Imagine working at a construction site and moving all the material from the car up a hill. It is difficult enough, and the day is still long. So when the foreman saw her park there, he had no idea that his day would get much better. This woman would soon regret parking there. After all, she deserved all the trouble she got herself into. This is what you get when you are rude and condescending. Here is how it all started. The construction worker was the foreman of a new project. He had to build a house on top of a hill, and the path towards the house was 250 feet. This meant bringing the supplies was difficult, and it had to be done by hand. Indeed, this was quite a complicated project. Not only building a house requires a lot of effort, but also carrying all the materials up a hill with your bare hands is a tough task. Thankfully, the workers had two parking spots at the bottom of the hill. These two parking spots were reserved for the constructors, so two no parking signs were installed to make sure the spots were always clear for the trucks that brought materials. But there were some issues. Close to the construction site, there was an elementary school, and ever since the workers had begun the project, they found a lot of cars parked illegally. But this wasn't as shocking as the mom who parked there on a fateful day. Whenever people parked there, waiting for their kids to finish their last class, the workers didn't bother them because they didn't need the space. And if they needed the space, they politely asked to move. Usually, they did. On the days when materials had to be delivered, the foreman had to make sure the parking spots were free. But on that day, there was a car parked there, on one of the spots. What happens next should definitely be part of a movie. There was a woman there, probably waiting for her kid to show up from school. He was getting ready to explain that she was parked illegally. He approached her and that's when things got out of hand. I get a phone call from the lumber delivery truck that is en route to our location, he says he'll be there in about two or three minutes, said the foreman in a Reddit post that went viral. So the woman parked in that spot had to leave really fast. Instead, she has a different attitude. That day, the truck was bringing lumber to frame the roof of the house, so it was quite a lot of material. It would have taken around an hour to unload, and he needed to park there so that it wouldn't have to be parked right in the middle of the street. With that in mind, the foreman had to tell the woman parked there that she is illegally parked, and she has to clear the spot for a truck that has to deliver materials.  The giant lumber truck was just turning around the corner, so before he could process and respond to her rude remark, the foreman looks at the truck driver and turns back to the woman's car. She had put her window back and was ignoring him. I put on my best customer service smile and wave at her through the window, she put it down halfway and angrily shouts what. The foreman tries to be polite, and with a stronger voice, he tells her to move the car. Then she has the brightest idea ever. Can't you guys just unload around me? Jesus, it's not that hard, she said dismissively. Shocked by her rudeness, he takes note of what she recommended and plans his revenge. I give her another smile and walk away, a brilliant plan forming in my head, he wrote on Reddit. I instruct the delivery driver to park as closely to her as possible and block her in with the porta potty that is at one end of our reserve spots and the parked car that is parked just adjacent to our spots on the other end, wrote the foreman. She doesn't get it first, but a few minutes later she realizes that she was actually stuck. The woman was busy and not paying attention to the construction workers, so it took her a while to see that she wasn't able to get out of there. The foreman had one more thing to do now that the plan was put into action. We unstrap the lumber and my guys begin humping material up the hill, meanwhile I call the police parking enforcement to let them know the situation, explained the Redditor. He added that his intention was to make sure he won't get in trouble for blocking the street. So the police told him they'd be there in 30 minutes.  As we continue to unload lumber the child of the parent shows up, and wouldn't you know what mom is just now realizing that the lumber truck is parked so close she can't get out of her driver door to meet her kid, added the foreman. She manages to get out of the car through the passenger door and glares at the foreman. After loading the kid in the car she stormed at the workers and said I'm in a big hurry, you need to move your damn truck right now so I can go. But he doesn't have time to respond because the truck driver decides to intervene. The truck driver is quick to reply that this is not possible. Ma'am in order to unload the lumber on the truck we had to unstrap it, and per our company policy I'm not allowed to move the truck with any unsecured load on it. Sorry. Of course she had a fit of rage, but soon enough the police officer comes and is shocked to see the entire scene. This sends her into near aneurysm levels of blood pressure, meanwhile I can barely contain my laughter, recalls the foreman. FK your policy I have somewhere to be, yelled the woman at driver. Meanwhile, the traffic officer was just parking her car behind the truck. The foreman saw the police officer getting outside her vehicle and told the enraged mom can't you just pull out around it? It's not that hard, giving her a taste of her own medicine. To his amazement, the woman gets back inside the car before swearing at him and starts the car. Before the police officer could be able to introduce herself to the culprit, the mom slams her car into reverse, crashes into the porta potty, knocks it over, and then tries to mount the curb and drive on the sidewalk. Imagine the face of the officer and the workers. The officer, driver and I are staring in disbelief as she gets halfway over the curb and gets stuck. I can hear her screaming obscenities over the idling truck from inside her car, said the foreman. But the mom had no idea she was being watched by the police officer. She gets slapped in cuffs as the parking officer calls for a second unit and she is promptly sat on the very curb she tried to drive over, he recalled in the long reddit story. But then, she starts to lie to the officer about the whole thing. Having seen enough, the officer approaches the car and orders the mom to go out of the car. My favorite part of the entire thing is watching her face go to shock as she realized she just did all of that in front of a police officer. So what happened next? She was in trouble and only did it worse when she decided to turn this problem in her favor. She told the officer that she wasn't told to move and tried to blame the workers. The mom didn't know that the officer was already informed on the situation. By the end of the ordeal she was arrested, charged with child endangerment, her kid was in the back of the car the whole time, reckless driving, destruction of property, the porta potty, said the foreman. But that wasn't the only offense. This mad woman was actually driving on a suspended license. On top of all that she also got her car towed, the kid went home with his grandma and she went to spend some quality time in a cell. The foreman concluded his story. People couldn't believe how many wrong decisions can a person make in less than a half an hour. One person was not even amazed that this woman already had her license suspended. Others agreed that it was a long story, but it was worth reading it. I never expected her to actually heed my advice to just pull out around it. Well this should be a lesson for her not to park in a tow zone. That is if she ever gets back her license.


