Digital Commons Network^™

“When I’M Not Heard, I Feel Like I Don’T Matter”: Advancing Equity In Disability Policy Through Critical Participatory Action Research With People With Intellectual Disability, Cris Marchionne

Student Theses

People with intellectual disability deserve a system that offers flexible, timely, and person-centered support — one that is innovative, sustainable, and holistic in enabling them to live fulfilling lives. This qualitative study, grounded in Critical Participatory Action Research (CPAR), examines how people with intellectual disability experience participation in decision-making within New York State's disability service system. By centering lived experience, the study identifies factors that facilitate or hinder participation in decision-making and examines structural, social, and policy-related barriers that limit agency. Through six focus groups and a Photovoice project with self-advocates receiving OPWDD services, participants described systemic barriers that limited …

Scrolling, Following, Deciding: The Hidden Power Of Digital Influence On Wise Financial Decision, Nur Fatihah Muhamad Irwan, Wan Rasyidah Wan Nawang

International Journal of Management, Finance and Accounting

The effect of social media and digital influencers on financial behaviours has been well documented, but there is yet any solid evidence of their role in driving wise financial decision-making among Malaysians in particular. This study hence sets out to examine the impact of social media engagement and parasocial interaction in shaping financial attitudes, and the influence of financial attitude, subjective norms, and perceived behavioural control on the intention to practice wise financial decision-making. The mediating role of financial attitude was also studied, specifically in the link between social media engagement, parasocial interaction, and intention. A total of 250 Malaysian …

Impact Of Environmental, Social, And Governance (Esg) Practices On The Stability And Profitability Of Financial Institutions In Malaysia, Sharifah Najihah Syed Ishar, Sharifah Fairuz Syed Mohamad, Nurul Sima Mohamad Shariff, Mazlynda Md Yusuf

International Journal of Management, Finance and Accounting

This study examines how Environmental, Social, and Governance (ESG) activities affect the stability and profitability of Malaysian financial institutions, in light of the country's growing emphasis on sustainable finance. Using annual data from 2014 to 2024, the study focuses on three main objectives: assessing whether stronger ESG practices enhance financial stability, identifying the most influential ESG pillar among environmental, social, and governance components, and evaluating whether ESG performance affects profitability. This study employs random-effects panel regression with robust standard errors, yielding empirical evidence relevant to Malaysia’s dual banking landscape. The results show that stronger ESG performance raises the stability of …

"Why Do Students Save Less?” A Study Of The Determinants Of Saving Intentions And Behaviours Among Undergraduate Students, Rna Hamza Ahmed Eissa, Chi Hau Tan, Ben Hou

International Journal of Management, Finance and Accounting

Despite the issue of low savings being a serious concern, limited research has been conducted on students’ saving behaviour in Malaysia, especially when it comes to private universities. This research focuses on examining factors that affect saving behaviour among undergraduate students at a private university in Malaysia, in reference to the Theory of Planned Behaviour. A mixed-method design was applied. Quantitative research was conducted, in which 122 valid responses were collected via an online survey and analysed using Partial Least Squares Structural Equation Modelling (PLS-SEM). In addition, qualitative research with 11 respondents was conducted, and the data were analysed using …

The Influence Of Employment And Education On Contraceptive Use Among Women Of Childbearing Age, Shamoi K. Brown, Anatassia Harris, Kriss-Ann Wilson, Nicholai Levy, Pauline Anderson-Johnson

International Nursing Research Congress (INRC)

Background: Although the majority of women of child-bearing age utilize a modern contraceptive method, there is a significant gap in family planning highlighted by 164 million women having an unmet contraceptive need. The unmet need for contraception is attributed to multiple factors, with education and employment remaining key determinants of contraceptive use. This results in a steady rise in unintended pregnancies, unsafe abortions and maternal death.

Purpose: The purpose of this study was to determine the influence of employment and education level on contraceptive use among females aged 15–49 years in Jamaica.

