Legal Custody Research Articles

Does Subsequent Criminal Justice Involvement Predict Foster Care and Termination of Parental Rights for Children Born to Incarcerated Women?

This longitudinal study of 83 incarcerated women, who gave birth during incarceration and retained their parental rights through brief sentences, examines the intersection between subsequent criminal justice involvement postrelease and child welfare outcomes. Ten years of multiple state-level administrative data sets are used to determine if arrest or conviction predict foster care and/or termination of parental rights. Findings indicate that only felony arrest is a significant predictor of foster care involvement. Additionally, 69% of mothers retained legal custody, despite subsequent criminal involvement for many, suggesting supportive parenting programs and resources need to be available to these women throughout and after incarceration.

Deaths While in Legal Custody and Incarceration in Seoul and Gyeonggi Province

The deaths while under police custody or prison may attract public interests or attentions that need to be handled carefully with scrutiny. Whenever such deaths occur in custody or during incarceration, controversial and legal issues or litigation may occur and a postmortem examination with meticulous investigation needs to be done. These deaths lie in a very complicated brew of ethical, legal and medical hurdles involving several authorities which can be hard to handle. In the past, some deaths became important public issues, 3) and some of these deaths have contributed to the total incidences of suicide. 5) Therefore, we conducted this study to examine these deaths so that we, forensic pathologists, may know how to handle sensitive issues regarding these types of deaths and we can make recommendations for policy to reduce more incidences of these deaths.

Deaths While in Legal Custody and Incarceration in Seoul and Gyeonggi Province

Deaths While in Legal Custody and Incarceration in Seoul and Gyeonggi Province

Rapid percutaneous tracheal catheterization using electrical guidance

To the Editor, Percutaneous needle tracheostomy or cricothyroidotomy establishes emergent airway access in situations of ‘‘cannot ventilate, cannot intubate.’’ 1 Currently, most clinicians and paramedics rely on palpation of anatomical landmarks and aspiration of air to guide needle puncture and confirm needle placement into the trachea. However, landmarking through palpation can be unreliable due to variability in patient sex, size, and body composition, and true aspiration of air from the trachea is hard to interpret in many cases. Moreover, difficulties can arise during needle insertion, including inability to cannulate the airway and perforation of the posterior or lateral aspects of the tracheal wall. Multiple attempts at needle insertion may be required, heightening these risks. Consequently, the complication rate of needle tracheostomy or cricothyroidotomy in emergency situations can be as high as 40%. Given this high complication rate and the critical and time-sensitive nature of the procedure, most physicians and paramedics would benefit from a reliable, objective, and unsophisticated method to increase its speed and accuracy. Here, we invent a novel method involving the simple presence or absence of an electrical current as a means to identify and guide needle placement into the trachea. With a grounded electrode on the body, the tip of an insulated needle maintains a closed electrical circuit when in contact with any tissue – in this case, the tracheal wall or peritracheal tissues (Fig. 1). Insertion of the tip of the insulated needle into the lumen of the air-filled trachea impedes the current, opening the electrical circuit. Based on these principles, the absence of electrical conductance could serve as a simple practical signal to detect insulated needle entrance into the trachea. Conveniently, most modern nerve stimulators have the ability to produce an audible and/or visual signal, enabling easy and rapid detection of the presence or absence of an electrical current. We demonstrated this concept in both a male and a female cadaver using a 21G 64 mm insulated needle with an 18G catheter assembly (MultiSet, Pajunk, Germany) and a commonly used nerve stimulator (HNS 12, B.Braun, Germany). Preliminary results proved encouraging, with 100% success in identifying the exact moment of needle tip entrance into the trachea (multiple insertions, more than five times for each cadaver), as viewed by bronchoscopy (Fig. 2). The cadavers were in legal custody of the Division of Anatomy of the author’s institution, and the procedures were performed with the permission from the Division of Anatomy and in compliance with the institutional ethical standards for the use of human material in medical education. As displayed in Fig. 2, real-time needle puncture of the tracheal wall was demonstrated with a corresponding change in current from an initial setting of 1.0 mA to 0.0 mA (pulse wideth 0.1 msec; 2 Hz), and it was also indicated by an instantaneous audible switch of signal tone. Importantly, this feature also serves as a warning signal, alerting the user that the needle tip is in contact with the posterior tracheal wall. The tracheal wall is also at risk of being punctured if the needle is advanced too far or is positioned too obliquely such that the needle tip touches a lateral aspect of the tracheal wall when advanced a short distance. Therefore, this technique can both confirm initial penetration of the tracheal wall and help guide positioning of the insulated needle in the airway. Once the needlecatheter assembly has been inserted successfully into the airway lumen, the needle is withdrawn. Following this step, the clinician has the option of providing temporary B. C. H. Tsui, MD (&) J. Tsui University of Alberta, Edmonton, AB, Canada e-mail: btsui@ualberta.ca

