‘You’re in Your Own Time Now’: Understanding Current Experiences of Transition to Civilian Life in Scotland
Abstract: An informal mentor system, recognistion of qualifications from non-UK nationals and further support for the families of serving personnel are among several recommendations made by a new report looking at the transition of veterans and their families to civilian life in Scotland. The report provides a detailed account of the Armed Forces milieu in Scotland set against developments and future plans for the expansion of several bases across the country. This set the scene for the study and allowed for an improved understanding of the implications and the outcomes of the study and how findings may be applied.
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