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Motivating property owners to mitigate seismic risks for existing buildings is a major challenge for many earthquake-prone regions. This article identifies primary factors that may affect the adoption of seismic retrofit by owners of commercial and residential buildings, assesses the influence of economic, social, regulatory, and individual factors on retrofit implementation in three California cities, and discusses potential approaches to promoting seismic retrofits. Data for three retrofit programs are utilized to create predictive models for retrofit probability. The results suggest that retrofit probability for multifamily residential buildings may increase with building height, median housing value, educational attainment, and population density in the neighborhood, but may decrease with building age, building size, land value, and housing vacancy rate in the neighborhood. The retrofit decision for commercial buildings is strongly correlated with the number of stories and rooms, land value, vacancy rate, and population density, while the retrofit decision for residential buildings is highly associated with building age, number of rooms, land value, median housing value, median contract rent, and educational attainment. Overall, promoting seismic retrofits requires careful consideration of different motivators and impediments to owner’s retrofit actions for commercial and residential buildings, and for older, taller, larger buildings, which tend to be more vulnerable but are associated with higher retrofit costs. In addition, neighborhood characteristics including median housing value and vacancy rate may be strong indicators of the retrofit probability among building clusters.

Breastfeeding is an important public health issue that significantly intersects with work, gender, and family relationships. Prior research has focused on partner dynamics in the breastfeeding family and specifically shown that male partners heavily influence women’s breastfeeding decisions and experiences. Much of this research emphasizes net gains of men’s involvement in breastfeeding. While acknowledging the importance of involved fathers early on, we argue for recognizing the dual potential for men’s involvement in breastfeeding to be both affirming and undermining to their breastfeeding partners. As part of a workplace case study, we conducted semi-structured, in-depth interviews with 32 women who were currently or recently breastfeeding. We identified four major themes: (1) encouraging/discouraging breastfeeding, (2) acknowledging/overlooking breastfeeding labor, (3) supporting/undermining breastfeeding decisions and goals, and (4) assisting with/avoiding domestic labor. Education directed at men should address the issue that not all intended support actions may be perceived as supportive by breastfeeding women and should provide concrete guidance on how men can be supportive, centering the needs of breastfeeding women.

Difficulty with sustaining attention to a task is a hallmark of ADHD. It would be useful to know which measures of sustained attention best predict a diagnosis of ADHD. Participants were 129 children with a diagnosis of ADHD and 129 matched controls who completed the fixed Sustained Attention to Response Task (SART). The number of commission and omission errors, standard deviation of response time (SDRT), tau, fast and slow frequency variability, d-prime, and mu were able to successfully classify children with and without ADHD. The mean response time, criterion, and sigma were not able to classify participants. The best classifiers were d-prime (0.75 Area Under the Receiver Operated Characteristic), tau (.74), SDRT (0.74), omission errors (0.72), commission errors (0.71), and SFAUS (0.70). This list of the best classifier measures derived from the SART may prove useful for the planning of future studies.

OBJECTIVES: Lead exposure has devastating neurologic consequences for children and may begin in utero. The American College of Obstetricians and Gynecologists recommends prenatal lead screening using a risk factor-based approach rather than universal blood testing. The clinical utility of this approach has not been studied. We evaluated a risk-factor based questionnaire to detect elevated blood lead levels in pregnancy. METHODS: We performed a secondary analysis of a cohort of parturients enrolled to evaluate the association of lead with hypertensive disorders of pregnancy. We included participants in this analysis if they had a singleton pregnancy ≥34 weeks’ gestation with blood lead levels recorded. Participants completed a lead risk factor survey modified for pregnancy. We defined elevated blood lead as ≥2 μg/dL, as this was the clinically reportable level. RESULTS: Of 102 participants enrolled in the cohort, 92 had blood lead measured as part of the study. The vast majority (78%) had 1 or more risk factor for elevated lead using the questionnaire yet none had clinical blood lead testing during routine visits. Only two participants (2.2%) had elevated blood lead levels. The questionnaire had high sensitivity but poor specificity for predicting detectable lead levels (sensitivity 100%, specificity 22%). CONCLUSIONS FOR PRACTICE: Prenatal risk-factor based lead screening appears underutilized in practice and does not adequately discriminate between those with and without elevated blood levels. Given the complexity of the risk factor-based approach and underutilization, the benefit and cost-effectiveness of universal lead testing should be further explored.

