmermann, K.L. ; Veer, P. van 't - \ 2018
EU - 19 p.
Overall Synthesis Report: Outcomes of WPs 5-10 synthesised for WP11-13 : deliverable D4.5
Hodgkins, Charo ; Timotijevic, Lada ; Zimmermann, K.L. ; Veer, P. van 't - \ 2018
EU - 10 p.
Position and final paper of RICHFIELDS : deliverable D1.2
Bogaardt, M.J. ; Copani, Giacomo ; Cueva, Javier de la; Finglas, Paul ; Geelen, M.M.E.E. ; Hodgkins, Charo ; Korousic, Barbara ; Mikkelsen, Bent ; Poppe, K.J. ; Pour Abdollahian, Golboo ; Puttelaar, J. van den; Raats, Monique ; Selnes, T. ; Timotijevic, Lada ; Veen, H.B. van der; Veer, P. van 't; Zimmermann, K.L. - \ 2018
EU - 49 p.
User-documented food consumption data from publicly available apps : An analysis of opportunities and challenges for nutrition research
Maringer, Marcus ; Veer, Pieter van 't; Klepacz, Naomi ; Verain, Muriel C.D. ; Normann, Anne ; Ekman, Suzanne ; Timotijevic, Lada ; Raats, Monique M. ; Geelen, Anouk - \ 2018
Nutrition Journal 17 (2018). - ISSN 1475-2891
Contextual data - Data management - Diet apps - Dietary intake assessment - Food consumption data - Legal and ethical governance - Research infrastructure - Technological innovations - User-documented data

Background: The need for a better understanding of food consumption behaviour within its behavioural context has sparked the interest of nutrition researchers for user-documented food consumption data collected outside the research context using publicly available nutrition apps. The study aims to characterize the scientific, technical, legal and ethical features of this data in order to identify the opportunities and challenges associated with using this data for nutrition research. Method: A search for apps collecting food consumption data was conducted in October 2016 against UK Google Play and iTunes storefronts. 176 apps were selected based on user ratings and English language support. Publicly available information from the app stores and app-related websites was investigated and relevant data extracted and summarized. Our focus was on characteristics related to scientific relevance, data management and legal and ethical governance of user-documented food consumption data. Results: Food diaries are the most common form of data collection, allowing for multiple inputs including generic food items, packaged products, or images. Standards and procedures for compiling food databases used for estimating energy and nutrient intakes remain largely undisclosed. Food consumption data is interlinked with various types of contextual data related to behavioural motivation, physical activity, health, and fitness. While exchange of data between apps is common practise, the majority of apps lack technical documentation regarding data export. There is a similar lack of documentation regarding the implemented terms of use and privacy policies. While users are usually the owners of their data, vendors are granted irrevocable and royalty free licenses to commercially exploit the data. Conclusion: Due to its magnitude, diversity, and interconnectedness, user-documented food consumption data offers promising opportunities for a better understanding of habitual food consumption behaviour and its determinants. Non-standardized or non-documented food data compilation procedures, data exchange protocols and formats, terms of use and privacy statements, however, limit possibilities to integrate, process and share user-documented food consumption data. An ongoing research effort is required, to keep pace with the technical advancements of food consumption apps, their evolving data networks and the legal and ethical regulations related to protecting app users and their personal data.

Advancing food, nutrition, and health research in Europe by connecting and building research infrastructures in a DISH-RI : Results of the EuroDISH project
Snoek, Harriëtte M. ; Eijssen, Lars M.T. ; Geurts, Marjolein ; Vors, Cecile ; Brown, Kerry A. ; Bogaardt, Marc Jeroen ; Dhonukshe-Rutten, Rosalie A.M. ; Evelo, Chris T. ; Fezeu, Leopold K. ; Finglas, Paul M. ; Laville, Martine ; Ocké, Marga ; Perozzi, Giuditta ; Poppe, Krijn ; Slimani, Nadia ; Tetens, Inge ; Timotijevic, Lada ; Zimmermann, Karin ; ’t Veer, Pieter van - \ 2018
Trends in Food Science and Technology 73 (2018). - ISSN 0924-2244 - p. 58 - 66.