Method: A secondary analysis was conducted using data …

Virtual Reality Training: Recognize Implicit Bias And Address Microaggressions In Nursing Education, Paige Ricca, Kathryn Vanderzwan, Antoinette Rosa, Rose Hernandez

International Nursing Research Congress (INRC)

Virtual reality (VR) simulations are gaining prominence as a method for diversity, equity, and inclusion (DEI) training in medical education but are seldom used in nursing programs. Although health-related programs in academic institutions have begun to address inclusion and bias, data suggest that racial climate remains a challenge in academic medical and nursing institutions. The main purpose of the study was to determine the feasibility and impact of DEI training for nursing students, faculty and clinical instructors. Two-10-minute VR simulations in a clinical and a classroom setting tailored for nursing faculty and students were developed to provide an immersive and …

The Influence Of Exercise On Cardiometabolic Risk In Perimenopause: A Systematic Review, Bibha Gautam, Deborah J. Clegg, Mary Madeline Rogge, Jeni Page

International Nursing Research Congress (INRC)

Purpose: Perimenopause is a biologically vulnerable period characterized by hormonal fluctuations, visceral fat accumulation, and increasing insulin resistance, factors that elevate cardiometabolic risk and contribute to the development of cardiometabolic syndrome (CMS), defined as the presence of three or more metabolic abnormalities. These changes reflect a continuum of metabolic vulnerability that may emerge before CMS becomes clinically detectable. Although regular exercise can mitigate this risk, limited evidence clarifies which exercise modalities are most effective in reducing metabolic risk and CMS prevalence among women undergoing the perimenopausal transition. Despite facing a distinct and often underrecognized vulnerability to CMS, perimenopausal women remain …

Tending To Emotional Wellness Needs In A Baccalaureate Second-Degree Accelerated Nursing Program, Paulette Dorney, Shirley Guider, Elise M. Colancecco, Taylor L. Grube, Karen Diance Groller, Shelly Strauss

International Nursing Research Congress (INRC)

Background: Baccalaureate second-degree accelerated nursing (ABSN) programs have grown substantially as a response to needs for a qualified workforce. These programs are designed to prepare prelicensure nurses to enter the workforce in as little as 11 to 18 months. To maintain the rigor of traditional nursing programs, ABSN programs have demanding, compressed schedules. Recent literature has brought attention to the impact of academic demands on the emotional wellness experienced by traditional four-year prelicensure nursing students (Bernier-Carney, 2025; Vo et al., 2023) but has failed to review its impact in ABSN cohorts.

Aim: This qualitative descriptive research study aimed to describe …

Strengthening Vaccine Confidence Among College Freshmen In The Post-Covid-19 Era, Karlen E. Luthy, Janelle L. B. Macintosh, Alyssa Vang, Janessa Johnson

International Nursing Research Congress (INRC)

The purpose of this study was to examine the effect of a vaccine education module (VEM) on college freshmen’s intended vaccination behaviors, vaccine-related perceptions, and vaccine knowledge. Although vaccine requirements for university students are a vital public health strategy, most institutions in the United States do not mandate all recommended immunizations. In today’s environment, where vaccine misinformation and hesitancy remain common, understanding how evidence-based education influences vaccine attitudes is increasingly important. A pre-COVID-19 study showed that a VEM improved students’ vaccine beliefs and intentions; this study assessed these outcomes in a post-COVID-19 context.

A pretest/posttest quasi-experimental design was used. Participants …

An Ai Driven Harm Response Management Tool To Prevent Adverse Events In Healthcare, Marion Claire Eckert, Greg Sharplin, Lachlan Darch, Georg Grossman

International Nursing Research Congress (INRC)

Introduction/Aim: The size, distribution, and skill mix of the nursing workforce are recognised drivers of patient outcomes, yet limited evidence exists on how workforce, clinical, and environmental variables interact to prevent harm. Despite extensive reporting systems, metropolitan hospitals continue to see rising rates of falls, medication errors, and violence, events typically identified only after they occur. This underscores the need to shift from retrospective surveillance to predictive, data-enabled harm prevention. The PreHaRM project, ‘Predictive Harm and Response Management’, aims to deliver this shift by implementing a predictive harm algorithm across South Australia’s two largest health networks, with potential for national …

