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The Extent To Which The Humanistic Approach In Japanese Juvenile Training Schools Affects Recidivism, Natalie Bui Jan 2024

The Extent To Which The Humanistic Approach In Japanese Juvenile Training Schools Affects Recidivism, Natalie Bui

AUCTUS: The Journal of Undergraduate Research and Creative Scholarship

Japan’s juvenile justice system is regarded as one of the most unique and successful implementations of reformative justice. This approach has remained effective in maintaining Japan’s low rates of juvenile delinquency and recidivism, despite massive changes in Japanese society over the past decade. While Japan’s crime seems to be on an impressive decline, the United States continues to struggle with social control, juvenile delinquency, and, more recently, demands for justice reform from social movements like the Black Lives Matter Movement. The American juvenile justice system needs reform now more than ever and where better to get inspiration, than the industrialized …


Transitions In Patterns Of Substance Use During Early Adolescence: Bidirectional Associations With Externalizing Behaviors, Courtney B. Dunn Jan 2024

Transitions In Patterns Of Substance Use During Early Adolescence: Bidirectional Associations With Externalizing Behaviors, Courtney B. Dunn

Theses and Dissertations

Early adolescents who engage in polysubstance use, defined as the use of three or more different substances, are at particularly high risk of future substance use disorders and adverse psychosocial outcomes. However, little is known about the development of substance use patterns during early adolescence, particularly among youth living in urban settings. Although theory and research suggest that youth with greater externalizing behaviors (e.g., aggression, delinquent behavior) may be more likely to escalate to polysubstance use at an early age, few studies have examined bidirectional relations between externalizing symptoms and polysubstance use. The goal of this study was to (a) …


Memory Reconsolidation And Alcohol Use Disorder: Intravenous Infusion Of Ketamine To Alleviate Addictive Symptoms In Alcohol Use Disorder Diagnoses, Yasaswi Veera Jan 2023

Memory Reconsolidation And Alcohol Use Disorder: Intravenous Infusion Of Ketamine To Alleviate Addictive Symptoms In Alcohol Use Disorder Diagnoses, Yasaswi Veera

Undergraduate Research Posters

According to the National Institute of Health, substance use disorder in the United States in 2021 caused nearly 106,000 deaths and an annual healthcare and criminal justice expenditure of roughly $200 billion, however, only 10% of diagnoses receive proper treatment. This is primarily due to the lack of previous research in addictive studies as well as the lack of accessibility to resources and proper treatments. Current treatments for alcohol use disorder range from medications and behavioral therapies, such as acamprosate, naltrexone, and cognitive behavior therapy. Much of these treatments consist of reconditioning the brain to associate alcohol with a negative …


Masculinity, Pornography, And Inceldom: The Use Of American Ideals Of Masculinity And The Consumption Of Heterosexual Pornography To Radicalize Young Men Into Inceldom, Adelaide Verdugo-Thomson Jan 2023

Masculinity, Pornography, And Inceldom: The Use Of American Ideals Of Masculinity And The Consumption Of Heterosexual Pornography To Radicalize Young Men Into Inceldom, Adelaide Verdugo-Thomson

AUCTUS: The Journal of Undergraduate Research and Creative Scholarship

The increased presence of the internet has granted many young American men a safe space to share beliefs and experiences, access new materials, and reach wider audiences. At the same time, heterosexual pornographic content has become increasingly accessible, and misogynistic beliefs are protected on various user-run forums. Male dominance in heterosexual pornography, the prevalence of rape myth acceptance, Incel slang, and the strong brotherhood bonds present in Incel communities may be radicalizing factors to encourage young American men to adopt Incel ideology. This literature review seeks to highlight the relationship between American masculinity, consumption of heterosexual pornography, and Inceldom in …


Racism Experiences And Mental Health: An Examination Of Direct, Vicarious, And Appropriated Racism Experiences On Mental Health Symptom Expression, Christina Barnett Jan 2022

Racism Experiences And Mental Health: An Examination Of Direct, Vicarious, And Appropriated Racism Experiences On Mental Health Symptom Expression, Christina Barnett

Theses and Dissertations

The current study aimed to corroborate existing models of racism-related experiences by creating an explanatory model that operationalized direct, vicarious, and appropriated racism experiences. This study explored whether the factors of direct and vicarious racism experiences influenced mental health outcomes via appropriated racism experiences in a sample of Black women. This association was not present. However, results showed a positive association between vicarious and direct racism experiences, as well as predictive relations between direct and vicarious racism experiences and depression and trauma symptoms. Results, limitations, implications, and recommendations for future research are included.

