Research: Caution flag for Tysabri?

Given that Tysabri will likely be used as long-term therapy, do we know enough about its effects over the long haul?

Expert Opin Pharmacother. 2006 Aug;7(12):1675-8.
Natalizumab in multiple sclerosis: proceed with caution?
Doggrell SA.
Senior Lecturer, School of Science, Charles Darwin University, PO Box 41246, Casuarina, Northern Territory, 0811 Australia. sheila.doggrell@cdu.edu.au.

Multiple sclerosis (MS) is an autoimmune inflammatory demyelinating disease of the CNS. In a Phase II clinical trial, natalizumab was shown to reduce the relapses in patients with relapsing MS, without improving the disability score. After 1-year of Phase III clinical trials, natalizumab was approved by the FDA for use in relapsing MS but was withdrawn 3 months later, due to two reported cases of progressive multifocal leukoencephalopathy (PML). The completed clinical trials with natalizumab for relapsing MS have recently been reported. In a trial of 1171 subjects with relapsing MS, natalizumab alone was shown to reduce the relapse rate and lesions, without causing PML. Although natalizumab was also shown to reduce the relapse rates and lesions in patients taking IFN-beta, two cases of PML with natalizumab occurred in these patients. An assessment of patients who had taken natalizumab for 1 - 2 years (approximately 3000), showed the incidence of PML to be 1/1000. A drug that is useful in relapsing MS will be used as a long-term therapy in large numbers of patients. For instance, in the 3 months that natalizumab was registered, 5000 patients commenced taking it. In the author's opinion, large numbers of patients should not be allowed to take natalizumab until its safety has been monitored in the long-term use in a clinical trial environment. Link.

technorati tag: multiple sclerosis

Journal: Dog days

It was too hot this weekend to fish or to deal with the bees nest in the front yard, my wife was away at a conference, so I spent the weekend indoors, puttering around the house, watching TV, and trying to get our finances in order.

We're going to be doing some serious remodeling: our house's existing 3-season porch, rotting from top to bottom, will be replaced with a 4-season space with lots of glass. It's going to be beautiful; we're really pleased with the design that's been produced for us, and we're very comfortable about the people that will actually do the work. It's expensive, though, and we'll have to throw some more debt on the pile we've already got.

I had a hard time pulling the trigger. After all, it's more money than I make in a year. I spent a lot of time fretting about it, talking to my dad, talking to another contractor, thinking about the future. There have been days lately when I've felt like my days in the work force are numbered. Actually, I almost always feel like my days in the work force are numbered, but some days, the number is smaller. So I'd think things like "Can we afford $X per month if I'm on disability?" and "If we hafta sell the house, how's this going to affect its value?"

Ultimately, though, when I played through the worst-case scenarios, they didn't seem all that bad. Somebody has to do something; we can't do it ourselves; if it's got to be done, it makes sense to do something nice; and it seems like a fair price. And yesterday, when I was pooped out in the recliner in front of the TV, I thought, Well, if I'm gonna be pooped out in the recliner in the future, it would be nice to have something to look at besides the TV.

technorati tag: multiple sclerosis

In the news: The circus peanut

Today's Chicago Trib has an article about the history and chemistry of the circus peanut. I haven't had one for maybe twenty years, but I loved 'em as a kid, especially when they got a little stale and al dente. Then again, I was a little sugar freak, and would eat granulated sugar right out of the ten-pound bag if there was nothing else sugary in the house. I'm a little less sugar-fiendish these days, so I'm not sure circus peanuts would have as much appeal.

Snip:

By all accounts, circus peanuts date to the 1800s when they were a seasonal treat and one of the original penny candies. 'There are few candies that actually have survived as long as circus peanuts,' said Jon H. Prince, owner of wholesale candy retailer www.candyfavorites.com. 'It's not so much candy as it's Americana.'

Spangler, which is celebrating its 100th anniversary and is best known for Dum-Dum lollipops and candy canes, has been producing circus peanuts since the 1930s in northwest Ohio. The candy is the most difficult of the company's products to make, Kerr said, because 'you've got all these variables coming together.' There's little room for error when it comes to cooking temperatures and ingredients -- mainly sugar, gelatin, corn syrup and artificial flavor. The toughest part is getting just the right moisture. Too much will leave a thin, crusty layer on the outside. Too dry and they'll cave inward. Bill Fenter, who has made circus peanuts for 23 years, scurries between mixers checking the temperature gauges and adding ingredients. 'I eat them once in a while,' he said. 'One or two. That's about enough for me.'