Leveraging Data To Facilitate Purposeful Culture Change, Felesia Bowen, Michele H. Talley, Nevette Sample, Maria Shirey

International Nursing Research Congress (INRC)

Background: Academic nursing environments face persistent challenges related to incivility and inclusivity (Bowen, Talley, Sample & Shirey, 2025) and recent studies have revealed negative correlations between incivility and inclusivity (Githens, 2011). Climate studies provide valuable insights into faculty, staff, and student experiences (Test, 2022), yet translating these findings into meaningful culture change requires intentional strategies.

Methods: Guided by principles of organizational change and healthy academic settings (Saunders, Sridaromont, & Gallegos, 2021), we analyzed climate study results to identify priority areas. A multidisciplinary team developed targeted interventions, including faculty and staff development workshops, student engagement forums, and policy revisions to address …

Stress, Stimulant Use, And Hypertension Among Lifetime Users With High Biobehavioral Dysregulation, Wonkyung Kniffen, Cory Crane, Victoria Pezzino, Caroline Easton

International Nursing Research Congress (INRC)

Stimulant use disorders are associated with cardiovascular morbidity, yet risk factors within users remain unclear. This study used latent class analysis (LCA) to identify biobehavioral dysregulation patterns and examine associations with perceived stress, stimulant use, hypertension, and comorbidity burden. Sequential associations from stress to stimulant use to hypertension were explored among individuals with high dysregulation.

We conducted a secondary analysis of NIH All of Us Research Program data from participants with lifetime stimulant use who completed surveys and had biometric and electronic health record data (N=1,480). Missing data were handled using multiple imputation. LCA identified dysregulation profiles based on sleep …

What Drives Consumers To Use Insurtech Apps? The Role Of Insurance Literacy, Jia Chun Chia, Hui Shan Lee, Bik Kai Sia

International Journal of Management, Finance and Accounting

Although financial technology has spread worldwide, the adoption of InsurTech in Malaysia is still low because of the knowledge-action gap, in which people continue to use traditional agents. This study examines the factors that determine behavioral intention to use InsurTech apps by incorporating the Unified Theory of Acceptance and Use of Technology (UTAUT) and including a novel insurance literacy factor. A cross-sectional quantitative research design was adopted, and 406 valid responses were gathered from 406 Malaysian Generation Z individuals and analyzed using partial least squares structural equation modelling (PLS-SEM). The findings indicate that the model explains 58% of the variance …

Understanding Trust As A Mediating Mechanism In Ai-Based Medical Tools And Clinical Decision Processes, Shanthi Isparan, Seow Ai Na, Chang Jing Jing, Hew Jun Jie

International Journal of Management, Finance and Accounting

The growing integration of artificial intelligence (AI) in healthcare has transformed clinical decision-making. Nevertheless, doctors’ engagement with AI-based tools remains hindered, particularly due to trust-related concerns. The purpose of this study is to examine the factors influencing doctors’ engagement with AI-based medical tools, with a focus on the mediating role of trust within the Unified Theory of Acceptance and Use of Technology (UTAUT). Data were collected from 197 doctors in Selangor and Kuala Lumpur through a structured survey and analysed using Partial Least Squares Structural Equation Modelling (PLS-SEM) with SmartPLS 4 software. The findings reveal that performance expectancy, effort expectancy, …

Can Ai-Generated Music Interventions Improve Health Outcomes? A Systematic Review, Nguyen Thi Khanh, Huu-Thanh Nguyen, Vi Do Pham Nhat, Carmen Wing Han Chan

International Nursing Research Congress (INRC)

Music interventions are effective for physical, psychological, cognitive and social well-being [1-3]. Artificial Intelligence (AI) can generate personalised therapeutic music instantly, creating a novel, accessible intervention. However, the effectiveness of these AI-generated interventions has not been systematically reviewed [4, 5]. This systematic review aimed to evaluate the efficacy of AI-generated music interventions for improving health outcomes.

