Living in our Shoes: Understanding the Needs of UK Armed Forces Families
Summary: This review was commissioned by the Ministry of Defence to explore the needs and concerns raised by Armed Forces families, as well as make recommendations for change. The responses to the Call for Evidence were extremely detailed and thoughtful, and concerns about various issues were tempered with positive comments about the exciting experiences and considerable opportunities that military life offers to members of the Armed Forces community. During the analysis of written submissions, face-to-face discussions, and our own observations at military bases, a number of key themes emerged about the challenges experienced by military families today. Across all three Services, the key issues raised were: accommodation, mobility, deployment and the amount of time, Serving personnel spend apart from their families, the impact of Service life on children and young people, the employment and careers of spouses/partners, the health and well-being of Serving personnel and family members and the impact of military life on personal relationships.
Abstract: Context: In response to the opioid crisis, federal guidelines were implemented, including the Veterans Health Administration's (VA) Opioid Safety Initiative in 2013. The impact of policies on patients near the end of life is unknown. Objective: Examine temporal trends in opioid prescribing, pain, and opioid overdoses among Veterans near the end of life. Methods: Retrospective, time series analysis of VA decedents between October 2009 and September 2018 whose next-of-kin participated in VA's Bereaved Family Survey (BFS). Using multivariate regression to adjust for sociodemographic and clinical covariates, we examined temporal trends in outpatient opioid prescribing, uncontrolled pain based on BFS report, and opioid overdose-related hospitalizations, in the last month of life, overall and by clinical diagnosis (cancer versus non-cancer). Results: Among 79,409 decedents, mean daily outpatient opioid dose in morphine milligram equivalents in the last month of life decreased from 4.6 mg in 2010 to 2.1 mg in 2018 (adjusted change -0.20 mg/year; P