Pharmacogenomics or the associations between genetic traits of individuals and their responses to drugs is believed to hold the key to the solution of low (30 to 60%) pharmaceutical efficacy observed in many of today’s drug treatments. In ASEAN, information pertaining to the prevalence of pharmacogenomic biomarkers is incomplete. Individual case safety reports (adverse effects or drug-related problems) per million population per year range from ~3600 in Singapore to just 9 in Brunei. Therefore, an ASEAN-wide pharmacogenomics consortium has recently been tasked to fill in the gap. As a collaborative project between ASEAN countries and RIKEN (Japan), the initial study will involve the next-generation sequencing of 100 important pharmacogenes in 1000 individuals across the 10 ASEAN nations. In Brunei, DNA from 100 anonymous healthy individuals will be extracted and the 100 pharmcogenes library constructed for sequencing at RIKEN. Genetic variations identified here and those from other ASEAN individuals will aid in the estimation of allelic frequencies of genotypic biomarkers of drug metabolisers. Such information should ultimately provide the important scientific support on the wider implementation of pharmacogenomic screening in Brunei and ASEAN using a customised pharmacogene panel.
Millions of human genomics variants from different studies have been made publicly available over the last three decades. While many genetic disorders have been identified consequently, much remains undeciphered and yet understanding of these variants is paramount to the realisation of personalised precision medicine. Regrettably, systematic variant data for the majority Austronesian population groups in Southeast Asia have been at best patchy if not upright shortcoming. Our current effort attempts to catalogue all the known genotypes, including their allele frequencies, in this region and link them to reported genetic disorders.
Seafarers are amongst occupational groups with the highest risk for mental illness. Quality of social relationships remains an important associate of depression as social isolation experienced by seafarers on-board is associated with poor mental health. In Brunei, the oil and gas industries contributed to over half of the country’s GDP and 90 percent of total export earnings by exporting oil and gas every day to various countries. This massive operations are supported by workforce of seafarers who spend up to 4 months and 14 days of sea time. Evidence has suggested that individuals with non-communicable diseases (NCDs) have a greater burden of mental illness. This study therefore aims to examine the current status of mental health and its associated NCDs’ risk factors among seafarers in Brunei. Based on the findings, recommendation guidelines to reduce NCDs’ risk factors among seafarers will be developed through research collaborations with experts of NCDs. By addressing this topic, evidence on the current status of mental health and its associated NCDs’ risk factors among seafarers can be established which can lead to improved work performance and the country’s economy.
Colorectal cancer (CRC) is the third most common cancer-related death reported worldwide. The incidence rate is increasing in Brunei Darussalam. It is therefore vital to develop and investigate novel therapy for colorectal cancer due to the increasing occurrences and the side effects that the radiotherapy and chemotherapy impose. Nanoparticles have been proven to acquire better treatment quality and offer an enhanced therapeutic effect as compared to bulky solids. The use of nanoparticles as therapeutic drug delivery systems has become a prominent research area. This project aims to elucidate the anti-cancer effect of silver nanoparticles synthesized from natural products through in vitro studies. The anti-cancer drug, 5-fluorouracil (5FU) will be used as the standard. The effect of the nanoparticles will be determined quantitatively and the mechanism of action of the nanoparticles in colorectal cancer will be elucidated through in vitro methods of nanoparticles on colorectal cancer cell lines.
The use of simulation in medical training offers useful opportunities to improve competence and confidence and is known to assist in minimizing risks to patients, thus improving patient safety. Regarded as an adjunct to clinical learning, the integration of simulation training in the undergraduate medical curriculum is fast becoming recognized as part of an innovative approach in medical education, which aims to stress the importance of clinical competency and proficiency of medical graduates. IPE using Simulation (Sim-IPE) has been practiced in the last decade to enhance student learning in a supportive and safe educational environment. The proponents for simulation put forth a cogent argument that simulation benefits both novice and experts without fear and enhances skill acquisition through experiential learning and stimulates performance reflection. There will be a three-pronged approach for studying the objectives of the research from the students by questionnaires, focus group discussions and individual interviews. Assessors and observers of the Interprofessional Education (IPE) event will also be invited to participate in the FGD to address the study’s objectives.