A systematic search was conducted across eight electronic databases (Cochrane, Medline, APA PsycINFO, PubMed, Scopus, Web of Science, IEEE Xplore, ACM Digital Library) from inception to September 2025. After screening, eight studies (N=1,267 participants) met the inclusion criteria, comprising four randomised controlled trials (RCTs) …

The New Economic Liberties, Daniel B. Rodriguez

Northwestern University Law Review

Despite the lack of serious interrogation at the federal constitutional level of economic regulations, there continues to be a fairly robust, energetic attention at the level of state constitutional law to so-called economic liberties. In a number of key cases, including, for example, matters involving occupational licensing, state courts have looked to unique features of their respective state constitutions to assess whether and to what extent regulations undertaken under the police power go too far. The rationales for evaluating and, in some cases, invalidating regulations under economic liberties principles are creative, and also controversial. The development of new interpretive approaches …

A Grounded Theory Study Of Confidence Building Among Newly Graduated Nurses, Justin Fontenot, Fuqin Liu, Jincy Immanuel, Laura Kubin, Niki Fogg

International Nursing Research Congress (INRC)

Aim: To develop a grounded theory explaining how newly graduated nurses build professional confidence during their transition to practice.

Background: Professional confidence is crucial for newly graduated nurses, particularly when handling uncertainty, advocating for patients, and remaining in the workforce; however, confidence is often viewed as an individual trait or outcome, which limits understanding of how it develops in practice.

Methods: Constructivist grounded theory was employed. Twelve recently graduated nurses in acute care settings participated in in-depth semi-structured interviews. Data collection and analysis occurred simultaneously, utilizing constant comparison, line-by-line and focused coding, memo writing, and theoretical integration.

Results: The core …

The Equipp Framework: Achieving Quality Through Lnterprofessional Synergy, Lynn Gallagher-Ford, Lee Ann Strait, Cynthia D. Beckett, Karey Dufour

International Nursing Research Congress (INRC)

The purpose of the workshop is to introduce interprofessional clinicians, evidence-based practice (EBP) experts, and process improvement (Pl) experts to a new framework titled: Evidence-based Quality in Practice and Process Framework (EQUiPP). It is uniquely designed to provide structure and guidance to synergistically align EBP and Pl work to effectively improve and sustain outcomes. Use of the EQUiPP Framework decreases the frequency of implementing ineffective changes, saves time and money, and improves care and outcomes. The EQUiPP Framework integrates evidence-based practice and process improvement methods for sustained quality.

The content of the workshop will guide healthcare interprofessionals to effectively plan …

Health Promotion In Tertiary Music Institutions: A Position Paper, Raluca Matei, B. Ackermann, J. Allen, U. Alpagut, K. Ananda-Owens, L. S. Araújo, R. Arnold, K. Árnason, T. Babyak, M. Baroody, F. Barreto Kochem, S. Bastepe-Gray, K. Behel, K. R. Beuschau, M. Bidlack, C. Blouin, A. Bull, A. Bush, S. Callan-Harris, K. Chesky, J-Y. Chi, R. Chiu, V. Cornett, M. Cortesi, S. Couth, A. Détári, U. Devadas, M. Doğantan-Dack, S. Dunbar, G. Ege

School of Health Professions

Health promotion in tertiary music education lacks shared guidance despite rising concern for musicians’ well-being. This position paper addresses that gap with a consensus-based, evidence-informed framework developed by 122 contributors across six continents and a variety of disciplines, including musicians and student representatives. It advances a broad understanding of health—physical, psychological, social, cultural, and occupational—and positions health promotion as integral to musicking rather than an add-on. We offer seven adaptable recommendations for institutions: (1) Reframe musicianship through health-informed cultural transformation; (2) Transform institutional culture and governance; (3) Collaborate across disciplines and expertise; (4) Equip educators, leaders, and staff to promote …

Foreword: Fifty-One Constitutions In An Evolving Federal Order, Misha Bogdanov, Olivia Christ

