• Title/Summary/Keyword: Frequency support

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The Effect of Hotel and Restaurant Employees' Eating Habits on Their Dining-out Behavior (호텔 및 외식업체 종사자들의 식생활 습관이 외식 행동에 미치는 영향에 관한 연구)

  • Cho, Han-Yung;Lee, Jong-Ho
    • Culinary science and hospitality research
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    • v.16 no.4
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    • pp.124-138
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    • 2010
  • This study aims to investigate the effect of hotel and restaurant employees' eating habits on their dining-out behavior. 309 workers from die hotel and restaurant companies participated in the survey, and SPSS 14.0 was used to perform frequency analyses, factor analyses, f-tests, ANOVA and multiple regression analyses. An exploratory factor analysis revealed three eating habits; unhealthy, healthy and ideal eating habits with 62.250% of the cumulative variance explained. The factor analysis included the priority on menu items, atmosphere and location of a restaurant with 60.658% of the total variance explained The results of the t-tests gave partial supports for the hypothesized gender difference in eating habits and for the hypothesis that eating habits would differ according to marital status. The result of ANOVA gave a partial support for die hypothesized age difference in eating habits. The result of the multiple regression analysis showed that all eating habits, unhealthy($\beta$=0.326, p<0.000), healthy($\beta$=0.290, p<0.000) and ideal($\beta$=0.305, p<0.000), had a significant effect on the priority on menu items. Eating habits explained 13.1% of die total variance in the importance of restaurant atmosphere and location. The influence of unhealthy eating habits was not statistically significant ($\beta$=0.002, p<0.965) while the influence of healthy($\beta$=0.309, p<0.000) and ideal eating habits($\beta$=0.189, p<0.000) was statistically significant Consequently, there was a partial support for the hypothesis that eating habits would influence die priority of restaurant atmosphere and location as a factor when dining out.

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Product Recommender Systems using Multi-Model Ensemble Techniques (다중모형조합기법을 이용한 상품추천시스템)

  • Lee, Yeonjeong;Kim, Kyoung-Jae
    • Journal of Intelligence and Information Systems
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    • v.19 no.2
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    • pp.39-54
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    • 2013
  • Recent explosive increase of electronic commerce provides many advantageous purchase opportunities to customers. In this situation, customers who do not have enough knowledge about their purchases, may accept product recommendations. Product recommender systems automatically reflect user's preference and provide recommendation list to the users. Thus, product recommender system in online shopping store has been known as one of the most popular tools for one-to-one marketing. However, recommender systems which do not properly reflect user's preference cause user's disappointment and waste of time. In this study, we propose a novel recommender system which uses data mining and multi-model ensemble techniques to enhance the recommendation performance through reflecting the precise user's preference. The research data is collected from the real-world online shopping store, which deals products from famous art galleries and museums in Korea. The data initially contain 5759 transaction data, but finally remain 3167 transaction data after deletion of null data. In this study, we transform the categorical variables into dummy variables and exclude outlier data. The proposed model consists of two steps. The first step predicts customers who have high likelihood to purchase products in the online shopping store. In this step, we first use logistic regression, decision trees, and artificial neural networks to predict customers who have high likelihood to purchase products in each product group. We perform above data mining techniques using SAS E-Miner software. In this study, we partition datasets into two sets as modeling and validation sets for the logistic regression and decision trees. We also partition datasets into three sets as training, test, and validation sets for the artificial neural network model. The validation dataset is equal for the all experiments. Then we composite the results of each predictor using the multi-model ensemble techniques such as bagging and bumping. Bagging is the abbreviation of "Bootstrap Aggregation" and it composite outputs from several machine learning techniques for raising the performance and stability of prediction or classification. This technique is special form of the averaging method. Bumping is the abbreviation of "Bootstrap Umbrella of Model Parameter," and it only considers the model which has the lowest error value. The results show that bumping outperforms bagging and the other predictors except for "Poster" product group. For the "Poster" product group, artificial neural network model performs better than the other models. In the second step, we use the market basket analysis to extract association rules for co-purchased products. We can extract thirty one association rules according to values of Lift, Support, and Confidence measure. We set the minimum transaction frequency to support associations as 5%, maximum number of items in an association as 4, and minimum confidence for rule generation as 10%. This study also excludes the extracted association rules below 1 of lift value. We finally get fifteen association rules by excluding duplicate rules. Among the fifteen association rules, eleven rules contain association between products in "Office Supplies" product group, one rules include the association between "Office Supplies" and "Fashion" product groups, and other three rules contain association between "Office Supplies" and "Home Decoration" product groups. Finally, the proposed product recommender systems provides list of recommendations to the proper customers. We test the usability of the proposed system by using prototype and real-world transaction and profile data. For this end, we construct the prototype system by using the ASP, Java Script and Microsoft Access. In addition, we survey about user satisfaction for the recommended product list from the proposed system and the randomly selected product lists. The participants for the survey are 173 persons who use MSN Messenger, Daum Caf$\acute{e}$, and P2P services. We evaluate the user satisfaction using five-scale Likert measure. This study also performs "Paired Sample T-test" for the results of the survey. The results show that the proposed model outperforms the random selection model with 1% statistical significance level. It means that the users satisfied the recommended product list significantly. The results also show that the proposed system may be useful in real-world online shopping store.