The mixture is squirted into starch molds that pull out the moisture and shape the peanut. Next, the candy crystalizes in temperature-controlled rooms for about 24 hours. Link.

Research: Developing longer journal names

For decades, scientists around the world have invested countless hours in the lab developing journals with longer and longer names, creating new branches of existing areas of research and fusing existing disciplines into new, longer names. Recently, the creation of lengthier taxonomies seemed to be stalled. However, scientists are heralding a breakthrough: translating existing names into German has yielded exponential growth. For example:

Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2006 Jul 27
Psychoneuroimmunology. The relationship between stress, immune system and health.Schulz KH, Gold S.
Universitatsklinikum Eppendorf, Transplantationszentrum und Institut fur Medizinische Psychologie, Martinistrasse 52, Gebaude S35, 20246, Hamburg, BRD, khschulz@uke.uni-hamburg.de.

I wonder how "psychoneuroimmunology" translates.
Actually, the abstract is kinda interesting:

Interdisciplinary psychoneuroimmunological (PNI) research increasingly demonstrates clinically relevant interrelations between psychological stressors and the onset or progression of chronic diseases. Disturbances of the bi-directional interaction between the nervous system, the immune system and the endocrine system have been hypothesized to be implicated in several diseases. Here, we review evidence from psychoneuroimmunology within the theoretical framework of allostatic load to conceptualize some of these associations. Interdisciplinary PNI research investigating the importance of psychological stress for the higher incidence of infections, decreased responses to vaccinations and delayed wound healing is reviewed. Furthermore, the literature supporting similar associations with regard to progression of oncological diseases and autoimmune disorders is reviewed with a focus on breast cancer and multiple sclerosis. The accumulating evidence regarding the importance of neuroendocrine-immune interaction in these diseases may thus lead to novel insights into pathogenetic mechanisms and could contribute to the development of novel preventive and therapeutic strategies.

Link.

Journal: A slightly lower angle

This weekend, we went to visit a friend who lives in Milwaukee. I went to law school with him; now he's a junior partner with important clients, a six-figure salary, and (IMHO) a moderate drinking problem. I don't really have any of the first, I certainly don't have the second, and I'm holding the line (IMHO) against the third. While we have less in common than we used to, we still laugh loudly and frequently when we're together, even before the booze comes out.

The nominal purpose of the visit was to see the fabulous Masters of American Comics exhibit at the fabulous Milwaukee Art Museum. The MAM itself is a real show: designed by archi-celeb Santiago Calatrava, it's perched at the edge of lake Michigan like a sort of sailboat-cum-Starship Enterprise. On a sunny day like Sunday, when Lake Michigan has a Mediterranean hue, the building really sings.

The exhibit was a real surprise, especially the Little Nemo cartoons by Winsor McCay. Drawn for the Sunday paper back in the very early 1900s, it depicts the imaginary dream-adventures of a tot in a dream metropolis called Slumberland (not to be confused with the furniture chain of the same name). Amazing!

And I enjoyed it all from the comfort of a wheelchair pushed by my sister-in-law. Which meant my eyeballs were about a foot too low for art-gawking, so at the end of the tour my legs were fresh but my neck was killing me.

This is the first time I've been in the 'chair since a trip through the Cleveland airport a few years ago. I'm still a little twitchy about the 'chair: I don't own one, and I think I'd find it hard to use one in the town where I live. While I understand at an intellectual level that it's good energy policy (don't burn gas if you could save it for something more important/fun), I just haven't gotten there yet; I'm afraid to run into somebody I know and have that uncomfortable conversation where they say, "Oh my God--are you okay? What happened?" Or if they know I've got MS, just plain "Oh my God--are you okay?"

I know that if I were to go to the grocery store and hop in one of those electric scooter carts, it would mean that I could get through a trip to the store without ending up totally discombobulated, that I'd have energy left over for something else. So I look forward to the day when I will be relieved to find that my ego has finally figured out what my feet and legs have been saying for years, and I can finally get on with it.

technorati tag: multiple sclerosis

Journal: Back in the saddle

This morning, I had my MRI (lower spine). The last time I had one was five years ago, and it seems like MRI technology has made great strides since then. It seemed to be over a lot faster (45 minutes?), and the space inside was pleasantly lit and well-ventilated. It's still too loud, though: after the first scan, I asked to have the music in the headphones shut off, because I couldn't really make out any voices or music over the thumpathumpa of the machine.