Climate adaptation is context specific, and inclusion of diverse forms of knowledge is crucial for developing resilient social–ecological systems. Emphasis on local inclusion is increasing, yet participatory approaches often fall short of facilitating meaningful engagement of diverse forms of knowledge. A central challenge is the lack of a comprehensive and comparative understanding of the social–ecological knowledge that various stakeholders use to inform adaptation decisions. We employed cultural consensus analysis to quantitatively measure and compare social–ecological knowledge within and across three stakeholder groups: government employees, researchers, and local residents in rural coastal Maryland. The results show that 1) local residents placed more emphasis on addressing socioeconomic and cultural changes than researchers and government employees, and 2) that the greatest variation in social–ecological knowledge was found among local residents. These insights yielded by cultural consensus analysis are beneficial for facilitating more inclusive adaptation planning for resilient social–ecological systems.

To determine whether a history of abortion is associated with the experience of infertility among women, 2,199 women who ever met medical criteria for infertility were studied. Data for the study c...

Objective The fetal risks and benefits of antihypertensives to treat gestational hypertension in pregnancy are understudied, particularly in low- and middle-income countries. Methods We performed a nested case-control study within a retrospective cohort of obstetrical patients in Botswana from 2014 to 2019. We included women carrying singletons who developed new onset non-severe hypertension (140-159 mm Hg systolic or 90-109 mm Hg diastolic blood pressure) after 20 weeks of pregnancy. Cases were defined as women with either small-for-gestational-age (SGA) infants or stillbirth, analyzed separately; controls were otherwise similar women without the adverse outcome in each analysis. Results We identified 1932 cases of SGA (7925 controls) and 316 cases of stillbirth (9619 controls). Cases with SGA were more likely to have used an anti-hypertensive than controls (33% vs 29%, adjusted odds ratio [aOR] 1.28, 95% confidence interval [CI] 1.15-1.43). Cases with stillbirth were more likely to have used an anti-hypertensive than controls (42% versus 29%, aOR 1.45, 95% CI 1.14-1.83). Conclusion Anti-hypertensive use for new-onset gestational hypertension was associated with an increased risk of having an SGA infant or a stillbirth among women who never developed severe hypertension. These data support conduct of a randomized clinical trial to determine the appropriate use of anti-hypertensives in non-severe gestational hypertension.

A substantial body of knowledge suggests that exposure to adverse family environments – including violence and neglect – influences many aspects of brain development. Relatively less attention has been directed toward the influence of “normative” differences in parenting behaviors. Given the rapid brain reorganization during late childhood, parenting behaviors are particularly likely to impact the structure of the brain during this time. This study investigated associations between maternal parenting behaviors and the organization of structural brain networks in late childhood, as measured by structural covariance. One hundred and forty‐five typically developing 8‐year‐olds and their mothers completed questionnaire measures and two observed interaction tasks; magnetic resonance imaging (MRI) scans were obtained from the children. Measures of maternal negative, positive, and communicative behavior were derived from the interaction tasks. Structural covariance networks based on partial correlations between cortical thickness estimates were constructed and estimates of modularity were obtained using graph theoretical analysis. High levels of negative maternal behavior were associated with low modularity. Minimal support was found for an association between positive maternal behaviors and modularity and between maternal communicative behaviors and modularity. Our findings suggest that variation in negative maternal behavior is associated with the structural organization of brain networks in children., Given the rapid brain reorganization during late childhood, “normative” differences in parenting behaviors are particularly likely to impact the structure of the brain during this time. For a 145 typically developing 8‐year‐olds, we found high levels of negative maternal behavior were associated with low modularity, where modules are clusters of nodes that are densely interconnected and sparsely connected to the rest of the brain network.

Hepatocytes metabolize energy-rich cytoplasmic lipid droplets (LDs) in the lysosome-directed process of autophagy. An organelle-selective form of this process (macrolipophagy) results in the engulfment of LDs within double-membrane delimited structures (autophagosomes) before lysosomal fusion. Whether this is an exclusive autophagic mechanism used by hepatocytes to catabolize LDs is unclear. It is also unknown whether lysosomes alone might be sufficient to mediate LD turnover in the absence of an autophagosomal intermediate. We performed live-cell microscopy of hepatocytes to monitor the dynamic interactions between lysosomes and LDs in real-time. We additionally used a fluorescent variant of the LD-specific protein (PLIN2) that exhibits altered fluorescence in response to LD interactions with the lysosome. We find that mammalian lysosomes and LDs undergo interactions during which proteins and lipids can be transferred from LDs directly into lysosomes. Electron microscopy (EM) of primary hepatocytes or hepatocyte-derived cell lines supports the existence of these interactions. It reveals a dramatic process whereby the lipid contents of the LD can be “extruded” directly into the lysosomal lumen under nutrient-limited conditions. Significantly, these interactions are not affected by perturbations to crucial components of the canonical macroautophagy machinery and can occur in the absence of double-membrane lipoautophagosomes. These findings implicate the existence of an autophagic mechanism used by mammalian cells for the direct transfer of LD components into the lysosome for breakdown. This process further emphasizes the critical role of lysosomes in hepatic LD catabolism and provides insights into the mechanisms underlying lipid homeostasis in the liver.