Governance - Nutrition - Policy - Public health - Research infrastructures - Roadmap
Background: Research infrastructures (RIs) are essential to advance research on the relationship between food, nutrition, and health. RIs will facilitate innovation and allow insights at the systems level which are required to design (public health) strategies that will address societal challenges more effectively. Approach: In the EuroDISH project we mapped existing RIs in the food and health area in Europe, identified outstanding needs, and synthesised this into a conceptual design of a pan-European DISH-RI. The DISH model was used to describe and structure the research area: Determinants of food choice, Intake of foods and nutrients, Status and functional markers of nutritional health, and Health and disease risk. Key findings: The need to develop RIs in the food and health domain clearly emerged from the EuroDISH project. It showed the necessity for a unique interdisciplinary and multi-stakeholder RI that overarches the research domains. A DISH-RI should bring services to the research community that facilitate network and community building and provide access to standardised, interoperable, and innovative data and tools. It should fulfil the scientific needs to connect within and between research domains and make use of current initiatives. Added value can also be created by providing services to policy makers and industry, unlocking data and enabling valorisation of research insights in practice through public-private partnerships. The governance of these services (e.g. ownership) and the centralised and distributed activities of the RI itself (e.g. flexibility, innovation) needs to be organised and aligned with the different interests of public and private partners.
Open Architecture Platform Design – initial concepts : deliverable D4.4
Hodgkins, Charo ; Timotijevic, Lada ; Ge, L. ; Zimmermann, K.L. ; Veer, P. van 't - \ 2017
EU - 36 p.
Report from first Stakeholder workshop : deliverable D3.3
Brown, Kerry A. ; Timotijevic, Lada ; Astley, Siân ; Finglas, Paul ; Zimmermann, K.L. ; Veer, P. van 't - \ 2017
EU - 94 p.
Report from second Stakeholder workshop : deliverable D3.4
Hodgkins, Charo ; Timotijevic, Lada ; Finglas, Paul ; Astley, Siân ; Veer, P. van 't - \ 2017
EU - 87 p.
Concepts and procedures for mapping food and health research infrastructure : New insights from the EuroDISH project
Brown, Kerry A. ; Timotijević, Lada ; Geurts, Marjolein ; Arentoft, Johanne L. ; Dhonukshe-Rutten, Rosalie A.M. ; Fezeu, Léopold ; Finglas, Paul ; Laville, Martine ; Perozzi, Giuditta ; Ocké, Marga ; Poppe, Krijn ; Snoek, Harriette M. ; Veer, Pieter van 't; Zimmermann, Karin L. - \ 2017
Trends in Food Science and Technology 63 (2017). - ISSN 0924-2244 - p. 113 - 131.
Determinants of dietary intake - EuroDISH - Europe - Food and health - Research infrastructure

Background: Recent initiatives in Europe have encouraged the formalisation of research infrastructure to unify fragmented facilities, resources and services; and to facilitate world-class research of complex public health challenges, such as those related to non-communicable disease. How this can be achieved in the area of food and health has, to date, been unclear. Scope and approach: This commentary paper presents examples of the types of food and health research facilities, resources and services available in Europe. Insights are provided on the challenge of identifying and classifying research infrastructure. In addition, suggestions are made for the future direction of food and health research infrastructure in Europe. These views are informed by the EuroDISH project, which mapped research infrastructure in four areas of food and health research: Determinants of dietary behaviour; Intake of foods/nutrients; Status and functional markers of nutritional health; Health and disease risk of foods/nutrients. Key findings and conclusion: There is no objective measure to identify or classify research infrastructure. It is therefore, difficult to operationalise this term. EuroDISH demonstrated specific challenges with identifying the degree an organisation, project, network or national infrastructure could be considered a research infrastructure; and establishing the boundary of a research infrastructure (integral hard or soft facilities/resources/services). Nevertheless, there are opportunities to create dedicated food and health research infrastructures in Europe. These would need to be flexible and adaptable to keep pace with an ever-changing research environment and bring together the multi-disciplinary needs of the food and health research community.

Outline methodology (facilitate knowledge transfer from phases 1 & 2 to the RICHFIELDS final design in phase 3) : deliverable D4.1
Brown, Kerry Ann ; Timotijevic, Lada ; Zimmermann, K.L. ; Veer, P. van 't - \ 2016
EU - 44 p.