Impact on health - Glycemic Index of local Bruneians rice.
A project is currently planned on determining the investigating the burden and risk factors of active TB, as well as the risk of progression from latent to active TB, using national-based surveillance data from MoH Brunei. Students interested to undertake this topic will be exposed to epidemiological concepts and biostatistical analysis.
The seasonality of infectious diseases has been a long known but less understood phenomenon. Equally perplexing is the differences in trends seen between temperate and tropical areas. Contributing factors that could be climate conditions and social/cultural differences in human behavior. Students who are interested in this topic have the opportunity to handle and analyze datasets relating to population health, meteorological and social science.
A project is currently planned on investigating the presence of spatial clustering or hot spots for Brunei, using national-based surveillance data from MoH Brunei. Students interested to undertake this topic have the opportunity to analyze the dataset using softwares such as R, ArcGIS and/or QGIS.
In Brunei Darussalam, breast cancer has remained consistently as the leading cause of death and a worrying trend of younger age of onset has emerged in recent years. High mortality in poor prognostic breast cancer, such as the triple negative, patients has been attributed to the lack of suitable biomarkers for therapeutic targeting. The functionally diverse and ubiquitously expressed calcium- and voltage-activated potassium BK channel has recently been shown to promote cancer cell proliferation, invasion and migration during the carcinogenic process. Preliminary evidence in aggressive glioma and cancer cell lines has demonstrated the promising potential of the channel, especially the gBK glioma splicing variant, serving as both a malignancy marker and an immuno-target. We, therefore, aim to establish for the first time the role of the high-grade-tumour-specific BK complex in the carcinogenesis of breast cancer. The expression spectrum of the complex (channel’s pore forming splicing variants and associated accessory subunits) in general cancer progression and breast tumours of different clinical stages and their cell proliferative and migratory effects will be studied. Establishment of this high-grade-tumour-specific BK complex as a prognosis marker will form the basis of preliminary pharmacological targeting of BK channel specific to breast cancer carcinogenesis.
With an increasing terminally ill population across the world, there is greater awareness and interest among international health policy makers in improving quality of life for terminally ill patients. In Brunei Darussalam hospital services are utilized more commonly particularly during the last days of life. The Wawasan 2015 for Brunei Darussalam has highlighted the delivery of high quality care in the acute hospital setting as an area of priority. Yet one of the most common complaints is that hospitals are related to care during last hours of life. Previous research also found that older people often experience perceived poor care and mistrust on the quality end of life care at hospitals. On the other side (of the world), palliative and end of life care in Brunei Darussalam yet remains in its developmental stages. Around 98% of Brunei Darussalam palliative population does not have access to palliative care5 and little is known about extent of palliative care needs among hospitalized patients from this population. The aim of this study is to explore the extent and meaning of terminal suffering among hospitalised Brunei Darussalam patients. . * Application invited for ONE PHD STUDENT -PhD in Nursing
Brunei Darussalam has one of the highest prevalence and incidence of End Stage Renal Disease (ESRD) in the world. Ministry of Health, Brunei Darussalam has shown the steady increase in number of patients undergoing renal replacement therapy. In 2014, 94.5% of total ESRD patients underwent dialysis and only 5.5% underwent transplant done elsewhere. The Department of Renal Services, Ministry of Health encourages ESRD patients to opt for kidney transplantation as their primary treatment choice rather than undergoing dialysis treatment three times a week as financial burden related to dialysis treatment and the renal translation proved as effective as in increasing survival and improving quality of life. Recently, Sultanate of Brunei successfully completed transplant surgeries at local level. However, similar to any other country, there is shortage of kidney donors at local level. Studies in western world explored cultural beliefs, mistrust, fear, lack of information, being old, and pre-existing medical conditions as barriers to living kidney donation among relatives of patients with chronic renal failure undergoing hemodialysis. Yet little is explored around barriers and facilitators of organ donation, in particular kidney donation among the perspectives of living eligible donors in Brunei Darussalam. This study aims to explore the perspectives of living donor kidney transplantation among family members of patients with ESRD in Brunei Darussalam.Application invited for ONE PHD STUDENT -PhD in Nursing