I have to say, I enjoy getting MRIs. I think I've had 5 now, and I enjoy not only getting nifty pictures (hey, that's my tongue right? it's enormous!) but also the meditative experience of some strictly-enforced quiet time, time for reflection, recollection.

The first time I had a scan, I was 22 years old. I was spending a lazy, beery senior year of college studying in Nottingham, England, sometimes going to class, sometimes going to the pub, sometimes thinking about the sorta serious girlfried I left behind, sometimes thinking about what to do with myself after graduation. After a few months, I found myself at the University hospital getting a spinal tap and a myelogram. A couple months later, my turn for an MRI (no charge, courtesy of the National Health) came up.

It seemed to take longer than I thought it would. I'd brought a CD to listen to, a single by Juliana Hatfield, "Forever Baby" plus a handful of bonus tracks, and they had to replay it several times. I don't remember what I thought about that time; probably about the girlfriend (we got married a couple months later).

This time, I thought about ordinary stuff: the job, the house, the girlfriend who is now my wife. Like the last time, I peed myself a bit. I also thought about the pictures, each one a slice of my midsection, with a round spinal cord near the middle. Any active lesions? Any inactive lesions? And then what? Novantrone? Tysabri?

Then I put my pants back on, and went back to work.

technorati tag: multiple sclerosis

In the news: Medical professionals' conscience rights

WaPo reports on the continuing debate over the right of medical professionals to refuse to perform certain procedures on the basis of moral objections. Snip:

Proponents of a 'right of conscience' for health workers argue that there is nothing more American than protecting citizens from being forced to violate their moral and religious values. Patient advocates and others point to a deep tradition in medicine of healers having an ethical and professional responsibility to put patients first.

The issue is driven by the rise in religious expression and its political prominence in the United States, and by medicine's push into controversial new areas. And it is likely to intensify as doctors start using embryonic stem cells to treat disease, as more states legalize physician-assisted suicide and as other wrenching issues emerge.
Some argue that health workers should not even be required to refer patients elsewhere for care they find objectionable.

"Think about slavery," said physician William Toffler of the Oregon Health and Science University in Portland. "I am a blacksmith and a slave owner asks me to repair the shackles of a slave. Should I have to say, 'I can't do it but there's a blacksmith down the road who will?' "

Others say that professional responsibility trumps personal belief.

"As soon as you become a licensed professional, you take on certain obligations to act like a professional, which means your patients come first," said R. Alta Charo, a bioethicist and lawyer at the University of Wisconsin at Madison. "You are not supposed to use your professional status as a vehicle for cultural conquest." Link.

As a frequent flyer in the world of medical services, count me among those who want our doctors, nurses, pharmacists, therapists, and others to leave their moral objections out of the exam room.

Before joining the legal profession, I had to decide whether I could live with working as an advocate for somebody who did stuff I found morally repugnant. I decided that I'd have a hard time working on behalf of someone who I believed to be guilty of a crime, and that meant I wouldn't be able to fulfill the professional obligations of a criminal defense lawyer. So I don't do that kind of work. But for pretty much everything else, I don't feel guilty by association.

Seems reasonable to expect medical professionals to be similarly responsible for finding work within whatever moral boundaries they have.

Research: Autoject and injection site reactions

After more than a dozen years on one injectable MS drug or another (Betaseron, then Avonex, the Copaxone, then Rebif), my midsection looks like hell: lots of red welts and tender spots. Yuck. Looks like using an Autoject device to administer Betaseron reduces injection site reactions (ISRs), according to this study. If I'm reading this abstract right, your chances of ISRs go down only by about 10% or so with an Autoject.

What's different about using an Autoject gizmo? I've never used one. Seems like the only real different might be increased stability and a straighter path for the needle. Is there something non-Autojectors could do to lessen their odds of ISRs? Here's the abstract:

Rev Neurol (Paris). 2006 Jun;162(6-7):735-40.Related Articles, Links
[Reduction of injection site reactions in multiple sclerosis (MS) patients newly started on interferon beta 1b therapy with two different devices.]
[Article in French]
Brochet B, Lemaire G, Beddiaf A; et l'Epicure Study Group*.
Departement de Neurologie, Federation des Neurosciences Cliniques du CHU de Bordeaux, Hopital Pellegrin, Bordeaux.