Keywords: vicarious racism, appropriated racism, direct racism, …


Characterizing The Patterns, Predictors, And Processes Involved In Recovery From Substance Use Disorders, Rebecca L. Smith Jan 2022

Characterizing The Patterns, Predictors, And Processes Involved In Recovery From Substance Use Disorders, Rebecca L. Smith

Theses and Dissertations

Alcohol and drug use disorders are associated with significant cost to individuals, families, and society.Approximately 40-75% of affected individuals remit from alcohol use disorders (AUD). Although the development of AUD is well studied, recovery from AUD and factors that contribute to recovery are not as well characterized. With the definition of recovery evolving towards a process rather than an outcome, there is a need to better understand psychosocial functioning and quality of life among individuals at different points in their recovery journeys. Concurrently, additional research is needed to understand the interplay between sources of recovery capital, individual differences in risk …


The Importance Of Connection: Contributions Of Relationships With Fathers And Connections To School To Delinquent Behavior And Positive Youth Development, Colleen S. Walsh Jan 2021

The Importance Of Connection: Contributions Of Relationships With Fathers And Connections To School To Delinquent Behavior And Positive Youth Development, Colleen S. Walsh

Theses and Dissertations

Risk-taking and boundary pushing are hallmarks of adolescent behavior, making the identification of promotive and protective factors related to both delinquent behavior and positive adolescent functioning essential. Previous studies have provided compelling evidence that suggests aspects of familial relationships may successfully attenuate delinquent behavior and support positive functioning outcomes. Despite these findings, the father-adolescent relationship is understudied in association with these outcomes. The current study examined relations between adolescents’ perception of school connectedness and father-adolescent relationship quality and delinquent behavior and positive adolescent functioning outcomes. This study used data collected when youth were nine and fifteen years old from the …


Can School Be A Source Of Trauma? Assessing Academic Traumatic Stress As A Mechanism Underlying The Health Outcomes Of Black Undergraduate Students, Ebony A. Lambert Jan 2020

Can School Be A Source Of Trauma? Assessing Academic Traumatic Stress As A Mechanism Underlying The Health Outcomes Of Black Undergraduate Students, Ebony A. Lambert

Theses and Dissertations

Research examining Black students’ school experiences demonstrates that exposure to oppressive power dynamics in schools may lead to adverse physiological and psychological consequences. Recent conceptualizations in public discourse further posit that traumatic educational experiences, operationalized here as academic trauma or the cumulative toll of adverse and oppressive experiences in academic settings, may influence Black students’ wellbeing even after they have graduated. However, academic trauma has yet to be investigated empirically, and the health contributions of such educational harm remain unstudied. Moreover, little is known about how culturally-relevant personal characteristics (e.g., emotion regulation strategies) influence Black students’ reactivity to academic trauma. …


Shedding Psychological Light On The Racial Disparities In School Disciplinary Measures: The Role Of Dehumanization As A Potential Mechanism, Ebony Lambert, Nao Hagiwara Jan 2020

Shedding Psychological Light On The Racial Disparities In School Disciplinary Measures: The Role Of Dehumanization As A Potential Mechanism, Ebony Lambert, Nao Hagiwara

Graduate Research Posters

Schools should be safe and supportive spaces for all students, yet Black students tend to face biased treatment in the education system, which often results in harsh disciplinary measures. This research examined the role of animalistic dehumanization (i.e., perceiving others as animal- like and uncultured and denying uniquely human characteristics), in predicting choice of harsher disciplinary measures for Black students as opposed to White students. It was hypothesized that individuals who dehumanize Black students to a greater degree would be more likely to believe that Black students need to be disciplined through harsher measures. Both Study 1 (in which dehumanization …


Characterizing Patterns Of Cannabis Use And Related Health Effects Among Young Adults Using Ecological Momentary Assessment, Alyssa Rudy Jan 2020

Characterizing Patterns Of Cannabis Use And Related Health Effects Among Young Adults Using Ecological Momentary Assessment, Alyssa Rudy

