Deputy Dean, University of Otago, Christchurch

Rutherford Discovery Fellow 2014–2019
MB ChB, PhD, FRACP
Email suetonia.palmer@otago.ac.nz
Tel +64 3 3640 640
Professor Suetonia Palmer is a practising kidney specialist and Professor at the University of Otago, Christchurch, New Zealand. She is a Rutherford Discovery Fellow (2014-2019) and a L’Oreál For Women in Science Fellow (2013). She is a Deputy Dean at the University of Otago, Christchurch. She received a Gold Medal for Research in 2018. She is a qualified physician who received her Fellowship of the Royal Australasian College of Physicians in 2006 and completed her PhD in Medicine in 2010. She received a postdoctoral fellowship to complete two years of study at study at Harvard Medical School until 2011.
Her work is investigating the effectiveness of therapies for improving the lives of people with kidney disease and how treatments can be delivered to address profound inequity based on ethnicity and socioeconomic opportunity. Her research methodologies include international collaborative randomized clinical trials, systematic reviews with network and conventional meta-analysis, qualitative explorations of patient and clinician experiences and perspectives, and large-scale epidemiological studies.
Suetonia was awarded a Rutherford Discovery Fellowship by the Royal Society of New Zealand in 2014 focusing on analytical technologies and qualitative research to improve the quality of clinical care. She is the Principal Investigator on Health Research Council grants for large trials in New Zealand and is a collaborator on global trials funded by the NHMRC in Australia.
She has published over 150 peer-reviewed journal papers including in the New England Journal of Medicine, The Lancet, JAMA and the Annals of Internal Medicine. She collaborates with academic clinicians and scientists in New Zealand, Australia, Canada and Europe. She has attracted $30 million in research funding from the Health Research Council of New Zealand, the Ministry of Business and Employment, and the National Health and Medical Research Council (NHMRC). She is an editor for Cochrane Kidney and Transplant and the Transplantation journal. She is President Elect of the Australia and New Zealand Society of Nephrology and the Chair of the New Zealand Chapter of Nephrology. She is the Chair of the Steering Committee for the CARI Guidelines. She serves on the National Renal Advisory Board to the Ministry of Health and the Data Monitoring Core Committee for the Health Research Council.
Her core research interests and values are: helping emerging researchers, conducting high-quality clinical trials, exploring inequity through empirical research, and translating medical research into evidence-based clinical care and policy.
Roles
- President-elect, Australia and New Zealand Society of Nephrology
- Principal Investigator, The PHOSPHATE trial (HRC Funded)
- Principal Investigator, The TEACH-PD trial (HRC Funded)
- Member, National Renal Advisory Board
- Editor, Cochrane Kidney and Transplant
- Member, Māori Research Development Komiti, University of Otago, Christchurch
- Member, Data Monitoring Core Committee, HRC
Professional interests
- Equity in outcomes in treatment of kidney diseases
- Systematic review and network/conventional meta-analysis of treatments for long-term conditions
- Patient-centred outcomes in clinical research and as a measure of care quality
- Randomised controlled trials of treatment effectiveness and acceptability
Recent and current students
- Ms Tania Huria, PhD candidate (2015 – ) 'Created Equal' A case study investigating health system perspectives of health disparity. Funded by a Health Research Council of New Zealand Māori Research Fellowship