EURRECA-Evidence-Based methodology for deriving micronutrient recommendations
Dhonukshe-Rutten, R.A.M. ; Bouwman, J.H. ; Brown, K. ; Cavelaars, A.J.E.M. ; Collings, R. ; Grammatikaki, E. ; Groot, C.P.G.M. de; Gurinovic, M. ; Harvey, L.J. ; Hermoso, M. ; Hurst, R. ; Kremer, B. ; Ngo, J. ; Novakovic, R.N. ; Raats, M.M. ; Rollin, F. ; Serra-Majem, L. ; Souverein, O.W. ; Timotijevic, L. ; Veer, P. van 't - \ 2013
Critical Reviews in Food Science and Nutrition 53 (2013)10. - ISSN 1040-8398 - p. 999 - 1040.
dietary assessment methods - nutrient intake adequacy - nutrition policy - intake values - consumption surveys - pregnant-women - europe - health - food - patterns
The EURopean micronutrient RECommendations Aligned (EURRECA) Network of Excellence explored the process of setting micronutrient recommendations to address the variance in recommendations across Europe. Work centered upon the transparent assessment of nutritional requirements via a series of systematic literature reviews and meta-analyses. In addition, the necessity of assessing nutritional requirements and the policy context of setting micronutrient recommendations was investigated. Findings have been presented in a framework that covers nine activities clustered into four stages: stage one “Defining the problem” describes Activities 1 and 2: “Identifying the nutrition-related health problem” and “Defining the process”; stage two “Monitoring and evaluating” describes Activities 3 and 7: “Establishing appropriate methods,” and “Nutrient intake and status of population groups”; stage three “Deriving dietary reference values” describes Activities 4, 5, and 6: “Collating sources of evidence,” “Appraisal of the evidence,” and “Integrating the evidence”; stage four “Using dietary reference values in policy making” describes Activities 8 and 9: “Identifying policy options,” and “Evaluating policy implementation.” These activities provide guidance on how to resolve various issues when deriving micronutrient requirements and address the methodological and policy decisions, which may explain the current variation in recommendations across Europe
The process of setting micronutrient recommendations: a cross-European comparison of nutrition-related scientific advisory bodies
Timotijevic, L. ; Barnett, J. ; Brown, K. ; Shepherd, R. ; Fernandez-Celemin, L. ; Domolki, L. ; Ruprich, J. ; Dhonukshe-Rutten, R.A.M. ; Sonne, A.M. ; Hermoso, M. ; Koletzko, B. ; Frost-Andersen, L. ; Timmer, A. ; Raats, M.M. - \ 2011
Public Health Nutrition 14 (2011)4. - ISSN 1368-9800 - p. 716 - 728.
folic-acid - health-policy - risk - science - perspectives - expertise - politics - context - trial
Objective - To examine the workings of the nutrition-related scientific advisory bodies in Europe, paying particular attention to the internal and external contexts within which they operate. Design - Desk research based on two data collection strategies: a questionnaire completed by key informants in the field of micronutrient recommendations and a case study that focused on mandatory folic acid (FA) fortification. Setting - Questionnaire-based data were collected across thirty-five European countries. The FA fortification case study was conducted in the UK, Norway, Denmark, Germany, Spain, Czech Republic and Hungary. Results - Varied bodies are responsible for setting micronutrient recommendations, each with different statutory and legal models of operation. Transparency is highest where there are standing scientific advisory committees (SAC). Where the standing SAC is created, the range of expertise and the terms of reference for the SAC are determined by the government. Where there is no dedicated SAC, the impetus for the development of micronutrient recommendations and the associated policies comes from interested specialists in the area. This is typically linked with an ad hoc selection of a problem area to consider, lack of openness and transparency in the decisions and over-reliance on international recommendations. Conclusions - Even when there is consensus about the science behind micronutrient recommendations, there is a range of other influences that will affect decisions about the policy approaches to nutrition-related public health. This indicates the need to document the evidence that is drawn upon in the decisions about nutrition policy related to micronutrient intake
EURRECA's General Framework to make the process of setting up micronutrient recommendations explicit and transparent
Dhonukshe-Rutten, R.A.M. ; Timotijevic, L. ; Cavelaars, A.J.E.M. ; Wit, L.S. de; Doets, E.L. ; Raats, M.M. ; Tabacchi, G. ; Wijnhoven, T.M.A. ; Roman, B. ; La Cruz, J.N. De; Gurinovic, M. ; Groot, C.P.G.M. de; Veer, P. van 't - \ 2010
Proceedings of the Nutrition Society 69 (2010). - ISSN 0029-6651 - p. E34 - E34.