Theses and Dissertations

Introduction: Rapid changes in cannabis use policy and prevalence, particularly among young adults, and the lack of information regarding cannabis harms warrant investigation regarding the daily use patterns of cannabis users. Little is known regarding how variability in cannabis use frequency and administration method use patterns may be associated with differential acute cannabis-related health effects (i.e., subjective intoxication and respiratory symptoms). The purpose of the study was to characterize daily and weekly cannabis use patterns and associated cannabis-related intoxication and respiratory symptoms and test the interactions of cannabis use frequency and cannabis administration method use on cannabis-related intoxication and respiratory …


The Intersection Of Social Stress, Mental Well-Being, And Sexual Health Among Black Women In Emerging Adulthood, Brandi Galloway Jan 2020

The Intersection Of Social Stress, Mental Well-Being, And Sexual Health Among Black Women In Emerging Adulthood, Brandi Galloway

Theses and Dissertations

With an estimated 37,000 new HIV infections each year, HIV continues to be a major public health concern. HIV affects some populations more than others. Young Black women, in particular, are disproportionately affected by HIV. While being a woman does not typically increase a person’s HIV risk, being Black and being a woman does.

Data indicate that individual-level factors do not fully address the differences in HIV and STIs between Black emerging adult women and their White counterparts. Thus, it is critical to better understand contextual factors such as social stress and mental-wellbeing which might better account for these disparities. …


Community Reentry And Juvenile Justice: The Role Of Developmental Science In Legislative Decision-Making, Kristina A. Mcguire Jan 2020

Community Reentry And Juvenile Justice: The Role Of Developmental Science In Legislative Decision-Making, Kristina A. Mcguire

Theses and Dissertations

The goals of the present study were to examine federal and selected state legislation for reentry initiatives within the juvenile justice system using content analysis, including determining if bill language utilized terminology reflecting research or developmental science. Thematic analysis was used to examine publicly available federal documents focused on juvenile justice reentry to understand how policymakers were promoting reentry initiatives. Federal bills and documents from April 1, 2008 to December 31, 2019 and state bills from January 1, 2015 to December 31, 2019 for Virginia, North Carolina, Iowa, Missouri, Maryland, New Jersey, Kansas, and Georgia that referenced juvenile justice and …


Predictors Of Employment In A Treatment Sample Of Individuals With Substance Use Disorders, Enkelejda Ngjelina Jan 2019

Predictors Of Employment In A Treatment Sample Of Individuals With Substance Use Disorders, Enkelejda Ngjelina

Theses and Dissertations

Efforts to increase employment rates through vocational skills training and job interview skills development have yielded mixed results. While initial studies of Job Seekers Workshop (JSW) found greater employment success for participants randomized to JSW as compared to a control condition (Hall, Loeb & Norton, 1977), a more recent Clinical Trials Network (CTN) study found no differences in employment outcomes between the JSW and control groups and the rate of employment overall was substantively lower than those reported in the early studies (Svikis et al., 2012). To better understand these discrepant findings, the present study conducted secondary analyses using the …


Examination Of The Role Of Dehumanization As A Potential Mechanism Underlying The Racial Disparities In School Disciplinary Measures., Ebony A. Lambert Jan 2018

Examination Of The Role Of Dehumanization As A Potential Mechanism Underlying The Racial Disparities In School Disciplinary Measures., Ebony A. Lambert

Theses and Dissertations

Schools should be safe and supportive spaces for all students, yet Black students tend to face biased treatment in the education system, which often results in harsh disciplinary measures. This research examined the role of animalistic dehumanization (i.e., perceiving others as animal-like and uncultured and denying uniquely human characteristics), in predicting choice of harsher disciplinary measures for Black students as opposed to White students. It was hypothesized that individuals who dehumanize Black students to a greater degree would be more likely to believe that Black students need to be disciplined through harsher measures. Additionally, it was hypothesized that the link …


Predictors Of Resilient Outcomes Among Juvenile Offenders, Kristina A. Mcguire Jan 2018

