Lakehead University Knowledge Commons

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The reliability of ultrasound assessment of muscle mass in end-stage renal disease patients receiving hemodialysis
(2026) Adri, Delight; Sanzo, Paolo; Zerpa, Carlos; Freill, Holly
Introduction: Muscle wasting is a major complication of end-stage renal disease (ESRD) particularly for patients undergoing hemodialysis. Muscle wasting is associated with morbidity, increased hospitalization, and mortality in ESRD patients. With the increasing prevalence of ESRD disease, it is important to routinely assess and monitor changes in muscle size to guide interventions and monitor disease progression in this population. Ultrasound is a reliable tool for muscle thickness assessment, however, its routine application in ESRD population undergoing hemodialysis is limited by the higher rate lower limb amputation. This often makes the rectus femoris muscle, which is commonly used as a surrogate for overall muscle mass inaccessible. Therefore, there was a need to explore different muscle sites for potential ultrasound muscle thickness assessment in this population. This study aimed to explore upper limb muscles including the biceps brachii and the triceps brachii muscles as potential and reliable alternative ultrasound muscle thickness assessment sites to the rectus femoris muscle and further explore the perception of healthcare professionals and patients on the integration of ultrasound assessment of muscle thickness into routine renal care. Methods: This study was a convergent parallel design. The quantitative aspect was a longitudinal design with 50 ESRD patients (30 males and 20 females) recruited for baseline ultrasound muscle thickness measurement with recruited patients reducing to 45 (27 males and 18 females) at 3 months follow up measurements. Muscle thickness, measured in centimeters (cm) of the rectus femoris muscle, biceps brachii muscle, and triceps brachii muscle A and B were performed by two dietitians. Measurements were performed during patients’ hemodialysis session by the first dietitian and immediately by the second dietitian blinded to the results of the first rater. Interclass correlation coefficient (ICC) was conducted to assess the inter-rater reliability of ultrasound-derived muscle thickness between the raters (dietitians) across timepoint. Pearson’s correlation and Spearman’s correlation were conducted to assess the association between the thickness of the rectus femoris muscle and the biceps brachii muscle thickness and the triceps brachii muscle A and B thickness. The qualitative aspect was conducted through a semi-structured interview. Nine participants (three dietitians, two nurses, a nephrologist, and three patients) were recruited and interviewed with guided interview scripts. Interviews were analysed using the Braun and Clarke (2006) approach to thematic analysis. Results: At baseline, inter-rater reliability of rectus femoris muscle thickness was excellent (ICC (2,1)=.91, 95% CI [.83, .96], n=33), good for biceps brachii muscle thickness (ICC (2,1)=.87, 95% CI [.76, .93], n=38), moderate for triceps brachii muscle A thickness (ICC (2,1)=.53, 95% CI [.27, .73], n=38), and moderate for triceps brachii muscle B thickness (ICC (2,1)=.66, 95% CI [.44, .81], n=38). At 3 months, the biceps brachii muscle thickness retained good inter-rater reliability (ICC (2,1)=.84, 95% CI [.68, .92], n=30), and the rectus femoris muscle thickness declined to good inter-rater reliability (ICC (2,1)=.75, 95% CI [.27, .91], n=21). Both triceps brachii muscle A thickness and triceps brachii muscle B thickness declined to poor inter-rater reliability (ICC (2,1)=.32, 95% CI [-.02, .60], n=30); and (ICC =.41, 95% CI [.05, .67], n=30) respectively. There was a moderate, positive, and significant association between the rectus femoris muscle and the biceps brachii muscle thickness for rater 1 at baseline (r=.44, 95% CI [.16, .66], n=42, p=.004), at 3 months (ρ=.42, 95% CI [.10, .67], n=36, p=.01). There was a moderate, positive, and significant association between the rectus femoris muscle and the biceps brachii muscle thickness for rater 2 (r=.53, 95% CI [.12, .77], n=22, p=.01) and triceps brachii muscle B thickness (r =.45, 95% CI [-.06, .67], n=22, p=.04) at 3 months. The themes identified in the interviews included (1) current assessment of muscle status, (2) ultrasound as a valuable clinical instrument, (3) competency, (4) application of ultrasound in hemodialysis care, (5) patients’ experience and acceptance, and (6) ultrasound data as potential motivational evidence. Conclusion: The biceps brachii muscle is a potential alternative muscle site for muscle thickness assessment but future validation with gold standard criterion is warranted for the hemodialysis population. Also, healthcare professionals and patients are receptive to the integration of ultrasound muscle thickness assessment into routine care as they perceive it to improve education, communication, and motivation.
Exploring pathways to blue justice: the theory and practice of blue justice in the St. Marys River Area of Concern
(2026) Hambleton, Julia; Levkoe, Charles; Lowitt, Kristen; Nguyen, Vivian
Unchecked growth of marine-based economies risks increasing displacement of coastal peoples, environmental degradation, loss of livelihood and access to marine resources, and exclusion from decision-making and governance. In response, blue justice is an organizing framework rooted in social and environmental justice that recognizes the meaningful involvement and fair treatment of small-scale fisheries and allied coastal groups in how marine resources are used, managed and enjoyed. The scholarship and practice of blue justice, while established in ocean fisheries, is underdeveloped in freshwater fisheries. This study applies the theory and practice of blue justice to the Lake Superior watershed through a case study of the St. Marys River, a 125 km connecting river situated between Lake Superior and Lake Huron by way of several different channels currently listed as a Great Lakes Area of Concern. Included in this study is a literature review and data collected through semi-structured interviews with key stakeholders and rights holders in the St. Marys River using a blue justice framework that highlights three analytical areas - recognitional, procedural and distributive justices. Findings reveal challenges that constrain social and environmental health in this Area of Concern and inform actions towards more equitable and sustainable decision-making. This research contributes to blue justice scholarship and offers a potential model for further exploration of blue justice in the Great Lakes basin.
