JSP 760 Tri-Service Regulations for Leave and Other Types of Absence Part 1: Directive
Summary: Joint Service Publication (JSP) 760 - Tri-Service Regulations for Leave and other Types of Absence - has a broad remit and encompasses the majority of reasons for the absence of a Service person from their designated place of work. These include the various types of leave available and those occasions when Service personnel1 are absent for other reasons, such as jury service or when in civil custody. Absences may be either pre-planned or in reaction to particular circumstances. Either way, all absences must be recorded on the Joint Personnel Administration (JPA) System to allow for the appropriate pay, allowances or career management action to be taken, and for the provision ofaccurate management information. Service personnel are not able to input leave retrospectively onto the JPA system, therefore Annual Leave requests must be submitted to unit HR at least 48 hours prior to the proposed period of absence.
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