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How I Became a Lord

Question: What is the process for becoming a Lord?

Robert Skidelsky: Well, appointed as a Lord, you're right to say that all members of the House of Lords are appointed and they're not elected.  Some have been, some are still hereditary, they sit there by virtue of the fact that their families have sat there in the past.  At one time, they were all appointed.  Well, ideally for outstanding public service and ability to contribute advice to the Queen as required.  It's all done in the name of the Queen.  This is the wonderful, fictional character of the British constitution.  I mean, when I was made a peer, I was made so by the Queen and the Queen, in a way, summoned me to advise her on matters of high policy.  And that is the standard formula that is used and one got a sort of, a wonderful bit of parchment or handwritten, "I, Queen," whatever, and so on.  But she doesn't actually have anything to do with it at all.  I think if she disapproved enormously of someone who it was proposed to make a peer, she could probably stop it.  But I think this would be a very unusual intervention.

Question: What power does the Queen exercise in British politics today?

Robert Skidelsky: No overt power.  But the power of being there and having been there for a long time now, her right to be consulted and to advise, because she has a weekly, usually a weekly meeting with the Prime Minister.  And at that point, she can say, "I'm worried about this or I don't like the way this is going."  The Prime Minister doesn't have to take any notice of that at all, but it's just the authority of being there and being in that position.  She has a few formal powers left, which, some powers of appointment.  But broadly speaking, she's a symbol.  If things, all her powers, in other words, are outsourced.  But if things go very, very badly wrong at any point, the theoretic possibility is they could be in-sourced again.  Now, in Britain, of course, that's almost inconceivable, it hasn't happened for, you know, a couple of hundred years, virtually.  But it's possible that they could be in-sourced again and the Queen's prerogative could be invoked by the Monarch personally if some terrible calamity occurred to the political system.  I think that's as accurately as I can describe it.

Question: What lessons can the history of Britain teach America, if China supersedes us?

Robert Skidelsky: Well, it's going to be a different story because Britain's world power was really based on a territorial empire and it lost that through de-colonization.  America's isn't, really, America's power in the world is based on its economic supremacy and also, I think the attraction of the American way of life and it's economic supremacy allows it to maintain very, very large military forces all around the world.  I mean, as America's economic power shrinks in the world relative to others, as it's bound to, doesn't mean it has to decline absolutely, but relatively speaking, America's role in the world will diminish.  So it's military power relative to others will diminish and so its attractiveness will diminish.

It's a question of how, it's a psychological adjustment, isn't it?  I mean, I feel sometimes Americans feel as though the only position they can possibly occupy is number one and if they're not number one, well, the end of the world has come.  But for many, many centuries, America wasn't number one and it's been number one, you know, relatively, for relatively few years really, since the Second World War.  Less than 100 years.  That's a short time.  I don't think America is doomed to decline quickly.  America is still way ahead of most every other country, really.  And so I think it's premature to talk about the end of the American empire.

But I think America has to be careful now.  It has to try and do more things in partnership with other countries and get other countries to sort of go along with it, more than was usual under the last president.  I think President Obama understands that, he's rhetoric is much better suited, I think, to this phase of American world leadership than was President Bush's rhetoric. 

Recorded on December 16, 2009

Robert Skidelsky appointed to the British Parliament to advise the Queen on matters of high policy, discusses the psychological adjustment America might need to make as it’s superseded by China.

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A new hydrogel might be strong enough for knee replacements

Duke University researchers might have solved a half-century old problem.

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  • Duke University researchers created a hydrogel that appears to be as strong and flexible as human cartilage.
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Hints of the 4th dimension have been detected by physicists

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Physicists have understood at least theoretically, that there may be higher dimensions, besides our normal three. The first clue came in 1905 when Einstein developed his theory of special relativity. Of course, by dimensions we’re talking about length, width, and height. Generally speaking, when we talk about a fourth dimension, it’s considered space-time. But here, physicists mean a spatial dimension beyond the normal three, not a parallel universe, as such dimensions are mistaken for in popular sci-fi shows.

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Predicting PTSD symptoms becomes possible with a new test

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Image source: camillo jimenez/Unsplash
Technology & Innovation
  • 10-15% of people visiting emergency rooms eventually develop symptoms of long-lasting PTSD.
  • Early treatment is available but there's been no way to tell who needs it.
  • Using clinical data already being collected, machine learning can identify who's at risk.

The psychological scars a traumatic experience can leave behind may have a more profound effect on a person than the original traumatic experience. Long after an acute emergency is resolved, victims of post-traumatic stress disorder (PTSD) continue to suffer its consequences.

In the U.S. some 30 million patients are annually treated in emergency departments (EDs) for a range of traumatic injuries. Add to that urgent admissions to the ED with the onset of COVID-19 symptoms. Health experts predict that some 10 percent to 15 percent of these people will develop long-lasting PTSD within a year of the initial incident. While there are interventions that can help individuals avoid PTSD, there's been no reliable way to identify those most likely to need it.

That may now have changed. A multi-disciplinary team of researchers has developed a method for predicting who is most likely to develop PTSD after a traumatic emergency-room experience. Their study is published in the journal Nature Medicine.

70 data points and machine learning

nurse wrapping patient's arm

Image source: Creators Collective/Unsplash

Study lead author Katharina Schultebraucks of Columbia University's Department Vagelos College of Physicians and Surgeons says:

"For many trauma patients, the ED visit is often their sole contact with the health care system. The time immediately after a traumatic injury is a critical window for identifying people at risk for PTSD and arranging appropriate follow-up treatment. The earlier we can treat those at risk, the better the likely outcomes."

The new PTSD test uses machine learning and 70 clinical data points plus a clinical stress-level assessment to develop a PTSD score for an individual that identifies their risk of acquiring the condition.

Among the 70 data points are stress hormone levels, inflammatory signals, high blood pressure, and an anxiety-level assessment. Says Schultebraucks, "We selected measures that are routinely collected in the ED and logged in the electronic medical record, plus answers to a few short questions about the psychological stress response. The idea was to create a tool that would be universally available and would add little burden to ED personnel."

Researchers used data from adult trauma survivors in Atlanta, Georgia (377 individuals) and New York City (221 individuals) to test their system.

Of this cohort, 90 percent of those predicted to be at high risk developed long-lasting PTSD symptoms within a year of the initial traumatic event — just 5 percent of people who never developed PTSD symptoms had been erroneously identified as being at risk.

On the other side of the coin, 29 percent of individuals were 'false negatives," tagged by the algorithm as not being at risk of PTSD, but then developing symptoms.

Going forward

person leaning their head on another's shoulder

Image source: Külli Kittus/Unsplash

Schultebraucks looks forward to more testing as the researchers continue to refine their algorithm and to instill confidence in the approach among ED clinicians: "Because previous models for predicting PTSD risk have not been validated in independent samples like our model, they haven't been adopted in clinical practice." She expects that, "Testing and validation of our model in larger samples will be necessary for the algorithm to be ready-to-use in the general population."

"Currently only 7% of level-1 trauma centers routinely screen for PTSD," notes Schultebraucks. "We hope that the algorithm will provide ED clinicians with a rapid, automatic readout that they could use for discharge planning and the prevention of PTSD." She envisions the algorithm being implemented in the future as a feature of electronic medical records.

The researchers also plan to test their algorithm at predicting PTSD in people whose traumatic experiences come in the form of health events such as heart attacks and strokes, as opposed to visits to the emergency department.