Estimating Respiratory Rate From Breath Audio Obtained Through Wearable Microphones.

Respiratory rate (RR) is a clinical metric used to assess overall health and physical fitness. An individual's RR can change from their baseline due to chronic illness symptoms (e.g., asthma, congestive heart failure), acute illness (e.g., breathlessness due to infection), and over the course of the day due to physical exhaustion during heightened exertion. Remote estimation of RR can offer a cost-effective method to track disease progression and cardio-respiratory fitness over time. This work investigates a model-driven approach to estimate RR from short audio segments obtained after physical exertion in healthy adults. Data was collected from 21 individuals using microphone-enabled, near-field headphones before, during, and after strenuous exercise. RR was manually annotated by counting perceived inhalations and exhalations. A multi-task Long-Short Term Memory (LSTM) network with convolutional layers was implemented to process mel-filterbank energies, estimate RR in varying background noise conditions, and predict heavy breathing, indicated by an RR of more than 25 breaths per minute. The multi-task model performs both classification and regression tasks and leverages a mixture of loss functions. It was observed that RR can be estimated with a concordance correlation coefficient (CCC) of 0.76 and a mean squared error (MSE) of 0.2, demonstrating that audio can be a viable signal for approximating RR.Clinical relevance-The subject technology facilitates the use of accessible, aesthetically acceptable wearable headphones to provide a technologically efficient and cost-effective method to estimate respiratory rate and track cardio-respiratory fitness over time.

Enacting Firm, Fair and Friendly Practice: A Model for Strengths-Based Child Protection Relationships?

Strengths-based solution-focused approaches are gaining ground in statutory child protection work, but few studies have asked front line practitioners how they navigate the complex worker-client relationships such approaches require. This paper describes one component of a mixed-methods study in a large Canadian statutory child protection agency in which 225 workers described how they applied the ideas of strengths-based practice in their daily work. Interviews with twenty-four practitioners were analysed using an interpretive description approach. Only four interviewees appeared to successfully enact a version of strengths-based practice that closely mirrored those described by key strengths-based child protection theorists and was fully congruent with their mandated role. They described navigating a shifting balance of collaboration and authority in worker-client relationships based on transparency, impartial judgement, attentiveness to the worker-client interaction and the value that clients were fellow human beings. Their accounts extend current conceptualisations of the worker-client relationship in strengths-based child protection work and are congruent with current understandings of effective mandated relationships. They provide what may be a useful model to help workers understand and navigate relationships in which they must reconcile their own authority and expertise with genuine support for the authority and expertise of their clients.

Which strengths-based practice? Reconciling strengths-based practice and mandated authority in child protection work.

The recent application of strengths-based practice in child protection settings has been accompanied by evidence of inconsistent implementation and concerns that the approach is incompatible with statutory work. Few studies have moved beyond asking whether child protection workers are implementing strengths-based practice to explore why the approach is enacted as it is. This article describes a mixed methods study using an online survey and interviews to elicit from 225 statutory child protection workers in a large Canadian agency how they applied strengths-based ideas and why they did what they did. The authors found that although strengths-based practice was popular, 70 percent of participants believed that it was not always applicable to child protection work. Participants described five distinct versions of the approach, only one of which was fully congruent with their mandated role. The study suggests that the common conflation of strengths-based and solution-focused approaches ignores important differences in the conceptualization of practitioner authority and leaves practitioners attempting to implement versions ofstrengths-based practice that do not fit statutory child protection work. Only when practitioners choose solution-focused models that support their use of mandated authority is consistent implementation a reasonable expectation.

The relationship between symbolic interactionism and interpretive description.

In this article I explore the relationship between symbolic interactionist theory and interpretive description methodology. The two are highly compatible, making symbolic interactionism an excellent theoretical framework for interpretive description studies. The pragmatism underlying interpretive description supports locating the methodology within this cross-disciplinary theory to make it more attractive to nonnursing researchers and expand its potential to address practice problems across the applied disciplines. The theory and method are so compatible that symbolic interactionism appears to be part of interpretive description's epistemological foundations. Interpretive description's theoretical roots have, to date, been identified only very generally in interpretivism and the philosophy of nursing. A more detailed examination of its symbolic interactionist heritage furthers the contextualization or forestructuring of the methodology to meet one of its own requirements for credibility.