Job Characteristics and Status of Community Occupational Therapist : Focus on OTs in Public Health Centers (지역사회 작업치료사의 업무 특성 및 실태 조사 : 보건소 근무 작업치료사를 중심으로)

  • Min, Kyoung-chul;Kim, Eun-hee;Woo, Hee-soon
    • The Journal of Korean society of community based occupational therapy
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    • v.10 no.3
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    • pp.37-52
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    • 2020
  • Objective : This study was conducted to identify occupational therapists working in public health centers, the characteristics and actual conditions of occupational therapists in the community, and use them as basic data on occupational therapists in the community as of 2020. Methods : 77 questionnaires were replied by e-mail from OTs work at nationwide health public centers. Job characteristics and status were analysed by descriptive statistics and check correlation between job satisfaction and other factors. Results : Most survey respondents were female(77.9%) and 20-30(96.1%).. Some occupational therapists worked for dementia related team(72.7%) and others worked for like visiting care, health care, and rehabilitation center etc. Rate of experiences of public health center was 1-2 years(67.5%), the most common type of contract was flexible part-time worker(61%) and work intensity(94.8%) and satisfaction of work was very high(85.7%). The highest difficulty of their job was budget administrative work(26.7%) and of non-work difficulty was inequality under contracts(27.2%). They usually participated at dementia shelter, visiting OT, group OT. Difficulty of their job was high in budget administration, dementia shelters, and visiting work treatments. Goals of treatment were high in improvement of cognitive ability and, family support. Frequency of treatment was high in improvement of cognitive therapy, family support, and evaluation. Occupational therapy targets for health centers were dementia, the general elderly, and adult brain lesions, including those for ordinary people, psychiatric disorders and children. It was found that the primary occupations for evaluation were nurses (35.7%) and occupational therapists (33.7%), and that MMSE-DS, SGDS, and SMCQ were used a lot. Conclusion : This study could identify the job characteristics and status of community OTs. We hope that this result could be basic data for building expertise and role for community OTs in changing situations like community cares.

Derivation of Constraint Factors Affecting Passenger's In-Vehicle Activity of Urban Air Mobility's Personal Air Vehicle and Design Criteria According to the Level of Human Impact (도심항공모빌리티 비행체 PAV 탑승자 실내행위에 영향을 미치는 제약 요소 도출 및 인체 영향 수준에 따른 설계 기준)

  • Jin, Seok-Jun;Oh, Young-Hoon;Ju, Da Young
    • Science of Emotion and Sensibility
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    • v.25 no.1
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    • pp.3-20
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    • 2022
  • Recently, prior to the commercialization of urban air mobility (UAM), the importance of R&D for air transportation-related industries in urban areas has significantly increased. To create a UAM environment, research is being conducted on personal air vehicles (PAVs). They are key means of air transportation, but research on the physical factors influencing their passengers is relatively insufficient. In particular, because the PAV is expected to be used as a living space for the passengers, research on the effects of the physical elements generated in the PAV on the human body is essential to design an interior space that supports the in-vehicle activities of the passengers. Therefore, the purpose of this study is to derive the constraint factors that affect the human body due to the air navigation characteristics of the PAV and to understand the impact of these constraint factors on the bodies of the passengers performing in-vehicle activities. The results of this study indicate that when the PAV was operated at less than 4,000 ft, which is the operating standard, the constraint factors were noise, vibration, and motion sickness caused by low-frequency motion. These constraint factors affect in-vehicle activity; thus, the in-vehicle activities that can be performed in a PAV were derived using autonomous cars, airplanes, and PAV concept cases. Furthermore, considering the impact of the constraint factors and their levels on the human body, recommended constraint factor criteria to support in-vehicle activities were established. To reduce the level of impact of the constraint factors on the human body and to support in-vehicle activity, the seat's shape and built-in functions of the seat (vibration reduction function, temperature control, LED lighting, etc.) and external noise reduction using a directional speaker for each individual seat were recommended. Moreover, it was suggested that interior materials for noise and vibration reduction should be used in the design of the interior space. The contributions of this study are the determination of the constraint factors affecting the in-vehicle PAV activity and the confirmation of the level of impact of the factors on the human body; in the future, these findings can be used as basic data for suitable PAV interior design.