Predictors Of Resilient Outcomes Among Juvenile Offenders, Kristina A. Mcguire

Theses and Dissertations

Research on resilience has almost completely bypassed the juvenile justice literature. Using data on 1,354 youth from the Pathways to Desistance study, the present study examined associations between individual, community, and familial risk and promotive factors and resilient outcomes, specifically gainful activity, in juvenile offenders. Results of both logistic and hierarchical regression models indicated significant associations between resilient outcomes in each domain: specifically individual (age at first arrest, motivation to succeed), community (geographic location, exposure to violence), and family (socioeconomic status, parental monitoring) predictors. Finally, this paper discusses reasons for non-significant findings and directions for future research on resilience among …


The Role Of Afrocentric Features In Mental Healthcare Utilization And Counselor Preferences In Black College Students, Randl B. Dent Jan 2017

The Role Of Afrocentric Features In Mental Healthcare Utilization And Counselor Preferences In Black College Students, Randl B. Dent

Theses and Dissertations

Though mental health issues are prevalent in Black young adults, they underutilize mental healthcare services. This research examined the role of feature-based discrimination in mental healthcare (under)utilization. Study 1, a secondary analysis of the National Longitudinal Study of Adolescent to Adult Health, provided no evidence supporting a link between skin tone and mental healthcare utilization, when controlling for depression diagnosis. However, when controlling for depression symptoms, there was a trend such that Black young adults with darker, as opposed to lighter, skin tone utilized healthcare less. Study 2, an experimental study with 33 Black college students, showed 73% of the …


The Influence Of Family Composition On Adolescent Problem Behavior: The Moderating Roles Of Gender And Adult Support, Jasmine Coleman Jan 2017

The Influence Of Family Composition On Adolescent Problem Behavior: The Moderating Roles Of Gender And Adult Support, Jasmine Coleman

Theses and Dissertations

There is convincing support for the link between family composition and adolescents’ problem behaviors. What is less clear is the extent to which these relations exist for African-American adolescents. Previous studies have demonstrated that this relation varies by gender. However, there is limited evidence to suggest the potential moderating influence of adult support. The purpose of this study was to examine the influence of family composition on adolescents’ physical aggression, delinquency, and substance use. The study comes from secondary analyses of a larger study that evaluated the effectiveness of a violence prevention program. The current study included 1,116 African-American middle …


Catching Up And Staying Out Of Trouble: Serious Juvenile Offenders’ Facility School Experiences And Their Transition To The Community, Lena Jäggi Jan 2016

Catching Up And Staying Out Of Trouble: Serious Juvenile Offenders’ Facility School Experiences And Their Transition To The Community, Lena Jäggi

Theses and Dissertations

Despite recent drops in rates, juvenile incarceration remains a serious issue in the United States (Hockenberry, 2013; Mendel, 2011). One shared part of the incarceration experience across different systems and facility types is the obligation for juvenile offenders to receive correctional education. Ample research demonstrates that increased academic achievement, attending community school, and being employed are connected to better community outcomes and desistance, yet little is known about how school experiences in the facility influences these outcomes. Applying life-course theory of the development of crime (Sampson & Laub, 1997, 2005), the present study investigates whether correctional education serves as a …


Therapist Adherence To Cognitive Behavioral Therapy For Anxious Youth Across A Case, Julia R. Cox Jan 2015

Therapist Adherence To Cognitive Behavioral Therapy For Anxious Youth Across A Case, Julia R. Cox

Theses and Dissertations

The field has developed many evidence-based treatments (EBTs); the integrity of EBTs being delivered, however, has been studied less than rigorously. Because many treatment manuals are developed to be delivered session-by-session, one way to assess treatment adherence, specifically, is across the course of the case: do therapists deliver treatment components in the order prescribed? The goals of this study were to characterize how therapists deviate from prescribed order and how adherence to order relates to child characteristics. Therapy process data were collected from a subsample of children (N = 33, aged 7-15) that received cognitive behavioral therapy (CBT) to address …


Use Of Prescription Drugs And Future Delinquency Among Adolescent Offenders, Tess K. Drazdowski, Lena Jäggi, Alicia Borre, Wendy L. Kliewer Jan 2015

Use Of Prescription Drugs And Future Delinquency Among Adolescent Offenders, Tess K. Drazdowski, Lena Jäggi, Alicia Borre, Wendy L. Kliewer

