The Tri-Service Resettlement and Employment Support Manual (TSRESM)
Abstract: This manual was originally released in response to an FOI request for information in February 2008. As of 5 October 2015 the Ministry of Defence has published an updated version on the manual in it’s place. The original copy as published in February 2008 can be found at the UK Government Web Archive. JSP 534: tri-service resettlement manual explains the support available to members of the UK armed services in making a successful transition from military to civilian life.
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