Johns Hopkins Gazette: July 21, 1997

In Brief

Estrogen replacement therapy may reduce risk of Alzheimer's disease

A joint Johns Hopkins, National Institute on Aging study has found that women on estrogen replacement therapy, orally or through skin patches, reduced their risk for Alzheimer's disease by 54 percent. Their findings add to the mounting evidence that ERT can reduce risk for Alzheimer's disease.

The link between ERT and reduced risk for Alzheimer's disease was strengthened when information on 472 women enrolled in the Baltimore Longitudinal Study of Aging revealed that, of the 45 percent on ERT, only nine developed Alzheimer's disease. Thirty-four women not on ERT did develop Alzheimer's disease. "If this connection can be clinically confirmed, we would anticipate a significant public health impact," said Claudia Kawas, a Hopkins associate professor of neurology and co-author of the report. Kawas added that only 12 to 15 percent of U.S. women eligible for ERT are receiving the therapy.

Researchers speculated that estrogen may reduce the risk of Alzheimer's disease by stimulating the growth of nerve cells and inhibiting levels of apolipoprotein E, a fatty acid closely linked to heart disease and AD. ERT may also deactivate chromosome-damaging oxidants and increase levels of neurotransmitters, such as acetylcholine.

Researchers, who published their results in the June issue of Neurology, added that a carefully controlled clinical study was needed to explore further the link and to rule out other variables. ERT, they caution, has been known to produce serious side effects and may increase the risk of uterine and breast cancer.

Blue Jays voted among the nation's top 5 percent

Following one of the most successful sports years in recent Hopkins history, the National Association of Collegiate Directors of Athletics placed Hopkins' athletic programs among the nation's top 5 percent. The NACDA awarded the Blue Jays 352.5 total points, good for 16th place out of 351 NCAA Division III schools competing for the 1996-97 Sears Director's Cup.

The NACDA awards points based on eight core sports and two "wild card" sports, one each for men and women. Hopkins received points for seven sports: men's soccer, women's basketball, men's swimming and diving, women's swimming and diving, baseball, men's lacrosse and women's lacrosse.

Hospital garners national recognition in two surveys

For the seventh year in a row, The Johns Hopkins Hospital is at the top of the U.S. News & World Report annual, national "Honor Roll" of hospitals. JHMI CEO and Dean Edward D. Miller and Hospital and Health System President Ronald R. Peterson set the tone for the celebration:

"To stay at the top of U.S. News & World Report's annual 'Honor Roll' of hospitals for a seventh straight year is a heartwarming and deserved tribute to every member of the Hopkins Medicine family. To be in the company of the nation's best hospitals would be sufficient; to be No. 1, again, when the rapid changes in health care constantly challenge our commitment to excellence, is to make us extraordinarily proud of our employees' dedication. We congratulate our sister institutions and colleagues around the nation who share the `Honor Roll' with us."

The hospital ranked first in gynecology, ophthalmology and urology; second in AIDS, gastroenterology and rheumatology; third in neurology, cancer, otolaryngology and pediatrics; fourth in orthopedics, pulmonary medicine, endocrinology and geriatrics; fifth in psychiatry and eighth in cardiology. The hospital also ranked 14th in rehabilitation medicine.

In the August issue of Good Housekeeping magazine, eight Hopkins faculty physicians were listed among the nation's "best doctors for women." Those named include Jean Anderson (general obstetrics and gynecology); Edward Trimble and Michael Steller (gynecologic oncology); Karin Blakemore and David Nagey (perinatology); Edward Wallach and Howard Zacur (reproductive endocrinology); and Thomas Elkins (urogynecology).

Hopkins publications earn CASE awards

Several Hopkins publications brought home an array of honors in the 1997 Circle of Excellence Awards sponsored by the Council for Advancement and Support of Education, the most widely recognized campus publications competition in the nation.

In the category of internal audience tabloids, Dome, edited by Mary Ellen Miller, received a gold medal for the second year in a row in a field of 35 entries. Hopkins Medical News, Johns Hopkins Medicine's national alumni magazine, edited by Edith Nichols (with staff members Kate Ledger and Mary Ann Ayd) was awarded a silver medal in a field of 42 entries in the category Special Interest Magazines. It was the only medical magazine to receive an award. And the new "Basic Science Case Statement," a targeted fund-raising brochure designed by Jackie McTear and directed by John Welby, received gold medals in the Individual Fund-Raising Publications category and in the Visual Design in Print, a category with 173 national entries.

The Johns Hopkins Magazine earned a bronze medal in the overall university magazine category, placing it among the top eight university magazines in the country. It also picked up a silver medal in the staff writing category, a silver in the special issues category (for the September 1996 special issue on the senses), and a gold in the best articles category for "Ejner's Hope," a story written by freelance writer Chuck Salter, which appeared in the February 1997 issue.

Why do Americans still have children?

With the costs of raising a child skyrocketing, and more mothers balancing the ever tougher demands of both child-raising and career, why do most American couples continue to have children?

Because they see children as a "status enhancing social resource," say researchers at the School of Public Health's Population Center. While a cost-benefit analysis would show that the costs of raising a child far outweigh the benefit in economic terms, according to Population Dynamics Professor Robert Schoen and colleagues, having a child is a little like owning a car, or a house. Having a child makes people feel more like good, productive citizens. Too, having children is a sure sign of being a successful adult.

In bygone eras, having children, and having a lot of them, served a more utilitarian function. Schoen notes that in traditional agrarian societies people had oodles of children so that they could have more hands to work the land. Also, having a lot of children meant that when parents got old they would have plenty of children and grandchildren to take care of them. Then, there was a clear cost benefit to having lots of kids. Not so now. So, why keep having kids? The answer, say demographers, lies in the threads of society.

"When a child is born, new relationships are established among adults," says Schoen. "These relationships amount to 'social capital.' Links to grandparents are strengthened, ties are created between in-laws. Siblings become aunts and uncles. A couple's children connect them to other couples with children. These are all vital links in one's sense of security."

According to Schoen and fellow demographers, the numbers of men and women who feel that raising a family is "very important" remained steady between 1969 and 1984."

"A child's value as social capital is a crucial factor that motivates childbearing in all societies," says Schoen. "It is especially important in low fertility populations such as the U.S., where 2.3 children is still the norm. People in the U.S. appear to believe that the economic sacrifices for children are unimportant when compared to the social benefits. Once more, they are not concerned about the impact of childbearing on their careers. They believe that parenthood is superior to childlessness."

If the child-as-social-capital scenario seems a little cold-hearted and utilitarian, there is a more sensitive side to it. "Children are not seen as consumer durables," says Schoen to anyone who may have found these conclusions too sterile and business-like. "Children are the threads from which the tapestry of life is woven."

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