A Study of a Pattern of the Stress Perceived by Stroke Patients through the Rehabilitative Process (뇌졸중 환자의 재활과정에 따른 스트레스 변화 양상)

  • Lee, Jung-Min
    • Journal of East-West Nursing Research
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    • v.1 no.1
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    • pp.82-98
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    • 1997
  • The purpose of this study was to determine pattern of the stress perceived by stroke patients over time. The ultimate goal of the research is to provide data to help nurses to design the plan of nursing care of the stroke patients both in the hospital and at home. A total of 57 admitted stroke patients were collected from one general hospital in Seoul from June, 12 to September, la, 1993. The data were collected for three phases(within one week after leaving the hospital). The tools for this study, three scales were used ; Stress scale developed by the investigator. Constitution classifing scale designed by Kho(1984), and Self-care measuring scale by Kang(1984). Data were analyzed in four steps using statistical analysis. First, demographic data were determined by descriptive statistics. Second. the pattern of stress perceived by stroke patients across three phases was measured using repeated measures ANOVA. Third, stress of stroke patients classified by constitution, paralyzed area. and attack frequency were measured using ANOVA or t-test, and the pattern of stress by group over time was determined using paired t-test in post hoc test. Fourth. Pearson correlation coefficients were calculated to determine the relationship between the stress and self-care activities. The results of this study are ; 1. The pattern of stress across three phases ; There was a decrease of the stress across three phases. In general. psychological stress as the highest among three phases(F=36.92. P=.000). There was a statistically significant difference of the physical stress(F=34.55, p=.000), the psychological stress (F=15.49, p=.0005) and the social stress (F=24.71. p=.000) among three phases. There was a statistically significant difference of the stress between the first phase (on admission) and the second phase(before leaving the hospital) and was a decrease of the stress (t =6.36. p=.000). 2. The pattern of stress of stroke patients classified by constitution across three phases ; Stroke patients classified as So-Eum perceived the highest stress among three groups(Tae-Eum, So-Eum. So-Yang). There was no statistically significant difference of stress according to the constitution of stroke patients among three phases. Hence. stress was not influenced by the constitution of stroke patients, but there was a statistically significant difference of stress over time. 3. The pattern of stress of stroke patients classified by the paralyzed area across three phases ; Right paralyzed stroke patients perceived higher stress than left paralyzed stroke patients. There was, however, no statistically significant difference of stress between two groups except 2nd phase. There was no statistically significant difference of the perception of stress bet ween the right and left paralyzed stroke patients. 4. The pattern of stress of stroke patients classified by the frequency of the relapse of the disease across three phases ; Stress was higher in stroke patients who had the relapse of the disease twice more than the first time. There was, however, no statistically significant difference of stress between two groups. There was no statistically significant difference of stress of stroke patients according to the relapse of the disease among three phases. Hence, stress was no influenced by the relapse of the disease. 5. The relationship between the stress and self-care activities ; There was a negative relationship between the stress and self-care activities each phase(on admission, r= -.1563 ; before leaving the hospital, r= -.4030 ; after leaving the hospital, r= -.5291). Hence, the higher the self-care activities, the lower the stress. This study has three important findings. First finding was that psychological stress perceived by stroke patients was the highest among three phases. The second finding was that factors such as the constitution, the paralyzed area, and the relapse of the disease did not have an influence on the stress perceived by stroke patients across three phases(on admission, before leaving the hospital, after leaving the hospital). There was a statistically significant decrease of the stress perceived by stroke patients across three phases. The third finding was that there was a negative relationship between the self-care ability and stress. In this study, these findings have implications for nursing care for the rehabilitation of stroke patients and suggest the need of nursing intervention to promote the self-care ability and to support the psychological self-esteem of stroke patients.