OBJECTIVES: To compare occurrence of injection site reactions (ISRs) in patients with relapsing remitting multiple sclerosis (RRMS) newly started on interferon beta 1b (Betaferon), using 3 delivery methods. STUDY DESIGN: A randomized, multicenter, phase IV, open label cross-over study was performed in 82 sites in France on 294 patients with RRMS beginning a treatment with interferon beta 1b. For the first month all patients used a standard injection technique. They then used an autoinjector, Betaject(R) or Betaject(R) Light, for one month each, according to the cross-over design. Primary outcome was defined as the percentage of injections sites with ISR evaluated by the investigator. Secondary endpoints included graduation of ISR, using a five-point scale by both investigators and patients, injection related pain assessed by patients, percentage of patients without ISR and a global evaluation by patients of injection devices. RESULTS: The percentage of ISRs were significantly reduced (p<0.0001) when using either Betaject(R) or Betaject(R) light (24.1 percent and 24.1 percent respectively) compared with the standard technique (35.9 percent). No significant difference was seen between the 2 autoinjectors. The mean ISR intensity scores according to physician or patient were significantly reduced (p<0.0001 for each) by the 2 autoinjectors compared to the standard injection technique. No significant difference on the pain scale comparing respectively the standard, Betaject(R) and Betaject(R) light techniques but the mean level of pain was less than 1.2/10. In addition, the percentage of ISR-free patients was significantly lower with the standard injection technique phase (52.4 percent) than with autoinjector use (respectively 68.1 and 66.7 percent). A non significant higher percentage of patients subjectively preferred Betaject(R) (53.7 percent) than to Betaject(R) light (46.3 percent). The main other adverse events reported were flu-like symptoms (30.7 percent), transient and moderate increase of transaminases (4.8 percent) and headache (4.4 percent). CONCLUSION: We conclude that autoinjector use reduces the occurrence of ISR during IFNB-1b therapy in RRMS. Link.

In the news: Report Assails NY on Program for Disabled

In today's NYT, an article about problems in NY in processing Medicaid claims for DME. Snip:

The situation has improved somewhat since the problems came to light 18 months ago, says the report, which is to be released today. But the report strongly asserts that the underlying problems at the state's Department of Health remain.
The report also supports charges made by patients, doctors, physical therapists and equipment vendors: that ever since the department eliminated the Medicaid office in New York City that handled most of the claims in the state, there have been too few people processing requests, many of those people are not qualified to do the job, and the staff reviewing the requests consistently finds flaws that do not really exist.
....
After the New York City office closed in October 2004 and its functions were moved to Albany, some doctors and therapists who order the equipment said, approvals of equipment requests halted for months, and then resumed at a trickle. For many patients, that meant being trapped in their apartments or using ill-fitting or broken devices.

The Department of Health at first denied that the move had hindered its ability to operate the program. Then it said the Albany office was enforcing rules on documentation that the New York City office had ignored. Then it blamed a flood in the office for the delays. Link.

Journal: Neuro visit, and my trajectory

This morning, I went to see my neurologist for a follow-up. It had been 5 months since my last visit, and during that interval I'd had the whole pain crisis with Lyrica, then no Lyrica, then back on Lyrica. I'd also felt like the fatigue thing had ratcheted up a couple clicks (especially in my trunk), despite taking a "relaxed attitude" towards my work this summer.

After a brief neuro examination (the foot-scratching, skin-poking, tip-toeing, etc.), he decided it might be useful to get a spinal MRI. I love getting new MRI films to look at, and I haven't had an MRI since I peed my pants in an MRI machine in Chicago in 2002, so I'm kinda looking forward to another round.

My neuro also had some interesting suggestions for the pain: if things get worse, maybe go back to the Cymbalta, because while it did cause me to sorta float away in a river of my own pee, it really was effective for the pain. We'd consult with the urologist about increasing or changing meds to deal with the Cymbalta flood effect. But that's a sort of Plan B to keep in the drawer until such time as I start going crazy about the pain again.

Lastly, we touched on switching from Rebif to one of the other disease modifiers. We talked briefly about trying Novantrone, the risks, the all-important timing question (you only get one shot at this, so is this the right time?), and I was pleased about the patient-centricity of the talk. Seems like we might be getting a bit closer to the time to try the Novantrone, and the decision about pulling the trigger is pretty much mine.

We talked about the gradual reductions in the maximum distance I can walk, and about the extent to which I'd be alarmed by further decreases. F'rinstance, what if in a year, my limit went from two or three football fields down to one. Would I be alarmed?