Psychology Publications

Non-medical use of prescription drugs (NMUPD) by adolescents is a significant public health concern. The present study investigated the profile of NMUPD in 1349 adolescent offenders from the Pathways to Desistance project, and whether NMUPD predicted future delinquency using longitudinal data. Results indicated that increased frequency and recency of NMUPD in adolescent offenders are related to some demographic factors, as well as increased risk for violence exposure, mental health diagnoses, other drug use, and previous delinquency, suggesting that severity of NMUPD is important to consider. However, ANCOVA analyses found that NMUPD was not a significant predictor of drug-related, non-aggressive, or …


Identifying Perceived Barriers To Monitoring Service Quality Among Substance Abuse Treatment Providers In South Africa, Bronwyn Myers, Zainoisa Petersen, Rehana Kader, J Randy Koch, Ron Manderscheid, Rajen Govender, Charles Dh Parry Jan 2014

Identifying Perceived Barriers To Monitoring Service Quality Among Substance Abuse Treatment Providers In South Africa, Bronwyn Myers, Zainoisa Petersen, Rehana Kader, J Randy Koch, Ron Manderscheid, Rajen Govender, Charles Dh Parry

Psychology Publications

Background

A performance measurement system is planned for South African substance abuse treatment services. Provider-level barriers to implementing these systems have been identified in the United States, but little is known about the nature of these barriers in South Africa. This study explored the willingness of South African substance abuse treatment providers’ to adopt a performance measurement system and perceived barriers to monitoring service quality that would need to be addressed during system development.

Methods

Three focus group discussions were held with treatment providers from two of the nine provinces in South Africa. These providers represented the diverse spread of …


Family Processes As Moderators Of The Impact Of Peer, School, And Neighborhood Influences On Adolescent Aggression, Alison Kramer-Kuhn Dec 2013

Family Processes As Moderators Of The Impact Of Peer, School, And Neighborhood Influences On Adolescent Aggression, Alison Kramer-Kuhn

Theses and Dissertations

Despite theoretical support for the role of the family in providing a foundation to protect youth against risks for aggression, there is little published literature examining a protective influence. This study examined family functioning and perceived parental messages about fighting and nonviolence as moderators of the relation between risk factors and adolescent aggression. The specific risk factors included affiliating with a delinquent group of peers, attending a school with norms that support aggression, and witnessing violence within the community. Secondary analyses were conducted on data collected from a high-risk sample of 537 adolescents in 2 cohorts from 18 schools. Adolescents …


The Seeds Of Mistrust: The Relationship Between Perceived Racism, Hiv Conspiracy Theories And Hiv Testing Attitudes, Joshua Brevard May 2013

The Seeds Of Mistrust: The Relationship Between Perceived Racism, Hiv Conspiracy Theories And Hiv Testing Attitudes, Joshua Brevard

Theses and Dissertations

Although the number of HIV infected peaked in the late 1980’s, HIV remains a major concern within the African American community (CDC, 2008). African Americans are disproportionately affected, comprising 14% of the U.S. population but representing 44% of new HIV infections in 2009 (CDC, 2011). It is vital to identify barriers to positive health behaviors like consistent condom use and HIV testing. This study focus on factors impacting attitudes towards HIV testing, including mistrust of the healthcare system, measured by support for HIV conspiracy theories (Thomas & Quinn, 1991). It also examined the prevalence of HIV conspiracy beliefs among African …


Antisocial Behavior From Adolescence To Early Adulthood: Heritability, Stability, And Correlates Using A Longitudinal Twin Sample, Ashley Dibble Feb 2013

Antisocial Behavior From Adolescence To Early Adulthood: Heritability, Stability, And Correlates Using A Longitudinal Twin Sample, Ashley Dibble

Theses and Dissertations

The purpose of this study was to examine the heritability, stability, and outcomes of antisocial behavior from adolescence into adulthood in a longitudinal twin sample. Specifically, the genetic and environmental influences on conduct disorder, adult antisocial behavior, and alcohol dependence were examined. The influence of genes and environment on the relationship between these disorders was also examined. The study utilized a subset of FinnTwin12, a population-based twin study that consists of five consecutive birth cohorts. The subsample consisted of 1035 twin pairs (N = 2070) and of that 2070, 1854 completed the intensive interview at age 14. At age 22, …


Stakeholder Views On Children’S Mental Health Services, Adriana Rodriguez Oct 2012