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Analysis of Bird Community by Habitat Type in Nak-dong Jeongmaek (낙동정맥의서식지유형별조류군집분석)

  • Han, Seung-Woo;Kang, Te-han;Park, Chi-Young;Shin, Yong-Un;Im, Eun-Hong;Lee, Joon-Woo
    • Korean Journal of Environment and Ecology
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    • v.30 no.3
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    • pp.335-343
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    • 2016
  • Of the Nak-dong Jeongmaek, five mountains, viz. Mt. Baek-byeong, Mt. Chil-bo, Mt. Baek-am, Mt. Un-ju, Mt. Go-heon, which are considered to well represent the natural environmental characteristics of Nak-dong Jeongmaek as well as its various terrain, were selected for this study. Two fixed plots were selected as sample study areas of each type of bird habitats and surveyed from May to October in 2015. According to the results of the survey conducted in the five mountains of Nak-dong Jeongmaek, a total of 47 species with 1,163 individuals birds was identified. The largest variety of species occupying a particular habitat type was found in the forest road and the ridge with 31 species. Also, the number of individuals was highest in the valley with 471 individuals. According to the results of nesting guild analysis of the vein (Pearson Chi-Square test, ${\chi}^2=13.377$, p = 0.037) by each Nak-dong Jeongmaek habitat type, the communities that belong to the canopy nesting guild showed a high frequency in development land and the valley while the communities that belong to the hole nesting guild showed a high frequency on the forest road and ridge. The results of Pearson Chi-Square test (${\chi}^2=15.555$, p=0.004) showed that the communities that belong to Bush foraging guild were most frequent in the development area and the community that belong to canopy foraging guild were most frequent inthe valley, the forest road and the ridge. These findings show that different habitat types of Nak-dong Jeongmaek support a great variety of birdlife by providing diverse and excellent resources.

Factors Associated with Active Participation in Health Promotion Programs at a Public Health Center (보건소 건강증진 프로그램 신청자의 참여 상태와 관련 요인)

  • Park, Yeun-Ju;Park, Hyun-Hee;Ryu, So-Yeon
    • Journal of agricultural medicine and community health
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    • v.35 no.3
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    • pp.287-300
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    • 2010
  • Objectives: We identified factors associated with any participation and with "good participation" (as assessed by frequency of attendance) in health promotion programs at a public health center in Korea. Methods: The subjects included 199 women who attended a baseline examination of health promotion programs during the first half of 2009. We collected data by structured interviews and physical examinations. Participation status was quantified by the frequency of attendance to the program. We classified the subjects as non-participants (0) and participants (1+ times), and as poor participants (0-29 times) and good participants (30+ times). Results: Of the 199 subjects, there were 57 (28.6%) non-participants, while 56 (28.1%) were classified as good participants. The factors that significantly affected participation status, as identified by univariate analysis, were personal factors (age, educational level, marital status, religion, living with someone, monthly income), environmental factors (method of access, accessibility of other facilities), body mass index, hypertension, perceived barriers to health, emotional salience, affectionate domain of social support, and depression. Multiple logistic regression analyses indicated that method of access was the most significant factor affecting participation in the health promotion program, and that the factors most highly associated with good participation were emotional salience, hypertension and body mass index. Conclusions: Our findings suggest that specific factors determine and enhance participation in health promotion programs offered by public health centers. These factors should be considered during the design and evaluation of health promotion programs that are offered by public health centers.

