The UK Armed Forces charity sector: a summary of provision
Abstract: Armed Forces charities are ‘established specifically to support past and present members of the Armed Forces and their families (the Armed Forces community). In this context, an Armed Forces charity must be able to apply this definition to their beneficiaries’ (Cole and Traynor, 2016). The UK Armed Forces charity sector today is a broad and diverse collection of charities, within which the number of charities providing welfare support is estimated at less than 500, supporting an Armed Forces community of approximately 6.5 million people (Royal British Legion, 2014). Along with the rest of the charitable sector in the UK, Armed Forces charities are facing significant financial challenges. They will need to work hard to sustain or improve income and to reduce expenditure at a time when regulatory costs are increasing and public trust is falling. These are among the emerging risks and trends for which Armed Forces charities are already preparing. Levels of collaboration and co-ordination within the sector are good, even exemplary, but collaboration more widely is less common and could offer positive opportunities for all organisations supporting the Armed Forces community in the future.
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