Northwestern University Law Review

On November 6 and 7, 2025, the Northwestern University Law Review, along with the Brennan Center for Justice and State Court Report, convened for its annual symposium, titled The Power of State Constitutional Rights. The symposium brought together judges, practitioners, and scholars to consider the substantive rights protected by state constitutions, the institutions charged with enforcing them, and the democratic processes through which state constitutional law changes. Across conversations about reproductive freedom, criminal procedure, labor, economic liberty, LGBTQ+ rights, voting, federalism, and judicial design, one proposition repeatedly, and emphatically, came into view: American constitutional law is not exhausted by the …

Child Labor And State Constitutionalism, Andrew Hammond, Helen Hershkoff

Northwestern University Law Review

Almost ninety years after Congress banned “oppressive” child labor as part of the Fair Labor Standards Act, employers are pushing state legislatures to let them put children to work in dangerous poultry plants, at hazardous construction sites, and during late shifts on school nights. Perversely, calls to rollback federal protections are camouflaged in the rhetoric of parents’ rights, casting child labor regulation as intrusive, paternalistic, and even socialist—echoing the same corporate arguments used a century ago when the Child Labor Amendment to the U.S. Constitution went down in defeat. These arguments mask the desperate economic circumstances of a parent claiming …

Court Reform And State Constitutions, Bryna Godar, Miriam Seifter

Northwestern University Law Review

State legislatures regularly propose and enact laws that seek to shape the substantive outcomes of state courts. These maneuvers, including court-packing, jurisdiction-stripping, and more creative changes to judicial selection or authority, would amount to legal earthquakes at the federal level. At the state level, these efforts often receive virtually no attention.

This Essay brings the potent category of outcome-shaping state court reform measures into focus and evaluates it as a question of state constitutional law. We argue that state constitutions, organized around principles of popular sovereignty, do not bar measures that align state courts with popular preferences or the public’s …

Textual (In)Difference In State Search-And-Seizure Provisions, Quinn Yeargain

Northwestern University Law Review

Over the past 250 years, state constitutional drafters have refined the scope of rights and liberties protected by their constitutions’ texts. Today, all state constitutions include a search-and-seizure provision—and though only a minority follow the layout, text, and context of the Fourth Amendment to the U.S. Constitution, most of them bear a striking resemblance to it. However, textual variations abound. Some of them may seem minor, like using the word “possessions” instead of “effects,” or mandating that warrants describe their intended targets “as nearly as may be” instead of requiring that they “particularly describ[e]” them. But others, like the addition …

Geduldig's Footnote: Five-Plus Decades Of State Courts Reckoning With Federal Pregnancy Discrimination Doctrine, Martha F. Davis

Northwestern University Law Review

In Geduldig v. Aiello (1974), the U.S. Supreme Court held that pregnancy discrimination does not constitute sex discrimination. The decision’s constitutional logic has recently been applied in Dobbs v. Jackson Women’s Health Organization and United States v. Skrmetti. Yet over five decades, state courts have overwhelmingly rejected Geduldig’s rationale—both in construing state employment discrimination statutes and in interpreting state constitutional equality provisions. Courts in at least sixteen states have rejected Geduldig’s rationale in construing state employment discrimination laws, while only four states have followed it. Of the ten states with Equal Rights Amendments that have addressed whether …

State Constitutionalism's Fragile Wall, Adam B. Sopko

Northwestern University Law Review

The adequate and independent state grounds (AISG) doctrine has long demarcated the perimeter of the U.S. Supreme Court’s authority to review state court decisions, limiting review to questions of federal law. AISG maintains the Court’s primacy over federal law and state courts’ supremacy over state law. A comprehensive review of all filings on the Court’s docket from state courts over the last twenty years reveals that recent applications of AISG consist of subtle but significant departures from existing norms that, together, suggest a reformulation of the Court’s power over state courts that threatens their sovereign law development role. This Essay …

State Greenhouse Gas Emissions Disclosure Laws And The Dormant Commerce Clause: Leveraging The State Interest In Protecting Residents From Deception To Pass The Pike Balancing Test, Matthew Macphail

Northwestern University Law Review

Misleading corporate claims about greenhouse gas emissions pose a high risk of consumer deception, as there is currently no uniform federal standard governing how companies must measure or disclose those emissions. Without a national regulatory scheme, firms can selectively report, use inconsistent methodologies, or market vague “carbon neutral” claims, making it difficult for consumers to assess accuracy or compare companies’ representations.