A Study on Nursing Service of Chronic Diseases by the First Step and Third Step Medical Treatment (1차 및 3차 진료기관 이용 만성질환자의 간호서비스에 관한 연구)

  • Cho Chong Sook
    • Journal of Korean Public Health Nursing
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    • v.10 no.2
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    • pp.103-118
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    • 1996
  • It is to be growing up the interest of community health affairs through visiting nursing care. The health medical treatment of Korea has been changed largely on the period. The juvenile population has decreased. This means that is has took the population consensus of advanced national organization to be increased by the old age. The transition of disease has changed from the contagious disease importance to the chronicity disease omportance because the domestic district population has experienced the sudden urbanization circumstance district population has experienced the sudden urbanization circumstance to be growing up $70\%$ of the whole population. When the nursing service has common function to be delivering from all direction to home, this study is getting the great important phase velocity in order to manage the kernel questional adult chronicity disease of health medical institution at the present age. (1) community over system or with people particularity (2) the first of third step medical treatments. The variety of medical treatments organization has quantity of the delivery manpower and specially between consumers and rdlated person. A qualitative difference is showed at the purpose to be seizing. That research related person is use at district health center in Seoul, by foundation on nurse registration book of H collage hospital and public health registration book. According the chronicity disease. age. and sex. nature agree-able standard 54 people took the content analysis on nurse registration book of total 108 people. The results of the study were as follows: 1. General background factors are houses or kind of medical facilities and number of patients in family. The first medical treatment is more patients than third medical treatment organization. The first medical treatment of economic environment os appering to be worse. 2. The chronicity disease frequency have been different speciality according to medical treatment organization. On case of the first medical treatment. Diabetes and High Blood Pressure were good but Cerebrum Vascular Accident(CVA) showed many for bed case. In addition. the number of family is comparative large exception of CVA on according for moving condition and health more than the first medical treatment. However. family condition. whole family percentage is decreasing preferably through the potential resource is increasing by the number of and the construction of family. The ability of real resource is considered to be low. 3. The average percentage of nurse service has appered to be differed two groups by the first step medical treatment(33.72 times) and third step medical treatment(45.70 times). However, the difference (the first step medical treatment and third step medical treatment) is to be limited to issue the medicine at the service. The condition of nurse care was the indirect nursing care. Supportiong area was to be related to volunteer service and administration support. 4. The various nursing care average percentage of the chronicity disease was increased by orders of Diabetes. High Blood Pressure. and CVA in examination result and the medical treatment. The indirect nursing care was also same. At third step medical treatment, orders of chronicity disease were same. The case of other area on service conditions were increased by order of Diabetes. High Blood Pressure, and CVA. However. it is never appearing the difference at bottleneck affairs nursing care. 5. When the visiting nursing care demand particularly. the average percentage of nursing care from the first step medical treatment that the time under a person is many more than the time over two people. However, there was no difference in statistic. Third step medical treatment is $49.81\%$ at the time under a person. The average nursing care service is appeared by more many when the visiting nursing care demand is a few by 12.83 at the time over two people. 6. By visiting nursing care percentage to be frequency that nursing care averaghe percentage and inter-relation are large. The related factor of the first medical treatment is 0.96. However, the related factor of third medical treatment has shown the decreased 0.49 for the condition of relation more than that. Therefore. the nursing care average percentage is related to the visiting times of a nurse. This result is be showing the obvious fact that the first step medical treatment is few more than third step medical treatment.

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A study on the adjustment problems of the aged (노후적응에 관한 연구 - 생활만족도 및 가족의 교류도를 중심으로-)