Hummingbirds have evolved to learn song from conspecifics independently of other bird clades that show this behaviour, such as parrots and oscine passerines. Little is known about how vocal learning occurs in hummingbirds. To determine the conditions necessary and sufficient for learning, we raised young Costa's hummingbirds, Calypte costae, in isolation in two experiments. The first experiment tested whether three pairs of males, raised either in silence or with only acoustic exposure to song, would produce wild-type song. They did not: each pair instead produced ‘isolate’ songs dissimilar to wild-type song. Each pair produced a unique isolate song with subtle differences from other pairs. Thus, exposure to song alone is insufficient to trigger learning. The second experiment tested whether individually housed males would learn songs when exposed to a live male model plus playback of song (1 h/day, 3 days/week, for 3 months). Seven of eight birds that heard Costa's-like songs learned to sing their tutor song. Each individual produced song that matched idiosyncratic features of the individual songs played to them, demonstrating attention to, and learning of the exact acoustic stimuli received. Two control birds exposed to acoustically dissimilar Anna's hummingbird, Calypte anna, song developed isolate song. Thus, exposure to species-specific song with a conspecific male is sufficient to trigger learning. The sensory phase began after fledging, around 23 days posthatch, and the sensorimotor phase began around 50 days posthatch, when singing also began. Song crystallization occurred approximately 125 days posthatch. Costa's also appear to be statistical learners; they learn to sing the songs they hear most often. Hummingbird song ontogeny appears to be similar to song ontogeny in passerines, despite its convergent origin.

Three new compounds containing a heptadentate lanthanide (LnIII ) ion chelator functionalized with oligothiophenes, nThept(COOH)4 (n=1, 2, or 3), were isolated. Their LnIII complexes not only display the characteristic metal-centered emission in the visible or near-infrared (NIR) but also generate singlet oxygen (1 O2 ). Luminescence efficiencies (ϕLn ) for [Eu1Thept(COO)4 ]- and [Eu2Thept(COO)4 ]- are ϕEu =3 % and 0.5 % in TRIS buffer and 33 % and 3 % in 95 % ethanol, respectively. 3Thept(COO)4 4- does not sensitize EuIII emission due to its low-lying triplet state. Near infra-red (NIR) luminescence is observed for all NIR-emitting LnIII and ligands with efficiencies of ϕYb =0.002 %, 0.005 % and 0.04 % for [YbnThept(COO)4 ]- (n=1, 2, or 3), and ϕNd =0.0007 %, 0.002 % and 0.02 % for [NdnThept(COO)4 ]- (n=1, 2, or 3) in TRIS buffer. In 95 % ethanol, quantum yields of NIR luminescence increase and are ϕYb =0.5 %, 0.31 % and 0.05 % for [YbnThept(COO)4 ]- (n=1, 2, or 3), and ϕNd =0.40 %, 0.45 % and 0.12 % for [NdnThept(COO)4 ]- (n=1, 2, or 3). All complexes are capable of generating 1 O2 in 95 % ethanol with ϕ1Ο2 efficiencies which range from 2 % to 29 %. These complexes are toxic to HeLa cells when irradiated with UV light (λexc =365 nm) for two minutes. IC50 values for the LnIII complexes are in the range 15.2-16.2 μm; the most potent compound is [Nd2Thept(COO)4 ]- . The cell death mechanisms are further explored using an Annexin V-propidium iodide assay which suggests that cell death occurs through both apoptosis and necrosis.

