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Abstract BackgroundBiomedical data warehouses (BDWs) have become an essential tool to facilitate the reuse of health data for both research and decisional applications. Beyond technical issues, the implementation of BDWs requires strong institutional data governance and operational knowledge of the European and national legal framework for the management of research data access and use. ObjectiveIn this paper, we describe the compound process of implementation and the contents of a regional university hospital BDW. MethodsWe present the actions and challenges regarding organizational changes, technical architecture, and shared governance that took place to develop the Nantes BDW. We describe the process to access clinical contents, give details about patient data protection, and use examples to illustrate merging clinical insights. Implementation (Results)More than 68 million textual documents and 543 million pieces of coded information concerning approximately 1.5 million patients admitted to CHUN between 2002 and 2022 can be queried and transformed to be made available to investigators. Since its creation in 2018, 269 projects have benefited from the Nantes BDW. Access to data is organized according to data use and regulatory requirements. ConclusionsData use is entirely determined by the scientific question posed. It is the vector of legitimacy of data access for secondary use. Enabling access to a BDW is a game changer for research and all operational situations in need of data. Finally, data governance must prevail over technical issues in institution data strategy vis-à-vis care professionals and patients alike.

Degree apprenticeships in the UK represent a shift in approach to degree-level study. As the model matures, it is important to hear perspectives of apprentices. Using Q methodology, the study aims to identify the different apprentices' viewpoints of the apprenticeship, exploring aspects of belonging, support, challenges and views of the learning experience. Thirty-five second-year computing apprentices at a UK university participated in the study. Centroid factor analysis revealed three perspectives: aligned student-workers, busy professionals, and the cast adrift. Aligned student-workers were balancing work and study effectively, finding value in both. Busy professionals were already consolidated as professionals, using this degree apprenticeship to upskill. Finally, the cast adrift, reported a lack of support in the workplace that was affecting their view on the apprenticeship. This exploratory study, resulting in a new research instrument and approach, contributes apprentices' perspectives to research and practice, as apprenticeship models expand in the UK and beyond.

This article compares policy aims with experiences following the introduction of a new model for STEM apprenticeships in the UK. Degree apprentices work while studying for a degree, undertaking work-based learning and attending on-campus classes. Specifically, this study explores an implementation in Scotland, where computing degrees are designed and delivered through partnerships between employers, universities, and the Scottish Government's skills agency, Skills Development Scotland. This collaboration is designed to bridge employer-reported skills gaps and to bring about an increase in highly-skilled workers. To examine the policy implementation behind the new degrees, a review was conducted of the policy documents that framed their introduction, including texts from university and employer websites promoting apprenticeships. The apprentices' perspectives, barely addressed in the policy documents, were examined through surveys and narrative interviews. The policy documents positioned the new degrees as a 'win-win' opportunity for employer-led higher education, and the apprentices recognised and valued the opportunity to undertake a work-based degree. However, underneath the superficial win-win narrative a complex implementation landscape was observed for employers, apprentices, "and" universities. Understanding these stakeholder contexts is essential for the longer term sustainability of degree apprenticeships.

Abstract Background Advance care planning in nursing homes is important to ensure the wishes and preferences of residents are recorded, especially during the COVID-19 pandemic. However, care staff and family members frequently report feeling unprepared for these conversations. More resources are needed to support them with these necessary discussions. This research aimed to develop, implement and evaluate a website intervention for care staff and family members to provide training and information about advance care planning during COVID-19. Methods The research was a primarily qualitative case study design, comprising multiple UK nursing home cases. Data collection included semi-structured interviews with care staff and family members which were coded and analysed thematically. A narrative synthesis was produced for each case, culminating in a thematic cross-case analysis of the total findings. Theoretical propositions were refined throughout the research. Results Eight nursing homes took part in the study, involving 35 care staff and 19 family members. Findings were reported according to the RE-AIM framework which identified the reach, effectiveness, adoption, implementation and maintenance of the intervention. Themes included: website content that was well received; suggestions for improvement; implementation barriers and facilitators; examples of organisational and personal impact. Conclusions Four theoretical propositions relating to advance care planning in nursing homes are presented, relating to: training and information needs, accessibility, context, and encouraging conversations. Implications for practice and training include an awareness of diverse learning styles, re-enforcing the right to be involved in advance care planning and encouraging opportunities for facilitated discussion. Trial registration ISRCTN registry (ID 18003630 ) on 19.05.21.