Clinical Manual of Emergency Psychiatry

Clinical Manual of Emergency Psychiatry

Clinical Manual of Emergency PsychiatryClinical Manual of Emergency Psychiatry RibaMichelle B.M.D., M.S. RavindranathDivyM.D., M.S. ; Washington, D.C., American Psychiatric Publishing, Inc., 2010, 434 pages, $62

Clinical Manual of Emergency PsychiatryClinical Manual of Emergency Psychiatry RibaMichelle B.M.D., M.S. RavindranathDivyM.D., M.S. ; Washington, D.C., American Psychiatric Publishing, Inc., 2010, 434 pages, $62

Ethics Rounds—Symbolic Resuscitation, Medical Futility, and Parental Rights

What should doctors do when they are caring for a dying child with a complex, chronic condition and whose parents will not agree to palliative care? What if those parents are cognitively delayed and have lost legal custody of the child because of their inability to care for her? This month's Ethics Rounds concerns a child with septo-optic dysplasia and respiratory failure. She is cared for by her grandmother and is legally a ward of the state. The doctors think that a do-not-resuscitate order is appropriate. Her grandmother agrees and is even ready to withdraw ventilator support. Her parents disagree. We asked 2 experts in bioethics consultation and palliative care to comment on this case. Joel Frader is Chief of General Academic Pediatrics and Medical Co-Director of Pediatric Palliative Care at Children's Memorial Hospital in Chicago, Illinois. Eric Kodish is Chair of the Department of Bioethics at the Cleveland Clinic in Cleveland, Ohio. D. K. is a 2-year-old girl with septo-optic dysplasia, microcephaly, seizure disorder, and severe developmental delay who is intubated for respiratory syncytial virus with respiratory failure. Her past medical history is significant for microcephaly and severe developmental delay since birth. Her baseline functioning is minimal — she has no purposeful movement and no speech or comprehension of language. She is unable to swallow and is given nutrition through a gastrostomy tube. Both of her parents are developmentally delayed and were unable to care for her at home. The state placed her with the maternal grandmother. Although the mother and father no longer have custody, they have been in the PICU and at the bedside daily since the patient was admitted to the hospital. The patient was admitted in respiratory failure and intubated. On the second hospital day, she suffered an acute respiratory decompensation on the ventilator and … Address correspondence to John D. Lantos, MD, Children's Mercy Bioethics Center, Children's Mercy Hospital, 2401 Gillham Road, Kansas City, MO 64108. E-mail: jlantos{at}cmh.edu

Ian: A 7-Year Old With Prenatal Drug Exposure and Early Exposure to Family Violence

A 7(1/2)-year-old boy is brought to a new primary care pediatrician because his grandparents, who have legal custody, want a "fresh look" at his behavior. Ian's grandmother begins the history with the comment, "He started out kind of rough." He was exposed to methamphetamine and marijuana throughout gestation and his mother had bipolar disease and hypertension. A Cesarean section for failure to progress was followed by normal Apgar scores and an unremarkable neonatal course. Ian's parents physically fought during the first 6 months of his life; at that time, the parents separated and the grandparents assumed care. Ian was expelled from three preschools due to physical aggression directed at other children. He also found it difficult to separate from his grandmother. In first grade, Ian often ran out of the classroom and was verbally, and at one time, physically abuse to his teacher. When he was expelled from school, the grandparents decided to home school Ian. Ian learned to read about 100 words and his spelling improved. Currently, Ian is in the first grade in a class of 10 children with behavioral problems; Ian has his own aid to insure his safety while in school. His teacher reports frequent fidgety behavior, difficulty sitting in his seat or at circle time, and trouble focusing on learning tasks. While his grandparents describe Ian as a "sweet and happy" child at home, they are concerned with repetitive behaviors (e.g., frequent flushing of the toilet because he worried that it is broken and brushing his teeth over 10 times each day), fear of leaving the house, and insisting on order to certain things such as his toys and having a "meltdown" when they are not in order. Severe tantrums are limited to once each month. A receptive and expressive language disorder was diagnosed at 4-years old followed by speech therapy and a social skills-language group program. A few months before the current pediatric visit, Ian had psychoeducational testing: The Wechsler Intelligence Scale-IV revealed verbal intelligence quotient (IQ) of 75 and a performance IQ of 108 with a full scale score of 81. The Gilliam Autism Rating Scale-2 indicated a probability of autism with significant scores in stereotype behavior, communication, and social interactions. During the physical examination, he constantly moved while in chair and required frequent redirection and refocusing on many tasks. Eye contact was appropriate, but he often used words out of context with scripted references to videos at home. Foul language was used both randomly and directed to the examiner. After saying, "here comes the bitch," he apologized. Ian demonstrated appropriate joint attention and reciprocal play without over-focusing on a single toy. Growth measurements were at the 95th percentile. Physical and neurological examinations were normal with the exception of mild asymmetry of auricle size and slightly abducted auricles in association with mildly small palpebral fissures.

