Due to the COVID-19 pandemic, eLearning became the lifeline of higher education. We explored university educators’ eLearning perspectives, practices, and future adoption intentions. In-depth interviews with 14 educators from a large university in Singapore were conducted. Educators had limited eLearning experience prior to COVID-19 emergency eLearning and expressed strong preferences for in-person sessions. The short notice to switch to eLearning and lack of eLearning experiences created stress and anxiety. Educators responded by making efforts that allowed for teaching to continue, conceding that some expectations had to be readjusted. Despite many obstacles, educators acknowledged reduced apprehension towards eLearning. Reflecting upon their experiences, educators highlighted opportunities and challenges of eLearning. A key opportunity was increased flexibility, which enabled students to learn independently. Additionally, eLearning triggered reflection upon educators teaching which could lead to improved practice. Reduction of some barriers to student–educator interaction were also mentioned. Key challenges include creating social, emotional, and cognitive engagement, catering to diverse student needs and providing holistic learning experiences. Considering opportunities and challenges, educators envisioned that eLearning would feature in their future teaching if practical and helpful for achieving educational goals. Hybrid or blended learning approaches were preferred, but support enabling the implementation of technology-based and pedagogy-informed teaching is necessary.

BackgroundThe enterosalivary nitrate‐nitrite‐nitric oxide pathway is an alternative pathway of nitric oxide generation, potentially linking the oral microbiome to insulin resistance and blood pressure (BP). We hypothesized that increased abundance of nitrate‐reducing oral bacteria would be associated with lower levels of cardiometabolic risk cross‐sectionally.Methods and Results ORIGINS (Oral Infections, Glucose Intolerance, and Insulin Resistance Study) enrolled 300 diabetes mellitus–free adults aged 20 to 55 years (mean=34±10 years) (78% women). Microbial DNA was extracted from subgingival dental plaque (n=281) and V3–V4 regions of the 16S rRNA gene were sequenced to measure the relative abundances of 20 a priori–selected taxa with nitrate‐reducing capacity. Standardized scores of each taxon's relative abundance were summed, producing a nitrate‐reducing taxa summary score (NO 3 TSS) for each participant. Natural log‐transformed homeostatic model assessment of insulin resistance, plasma glucose, systolic BP, and diastolic BP were regressed on NO 3 TSS in multivariable linear regressions; prediabetes mellitus and hypertension prevalence were regressed on NO 3 TSS using modified Poisson regression models. Nitrate‐reducing bacterial species represented 20±16% of all measured taxa. After multivariable adjustment, a 1‐SD increase in NO 3 TSS, was associated with a −0.09 (95% CI, −0.15 to −0.03) and −1.03 mg/dL (95% CI, −1.903 to −0.16) lower natural log‐transformed homeostatic model assessment of insulin resistance and plasma glucose, respectively. NO 3 TSS was associated with systolic BP only among patients without hypertension; 1‐SD increase in NO 3 TSS was associated with −1.53 (95% CI, −2.82 to −0.24) mm Hg lower mean systolic BP. No associations were observed with prediabetes mellitus and hypertension.ConclusionsA higher relative abundance of oral nitrate‐reducing bacteria was associated with lower insulin resistance and plasma glucose in the full cohort and with mean systolic BP in participants with normotension.

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These findings have useful implications for the oral care training of nursing home caregivers. While attitudes towards the importance of oral care may be positive among nursing home caregivers, our study suggests that future interventions should include practical skills training for oral care management and consider organisational strategies for encouraging oral care provision.