- Dr Amanda Landers, PhD candidate (2020 – ) Evaluating a model of care for patients with chronic obstructive pulmonary disease in their last year of life
- Dr Bhadran Bose, PhD candidate (2019 – ) University of Queensland
- Josie Nicholas-McAnergney, Summer Student Research 2018/2019 Ethnicity and assessment for kidney transplantation
- Harriet Gray, Summer Student Research 2017/2018 Reporting of Māori experiences of health services in qualitative research: Systematic review and meta-synthesis
Publications
Natale, P., Palmer, S. C., Tunnicliffe, D. J., Toyama, T., & Strippoli, G. F. M. (2023). Glucagon-like peptide 1 (GLP-1) receptor agonists for people with chronic kidney disease and diabetes. Cochrane Database of Systematic Reviews, 2023(4), CD015849. doi: 10.1002/14651858.CD015849
Chandra, Y., Malani, J., Irvine, J. H., Krishnan, A., Johnson, D. W., Ritchie, A. G., & Palmer, S. C. (2023). Incidence, treatment patterns and clinical outcomes associated with acute kidney injury in Fiji: A retrospective cohort study. Journal of Nephrology. Advance online publication. doi: 10.1007/s40620-023-01628-6
Chung, E. Y. M., Palmer, S. C., Saglimbene, V. M., Craig, J. C., Tonelli, M., & Strippoli, G. F. M. (2023). Erythropoiesis-stimulating agents for anaemia in adults with chronic kidney disease: A network meta-analysis (Review). Cochrane Database of Systematic Reviews, 2, CD010590. doi: 10.1002/14651858.CD010590.pub3
Palmer, S. C., Ruospo, M., Saglimbene, V., & Strippoli, G. F. M. (2023). Sexual dysfunction. In J. C. Craig, D. A. Molony & G. F. M. Strippoli (Eds.), Evidence-based nephrology (Vol. 2). (2nd ed.) (pp. 570-583). Hoboken, NJ: John Wiley & Sons. doi: 10.1002/9781119105954.ch77
Palmer, S. C., van Zwieten, A., Saglimbene, V., Ruospo, M., & Strippoli, G. F. M. (2023). Neurocognitive disorders. In J. C. Craig, D. A. Molony & G. F. M. Strippoli (Eds.), Evidence-based nephrology (Vol. 2). (2nd ed.) (pp. 539-550). Hoboken, NJ: John Wiley & Sons. doi: 10.1002/9781119105954.ch75
Hanson, C. S., Logeman, C., Dew, M. A., & Palmer, S. C. (2023). Depression. In J. C. Craig, D. A. Molony & G. F. M. Strippoli (Eds.), Evidence-based nephrology (Vol. 2). (2nd ed.) (pp. 499-516). Hoboken, NJ: John Wiley & Sons. doi: 10.1002/9781119105954.ch73
Chapter in Book - Research
Nguyen, T. T., Palmer, S. C., Cho, Y., Mudge, D. W., Strippoli, G. F. M., Craig, J. C., … Htay, H. (2023). Peritoneal dialysis: Infections. In J. C. Craig, D. A. Molony & G. F. M. Strippoli (Eds.), Evidence-based nephrology (Vol. 2). (2nd ed.) (pp. 138-155). Hoboken, NJ: John Wiley & Sons. doi: 10.1002/9781119105954.ch48
Chapter in Book - Research
Palmer, S. C., & Strippoli, G. F. M. (2023). Urinary tract infection. In J. C. Craig, D. A. Molony & G. F. M. Strippoli (Eds.), Evidence-based nephrology (Vol. 1). (2nd ed.) (pp. 305-310). Hoboken, NJ: John Wiley & Sons. doi: 10.1002/9781119105954.ch20
Chapter in Book - Research
Palmer, S. C., Ruospo, M., Saglimbene, V., & Strippoli, G. F. M. (2023). Sexual dysfunction. In J. C. Craig, D. A. Molony & G. F. M. Strippoli (Eds.), Evidence-based nephrology (Vol. 2). (2nd ed.) (pp. 570-583). Hoboken, NJ: John Wiley & Sons. doi: 10.1002/9781119105954.ch77
Chapter in Book - Research
Palmer, S. C., Strippoli, G. F. M., Craig, J. C., & Molony, D. A. (2023). Chronic kidney disease-mineral and bone disorder. In J. C. Craig, D. A. Molony & G. F. M. Strippoli (Eds.), Evidence-based nephrology (Vol. 1). (2nd ed.) (pp. 589-616). Hoboken, NJ: John Wiley & Sons. doi: 10.1002/9781119105954.ch36
Chapter in Book - Research
Palmer, S. C., van Zwieten, A., Saglimbene, V., Ruospo, M., & Strippoli, G. F. M. (2023). Neurocognitive disorders. In J. C. Craig, D. A. Molony & G. F. M. Strippoli (Eds.), Evidence-based nephrology (Vol. 2). (2nd ed.) (pp. 539-550). Hoboken, NJ: John Wiley & Sons. doi: 10.1002/9781119105954.ch75