EURRECA is a Network of Excellence with the objective of addressing the problem of national variations in micronutrient recommendations and working towards a framework of advice to better inform policy-makers. It became apparent that the network needed a framework that puts the process of recommendation setting in the context of science, policy and society. Although variability in recommendations originates from the scientific evidence-base used and its interpretation (e.g. health outcomes, types and methods of evaluation of evidence, quantification of risk/benefit), the background information provided in the recommendation reports does not easily facilitate the disentangling of the relative contribution of these different aspects because of lack of transparency. The present report portrays the general framework (see Figure) that has been developed by and for EURRECA in order to make the process of setting up micronutrient recommendations explicit and transparent. Low resolution version High resolution version In explaining the link from science to policy applications, the framework distinguishes four principal components or stages (see Figure). These stages are: a) Defining the nutrient requirements: A judgement about the (best) distribution(s) of the population requirement is necessary for estimating nutrient requirements. Many assumptions need to be made about the attributes of the population group. Furthermore, several factors (consumer behaviour as well as physiology) are to be included to characterize optimal health. b) Setting the nutrient recommendations: All available evidence is needed to formulate recommendations. Incorporating different endpoints provide the basis to formulate an optimal diet in terms of (non-)nutrients and food(group)s. c) Policy options: Policy options should be formulated on how the optimal diet can be achieved. They concern the advice of scientist and/or expert committees to the policy makers. Current policy options are setting up a task force, food based dietary guidelines, general health education, educational programme for specific group(s), voluntary or mandatory fortification, labelling, supplementation (general or for specific groups), inducing voluntary action in industry, legislation on micronutrient composition in food products, fiscal change, monitoring and evaluation of intake (via food consumption surveys) and/or nutritional status. d) Policy applications: Policies and planning, usually done by government, that lead to nutritional interventions or programmes. They usually require consideration of scientific, legal, regulatory, ethical and cultural issues, economic implications, and political and social priorities. This framework illustrates three dimensions of the process of setting (micro)nutrient requirements: 1) The logical sequence of scientific thinking from setting physiological requirements for nutritional health leading to evidence-based derivation of Nutrient Intake Values. 2) In the early stages nutritional and epidemiological science is the dominant source and in the later stages evidence from consumer and social sciences as well as stakeholder influences is used in deriving the options for changing the distribution of nutrient intakes. 3) The wider socio-political context: a feedback loop between health perception, actual health and food intake exists and is directly affected by the food industry and many other stakeholders. Moreover, from the viewpoint of policymakers, there are concerns for health promotion and disease prevention because of population health indices, costs of health care, and economic interests in the agro-food sector. In conclusion: A systematic approach for development and regular review of micronutrient requirements in Europe, transparently based on scientific evidence and best practices, enables national and international authorities/bodies to use the best available information obtained through evidence-based nutrition and accomplish well-considered food policy. Funded by an EU FP6 Network of Excellence (EURRECA, grant no. FP 6–036196-2). G. T. performed part of the work under a short-term contract for WHO Europe.
European micronutrient recommendations aligned: a general framework developed by EURRECA
Dhonukshe-Rutten, R.A.M. ; Timotijevic, L. ; Cavelaars, A.J.E.M. ; Raats, M.M. ; Wit, L.S. de; Doets, E.L. ; Roman, B. ; Ngo-de la Cruz, J. ; Gurinovic, M. ; Groot, C.P.G.M. de; Veer, P. van 't - \ 2010
In: 3rd European Public Health Conference, Amsterdam, The Netherlands, 10 - 13 November, 2010. - - p. 125 - 125.
In Europe, micronutrient recommendations have been established by (inter)national committees of experts and are used by public health-policy decision makers to monitor and assess the adequacy of the diets of population groups. Current micronutrient recommendations are, however, heterogeneous, whereas the scientific basis for this is not obvious. Alignment of setting micronutrient recommendations is necessary to improve the transparency of the process, the objectivity and reliability of recommendations that are derived by diverse regional and (inter)national bodies. Objective: To align transparent decision making for evidence-based policy making, stakeholder involvement and alignment of policies across Europe. Results: The General Framework as proposed by Eurreca envisions the derivation of nutrient recommendations as scientific methodology, embedded in a policy-making process that also includes consumer issues, and acknowledges the influences of the wider sociopolitical context by distinguishing the principal components of the framework: (a) defining the nutrient requirements for health, (b) setting nutrient recommendations, (c) policy options and (d) policy applications. Conclusion: The General Framework can serve as a basis for a systematic and transparent approach to the development and review of micronutrient requirements in Europe, as well as the decision making of scientific advisory bodies, policy makers and stakeholders involved in this process of assessing, developing and translating these recommendations into public health nutrition policy.
