Review of the Reserve Forces' and Cadets' Associations 2019
Abstract: Founded in 1908, the RFCAs are unclassified arms-length bodies, each with a scheme of association, and regulated through Defence Council regulations as provided for in the Reserve Forces Act 1996 (RFA96). Additionally, CRFCA has been constituted by the RFCAs as a joint committee, to provide a central coordination and a focus to enable the Associations to fulfil the requirements of their customers within resources. MOD has completed a tailored review of the RFCAs, in line with the latest Cabinet Office guidance on public bodies. The review found that the RFCAs’ work in engaging with the nation, particularly across their regional network, is of great value to defence. The review has identified opportunities to modernise and put the RFCAs on a more sustainable footing to maximise their potential through improved efficiency and effectiveness, addressing extant legal and financial issues. The change programme proposed by the review will enable defence to assure of regularity and propriety, and consequently be able to protect and potentially grow the RFCAs’ role in supporting our Reserves and Cadets across the country.
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