EBP has widely been accepted as an appropriate framework for health care professionals including healthcare professionals to embrace and use as a basis for their practice. Several studies identified that EBP can lead to a higher quality of care, improved patient outcomes, a culture of safety, and decreased cost of health care. Besides the benefits of using EBP in health care, there were inconsistencies in its utilization and implementation in the clinical working environment. The Ministry of Health in Brunei Darussalam wanted to achieve service excellence through strategy Vision 2035 by utilizing evidence based approaches, interventions and practices in the health care system. Vision 2035 also indicate the Ministry’s expectation towards healthcare professionals in ensuring high quality healthcare settings care they provide to patients are based on current research findings. To achieve Vision 2035, there is a need to build an organizational cultures that support EBP, implement strategies to enhance healthcare professionals’ EBP knowledge and skills, and provide environments where EBP can thrive and be sustained is necessary. However, this appeared to be a challenging agenda and goal the level of healthcare professionals’ understanding or skills to apply EBP in their daily practice in Brunei is currently unclear. Healthcare professionals’ ability to integrate and utilize research evidence into the practice in order to deliver optimal patient care in Brunei Darussalam has not been investigated. This study will be undertaken to understand the level of healthcare professionals’ utilisation of EBP in their daily care. The outcomes from this study will be highly significant in promoting EBP in Brunei Darussalam’s health care system by informing educators in that areas that needs improvement in healthcare settings education and policy makers in planning healthcare professionals’ professional development opportunities.Application invited for ONE PHD STUDENT -PhD in Nursing
Women and their partners celebrate pregnancy with joy. However, not all outcomes of pregnancies are successful. Some couples experienced pregnancies’ losses such as through miscarriages, the born of deceased and even stillbirth babies that resulted to the experiences of grief. The period of mourning and grief following the loss or death or even poor prognosis of the infants is usually termed as bereavement. These experiences posed challenges to nurses’/midwives’ and other healthcare practitioners' (e.g. Doctors, religious advisors, psychologists, and etcs) in exercising ther roles in caring for the bereaved couples. In addition, husbands of the women are too faced with great challenges during this vulnerable period. Islam being the national religion and Malay being the dominant citizen in Brunei requires that the provision of healthcare, specifically nursing/midwifery care to be tailored to these needs. These include taking into account the Multicultural societies of Brunei in application of the Melayu Islam Beraja. Hence, this project highlight the significance of delivering cultural specific nursing/midwifery care in Brunei that uphold the ‘Melayu Islam Beraja’ as the country’s philosophy, and is in line with the aspiration of His Majesty the Sultan on becoming a country as ‘a zikir nation’. Therefore, the data from this project will have significant implications for developing educational and health intervention programs targeted at helping couples and their family experiencing pregnancy loss. This project is jointly led by Dr. Siti Mazidah from Faculty of Art and Social Sciences and Dr. Khadizah from PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam with other research experts fromARSB IHS, Institute of Policy Studies (IPS), Sultan Omar Ali Saifuddien Centre for Islamic Studies (SOASCIS) and the Ministry of Health.
One of the current cultural practice of warming women’s body in the postnatal period in Brunei is called “Berdiang”. Charcoals are heated on fire and put into a big can and women are to lie beside the can. However, the use of charcoal burnt with fuel in fire can be viewed to be hazardous if practice in poorly ventilated confined spaces. It can lead to carbon monoxide production and consequently poisoning. This study aims to determine women’s awareness of the practice of “Berdiang”; whether they have been previously involved in this practice, and; if there are any intention to carry out this practice following their current delivery. This research is led by Dr. Khadizah abd Dk. Dr. Nurolaini from PAPRSB IHS, with other research experts in the same faculty, and the Ministry of Health.