Chapter in Book - Research
Chandra, Y., Malani, J., Irvine, J. H., Krishnan, A., Johnson, D. W., Ritchie, A. G., & Palmer, S. C. (2023). Incidence, treatment patterns and clinical outcomes associated with acute kidney injury in Fiji: A retrospective cohort study. Journal of Nephrology. Advance online publication. doi: 10.1007/s40620-023-01628-6
Journal - Research Article
Chung, E. Y. M., Palmer, S. C., Saglimbene, V. M., Craig, J. C., Tonelli, M., & Strippoli, G. F. M. (2023). Erythropoiesis-stimulating agents for anaemia in adults with chronic kidney disease: A network meta-analysis (Review). Cochrane Database of Systematic Reviews, 2, CD010590. doi: 10.1002/14651858.CD010590.pub3
Journal - Research Article
Natale, P., Palmer, S. C., Tunnicliffe, D. J., Toyama, T., & Strippoli, G. F. M. (2023). Glucagon-like peptide 1 (GLP-1) receptor agonists for people with chronic kidney disease and diabetes. Cochrane Database of Systematic Reviews, 2023(4), CD015849. doi: 10.1002/14651858.CD015849
Journal - Research Article
Walker, R. C., Abel, S., Palmer, S. C., Walker, C., Heays, N., & Tipene-Leach, D. (2023). "We need a system that's not designed to fail Māori": Experiences of racism related to kidney transplantation in Aotearoa New Zealand. Journal of Racial & Ethnic Health Disparities, 10, 219-227. doi: 10.1007/s40615-021-01212-3
Journal - Research Article
Azukaitis, K., Palmer, S. C., Strippoli, G. F. M., & Hodson, E. M. (2022). Interventions for minimal change disease in adults with nephrotic syndrome (Review). Cochrane Database of Systematic Reviews, 3, CD001537. doi: 10.1002/14651858.CD001537.pub5
Journal - Research Article
Bose, B., Chung, E. Y. M., Hong, R., Strippoli, G. F. M., Johnson, D. W., Yang, W.-l., … Palmer, S. C. (2022). Immunosuppression therapy for idiopathic membranous nephropathy: Systematic review with network meta-analysis. Journal of Nephrology. Advance online publication. doi: 10.1007/s40620-022-01268-2
Journal - Research Article
Morrone, L., Palmer, S. C., Saglimbene, V. M., Perna, A., Cianciolo, G., Russo, D., … on behalf of the Mineral Metabolism Study Group of the Italian Society of Nephrology. (2022). Calcifediol supplementation in adults on hemodialysis: A randomized controlled trial. Journal of Nephrology, 35, 517-525. doi: 10.1007/s40620-021-01104-z
Journal - Research Article
Natale, P., Palmer, S. C., Jaure, A., Hodson, E. M., Ruospo, M., Cooper, T. E., … Strippoli, G. F. M. (2022). Hypoxia-inducible factor stabilisers for the anaemia of chronic kidney disease (Review). Cochrane Database of Systematic Reviews, 8, CD013751. doi: 10.1002/14651858.CD013751.pub2
Journal - Research Article
Templeton, E. M., Lassé, M., Kleffmann, T., Ellmers, L. J., Palmer, S. C., Davidson, T., Scott, N. J. A., Pickering, J. W., Charles, C. J., Endre, Z. H., Cameron, V. A., Richards, A. M., Rademaker, M. T., & Pilbrow, A. P. (2022). Identifying candidate protein markers of acute kidney injury in acute decompensated heart failure. International Journal of Molecular Sciences, 23, 1009. doi: 10.3390/ijms23021009
Journal - Research Article
Viecelli, A. K., Duncanson, E., Bennett, P. N., D'Antoine, M., Dansie, K., Handke, W., … Palmer, S., … on behalf of the Symptom monitoring With Feedback Trial (SWIFT) Investigators. (2022). Perspectives of patients, nurses, and nephrologists about electronic symptom monitoring with feedback in hemodialysis care. American Journal of Kidney Diseases, 80(2), 215-226. doi: 10.1053/j.ajkd.2021.12.007
Journal - Research Article