BACKGROUND: High obesity rates among young black and Hispanic children place them at a higher risk for adult obesity and its co-morbidities. Neighborhoods with predominately racial and ethnic minority residents have fewer healthful food options, which may contribute to obesity disparities. Yet few studies have assessed the relationship between neighborhood food environments and obesity in this population. METHODS: Electronic health records from two pediatric primary care clinics serving predominately low-income, black and Hispanic children were used to create a cohort of 3,724 2-5 year-olds, encompassing 7,256 visits from 2007 to 2012 (mean 1.9 visits per patient, range: 1-5 visits per child). Longitudinal regression was used to model the association of mean body mass index z-score (BMI-z) over time and 3 measures of the neighborhood food environment: healthful food availability, availability of stores accepting the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) benefits, and fast food availability. RESULTS: Compared to peers in neighborhoods with no or few stores accepting WIC, children in neighborhoods with many WIC stores had higher BMI-z at age 2 years (average difference of 0.272 95% CI 0.041 – 0.503; p=0.021). No relationship was found for healthful food or fast food availability. Although children in neighborhoods with low fast food availability did not have statistically significantly different BMI-z at age 2 as compared to children in areas with high fast food availability, they did have a statistically significantly higher change in average BMI-z over time (0.006 per month, 0.000 – 0.012, p=0.024). CONCLUSIONS: Access to WIC stores was associated with lower obesity rates and more healthful average BMI-z over time and represents a potentially important neighborhood food environment characteristic influencing racial/ethnic disparities in childhood obesity among young black and Hispanic children. More studies are needed to assess what aspects of WIC stores may underlie the observed association. WHAT’S NEW: Access to WIC stores represents a potentially important neighborhood food environment characteristic influencing racial and ethnic disparities in childhood obesity among young black and Hispanic children.

Studies of medical help-seeking presume that self-identifying as having a health problem precedes medical contact, but this ordering of the identity-behavior relationship has not been systematically examined. We used longitudinal data from the National Survey of Fertility Barriers (2004 to 2010) on 412 women with infertility to document the temporal relationship between self-identifying as having a fertility problem and making medical contact. The symbolic interactionist perspective suggests that infertility will be perceived as identity disruption and that in response women will align self-identity and medical behavior over time. Cross-tabulation analysis indicated that more women do self-identify as having a fertility problem first (24 percent) as opposed to making medical contact first (5.5 percent). There was also a tendency toward aligning self-identification and behavior over time. Latent class analyses revealed six patterns: 1) consistently involved, 2) early consulters, 3) consistently uninvolved, 4) consistent perceivers, 5) medical dropouts, and 6) early perceivers. Strong fertility intent and primary infertility, two identity-relevant characteristics, had the strongest associations with latent class membership. The relationship between self-identification and medical help-seeking is thus dynamic and complex.

Lanthanide ion (LnIII ) complexes, [Ln(3Tcbx)2 ]3+ (LnIII =YbIII , NdIII , ErIII ) are isolated with a new pyridine-bis(carboxamide)-based ligand with a 2,2':5',2''-terthiophene pendant (3TCbx), and their resulting photophysical properties are explored. Upon excitation of the complexes at 490 nm, only LnIII emission is observed with efficiencies of 0.29 % at 976 nm for LnIII =YbIII and 0.16 % at 1053 nm for LnIII =NdIII . ErIII emission is observed but weak. Upon excitation at 400 nm, concurrent 1 O2 formation is seen, with efficiencies of 11 % for the YbIII and NdIII complexes and 13 % for the ErIII complex. Owing to the concurrent generation of 1 O2 , as expected, the efficiency of metal-centered emission decreases to 0.02 % for YbIII and 0.05 % for NdIII . The ability to control 1 O2 generation through the excitation wavelength indicates that the incorporation of 2,2':5',2''-terthiophene results in access to multiple sensitization pathways. These energy pathways are unraveled through transient absorption spectroscopy.

The transition from childhood to adolescence involves important neural function, cognition, and behavior changes. However, the links between maturing brain function and sustained attention over this period could be better understood. This study examined typical changes in network functional connectivity over childhood to adolescence, developmental differences in attention deficit/hyperactivity disorder (ADHD), and how functional connectivity might underpin variability in sustained attention development in a longitudinal sample. A total of 398 resting state scans were collected from 173 children and adolescents (88 ADHD, 85 control) at up to three timepoints across ages 9-14 years. The effects of age, sex, and diagnostic group on changes in network functional connectivity were assessed, followed by relationships between functional connectivity and sustained attention development using linear mixed effects modelling. The ADHD group displayed greater decreases in functional connectivity between salience and visual networks compared with controls. Lower childhood functional connectivity between the frontoparietal and several brain networks was associated with more rapid sustained attention development, whereas frontoparietal to dorsal attention network connectivity related to attention trajectories in children with ADHD alone. Brain network segregation may increase into adolescence as predicted by key developmental theories; however, participants with ADHD demonstrated altered developmental trajectories between salience and visual networks. The segregation of the frontoparietal network from other brain networks may be a mechanism supporting sustained attention development. Frontoparietal to dorsal attention connectivity can be a focus for further work in ADHD.