Childbirth is long known as a normal process in a woman's life event. However, it is a significant experience; not only to the women, but also the men as their husband. In some countries and culture, the event is also fundamental to the couples' families. Hence, women's health throughout the childbirth period is an important aspect of their life. Historically, as defined by the World Health Organisation (WHO), health is not merely the absence of diseases and infirmity, but comprises of a holistic aspects: physical/biological; psychological/mental; social; and spiritual. All these aspects are inter-connected and inter-related to each other contributing to the complete health of women, their husbands and other carers throughout the childbirth event. Although there are substantial amount of research conducted into various areas of childbirth. The research mainly focuses on the physical/biological being of the women. The study specific to the spiritual being of women during childbirth is still consider as a grey area, and Brunei is not exceptional. Taking the spiritual aspects for granted or ignoring them will incomplete the wellbeing of women throughout childbirth. This research has three stages. The first stage is aimed at a one year research project focusing on the antenatal period. Throughout the antenatal period, a woman may be hospitalized due to medical reasons and complications of childbirth. These are such as having medically diagnosed for having high blood pressure; diabetes; and anaemia. Common complications throughout childbirth may include hyperemesis gravidarum; constipations; and backpain/joint pain. Due to these diagnoses or complications, women are usually interpreted as sick. Spiritual wellbeing of the women, in particular, their religious needs are often taken for granted. It is noteworthy that the dominant religion of the population of Brunei is Islam that comprises of about 80% of the total population. Islam is not only a religion in Brunei, but also that guided the daily living of Muslim in Brunei. Praying (Shalah) five times in a day is the first pillar of Islam. It can be considered as an aspect of basic religious need for any hospitalized individual, including the pregnant woman. Muslim also recite du'a and zikir; and read al-qur'an to strengthen spiritual wellbeing. This propose study aim at exploring nurses'/midwives' roles in providing spiritual care (in particular the religious aspect) to women during hospitalization at the antenatal period. These religious needs are such as assisting women to perform prayer (shalah); encouraging du'a and dzikir; reading al-qur'an and other religious needs. The study objectives are to: 1) describe the religious needs of women during hospitalization in the antenatal period. 2) explain the facilitators and barriers for nurses/midwives in assisting women for meeting their religious needs during hospitalization in the antenatal period 3) suggest recommendations for assisting women in meeting their religious needs during hospitalization in the antenatal period. The second, third and fourth stages of this project will focus on labour and the postnatal period; and the care of the newborn. This large project is targeted at enhancing the Ibadah-friendly hospital Initiatives which are already in existence in Brunei Public Hospitals. This project will be co-led by Dr. Khadizah from PAPRSB Institute of Health Sciences (PAPRSBIHS) and Dr. Azmi from Sultan Omar Ali Saifuddien Centre for Islamic Studies (SOASCIS) with involvement of other research experts from PAPRSB IHS, Institute of Policy Studies; and the Ministry of Health.