Walker, R. C., Abel, S., Palmer, S. C., Walker, C., Heays, N., & Tipene-Leach, D. (2022). Values, perspectives, and experiences of indigenous Māori regarding kidney transplantation: A qualitative interview study in Aotearoa/New Zealand. American Journal of Kidney Diseases, 80(1), 20-29. doi: 10.1053/j.ajkd.2021.12.010
Journal - Research Article
Walker, R. C., Hay, S., Walker, C., Tipene-Leach, D., & Palmer, S. C. (2022). Exploring rural and remote patients' experiences of health services for kidney disease in Aotearoa New Zealand: An in-depth interview study. Nephrology, 27, 421-429. doi: 10.1111/nep.14018
Journal - Research Article
Bernier-Jean, A., Wong, G., Saglimbene, V., Ruospo, M., Palmer, S. C., Natale, P., … Strippoli, G. F. M. (2021). Dietary potassium intake and all-cause mortality in adults treated with hemodialysis. Clinical Journal of the American Society of Nephrology, 16(12), 1851-1861. doi: 10.2215/cjn.08360621
Journal - Research Article
Bernier-Jean, A., Wong, G., Saglimbene, V., Ruospo, M., Palmer, S. C., Natale, P., … Strippoli, G. F. M. (2021). Self-reported physical activity and survival in adults treated with hemodialysis: A DIET-HD cohort study. Kidney International Reports, 6, 3014-3025. doi: 10.1016/j.ekir.2021.09.002
Journal - Research Article
Chung, E. Y. M., Palmer, S. C., Natale, P., Krishnan, A., Cooper, T. E., Saglimbene, V. M., … Strippoli, G. F. M. (2021). Incidence and outcomes of COVID-19 in people with CKD: A systematic review and meta-analysis. American Journal of Kidney Diseases, 78(6), 804-815. doi: 10.1053/j.ajkd.2021.07.003
Journal - Research Article
González-González, J. G., González-Colmenero, A. D., Millán-Alanís, J. M., Lytvyn, L., Solis, R. C., Mustafa, R. A., Palmer, S. C., … Rodríguez-Gutiérrez, R. (2021). Values, preferences and burden of treatment for the initiation of GLP-1 receptor agonists and SGLT-2 inhibitors in adult patients with type 2 diabetes: A systematic review. BMJ Open, 11, e049130. doi: 10.1136/bmjopen-2021-049130
Journal - Research Article
Huang, R., Palmer, S. C., Cao, Y., Zhang, H., Sun, Y., Su, W., … Li, X. (2021). Cardiac rehabilitation programs for chronic heart disease: A Bayesian network meta-analysis. Canadian Journal of Cardiology, 37, 162-171. doi: 10.1016/j.cjca.2020.02.072
Journal - Research Article
Huria, T., Pitama, S. G., Beckert, L., Hughes, J., Monk, N., Lacey, C., & Palmer, S. C. (2021). Reported sources of health inequities in Indigenous Peoples with chronic kidney disease: A systematic review of quantitative studies. BMC Public Health, 21, 1447. doi: 10.1186/s12889-021-11180-2
Journal - Research Article
Palmer, S. C., Tendal, B., Mustafa, R. A., Vandvick, P. O., Li, S., Hao, Q., … Strippoli, G. F. M. (2021). Sodium-glucose cotransporter protein-2 (SGLT-2) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists for type 2 diabetes: Systematic review and network meta-analysis of randomised controlled trials. BMJ, 372, m4573. doi: 10.1136/bmj.m4573
Journal - Research Article
Rademaker, M. T., Pilbrow, A. P., Ellmers, L. J., Palmer, S. C., Davidson, T., Mbikou, P., Scott, N. J. A., Permina, E., Charles, C. J., Endre, Z. H., & Richards, A. M. (2021). Acute decompensated heart failure and the kidney: Physiological, histological and transcriptomic responses to development and recovery. Journal of the American Heart Association, 10, e021312. doi: 10.1161/jaha.121.021312
Journal - Research Article
Saglimbene, V. M., Su, G., Wong, G., Natale, P., Ruospo, M., Palmer, S. C., … Strippoli, G. F. M. (2021). Dietary intake in adults on hemodialysis compared with guideline recommendations. Journal of Nephrology, 34, 1999-2007. doi: 10.1007/s40620-020-00962-3
Journal - Research Article
Badve, S. V., Pascoe, E. M., Tiku, A., Boudville, N., Brown, F. G., Cass, A., … Palmer, S. C., … Walker, R. J., … for the CKD-FIX Study Investigators. (2020). Effects of allopurinol on the progression of chronic kidney disease. New England Journal of Medicine, 382(26), 2504-2513. doi: 10.1056/NEJMoa1915833