It's hard to get one's head around questions like that. While I'd sure be alarmed if something like that happened overnite, if my limitations continue to evolve slowly, I'm not sure it's time for Novantrone. The changes in function MS hath wrought in me are have been devastating, if you think about them all at once, as compared to one's pre-MS (twenty-year-old) body. But for me, MS has been a lobster-pot disease. The kettle has increased in temperature so gradually over 14 years that it's hard to imagine a point where I wouldn't be able to adapt to another tenth of a degree.

And every change is relative to the day before, not to the very beginning; it's impossible to try to think back to pre-MS. That seems like so long ago: I can't really remember what it was like to play soccer, to walk a mile in the hot sun, to make love with abandon. It would be like some kind of miracle just to go back to last month.

technorati tag: multiple sclerosis

In the news: Chocolate bar for PMS

From WaPo, a story about really clever marketing: it's a bar of rich Swiss chocolate that supposedly contains some stuff to ease PMS. Sounds like a license to print money. Snip:

It's a hunk of chocolate, designed specifically to alleviate the effects of premenstrual syndrome. (More than, say, a Snickers bar already does.) The irritability, the anxiety, the moodiness -- all of it is allegedly soothed by the Wonder Bar, at $3.69 a pop. As it says on the wrapper, 'Take sweet revenge on PMS, menopause & everyday cravings with this delicious Swiss chocolate, rose oil, herbs and soy.'

The concept, which is explained on the inside of the wrapper, is that the Wonder Bar is filled with PMS-fighting ingredients, including pure soy powder, flaxseed and something called Chaste Tree Berry. The latter, we are informed, "was shown to balance hormones." The soy and flaxseed contain "phytoestrogens," which according to the wrapper are similar to human estrogen and help balance hormones, "and thus help relieve the symptoms of PMS and menopause.

Kramer emphasizes that the Wonder Bar isn't touted as a cure-all. Which is wise, because it isn't hard to find doctors who are pretty skeptical that a woman with PMS can snack her way to peace of mind. Chaste Tree Berry has never been proved to work against PMS or menopause in any scientific study, says Edward Lichten, a gynecologist based in Birmingham, Mich., with 35 years of experience. And he adds that while ingredients like soy have been shown to help, you'd need to consume a whole lot of it before you felt any positive effects. Link.

The writer goes on to speculate about a male-oriented product with a similar angle: beer with anti-baldness properties.

Maybe. Or maybe I'll just have a little of that chocolate.

In the news: Zits and milk

Yes, I still get zits. Even at age 35, I get 'em, just like my dad. Even as I write, I'm aware of the subtle throb of from the M & M-sized carbuncle on my right shoulder.

I've always associated my more virulent outbreaks with not getting enough sleep, with high-stress periods, but I knew lots of people thought certain foods could contribute: greasy stuff, chocolate, etc. Turns out diet can be a factor, but it's not pizza that makes you a pizza-face. Snip from the NYT:

Those who drank three or more cups of milk a day, the researchers found, were 22 percent more likely to experience severe acne compared with those who drank one serving a week or less. Skim milk had the greatest effect. Cream cheese and cottage cheese were also associated with outbreaks, while chocolate and greasy foods were not. The researchers attributed the effect to hormones in milk; other studies have had similar findings. Link.

Shoutout: Suggestions

I love seeing what Google searches turn up links to my blog. Yesterday, somebody asked Google what to do to about a dog's "pasty stool." Well, I'm not an expert, but I've got some suggestions:

1. Beat in some egg whites, then bake for 8-10 minutes at 350 degrees. Egg whites will help to add some cohesion without the stool too tough. Just be sure not to overbake.

2. Place the stool on wax paper and freeze for about an hour. This will make it firm enough to slice, but not too hard to work with.

3. Dissolve 1 packet of unflavored gelatin in 2 tablespoons of water over low heat. Whisk the stool into the gelatin and pour into ramekins. Chill for at least 4 hours.

Let me know how things turn out!

