Background: The metaverse as a digital environment for Industrial Revolution 4.0 is one major form of use of the internet. There are 202.6 million internet users in Indonesia in 2021, or 73.7% of the total population. A total of 138.1 million Indonesians aged 18–64 years have used the internet to make purchases through e-commerce and 74.4% make food purchases through online food delivery applications. Most of the foods sold in online applications are foods that are high in carbohydrate and fat, but with fewer vegetables and fruits. So, it can be concluded that the food sold is energy dense, nutrition poor. Because of that, people run the risk of degenerative diseases such as hypertension, diabetes mellitus, stroke, and others. By using the health belief model approach, this study aims to analyze the association between the habits of consuming food and beverages purchased online through the Grab Food or Go Food applications with the nutritional status of the people in Surabaya and Pasuruan, East Java, Indonesia. Methods: This research is quantitative research using a cross-sectional approach. Data collection was carried out offline using paper questionnaires and analysis with SPSS. Result: There was significant association between the characteristics of the respondents (age, marriage status, profession, education level, income, and allowance) and health beliefs. However, there was no association between health beliefs and the frequency of online orders. Finally, no significant association was found between perceived susceptibility, perceived severity, perceived benefit, perceived barrier, cues to action, self-efficacy and nutritional status. Thus, it is still important for the government to increase socialization and education in the importance of balanced nutrition and nutritional status so that people can protect themselves and prevent the onset of degenerative diseases.

Elderly individuals with diabetes should maintain a normal body mass index (BMI) to help control their blood glucose levels. This study investigated barriers to physical activity (PA), self-efficacy to overcome those barriers, and PA self-efficacy among elderly individuals with diabetes in relation to BMI. This cross-sectional study included 56 participants. Data were collected by a questionnaire interview and direct measurements for anthropometric data. PA self-efficacy was measured using 8 questions describing different levels of PA, where participants rated the strength of their belief that they could engage in that activity. Self-efficacy to overcome barriers was measured using 10 questions capturing participants' confidence in their ability to engage in PA despite different possible barriers. Mean scores for these parameters were analyzed using the chi-square test and the independent t-test. In total, 89.3% of participants had a low PA level and 58.9% had more than 3 hours of sedentary activity per day. Furthermore, 55.4% were obese and 14.3% were overweight. The mean scores for PA self-efficacy and self-efficacy to overcome barriers were 59.1± 26.4 and 52.5±13.8, respectively. PA level was related to BMI (p<0.001; r=0.116) and sedentary activity (p<0.05; r=0.274). PA self-efficacy and age were not related to BMI. Barriers to PA were associated with PA levels (p<0.05). Physical inactivity was a major problem in elderly individuals with diabetes, and was correlated with higher BMI. Lower levels of PA might be mediated by sedentary activity.

Background: The maternal mortality rate in Surabaya is still quite high due to ineffectice referral health systems. Primary Health Care (PHC) has difficulty referring patients to hospitals which have available resources. The purpose of this study is to develop a mobile app system framework for the maternal referral system. Design and methods: This study was developed based on the results of the Focus Group Discussion (FGD) with midwives, doctors and primary health care heads about the referral system regulation in Surabaya City. Results: A mobile app system can be used to communicate patients’ conditions to the hospital. The hospital then will refer back to the PHC as a home care service after the birth. This mobile app has gone through a trial and a development process; it is currently in the process of structuring the mobile app based on the bugs that occur in the system. Conclusions: This mobile app still needs development, especially in minimizing system bugs, and providing faster, more accurate communication.

Insomnia was a problem of Covid-19 patients often moaned because the physical and psychological condition of patients are weak. This study aims to analyze the association between respondent’s characteristics, social factors, and medication adherence with insomnia when Covid-19 survivor become isolated patients. This study used a descriptive and analytical cross-sectional design. The study was conducted in August 2021. The population of this study was all Covid-19 survivors. The sample of this study was part of Covid-19 survivors with a total number of 191. Data were collected by an online questionnaire via google form and analyzed by chi-square test. Almost all respondents (83.77%) were female, and most of the respondents (73.30%) worked as health workers. The age mean of the respondents was 31.51 (SD 8.82, min=18, max=60). Insomnia was experienced by almost half of the respondents (41.36%). There was no association between sex (OR = 1.92, 95% CI 0.89-4.17; p=0.113), type of work (OR = 1.11, 95% CI 0.58-2.11; p=0.868), medication adherence (OR = 0.47, 95% CI 0.05-4.56; p=0.644), and motivation (p=0.269) with insomnia. There was an association between optimism (p=0.043) and discrimination (OR=4.19, 95% CI 1.86-9.43, p=0.001) with insomnia. Insomnia was experienced by almost half of isolated patients in inpatient rooms of Indonesian health care facilities. Factors associated with insomnia were optimism and discrimination. Treatment for Covid-19 patients should pay attention to their physical care and give psychological care.

Background: The population of elderly worldwide is increasing unnoticed, including in Indonesia. The world's population is aging, and many elderly people experience age-related malnutrition, including deficiencies in some micronutrients. Malnutrition in the elderly is a serious condition when the nutritional needs of the elderly do not match their food intake. Objectives: This systematic review broadly reviews various micronutrient problems and health impacts on the elderly in several countries. Methods: Systematic review following PRISMA guidelines. Several databases have been accessed; the PubMed, Google Scholar, and ScienceDirect databases use a combination of MESH terms and relevant keywords. The inclusion criteria applied were studies written in English, evaluating relevant topics, providing full text, and published studies from 2017-2022 Discussion: Many disorders associated with aging are related to micronutrient deficiencies. Various factors cause micronutrient deficiencies in the elderly, but inadequate food intake is the main factor influencing this deficiency. Nutritional deficiencies experienced by the elderly are closely related to decreased immune function. The results of this review explain that the elderly experience malnutrition due to a lack of the following nutrients: vitamin D, folic acid, calcium, and vitamin B12. Conclusions: Micronutrient deficiency in the elderly causes a variety of comorbidities that reduce the elderly's quality of life in old age, such as heart disease, high blood pressure, diabetes, electrolyte imbalance, dementia, and anemia. The development of food-based dietary guidelines and health promotion regarding elderly nutrition in several countries should be recommended, and it is also necessary to update national food intake references.