In 2023, California introduced legislation requiring companies doing business in the state to disclose their greenhouse gas emissions in an effort to bring transparency to this area. But such state-level mandates face a constitutional obstacle: the Dormant Commerce Clause, …

Alport Syndrome In Children: Bridging Genetic Insights To Clinical Management—A Narrative Review, Shawn Iqbal, Halima Saadia Janjua

Student Publications

Background and Objective: Alport syndrome is a hereditary disorder of type IV collagen that commonly presents in childhood with persistent hematuria and carries a lifelong risk of progressive kidney disease and extrarenal complications. Despite advances in genetic diagnostics, important gaps remain in early risk stratification, variant interpretation, and recognition of expanding phenotypes. This narrative review aims to synthesize current evidence on the genetic architecture, clinical spectrum, and management of pediatric Alport syndrome, with a focus on early diagnosis and disease-modifying interventions.

Methods: A targeted literature search was conducted using PubMed/MEDLINE to identify English-language human studies published between January 2000 and …

Analysis Of The Determinants Of Buy-Now-Pay-Later Payment Mode Among Malaysians In Klang Valley, Wai Zhi Tay, Chi Hau Tan

International Journal of Management, Finance and Accounting

The Buy Now, Pay Later (BNPL) service has become increasingly popular in Malaysia in recent years, especially in the Klang Valley. The BNPL service offers consumers a more convenient payment method and access to credit, raising concerns about increased household debt and financial vulnerability. In this study, this paper used financial literacy, perceived risk, credit attitude, and economic vulnerability to examine which factors influence the intention to use the BNPL payment mode. The Theory of Planned Behaviour (TPB) is used to explain the factors influencing consumers’ intention to use BNPL services. This study adopts a quantitative research design and collects …

Dividend Yield Modelling And Forecasting Under The Wilkie Investment Model With Inflation Effects: Evidence From Malaysia, Ilya Adlina Abd Halim, Norizarina Ishak, Siti Raihana Hamzah, Ahmad Fadly Nurullah Rasedee

International Journal of Management, Finance and Accounting

This study uses the Wilkie Investment Model in the context of the Malaysian stock exchange, incorporating inflation as a significant factor in explaining investment behavior in line with local economic conditions. Although the Wilkie model is broadly utilised in actuarial science and has been assessed in many developed countries, its use in emerging markets such as Malaysia is still limited. Based on historical data from Malaysia, both the dividend yield and inflation series were revealed to be stationary using the Augmented Dickey-Fuller (ADF) test. Therefore, the series is applicable for time series analysis. The study used Malaysian data to estimate …

Genomic Characterization Of Er-Positive Primary Tumors And Corresponding Relapses Identifies Potentially Targetable Alterations, Caroline Schagerholm Stanev, Stephanie Robertson, Hosein Toosi, Emmanouil G. Sifakis, Jens Lagergren, Johan Hartman

Faculty, Staff and Students Publications

The majority of breast cancer patients have tumors expressing estrogen receptor α (ER) and receive endocrine therapy. However, around one-third relapse in their disease, predominantly with retained ER expression. Molecular alterations are proposed to be contributors to the resistance mechanisms. Patients with ER-positive, human epidermal growth factor receptor 2 (HER2)-negative primary breast cancer with an ER-positive relapse <  5 years of ongoing endocrine therapy were retrospectively assessed. Extracted DNA was analyzed through panel sequencing, and RNA by microarray, from patients’ primary (n = 58), and paired relapse tumors (n = 54), and tumor-free lymph nodes (DNA germline controls, n = 62). Several single-nucleotide variations and copy number variations showed nominal exploratory associations with worse overall survival. Copy number correlations with intrinsic subtypes and …