In the news: Wisconsin tax check-off for MS

Next year, Wisconsin tax forms will have a new "check-off" box allowing taxpayers to contribute $1 to support multiple sclerosis patients. The money will help modify homes and cars, buy wheelchairs and other equipment, and pay for transportation and respite care. Snip from the Milwaukee Journal-Sentinel:

'All this is a very unfortunate trend,' said Todd Berry, president of the non-profit Wisconsin Taxpayers Alliance and a former state Department of Revenue official. 'It has occurred because full-time professional legislators at the state and federal levels view the tax system as an easy - and almost impossible to oppose - way to give constituents, supporters and interest groups things they want,' Berry said. 'There is virtually no downside risk politically. Taxpayers don't realize that the reason their Wisconsin income tax booklet and form is at least 50 percent longer than it need be, and that they spend hundreds of dollars going to tax practitioners out of fear of the paperwork, is because of all the ornaments added to what has become a Christmas tree of a tax system.'

Berry also said 'virtually no one' participates in the checkoffs. In 2004, only 7% of taxpayers gave $1 to the public campaign fund, and no other cause was supported by more than 1% of all taxpayers, records show. Berry also predicted that the trend will continue. 'Once you get started in this, it becomes harder and harder to rein it in,' he said. 'Everyone has a pet cause.'Link.

As a person with MS, let me say this: Thanks, but no thanks. I agree with Todd Berry's comments about how this is really dumb from a tax policy perspective, and would add that if we really wanted to help people with MS we'd adequately fund Medicaid and figure out a way to ensure that everybody has access to medical care from the whole hospital, not just the emergency room.

I'm not sure if the National MS Society or the Wisconsin chapter took a position on this one, but I'm fascinated by the whole "disease lobby" phenomenon. Advocacy by one Society or Foundation has resulted in little patches of favorable legal treatment for sickies of one stripe or another. Along these lines, I'm interested in the origins of the Medicare provisions that ensure a shorter eligibility waiting period for people with end-stage renal disease (ESRD).

Visual: Flickr image of Chicago building

Thanks, Zech!
technorati tag: multiple sclerosis

In the news: Big PhRMA firms block generics

As a person with a chronic illness, I have a love/hate relationship with the pharmacoindustrial complex. On the one hand, I love the products they've developed to make my life better. Significantly better. I love that they're working on more products to sell me to make my life better still. The problem is, they're businesses that exist to make a buck (well, bazillions of bucks), and sometimes this leads them to be evil. Case in point, from the WaPo:

Some at the FDA, as well as leaders in the generic drug industry, complain that 'citizen petitions' -- requests for agency action that any individual, group or company can file -- are being misused by brand-name drugmakers to stave off generic competition.

The simple act of filing a petition, they say, triggers another round of time-consuming and often redundant reviews of the generics by the FDA, which can take months or years. In the process, consumers continue to pay millions of dollars more for the brand-name drugs. Link.

In the news: Happiness research confirms money can't buy happiness

From today's WaPo, a piece about an article in Science about the reasons why money can't buy happiness:

The journal Science reported last week yet more evidence and another theory about why wealth does not make people happy: "The belief that high income is associated with good mood is widespread but mostly illusory," one of its studies concluded. "People with above-average income . . . are barely happier than others in moment-to-moment experience, tend to be more tense, and do not spend more time in particularly enjoyable activities. The effect of income on life satisfaction seems to be transient. We argue that people exaggerate the contribution of income to happiness because they focus, in part, on conventional achievements when evaluating their lives and the lives of others."

"People grossly exaggerate the impact that higher incomes would have on their subjective well-being," said Alan Krueger, a professor of economics and public affairs at Princeton University and an author of the study. "If you want to know why I think poor people are not that miserable, it is because they are able to enjoy things that Bill Gates has not been able to enjoy, given his schedule at Microsoft," Krueger surmised. Link.

I'm intrigued by the emerging discipline of happiness studies. At some level, studies like this one provoke a "Well, duh" reaction. But really, what if this kind of research could be translated into actual changes in human behavior? What if it somehow trickled into human consciousness? Couldn't it really make a dent in the human condition in a way that all the other sciences can't?

On the other hand, based on personal experience, discovering the reasons why one isn't happier doesn't necessarily lead to changes in behavior. That's a problem behavioral science and neuroscience (and religion?) have been working on for a long time. Even if there is some information to be gained from this kind of research about how to live better, what's it for?

Well, I guess, it's for me. I find it somehow comforting to know that, based on published, peer-reviewed research, winning the lottery wouldn't make me happier in the long term. I find it especially comforting to know that I'm capable, on a biological level, of adapting to pretty much any awfulness Fate tosses at me. If only I could remember this stuff when making the big decisions in my life.

Now, what's the Powerball jackpot up to this week?