  • 서병숙
    • Journal of the Korean Home Economics Association
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    • v.27 no.2
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    • pp.133-148
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    • 1989
  • This study attempts of analyze empirically the living status of the elderly in Korea by finding out the problems of it in the family and by clarifying the influences of the family environmental variables and the values on the adjustment of the aged. To carryout the aim of this study, the causes and the patterns of the problems for the aged had been found out through the review of literature. Based on them the questionnaire was prepared including the questions of the values, family environmental vriables as well as the degree of satisfaction of thier liver and the extent of life interchange. The former variables were taken as independent and the latter were taken as dependent variables, so that the relationship between the two variables could be exemplified. The 400 aged over 60 living in Seoul and the other cities were selected through the purposive sampling and interviewed. The answers of the 376 respondents, 94% of the sample, were analyzed for this study. The following results have been found out through the various statistical analysis such as frequency distribution, chi-square test, pearson's correlation, analysis of variance and cluster analysis. At first, the results from the examination of the frequency distribution regarding the living status of the aged are; I) sixteen percent of the respondents living with their married offspring were receiving economical support, though they pointed out the problems of the extended family are the inconveniences with their children (60%) and simpleness (20%) of their livers. It seems that the aged in Korea are poor and have negative opinion on the relationship with their offspring even if they live in the same house. Secondly, it has been found out that the family environmental variables, especially such as sex, occupation, residence, education, level, living ability and the family type, play and important role not only on the degree of satisfaction of their liver but also on the extent of interchange of their lives. However, the variables such as religion and whether the spouse is alive or not do not play and important role. Thirdly, the reported main reasons of their delightness were healthy life (1.87%), the well-being of their offspring (2.08%), the spouse's long life (3.38%), religious activity (5.05%), the hobby activity (4.31%) and the participation in the social activity (5.05%). While, they mainly concern about the illness (1.98%), offspring (2.00%), econmic difficulties (3.39%), inharmonious home (3.81%) and the despicable treatment (3.81%). The respondents wer classified into two groups, they are dependent and independent, using cluster analysis. Health, social activity, offspiring, religion, couple's long life among the factors which lead them to be delighted were turned out to be statistically signhificant at 0.01 significance level between the two groups. As far as their worrisome matters are concerned, health and economic difficulties were significantly different between the two groups. Fourthly, regarding the life interchange, it has been proved that there is a statistically significant differences betwwen the two groups in the economic and the emotional satisfaction, help for ordinary life, status in the family, subjective and objective relationship with offspring, but not in economic dependency and the activity status. Fifthly, it has been noted that there is a high correlation between the degree of life's satisfaction and the extent of life interchange. On the basis of the results mentioned above, it could be concluded taht; i) The majority of the aged in Korea are not economically active, and thus they live with their married offspring even of they have a negative opinion on the subjective relationship with them. This can be pointed out as the main problem of the aged and thus it needs to be studied further. ii) the environmental variables such as age, sex education level, family type and occuption (which can not be changed by their effrot) turned out to give an important effect on the extent of the life interchange among the aged. iii) The respondents who are identified as independent group have a higher degree of life satisfaction and family status than the group identified as defendent. Thus, it can be inferred that it is possible for them to adjust their life by making an effort to modify themselves. iv) The high correlation between the extent of life interchange and the degree of life satisfaction indicates that the elderly themselves can adjust in order to obtain the higher degree of life satisfaction. Therefore, the following suggestions are derived from this study. First of all, the aged should try to be psychologically independent. Second, they need to control themselves in order to achieve self-assurance. Third, the community have to prepare a program of self-development for the aged. Fourth, the social welfare policy that can solve the problem of illness and poverty of the elderly should be introduced, so that their minimum requirements can be satisfied.

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Extrauterine Growth Restriction in Very Low Birth Weight Infants (극소 저체중 출생아의 자궁 외 성장 지연)

  • Kim, Eun-Sun;Sohn, Jin-A;Lee, Eun-Hee;Choi, Eun-Jin;Lee, Hyun-Ju;Lee, Jin-A;Choi, Chang-Won;Kim, Ee-Kyung;Kim, Han-Suk;Kim, Beyong-Il;Choi, Jung-Hwan
    • Neonatal Medicine
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    • v.17 no.1
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    • pp.53-63
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    • 2010
  • Purpose : Extrauterine growth restriction (EUGR) in preterm infants is a major problem in neonatal intensive care units (NICUs) and it has been related to long-term growth deficit and neurodevelopmental issues. The aim of this study was to investigate the frequency of and risk factors for EUGR. Methods : The study subjects consisted of very low birth weight (VLBW) infants with a gestational age $\leq$32 weeks that were born at the Seoul National University Children's Hospital between November 2005 and April 2009. EUGR was defined as weight for gestation, lower than the 10th percentile on discharge. Results : The frequency of EUGR was 67% (n=111/166). By multiple logistic regression, the presence of small for gestational age (SGA) was the greatest predictor of EUGR, birth weight and daily weight gain during the first 28 days were independent predictors of EUGR. Risk factors for EUGR in non-SGA infants were evaluated because 56% (64/114) of non-SGA infants developed EUGR at discharge. Daily weight gain in the first 28 days was also decreased in EUGR group and independently predicted the risk of EUGR in the non-SGA group. Conclusion : EUGR was a common problem in the NICU. SGA was the most significant predictive factor of the EUGR. Half of the non-SGA infants also developed EUGR, revealing poor weight gain in the early days was as an important predictor. These results support the importance of early nutritional intervention for weight gain which have lagged behind other modern therapeutic interventions when the infant is clinically unstable.