Parental and Social Institutional Responsibilities to Children's Needs in the Divorce Transition: Fathers' Perspectives

A total of 82 separated and divorced fathers were interviewed in a study utilizing thematic analysis to examine fathers' narratives about their divorce experiences, particularly in regard to their relationship with their children, and grounded theory analysis to uncover themes related to fathers' perceptions of their children's needs, and parental and social institutional responsibilities to these needs, during the divorce transition. We found that contextual factors, particularly the legal custody determination process, largely determine both the level of paternal involvement and quality of father-child attachment after divorce. A sharp discontinuity between pre- and post-divorce father-child relationships was observed, more marked than in earlier studies. Fathers' psychological reaction to the actual or threatened loss of the father-child relationship was also more pronounced than previously reported, a consequence of fathers' increasing levels of involvement with and attachment to their children before divorce. Implications for practice and policy are discussed.

Taking Custody of Motherhood: Fathers' Rights Activists and the Politics of Parenting

What makes a good in contemporary American society? And more important, can good fathers effectively mother their children? Without a doubt, over the past several decades, the cultural imagery surrounding what it means to be a fully participatory has shifted dramatically (Burgess 1997; Coltrane 1989; Hobson and Morgan 2002; Ranson 2001). Instead of the ideal being simply the breadwinner of the family, this father - with commentators primarily spotlighting the desired behavior of the white male - combines both earning a living with the day-to-day care of his children (Pleck 1987). In other words, not only does he work full time, but he also is present at his children's birth, goes to school conferences, does their laundry, and prepares their meals. He is fully connected and essential to his children's well-being (Farrell 2001). This father is, in fact, just like any other modern mother. While this recent paternal imagery has been extremely powerful, scholars have also noted that fathers' actions have yet to meet this emerging ideal.1 While their contributions to child care have been increasing over time, particularly since the 1980s, fathers still lag behind mothers in the amount of parental work they perform on a regular basis (Ahmeduzzaman and Roopnarine 1992;Aldous, Mulligan, and Bjarnason 1998; Sandberg and Hofferth 2001; Sayer, Bianchi, and Robinson 2004). In fact, in one of the most recent and comprehensive studies that explored this division of responsibility issue, in 2000, Bianchi, Robinson, and Milkie (2006, 116) found enormous gaps in paid and unpaid work between the sexes, with women allocating 12.9 hours a week to child care, and men only completing 6.5 hours on this task. Nevertheless, despite the fact that real world practices have yet to catch up to the new cultural ideal of fatherhood, fathers' rights groups have seized upon this compelling imagery in making their political claims. More specifically, these fathers' rights organizations, composed primarily of white, middle-class men, have grown in number in recent years in order to challenge the legal system that they must confront when their families dissolve. One of their most prominent assertions is that the family law system, specifically through its child custody procedures that tend to physically place children with their mothers, denies them the opportunity to effectively personify their father roles. In this essay I explore precisely how fathers' rights groups have tapped into the cultural symbolism of the father in order to buttress their claims. RESEARCH CONTEXT The fathers' rights movement began to grow quite rapidly in the United States during the 1980s. With some estimates placing them at ten thousand members in total (Crowley 2008, 37), fathers' rights activists across the board charge that once their families break up, they lack certain parental rights (Clatterbaugh 2000; Coltrane and Hickman 1992; Fineman 1991;Williams and Williams 1995). Their grievances revolve around two critical areas: child support and child custody policy (Crowley 2003). For fathers' rights groups, these two issues are highly interlinked. Activists complain that policy makers force them to pay exorbitant amounts of child support to the mothers of their children, who typically receive primary physical custody. However, these payments would not be necessary at all, argue these men, if the child custody system were reformed in a way to automatically give fathers equal time with their children. Across the United States, judges make custody determinations for dissolving families.There are two types of joint custody at stake Jomi legal custody refers to a partnership between parents over the major decisions that they must make regarding their children's weH-being; joint physical custody refers to equally shared living arrangements for the involved children. Although joint legal custody is fairly common in the United States, joint physical custody is not and therefore is the focus of fathers' rights groups' concerns. …