Journal - Research Article
Chung, E. Y. M., Ruospo, M., Natale, P., Bolignano, D., Navaneethan, S. D., Palmer, S. C., & Strippoli, G. F. M. (2020). Aldosterone antagonists in addition to renin angiotensin system antagonists for preventing the progression of chronic kidney disease (Review). Cochrane Database of Systematic Reviews, 10, CD007004. doi: 10.1002/14651858.CD007004.pub4
Journal - Research Article
Kelly, J. T., Conley, M., Hoffmann, T., Craig, J. C., Tong, A., Reidlinger, D. P., … Palmer, S. C., … Campbell, K. L. (2020). A coaching program to improve dietary intake of patients with CKD: ENTICE-CKD. Clinical Journal of the American Society of Nephrology, 15(3), 330-340. doi: 10.2215/cjn.12341019
Journal - Research Article
Lunney, M., Ruospo, M., Natale, P., Quinn, R. R., Ronksley, P. E., Konstantinidis, I., Palmer, S. C., … Ravani, P. (2020). Pharmacological interventions for heart failure in people with chronic kidney disease (Review). Cochrane Database of Systematic Reviews, 2, CD012466. doi: 10.1002/14651858.CD012466.pub2
Journal - Research Article
Morton, R. L., Lioufas, N., Dansie, K., Palmer, S. C., Jose, M. D., Raj, R., … McDonald, S. (2020). Use of patient-reported outcome measures and patient-reported experience measures in renal units in Australia and New Zealand: A cross-sectional survey study. Nephrology, 25(1), 14-21. doi: 10.1111/nep.13577
Journal - Research Article
Natale, P., Palmer, S. C., Ruospo, M., Saglimbene, V. M., Craig, J. C., Vecchio, M., … Strippoli, G. F. M. (2020). Immunosuppressive agents for treating IgA nephropathy (Review). Cochrane Database of Systematic Reviews, 3, CD003965. doi: 10.1002/14651858.CD003965.pub3
Journal - Research Article
Palmer, S. C., Mavridis, D., Johnson, D. W., Tonelli, M., Ruospo, M., & Strippoli, G. F. M. (2020). Comparative effectiveness of calcimimetic agents for secondary hyperparathyroidism in adults: A systematic review and network meta-analysis. American Journal of Kidney Diseases, 76(3), 321-330. doi: 10.1053/j.ajkd.2020.02.439
Journal - Research Article
Pontone, G., Guaricci, A. I., Palmer, S. C., Andreini, D., Verdecchia, M., Fusini, L., … Strippoli, G. F. (2020). Diagnostic performance of non-invasive imaging for stable coronary artery disease: A meta-analysis. International Journal of Cardiology, 300, 276-281. doi: 10.1016/j.ijcard.2019.10.046
Journal - Research Article
Saglimbene, V. M., Wong, G., Teixeira-Pinto, A., Ruospo, M., Garcia-Larsen, V., Palmer, S. C., … on behalf of DIET-HD investigators and dieticians. (2020). Dietary patterns and mortality in a multinational cohort of adults receiving hemodialysis. American Journal of Kidney Diseases, 75(3), 361-372. doi: 10.1053/j.ajkd.2019.05.028
Journal - Research Article
Saglimbene, V. M., Wong, G., van Zwieten, A., Palmer, S. C., Ruospo, M., Natale, P., … Strippoli, G. F. M. (2020). Effects of omega-3 polyunsaturated fatty acid intake in patients with chronic kidney disease: Systematic review and meta-analysis of randomized controlled trials. Clinical Nutrition, 39, 358-368. doi: 10.1016/j.clnu.2019.02.041
Journal - Research Article
Shaman, A. M., Smyth, B., Arnott, C., Palmer, S. C., Mihailidou, A. S., Jardine, M. J., … Jun, M. (2020). Comparative efficacy and safety of BP-lowering pharmacotherapy in patients undergoing maintenance dialysis: A network meta-analysis of randomized, controlled trials. Clinical Journal of the American Society of Nephrology, 15(8), 1129-1138. doi: 10.2215/cjn.12201019
Journal - Research Article