Globally and locally, there is an increased epidemic of people with life-limiting diseases that includes cancer, metabolic diseases (Diabetes mellitus), renal failure and cardio-vascular diseases. Quality of life for people with life-limiting diseases is often threatened due to poor access and use of available health care resources. Older people live with more multi-morbid life limiting illness and tend to use lesser oral care services. In 2015, only 12% older Brunei people above 55 years (n=17456) used oral care services. Around 1357 (0.4% of total Brunei population) Bruneians die every year. However, currently neither ‘geriatric oral care services’ nor ‘oral palliative care services’ are available in Brunei Darussalam. This is also similar to global context where there is a lack of understanding on need for specialized oral care. Poor oral hygiene in frail elderly at the end of life facilitates the colonization of pathogens on the surfaces of teeth, tongue and dentures (Chalmers, 2005). This further increases the risk of respiratory infections which can be life threatening (Azarpazhooh, 2006). Saliva production is reduced and the cleansing effect of saliva on the tongue and mucous membrane is lost. Radiotherapy or chemotherapy can also cause xerostomia (Pinna et al 2015). Dry mouth is the most common oral health problem among seriously-ill patients and affects more than 90% of hospice cancer patients (Fischer, 2014). Specific oral problems like root caries, burning mouth, difficulty speaking, swallowing, altered taste sensation, aphthous ulcers and denture related problems are common. Majority of the patients at the end of life are more prone to oral candidiasis (thrush). Untreated acute dental pain often led to delirium among terminally ill patients (Chalmers 2000). Various barriers yet challenge quality oral care services for people with life-limiting illnesses. Patient and family centered issues related to why lack of utilization is yet unknown. Indeed, 40% of terminally-ill patients tend to lose the ability to communicate with their care-givers about their oral health issues (Chen et al 2013). As a result may suffer treatable pain or infection in the mouth that often get unnoticed and non-referred. On the other hand, main clinical barriers include lack of clinical assessment tools for health care practitioners to assess and refer patient with oral care problems to dental health practitioners. Similarly, there is no stronger evidence available on standards of oral care treatment guidelines for terminally ill population. In this context, our study aims to 1) To develop baseline knowledge base on current oral care practices for people with life-limiting illness by health care practitioners 2) To develop a new clinical tool “Oral Palliative Care Assessment and Referral (OPCAR) instrument” for assessing and referring palliative patients to oral care services 3) To validate the new clinical tool “Oral Palliative Care Assessment and Referral (OPCAR) instrument” for assessing and referring palliative patients to oral care services 4) To conduct a randomized controlled trial (RCT) to test the effectiveness of newly developed clinical tool in improving quality of life among people with life limiting illness
D-allulose is a pure form of rare sugar manufactured synthetically without animal or alcohol derivatives. The aim of this 24-week double-blinded, prospective, randomized controlled trial is to investigate the effect of consumption of D-allulose on overweight and obese individuals, and to compare with erythritol (non-calorie sweetener). The objectives of the trial are to evaluate and compare the effect of D-allulose and erythritol by measuring: (i) body weight and BMI change; (ii) body fat composition (iii) full blood count, HbA1c, TNF-alpha, urine, lipid, renal and liver function profiles at 12 and 24 weeks; and (iv) evaluate overall satisfaction on the D-allulose consumption and assess participants’ diet and physical activity using a novel mobile application. Healthy adults with BMI 25 and above will be recruited from the community and clinical setting. We aim to recruit a total of 80 participants of which 40 will be randomly assigned to test product (D-allulose) and 40 to control (erythritol, a non-calorie sweetener). This randomised product (test or control) is to be diluted in liquid and consumed three times a day, 30 minutes before meal or immediately after meals. Daily consumption of this randomized products will be recorded by participants via a mobile application which is also used to record meals consumed as per protocol. Baseline measurements of participants will include the following: body temperature, blood pressure, heart rate, weight and height, waist and hip circumference and percentage body fat. Baseline blood tests will include the following: full blood count, plasma insulin and glucose, HbA1c, GIP, GLP-1, TNF-alpha, fasting lipid, renal and liver function profiles and urine for microscopic examination.
Majority of lung cancer patients were diagnosed in Stage 3 or 4 and overall median survival time was 6.1 months in Brunei Darussalam. Although the survival time was comparable to some developed countries, survival can be improved by early detection. Improving awareness of individuals on risk factors, early signs and symptoms, and practice of regular check up, the survival can be improved. Therefore, we are interested to assess the awareness and practice in the community. The study will involve, designing and validation of research tool, and a survey method to achieve the study objectives.
Development and validation of instrument for quality of life of elderly
Community-based health promotion for elderly