ANALYSIS OF MEDIATION AGREEMENTS OF FAMILIES REPORTING SPECIFIC TYPES OF INTIMATE PARTNER ABUSE

The purpose of this study was to carefully measure Intimate Partner Abuse (IPA) behaviors among a large (n = 864 couples) sample of pairs of husbands and wives who were mandated to attend divorce mediation and then to: categorize the behaviors into theoretically‐driven types of IPA, determine the number of cases screened out of mediation for any reason, and investigate whether measured outcomes of mediation (primary physical and legal custody) were related to IPA. Results indicated that rarely was IPA not reported—the most frequently reported IPA behavior was psychological abuse (98% of wives; 97% of husbands), followed by physical abuse (58% of wives; 54% of husbands), escalated physical abuse (62% of wives; 50% of husbands), and sexual intimidation, coercion and rape (56% of wives; 29% of husbands). Rarely were couples reporting IPA screened out of mediation (5%), and rarely were supervised parenting time or restrictions on contact between parents included in mediated agreements made by couples reporting IPA (6.5%). The overall level of IPA was unrelated to the specific terms of mediated agreements; however, by far the most frequent type of mediated agreement the couples' negotiated in mediation was for primary physical custody to go to the wife and for the husband and wife to have joint legal custody (59% of cases). Analysis of the implications of these findings and policy recommendations are included.

Ian: A 7-Year Old With Prenatal Drug Exposure and Early Exposure to Family Violence

A 7(1/2)-year-old boy is brought to a new primary care pediatrician because his grandparents, who have legal custody, want a "fresh look" at his behavior. Ian's grandmother begins the history with the comment, "He started out kind of rough." He was exposed to methamphetamine and marijuana throughout gestation and his mother had bipolar disease and hypertension. A Cesarean section for failure to progress was followed by normal Apgar scores and an unremarkable neonatal course. Ian's parents physically fought during the first 6 months of his life; at that time, the parents separated and the grandparents assumed care. Ian was expelled from three preschools due to physical aggression directed at other children. He also found it difficult to separate from his grandmother. In first grade, Ian often ran out of the classroom and was verbally, and at one time, physically abuse to his teacher. When he was expelled from school, the grandparents decided to home school Ian. Ian learned to read about 100 words and his spelling improved. Currently, Ian is in the first grade in a class of 10 children with behavioral problems; Ian has his own aid to insure his safety while in school. His teacher reports frequent fidgety behavior, difficulty sitting in his seat or at circle time, and trouble focusing on learning tasks. While his grandparents describe Ian as a "sweet and happy" child at home, they are concerned with repetitive behaviors (e.g., frequent flushing of the toilet because he worried that it is broken and brushing his teeth over 10 times each day), fear of leaving the house, and insisting on order to certain things such as his toys and having a "meltdown" when they are not in order. Severe tantrums are limited to once each month. A receptive and expressive language disorder was diagnosed at 4-years old followed by speech therapy and a social skills-language group program. A few months before the current pediatric visit, Ian had psychoeducational testing: The Wechsler Intelligence Scale-IV revealed verbal intelligence quotient (IQ) of 75 and a performance IQ of 108 with a full scale score of 81. The Gilliam Autism Rating Scale-2 indicated a probability of autism with significant scores in stereotype behavior, communication, and social interactions. During the physical examination, he constantly moved while in chair and required frequent redirection and refocusing on many tasks. Eye contact was appropriate, but he often used words out of context with scripted references to videos at home. Foul language was used both randomly and directed to the examiner. After saying, "here comes the bitch," he apologized. Ian demonstrated appropriate joint attention and reciprocal play without over-focusing on a single toy. Growth measurements were at the 95th percentile. Physical and neurological examinations were normal with the exception of mild asymmetry of auricle size and slightly abducted auricles in association with mildly small palpebral fissures.