What is the association between polycystic ovary syndrome (PCOS) and pre-eclampsia? Data suggest that patients with PCOS are at increased risk of developing pre-eclampsia; however, several studies have not found an independent association between the two.A retrospective case-control study of singleton deliveries at a tertiary care hospital from 2011 to 2015. Patients with pre-eclampsia (cases) were matched to the next delivery without pre-eclampsia (controls) on gestational age week. Medical history data, a diagnosis or clinical features of PCOS and obstetric data, including pre-eclampsia, were abstracted from the medical record. Groups were compared with the chi-squared test, and conditional logistic regression was used to calculate odds ratios (OR) and 95% confidence intervals (95% CI). OR were adjusted for maternal age at delivery and race/ethnicity.This study included 435 cases and 435 controls. Cases were more likely to be Black compared with controls. Age, comorbidities, features of PCOS and use of IVF were similar between groups. Patients with pre-eclampsia were not more likely to have PCOS (8.3%) than those without pre-eclampsia (6.2%, adjusted OR 1.40, 95% CI 0.81-2.30). Sensitivity analyses for body mass index and parity suggested an increased pre-eclampsia risk for patients with PCOS and these additional factors, however no group showed a statistically significant association between PCOS and pre-eclampsia.In this study, a history of PCOS was not associated with the risk of pre-eclampsia. Further investigation is necessary to determine whether there are subgroups of PCOS patients who are at increased risk of pre-eclampsia.

Summary Retrospective analysis of the post–propensity score (PS)–matched cohort of 8426 outpatients balanced in clinical and demographic covariates showed that treatment with casirivimab-imdevimab monoclonal antibody was effective against the SARS-CoV-2 Delta variant to reduce hospitalization, mortality, and intensive care unit admission rates within 30 days. Background Real-world data on the effectiveness of neutralizing casirivimab-imdevimab monoclonal antibody (Cas-Imd mAb) against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among high-risk patients may inform the response to future SARS-CoV-2 variants. Methods This study covers an observational retrospective data analysis in Banner Health Care System sites, mainly in Arizona. During the study period, the prevalence of SARS-CoV-2 Delta variant was between 95% and 100%. Of 29 635 patients who tested positive for coronavirus disease 2019 (COVID-19) between 1 August 2021 and 30 October 2021, in the Banner Health Care System, the study cohort was split into 4213 adult patients who received Cas-Imd mAb (1200 mg) treatment compared to a PS-matched 4213 untreated patients. The primary outcomes were the incidence of all-cause hospitalization, intensive care unit (ICU) admission, and mortality within 30 days of Cas-Imd mAb administration or Delta variant infection. Results Compared to the PS-matched untreated cohort, the Cas-Imd mAb cohort had significantly lower all-cause hospitalization (4.2% vs 17.6%; difference in percentages, −13.4 [95% confidence interval {CI}, −14.7 to −12.0]; P Conclusions Cas-Imd mAb treatment was associated with a lower hospitalization rate, ICU admission, and mortality within 30 days among patients infected with the SARS-CoV-2 Delta variant.

There are growing concerns that increased screen device usage may have a detrimental impact on classroom behaviour and attentional focus. The consequences of screen use on child cognitive functioning have been relatively under-studied, and results remain largely inconsistent. Screen usage may displace the time usually spent asleep. The aim of this study was to examine associations between screen use, behavioural inattention and sustained attention control, and the potential modifying role of sleep. The relations between screen use, behavioural inattention, sustained attention and sleep were investigated in 162 6- to 8-year-old children, using parent-reported daily screen use, the SWAN ADHD behaviour rating scale, The sustained attention to response task and the children’s sleep habits questionnaire. Tablet use was associated with better sustained attention performance but was not associated with classroom behavioural inattention. Shorter sleep duration was associated with poorer behavioural inattention and sustained attention. Sleep quality and duration did not act as mediators between screen usage and behavioural inattention nor sustained attention control. These findings suggest that careful management of the amount of time spent on electronic screen devices could have a beneficial cognitive impact on young children. The results also highlight the critical role of sleep in enhancing both behavioural attention and sustained attention, which are essential for supporting cognitive development and learning.