Walker, R. C., Tong, A., Howard, K., & Palmer, S. C. (2020). Clinicians' experiences with remote patient monitoring in peritoneal dialysis: A semi-structured interview study. Peritoneal Dialysis International, 40(2), 202-208. doi: 10.1177/0896860819887638
Journal - Research Article
Walker, R. C., Tong, A., Howard, K., Darby, N., & Palmer, S. C. (2020). Patients' and caregivers' expectations and experiences of remote monitoring for peritoneal dialysis: A qualitative interview study. Peritoneal Dialysis International, 40(6), 540-547. doi: 10.1177/0896860820927528
Journal - Research Article
Bach, K. E., Kelly, J. T., Palmer, S. C., Khalesi, S., Strippoli, G. F. M., & Campbell, K. L. (2019). Healthy dietary patterns and incidence of CKD: A meta-analysis of cohort studies. Clinical Journal of the American Society of Nephrology, 14(10), 1441-1449. doi: 10.2215/cjn.00530119
Journal - Research Article
Chan, S., Pascoe, E. M., Clayton, P. A., McDonald, S. P., Lim, W. H., Sypek, M. P., Palmer, S. C., … Johnson, D. W. (2019). Infection-related mortality in recipients of a kidney transplant in Australia and New Zealand. Clinical Journal of the American Society of Nephrology, 14(10), 1484-1492. doi: 10.2215/cjn.03200319
Journal - Research Article
Chung, E. Y. M., Palmer, S. C., & Strippoli, G. F. M. (2019). Interventions to prevent nonmelanoma skin cancers in recipients of a solid organ transplant: Systematic review of randomized controlled trials. Transplantation, 103(6), 1206-1215. doi: 10.1097/TP.0000000000002641
Journal - Research Article
Ha, J. T., Neuen, B. L., Cheng, L. P., Jun, M., Toyama, T., Gallagher, M. P., … Palmer, S. C., … Badve, S. V. (2019). Benefits and harms of oral anticoagulant therapy in chronic kidney disease: A systematic review and meta-analysis. Annals of Internal Medicine, 171, 181-189. doi: 10.7326/m19-0087
Journal - Research Article
Huria, T., Palmer, S. C., Pitama, S., Beckert, L., Lacey, C., Ewen, S., & Smith, L. T. (2019). Consolidated criteria for strengthening reporting of health research involving indigenous peoples: The CONSIDER statement. BMC Medical Research Methodology, 19, 173. doi: 10.1186/s12874-019-0815-8
Journal - Research Article
Iannone, A., Ruospo, M., Palmer, S. C., Principi, M., Barone, M., Di Leo, A., & Strippoli, G. F. M. (2019). Systematic review with network meta-analysis: Endoscopic techniques for dysplasia surveillance in inflammatory bowel disease. Alimentary Pharmacology & Therapeutics, 50(8), 858-871. doi: 10.1111/apt.15493
Journal - Research Article
Kelly, J. T., Warner, M. M., Conley, M., Reidlinger, D. P., Hoffmann, T., Craig, J., … Palmer, S., & Campbell, K. L. (2019). Feasibility and acceptability of telehealth coaching to promote healthy eating in chronic kidney disease: A mixed-methods process evaluation. BMJ Open, 9(1), e024551. doi: 10.1136/bmjopen-2018-024551
Journal - Research Article
Natale, P., Palmer, S. C., Ruospo, M., Saglimbene, V. M., Rabindranath, K. S., & Strippoli, G. F. M. (2019). Psychosocial interventions for preventing and treating depression in dialysis patients (Review). Cochrane Database of Systematic Reviews, 12, CD004542. doi: 10.1002/14651858.CD004542.pub3
Journal - Research Article
Palmer, S. C., Chung, E. Y. M., McGregor, D. O., Bachmann, F., & Strippoli, G. F. M. (2019). Interventions for preventing bone disease in kidney transplant recipients (Review). Cochrane Database of Systematic Reviews, 10, CD005015. doi: 10.1002/14651858.CD005015.pub4
Journal - Research Article
Palmer, S. C., Gray, H., Huria, T., Lacey, C., Beckert, L., & Pitama, S. G. (2019). Reported Māori consumer experiences of health systems and programs in qualitative research: A systematic review with meta-synthesis. International Journal for Equity in Health, 18, 163. doi: 10.1186/s12939-019-1057-4
Journal - Research Article