Our results indicate that support from clinicians and maternal depressive symptoms are associated with breastfeeding duration. Attention to these issues may help to promote breastfeeding continuation among mothers who initiate. Policies to enhance scheduling flexibility and privacy for breastfeeding mothers at work or school may also be important, given the elevated risk of discontinuation associated with return to work or school.

Introduction The Oncotype DX assay was recently reported to predict risk for distant recurrence among a clinical trial population of tamoxifen-treated patients with lymph nodenegative, estrogen receptor (ER)-positive breast cancer. To confirm and extend these findings, we evaluated the performance of this 21-gene assay among node-negative patients from a community hospital setting.

Black and Latino children had worse asthma status and less use of preventive asthma medications than white children within the same managed Medicaid populations. Most other processes of asthma care seemed to be equal or better for minorities in the populations that we studied. Increasing the use of preventive medications is a natural focus for reducing racial disparities in asthma.

ULTIPLE RANDOMIZED trials have demonstrated warfarin therapy to be highly efficacious in reducing risk of ischemic stroke and other systemic thromboembolism in patients with atrial fibrillation, with relatively low rates of bleeding. 1-5 Aspirin has substantially less efficacy, particularly among patients at moderate to high risk of stroke. 2,3,6 However, concerns persist about the effectiveness and safety of anticoagulation with warfarin in persons treated in usual clinical care because the randomized trials enrolled highly selected patients, included few very elderly patients, and closely monitored anticoagulation. This has important clinical implications because atrial fibrillation occurs commonly, particularly among the elderly, 7 and because the potential benefits vs risks of warfarin therapy are dependent on good control of anticoagulation intensity within a relatively narrow international normalized ratio (INR) range. 8-10

Practices that support early intervention for asthma flare-ups by parents at home, particularly written management plans, are strongly associated with reduced risk of adverse outcomes among children with asthma.