909 resultados para Long-term unemployment


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"September 23, 1992; updated May 18, 1993."

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The chapter reflects on the first two years of the Restart Scheme introduced by the Manpower Services Commission for Long term unemployed people in the UK from a facilitator's perspective ten years later. It examines the actual weekly program for participants with some case examples from one of the pilot centres, Crawley College, West Sussex, an area of low unemployment. The observations suggested that even in a place where there are many job vacancies, there will be a 3-4% of the population who are unable to compete for jobs and participate in the work force unless sheltered workshops and specialized training initiatives are established.

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With transplant rejection rendered a minor concern and survival rates after liver transplantation (LT) steadily improving, long-term complications are attracting more attention. Current immunosuppressive therapies, together with other factors, are accompanied by considerable long-term toxicity, which clinically manifests as renal dysfunction, high risk for cardiovascular disease, and cancer. This thesis investigates the incidence, causes, and risk factors for such renal dysfunction, cardiovascular risk, and cancer after LT. Long-term effects of LT are further addressed by surveying the quality of life and employment status of LT recipients. The consecutive patients included had undergone LT at Helsinki University Hospital from 1982 onwards. Data regarding renal function – creatinine and estimated glomerular filtration rate (GFR) – were recorded before and repeatedly after LT in 396 patients. The presence of hypertension, dyslipidemia, diabetes, impaired fasting glucose, and overweight/obesity before and 5 years after LT was determined among 77 patients transplanted for acute liver failure. The entire cohort of LT patients (540 patients), including both children and adults, was linked with the Finnish Cancer Registry, and numbers of cancers observed were compared to site-specific expected numbers based on national cancer incidence rates stratified by age, gender, and calendar time. Health-related quality of life (HRQoL), measured by the 15D instrument, and employment status were surveyed among all adult patients alive in 2007 (401 patients). The response rate was 89%. Posttransplant cardiovascular risk factor prevalence and HRQoL were compared with that in the age- and gender-matched Finnish general population. The cumulative risk for chronic kidney disease increased from 10% at 5 years to 16% at 10 years following LT. GFR up to 10 years after LT could be predicted by the GFR at 1 year. In patients transplanted for chronic liver disease, a moderate correlation of pretransplant GFR with later GFR was also evident, whereas in acute liver failure patients after LT, even severe pretransplant renal dysfunction often recovered. By 5 years after LT, 71% of acute liver failure patients were receiving antihypertensive medications, 61% were exhibiting dyslipidemia, 10% were diabetic, 32% were overweight, and 13% obese. Compared with the general population, only hypertension displayed a significantly elevated prevalence among patients – 2.7-fold – whereas patients exhibited 30% less dyslipidemia and 71% less impaired fasting glucose. The cumulative incidence of cancer was 5% at 5 years and 13% at 10. Compared with the general population, patients were subject to a 2.6-fold cancer risk, with non-melanoma skin cancer (standardized incidence ratio, SIR, 38.5) and non-Hodgkin lymphoma (SIR 13.9) being the predominant malignancies. Non-Hodgkin lymphoma was associated with male gender, young age, and the immediate posttransplant period, whereas old age and antibody induction therapy raised skin-cancer risk. HRQoL deviated clinically unimportantly from the values in the general population, but significant deficits among patients were evident in some physical domains. HRQoL did not seem to decrease with longer follow-up. Although 87% of patients reported improved working capacity, data on return to working life showed marked age-dependency: Among patients aged less than 40 at LT, 70 to 80% returned to work, among those aged 40 to 50, 55%, and among those above 50, 15% to 28%. The most common cause for unemployment was early retirement before LT. Those patients employed exhibited better HRQoL than those unemployed. In conclusion, although renal impairment, hypertension, and cancer are evidently common after LT and increase with time, patients’ quality of life remains comparable with that of the general population.

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In part because of high and persistent youth unemployment, adolescent students’ transition from school to work is an important policy and research topic. Many countries have implemented public programs offering summer jobs or work while in high-school as measures to smooth the transition. While the immediate effect of the programs on school attendance, school grades, and disposable income is well documented, their effect on the transition to the labor market remains an open question. Observational studies have shown strong positive effects of summer jobs, but also that the estimated effect is highly vulnerable to selection bias. In this paper, some 3700 high-school students applying for summer jobs in the period 1995-2003,via a program, are followed to 30 years of age. A quarter of the applicants were randomly offered a summer job each year. Among the remaining students, 50% had a (non-program related) summer job while in high-school. We find the income, post high-school, for the offered and non-offered groups to be similar and conclude that the effect of summer jobs on the transition to the labor market is inconsequential.

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Mode of access: Internet.

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