Family characteristics of stuttering children

Stuttering is a functional impairment of speech, which is manifested by conscious, but nonintentionally interrupted, disharmonic and disrhythmic fluctuation of sound varying in frequency and intensity. Aetiology of this disorder has been conceived within the frame of theoretical models, which tend to connect genetic and epigenetic factors. The goal of the paper was to study the characteristics of the family functioning of stuttering children in comparison to the family functioning of children without speech disorder, which confirmed the justification of the introduction of family orientated therapeutic interventions into the therapy spectrum of child stuttering. Seventy-nine nucleus families of 3 to 6-year-old children were examined; of these, 39 families had stuttering children and 40 had children without speech disorder. The assessment of family characteristics was made using the Family Health Scale, an observer-rating scale which according to semistructured interview and operational criteria, measures 6 basic dimensions of family functioning: Emotional State, Communication, Borders, Alliances, Adaptability & Stability, Family Skills. A total score calculated from the basic dimensions, is considered as a global index of family health. Families with stuttering children compared to families with children without speech disorder showed significantly lower scores in all the basic dimension of family functioning, as well as in the total score on the Family Health Scale. Our research results have shown that stuttering children in comparison with children without speech disorder live in families with unfavourable emotional atmosphere, impaired communication and worse control over situational and developmental difficulties, which affect children's development and well-being. In the light of previous research, the application of family therapy modified according to the child's needs is now considered indispensable in the therapeutic approach to stuttering children. The assessment of family characteristics with special reference to the ability of parents to recognize specific needs of children with speech disorder and adequate interaction, as well as readiness of parents for therapeutic collaboration are the necessary elements in legal custody evaluations.

Policies regarding coercive care in Swedish child and adolescent psychiatry

Results A great variation was found between the different clinics regarding the estimated numbers of involuntarily admitted patients and the practice regarding local guidelines for involuntary hospitalization and treatment, information to patients and relatives, and follow-up of coercive measures. There was a notable difference in the handling of voluntarily admitted inpatients that were also coercively placed simultaneously in the legal custody of social services.

Parenting by persons with intellectual disability: an explorative study in the Netherlands

As a sequel to a report by the Health Council of the Netherlands on contraception in persons with intellectual disabilities (IDs), a fierce debate about parenthood by such persons occurred, in which a lack of knowledge about parenting competences became clear. Therefore, the Ministry of Health commissioned a study investigating examples of 'successful parenthood' by persons with IDs. In conformity with the literature and with legal categories, we defined 'successful parenthood' as 'good enough parenthood', meaning no indications for child abuse and/or neglect, no dealings with child protection agencies and no legal custody. We combined a nationwide quantitative questionnaire study with a qualitative interview study. Questionnaires were sent to all institutions involved in caring for persons with ID, interviews were held with 'good enough' parents and their professional caregivers, selected on the basis of returned questionnaires. Parenthood occurs in around 1.5% of persons with ID in the Netherlands and is mostly restricted to those with mild handicaps. In total, 51% of the cases were regarded, by caregivers, as not-good-enough parenthood, 33% were clearly good enough and 16% were doubtful. Predicting factors included the ability and the willingness to follow advice, the quality of the social network and the acceptance of parenting in the community. However, there is not one decisive predicting factor; particularly, the predictive value of the IQ alone is small. A general policy of discouragement of parenthood, as advocated by the Dutch Ministry, is not supported by our results; moreover, it would probably be impossible and have negative effects on social acceptance of parents with ID. The overall conclusion from the study therefore is that some kind of balancing model, in which positive and negative factors are weighed, may be useful to predict success and need for support.

The Consequences of Child Support Policy for Family Financial Well-Being

The study examined the impact of child support policy on the financial well-being of one family experiencing divorce in Minnesota. Data were collected from a court record of a 1999 marital dissolution with joint legal and physical custody and a child support order that deviated from state guidelines. The analysis compared the needs-adjusted income the parties had while in the marriage with the needs-adjusted incomes provided by the actual child support order, and with hypothetical amounts consistent with the child support guidelines, and with the situation of sole physical custody. Financial well-being was measured using three types of ratios estimating income in relation to financial needs. Incomes were divided by (a) Federal Poverty Income Guidelines for 1999; (b) Economic Policy Institute's basic budget for Minneapolis-Saint Paul, Minnesota for 1999; and (c) USDA Parental Expenditures on Children for 1999. Results indicated that regardless of the needs standard used, the best financial outcomes were for the father's household. The deviations from the child support guidelines did not seem justified based on the financial calculations, and were not in the best interests of the children. Implications for educators were discussed.