The effects of an intensity coaching intervention in Pickleball on the fitness and well-being of older adults
(2026) Brough, Amy; Sanzo, Paolo; Klarner, Taryn; Zerpa, Carlos
Pickleball is one of the fastest-growing sports among older adults and has demonstrated potential physical, psychological, and social health benefits. However, despite its increasing popularity, limited research has examined the effects of structured pickleball coaching interventions on functional fitness and psychological well-being in older adults. Therefore, the purpose of this study was to examine the effects of a four-week pickleball intensity coaching intervention on functional fitness and psychological well-being in older adults.
Deformation processes in a mid-crustal strike-slip shear zone: insights from the Archean Quetico Shear Zone, Superior Province, Canada
(2026) Tiitto, Hanna; Stephan, Tobias; Phillips, Noah
The Quetico Shear Zone serves as an excellent analogue for active strike-slip shear zones at seismogenic depths. The Quetico Shear Zone is a right-lateral, strike-slip shear zone located at the boundary between the Wabigoon and Quetico subprovinces and has a strike length of at least 400 km. This research focuses on the eastern extent of the shear zone, north of Thunder Bay, and aims to constrain the kinematics, structures, conditions, and timing of deformation processes within the shear zone and adjacent paleo-earthquake surfaces. We found that Quetico Shear Zone deformation is characterized by increased mylonitization and brittle deformation with increasing proximity to the shear zone trace (within 500 m) where paleo-earthquake surfaces (i.e., pseudotachylite veins) were found. Mylonitization produces recrystallized quartz ribbons and a strong foliation unique to the Quetico Shear Zone (stronger than regional Quetico subprovince transpressional structures), particularly in granitic units. Non-granitic rock units within the core of the shear zone display pervasive brittle deformation with numerous faults. The recrystallized quartz grain sizes do not correlate with increased mylonitization and proximity to the shear zone. Recrystallized quartz grain sizes remained constant within error, with a median stress value of 80 MPa. The temperatures of quartz recrystallization also show no clear evolution with increasing proximity to the Quetico Shear Zone trace, with a median value of 487°C. The quartz recrystallization temperatures correlate to retrogressive temperatures from stable mineral assemblages, which are lower than estimated peak metamorphic temperatures from stable mineral assemblages (up to 700°C). The slip systems within the samples show an overprint from a higher-temperature prism slip distal to the shear zone core to a lower-temperature rhomb slip within the shear zone core. The calculated strain rates for the shear zone (3.9E-10 to 9.5E-12 s-1) are comparable to those in active shear zones. Apatite and titanite provided the best ages for deformation, mainly producing interpreted ages younger than the Quetico subprovince metamorphism. The interpreted Quetico Shear Zone deformation ages are 2618 to 2596 Ma. The exhumed Quetico Shear Zone appears to consist of an increasingly localized zone of deformation with proximity to the shear zone trace, though the shear zone records constant stress conditions across the shear zone core, indicating another weakening mechanism (e.g., fluid infiltration or fabric intensity) may be localizing deformation. The timing of this event is shortly after the Kenoran orogeny and may be related to the Sacred Heart Orogeny in the Minnesota River Valley.
Pride flags in every classroom, but they didn’t teach us queer sex ed: a qualitative exploration of 2SLGBTQIA+ students’ experiences with sexual health education in Ontario
(2026) Knight, Sara; Murphy-Oikonen, Jodie; Chisholm, Jennifer; Miller, Katherine Kortes; Sanders, Chris
The purpose of this qualitative research study was to explore how 2SLGBTQIA+ secondary students experience Ontario’s sexual health curriculum, and how those experiences shape their ability to navigate sex, relationships, and identity. Although Ontario’s Health and Physical Education Curriculum formally includes content related to sexual orientation, gender identity, and healthy relationships, there remains limited research on how 2SLGBTQIA+ students themselves interpret and experience this education in practice (Gowen & Winges-Yanez, 2014; Ontario Ministry of Education, 2019). Using a descriptive phenomenological approach, this study centred the lived experiences of 12 2SLGBTQIA+ youth and young adults who attended secondary school in Ontario and received school-based sexual health education. Participants were recruited through purposive and snow ball sampling, and data were collected through semi-structured qualitative interviews. Interview data were analyzed using reflexive thematic analysis (Braun & Clarke, 2022). Four central themes were identified: 1) cisheteronormativity as the curricular baseline; 2) teaching sexual health: tone, comfort, and classroom control; 3) curricular influence on relational scripts and identity development; and 4) filling in the gaps: peers, pornography, and the internet. Overall, findings suggest that Ontario’s sexual health curriculum was experienced as inconsistent and often disconnected from 2SLGBTQIA+ students’ lived realities. This research has implications for sexual health education policy, educator training, classroom implementation, and social work practice with 2SLGBTQIA+ youth.