Urgent Care Utilization in a Pediatric Population With Private Health Insurance

INTRODUCTION

Pediatric urgent care (UC) utilization patterns have been studied in Medicaid enrollees, but not in those with private insurance.

METHODS

Utilization patterns of UC at a suburban pediatric primary care practice with patients with private health insurance were reviewed. Descriptive data were obtained.

RESULTS

Three hundred twenty-five charts were reviewed. Most UC visits were for children under 6 years of age (59.7%), a diagnosis of fever (12.2%), and with low severity illness (57.8%). Seventy percent occurred during weekdays and during times when the primary care practice was open. Most children (67.4%) had a diagnostic test performed at UC and 42.2% received a prescription for antibiotics.

DISCUSSION

Primary care providers should target caregiver education on low acuity conditions and consider process improvements to accommodate urgent visits. While pediatric UC benchmarks are needed, data suggests that general UCs are at risk for overprescribing antibiotics compared to national ambulatory averages.

Effect of n-alcohols on the structure and stability of the Drosophila odorant binding protein LUSH

LUSH is an odorant binding protein expressed in the olfactory organs of Drosophila melanogaster that is required for the detection of alcohol in adult flies. Here we demonstrate that, in the absence of ligand, in vitro LUSH exists in a partial molten globule state. The presence of short-chain n-alcohols at pharmacologically relevant concentrations less than 50 mM shifts the conformational equilibrium to a more compact state that exhibits reduced binding of the fluorescent dye 1-anilino-8-naphthalenesulfonic acid. Equilibrium unfolding studies of LUSH-alcohol complexes reveal that, for a series of short-chain n-alcohols, each methylene group can contribute approximately 1 K cal mol(-1) to the overall stability of the protein-alcohol complex. Using NMR spectroscopy, we have identified the regions of LUSH that show increased conformational stability on binding alcohols. These residues primarily line the alcohol-binding pocket. The results presented here provide a direct measure of the degree of stability that alcohol imparts on LUSH. These observations may represent a model for how ethanol can stabilize alternative protein conformations in alcohol-sensitive human proteins and ultimately lead to the observed changes in higher order function throughout the central nervous system.