Health and healthcare utilization among single mothers and single fathers in Sweden

To analyse self-rated health and healthcare utilization with regard to whether the respondents were single or couple parents, mothers or fathers. A postal questionnaire was distributed nationwide to 4,000 randomly chosen individuals 20-64 years of age, with a response rate of 66%. A total of 1,041 respondents had legal custody of a child (150 were single parents and 891 were couple parents), and thus met the definition of a parent used for this study. Analyses of self-rated health and health care utilization were performed according to sex, age, sociodemographic, and socioeconomic characteristics. Three different statistical methods were applied: Spearman correlation analyses, chi-square analyses and multivariate logistic regression. Both single fathers and single mothers reported worse health than their couple counterparts. However, single fathers had contact with a physician more frequently (OR 1.84) than couple fathers, whereas single mothers did not. Furthermore, single mothers refrained from seeing a physician despite a medical need much more often (OR 2.07) than couple mothers. An uneven distribution of sociodemographic and socioeconomic characteristics might help us to understand why single parents, both mothers and fathers, have worse health than parents who live together. Previously recognized gender differences with regard to healthcare utilization were present in our study as well, and it is possible that these differences are related to the unequal distribution of sociodemographic and socioeconomic assets between single fathers and single mothers found here.

Prognosis of cocaine body-packers

To study the prognosis and complications of cocaine body-packing (concealment of cocaine in the body for transportation between countries). We retrospectively reviewed the files of all cocaine body-packers hospitalized during a 4-year period in a medico-judiciary emergency unit. Subjects included in the survey were identified from the hospital databases using ICD-10 codes. The Medico-Judiciary Emergency Unit of Hôtel-Dieu university hospital in Paris is a unique medical and surgical emergency unit receiving all patients in legal custody arrested at the two Paris international airports and suspected of body-packing. All the cases of cocaine body-packers (n=581) hospitalized between January 1999 and December 2002 were studied. They had been arrested at Paris airports while arriving from drug-producing countries. The mean number of carried packets was 70.0+/-20.4 (range 18-150). The mean duration of hospitalization was 5.0+/-1.6 days (range 1-18). No complication occurred in 573 body-packers cases. Eight subjects developed a complication requiring admission to an intensive care unit: six acute cocaine intoxications due to packet rupture and two intestinal occlusions. No one died. Surgical treatment was necessary in six cases. Good prognosis observed in these body-packers cases is due to the careful monitoring of asymptomatic patients, allowing early detection and treatment of complications. Surgical removal of the packets when complication occurs is warranted.

Percy Bysshe Shelley, a biography: youth's unextinguished fire, 1792-1816

This biography, incorporating recent research and scholarship, stresses the intimate relationship between Shelley's life (1792-1822) and his poetry. Unusual aristocratic family influences, a unique and precocious childhood, traumatic educational events, and parental rejection molded the concurrent development of his radical sociopolitical beliefs and his poetic identity. Political activism (Ireland and Wales) prefigured the disastrous dissolution of Shelley's first marriage, replaced by involvement with William Godwin and elopement with Mary Wollstonecraft Godwin. After losing legal custody of his two children by his first wife because of his radical writing and behavior, increasing social ostracism, health concerns, and critical attacks on his poetry led to exile in Italy. Here, before his untimely death, he composed his greatest lyrics and most profound poetry amid personal anguish involving the deaths of his and Mary's children, Keats's death, romantic intrigues, marital disaffection, disillusionment with Byron, and political turbulence at home and abroad. Illustrated, Now retired, Dr. Bieri taught at the University of Texas at Austin.

An Exploration of the Grandparent Caregiver Role

Using role theory to guide a qualitative analysis of 26 grandparents raising grandchildren, the role transition from grandparent to grandparent caregiver was explored. Participants were predominantly female, low income, married, with an average age of 53. On average, participants were raising 1.7 grandchildren for 4 years and at the time of interview had legal custody of the grandchildren. Face-to-face, semi-structured interviews were used. With a 92% interrater reliability, themes focused on the grandparent caregiver role being off-time or unexpected, achieving a sense of role clarity, and the experience of role conflict.