Stakeholder Views On Children’S Mental Health Services, Adriana Rodriguez

Theses and Dissertations

Identification of evidence-based treatments (EBTs) has been an important development; however recently, some shortcomings of the approach have been highlighted. These complexities have led to a surge in transportability research in mental health services science with goals of identifying needed strategies to encourage the adoption of innovations. The mental health system ecological (MHSE) model is an approach necessary to assist with closing this gap effectively as it integrates mental health contexts: client-level, provider-level, intervention-specific, service delivery, organizational, and service system characteristics. The aim of this study is to use the MHSE model to examine perspectives of mental health stakeholders on …


To Use Or Not To Use: The Role Of Affect And Cognition In Changing Attitudes Toward Using Condoms Among African American Women, Kristina Hood Jul 2012

To Use Or Not To Use: The Role Of Affect And Cognition In Changing Attitudes Toward Using Condoms Among African American Women, Kristina Hood

Theses and Dissertations

The current project involved three studies designed to examine which characteristics of persuasive communications change condom use attitudes. Study 1 investigated the effect of message type (affective versus cognitive) and source (male versus female) on attitude change among a sample of African American women attending college. In Study 1 (N = 146), the affective message and female source produced the most positive change in condom use attitudes. Study 2 examined whether message type and source were associated with favorable condom attitudes in a community sample and whether these findings differed from a college sample. Twenty-seven women participated in group discussions …


The Effect Of Legal Status On Responses To Brief Motivational Interviewing With Substance Users, Thomas Moore May 2012

The Effect Of Legal Status On Responses To Brief Motivational Interviewing With Substance Users, Thomas Moore

Theses and Dissertations

The effectiveness of drug abuse treatment for clients coerced into care remains controversial. Some studies find clients with legal pressure do better than those without legal pressure, while others report the exact opposite. Opposing views are often fueled by the wide-ranging models that guide delivery of addiction treatment. The present study examined how participants with and without legal pressure to attend treatment responded to a motivational (MET) vs. traditional (TAU) form of addiction treatment. Additionally, the predictive value of the Readiness to Change (RTC) score, from the URICA, was assessed across days of substance use and treatment retention. Legal status …


Blurring The Lines Of Traditional Gender Roles: Beliefs Of African American Women, Jasmine Abrams May 2012

Blurring The Lines Of Traditional Gender Roles: Beliefs Of African American Women, Jasmine Abrams

Theses and Dissertations

Gender role beliefs of African American women in the United States should be investigated in a manner that considers their unique experiences and the distinct background of her cultural sharing group. In this study, gender role beliefs of African American women were examined by addressing the research question: What are the gender role beliefs of African American women for African American men and women? Eight focus groups comprising 44 African American women were conducted. Women were diverse in terms of age, religion, and socio-economic status. An ethnographic phenomenological approach was used to explore views related to gender roles among African …


Childhood Maltreatment, Coping, And Coping Self-Efficacy Among Offenders, David Guion Nov 2011

Childhood Maltreatment, Coping, And Coping Self-Efficacy Among Offenders, David Guion

Theses and Dissertations

This study explored the relationship between childhood interpersonal trauma and coping self-efficacy, coping styles, and emotion regulation difficulties among male and female offenders in detention and diversion centers (N = 183). The coping-relapse model of recidivism posits that offenders’ coping ability plays a pivotal role in successful reentry (Zamble & Quinsey, 1997). Past research reveals that childhood maltreatment is associated with avoidant coping and emotion regulation difficulties, which could negatively impact reentry (e.g., Cloitre et al., 2009; Min, Farkas, Minnes, & Singer, 2007). The relationship between childhood maltreatment and coping self-efficacy has not been addressed. This study found that childhood …


Indirect Screening: Enhancing Identification Of Illicit Drug Use During Pregnancy, Courtney Smith Oct 2011

Indirect Screening: Enhancing Identification Of Illicit Drug Use During Pregnancy, Courtney Smith

Theses and Dissertations

OBJECTIVE: Most drug use screening measures rely on and are validated against self-report. Fear of negative consequences often promotes denial of drug use. For pregnant women, social stigma and fear of legal consequences make underreporting of drug use even more likely. An indirect screener that could effectively identify pregnant women at risk for illicit drug use without reliance on disclosure would be clinically significant. The purpose of the current study was to develop and validate an indirect measure of prenatal drug use by comparing correlates of prenatal drug use to urinalysis results. METHOD: Pregnant women attending an OB appointment at …