European micronutrient recommendations aligned: a general framework developed by Eurreca
Dhonukshe-Rutten, R.A.M. ; Timotijevic, L. ; Cavelaars, A.J.E.M. ; Raats, M.M. ; Wit, L.S. de; Doets, E.L. ; Tabacchi, G. ; Roman, B. ; Ngo-de la Cruz, J. ; Gurinovic, M. ; Groot, C.P.G.M. de; Veer, P. van 't - \ 2010
European Journal of Clinical Nutrition 64 (2010)S2. - ISSN 0954-3007 - p. S2 - S10.
nutrient intake values - energy
Background: In Europe, micronutrient recommendations have been established by (inter)national committees of experts and are used by public health-policy decision makers to monitor and assess the adequacy of the diets of population groups. Current micronutrient recommendations are, however, heterogeneous, whereas the scientific basis for this is not obvious. Alignment of setting micronutrient recommendations is necessary to improve the transparency of the process, the objectivity and reliability of recommendations that are derived by diverse regional and (inter)national bodies. Objective: This call for alignment of micronutrient recommendations is a direct result of the current sociopolitical climate in Europe and uncovers the need for an institutional architecture. There is a need for evidence-based policy making, transparent decision making, stakeholder involvement and alignment of policies across Europe. Results: In this paper, we propose a General Framework that describes the process leading from assessing nutritional requirements to policy applications, based on evidence from science, stakeholder interests and the sociopolitical context. The framework envisions the derivation of nutrient recommendations as scientific methodology, embedded in a policy-making process that also includes consumer issues, and acknowledges the influences of the wider sociopolitical context by distinguishing the principal components of the framework: (a) defining the nutrient requirements for health, (b) setting nutrient recommendations, (c) policy options and (d) policy applications. Conclusion: The General Framework can serve as a basis for a systematic and transparent approach to the development and review of micronutrient requirements in Europe, as well as the decision making of scientific advisory bodies, policy makers and stakeholders involved in this process of assessing, developing and translating these recommendations into public health nutrition policy
Institutional contexts in which micronutrient reference values are developed across Europe
Timotijevic, L. ; Raats, M.M. ; Barnett, J. ; Brown, K. ; Fernandez, L. ; Domolki, L. ; Ruprich, J. ; Dhonukshe-Rutten, R.A.M. ; Sonne, A.M. ; Hermoso, M. ; Koletzko, B. ; Frost-Andersen, L. - \ 2010
Progress has been made towards a coherent public health nutrition policy across Europe; however this remains a challenge mainly due to the variety of public health nutrition (PHN) policy traditions between countries and the diversity in scientific bases used to inform policy(1) This is particularly apparent in the misalignment of micronutrient reference values (MRV) across European countries and regions(2). MRV often inform food and nutrition policies which are becoming an increasingly more important part of public health policies due to the burden associated with nutrition-related diseases. Desk research and a questionnaire completed by key informants were used to collect data relating to the processes used to develop current MRV in thirty-one European countries, employing methods reported previously(2). Data were collected on the process of scientific decision-making, including information on the transparency and openness of the process. Considerable diversity was observed across Europe in the institutional context and nutrition policy imperatives driving the process of developing MRV. In those countries that have an established tradition of PHN policy the presence of advisory bodies is seen as key in developing MRV and advising government departments charged with applying science into policy and practice. This position is partly predicated by the institutional context (whether there is a dedicated department in charge of public health and how it is linked with other departments, the diversity of bodies and organisations involved in setting the agendas and making decisions in PHN, the broader governance context etc.), the PHN tradition and the historical context. Although the implication for nutrition policy is that there is a dedicated scientific institution or basis that acts as policy advisor and consequently facilitates development of dedicated national-level nutrition policies, it raises the issue of the extent to which scientific advisory committees are open, transparent and inclusive in the process. It appears that there is a considerable divide in terms of the openness and transparency of the process between the countries with an emerging democracy and those with established and increasingly participatory governance structures; also, in the complexity of the governance system in charge of developing MRV and hence the extent to which these levels are specifically tailored to national needs. In those countries with a more developed institutional architecture, scientific advisory bodies appear to be more than just a source of technical and scientific advice, instead acting as a link between evidence and policy. In particular, the remaining question is to what extent this model of informing national level of PHN policy can service the policy imperatives and the needs of wider society for the development of PHN policy that includes the framing of a wider section of society. In addition, the selection of the advisory panel members is not always clear and could lead to MRV that are eminence rather than evidence based.
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