A new pyridine-bis(carboxamide)-based ligand with a bithiophene pendant, 2Tcbx, was synthesized. Its lanthanide ion (LnIII) complexes, [Ln(2Tcbx)2]3+, were isolated and their photophysical properties were explored. Upon excitation at 360 nm, these complexes display emission in the near-infrared (NIR) with efficiencies of 0.69% for LnIII = YbIII, 0.20% for LnIII = NdIII, and 0.01% for LnIII = ErIII, respectively. Concurrent 1O2 formation was seen for all complexes, with efficiencies of 19% for the YbIII complex, 25% for the NdIII complex, and 9% for the ErIII complex. When exciting at a longer wavelength, 435 nm, only LnIII emission was observed and larger efficiencies of LnIII-centered emission were obtained. The lack of 1O2 generation indicates that energy pathways involving different ligand conformations, which were investigated by transient absorption spectroscopy, are involved in the sensitization process, and enable the wavelength-dependent generation of 1O2.

Lanthanide ion (LnIII) complexes with two new 1,8-naphthalimide-based ligands, Nap-dpe and Nap-cbx, were isolated, and their photophysical properties were explored. Upon excitation at 335 nm, Nap-dpe and Nap-cbx sensitize visible and near-infrared emitting LnIII ions (LnIII = EuIII, NdIII, and YbIII) and generate singlet oxygen (1O2). The quantum yields of EuIII luminescence for [Eu(Nap-cbx)3]3+ and [Eu(Nap-dpe)3]3+ are 16.7% and 8.3%, respectively, with 1O2 generation efficiencies of 41% and 59%, respectively. The efficiencies of 1O2 generation for the NIR emitting complexes [Ln(Nap-dpe)3]3+ are 59% and 56%, respectively, and those for [Ln(Nap-cbx)3]3+ (LnIII = NdIII, YbIII) are 64% and 61%, respectively. In an oxygen-free environment, the quantum yields of EuIII luminescence for [Eu(Nap-cbx)3]3+ and [Eu(Nap-dpe)3]3+ increase to 20% and 18%, respectively.

There is a long-standing assumption that covert measurement of orienting, the shifting of the “mind’s eye” independent of a saccade to a location in space, is a more “pure” measure of underlying attention than overt measurement of orienting. Testing attention covertly often relies on target detection tasks, which depend on making a decision about when and where a target has appeared and what is the appropriate action, all of which are potential confounds in measuring attention in children. This study cross-sectionally examined developmental profiles at ages 6–12 years of endogenous visual orienting. We used two tasks: one that measured orienting with a traditional covert attention button press response and one that measured orienting with eye tracking to measure overt saccades. The results obtained from the two orienting tasks demonstrate that each task measures distinct underlying processes with clear developmental profiles. Orienting, when measured by overt saccades, may be mature by 6 years of age, whereas the more complex manual response selection skills required in manual reaction time covert attention tasks continue to develop through middle childhood.

Campus sexual violence is prevalent and consequential. After a climate survey at our university revealed high rates of sexual violence, a semester-long academic course was designed as a curricular intervention for first-year students. This study examines an assignment completed at the beginning and end of the course. Students were asked: “What are the root causes of sexual violence?” Thematic analysis of papers revealed that many students altered or expanded their thinking to more complex, structural factors compared to their initial perceptions. An academic course may broaden students’ understanding of the determinants of sexual violence.

In 2017, U.S. damages from natural hazard events exceeded $300B, suggesting that current targets for building performance do not sufficiently mitigate loss. The significant costs borne by individuals, insurers, and government do not include impacts from social disruption, displacement, and subsequent economic and livelihood effects. In 2016, Congress mandated the National Institute of Standards and Technology (NIST) develop a report (NIST SP 1224) describing the research needs, implementation activities, and engineering principles necessary to improve the performance of residential and commercial buildings subjected to natural hazards. An Immediate Occupancy Performance Objective (IOPO) could help preserve building and social functions post event, minimizing physical, social, and economic disaster. The stakeholder-informed NIST report sets forth items needed for multi-hazard building design that can support enhanced resilience decision-making. This paper highlights the social and economic considerations that require additional research, particularly with regard to feasibility and potential impacts from an IOPO. These topics must be considered prior to and throughout the IOPO technical development and community implementation processes to ensure better outcomes after natural hazard events.