Our next panel is about exactly the subject. We're calling it the death of Till Death Do Us Part, with a question mark at the end. And it's going to look at the impact of extended human life and health on family and social relationships. Our moderator is Liza Mundy, who is the director of the New America Foundation's Work and Family program, which seeks to reframe the conversation to reflect the enormous changes that have taken place within families, workplaces, and the lives of men and women over the past several decades. Liza is one of the foremost journalists writing about family, gender, and work issues. She's written for publications, including The Atlantic, Time, The New Republic, Slate, of course, Mother Jones, and lots of others. And like Joel, she was a staff writer for The Washington Post. And she's the author of the excellent book, The Richer Sex, How the New Majority of Female Breadwinners is Transforming Sex, Love, and Family. And Liza is going to introduce the panel there. Thank you so much. It's great to be here. I'm really excited about this conversation. I'll introduce our panelists. We are really fortunate to have two great discussants of how technology and longevity are going to affect our personal lives and our relationships. We have Sonya Erison, who is a technology analyst and author of the National Best Seller 100 Plus, how the coming age of longevity will change everything from careers and relationships to family and faith. And if you all want to come up and take these two chairs, I think I'll sit in this one. And she's based in San Francisco, where she's been director of the Technology Studies Department at the Pacific Research Institute. She's a founder, academic advisor, and trustee at Singularity University. She's focused on exponentially growing technologies and their impact on society. Her work has appeared in The Wall Street Journal, The Economist, MSNBC, and The Today Show. And we're also fortunate to have Chris Hackler, who is the recently retired director of the Division of Medical Humanities at the University of Arkansas for Medical Sciences College of Medicine. For more than a decade, he was a Woodrow Wilson visiting fellow of the Council of Independent Colleges and lectured at medical schools and college campuses around the country and abroad. He's written books and articles on end-of-life decisions and on rationing and healthcare reform in the context of an aging population. He's currently working on social issues in the use of genetic and reproductive technologies. So we will get started with what we hope will be an invigorating conversation and we will open it up to questions after about 30 minutes unless we start to flag and then we'll open it up sooner. And as Jacob said, I'm a former staff writer for The Washington Post and I wanted just very briefly to kind of frame our conversation. One of the first stories that, one of the first articles that came to mind thinking about this topic is a piece I did a couple of years ago for The Washington Post Magazine looking at a situation, a man in this area named Dave Kendall, a wonderful man, a federal worker, ordinary, living in the suburbs. His wife was diagnosed in her late 40s with Huntington's disease, which as I'm sure you know is a degenerative neurological disease, something that he was only about 50, it came as obviously a great surprise to both of them. When I got to know him a couple of years into their ordeal, he was taking extraordinarily good care of his wife Diana in their home in the Virginia suburbs. He had, he works with his hands, he had set up sort of amazing systems in his home to transport her as her mobility declined. So it's interesting because we talk about the death of Till Death Do Us Part. He had a very, very strong conviction about marriage and about marital caregiving and it was his very strong view and he lived it until her end, that they were in it until Death Do Us Part and that it was his job to be her caregiver and her caretaker and there is no question, although she is no longer alive, that he extended through his caregiving her longevity. So we can talk about technology and robots and everything and that's all great but human caregiving in terms of extending our lifespan and the quality of our life is something that we can't forget about. So people, every day he got up and went to his federal job, he's probably furloughed right now, but then he came home every night to a second shift in which he was taking really inspirational and extraordinarily care of his wife and extending her lifespan and extending for him the situation that he was living in. So that's one story that I thought about that had a lot of personal meaning for me. In my own life, my mother who is 79 and just the other day, she lives in Richmond, she called Eric Cantor to fuss at him because she's, well, his office because she's worried about us. She married for the second time in her life at 78 to another 78 year old man and it has been an extraordinary blessing in our family to see the happiness and the companionship and the mutual caregiving that they have enjoyed together and there's no question again in my mind that through their tending, loving tending of each other that they will also have an impact, I hope on each other's longevity and live long and prosper is the hope of them and everybody in our family. So this subject has a lot of personal meaning for me and just the final sort of intellectual framework, I would think of when we talk about why we're living longer, there are all sorts of technological reasons but there's also an interesting theory called the grandmother hypothesis that also relates to this, which is that when evolutionary biologists and anthropologists think about why do women live past menopause? Why do women live past their reproductive years and their ability to have children? One of the answers to this mystery is what they call the grandmother hypothesis, which is again that one reason we live longer as a species is because we have grandmothers who can take care of the children while the parents are out there foraging for nuts and berries or hunting or whatever, that the grandmothers are taking care of the children and extending their longevity and that long-lived women who thereby enable their daughters and daughters-in-law to have lots of children will pass along their genes. So both sort of genetically and through their caregiving, grandmothers have had a major influence on extending the human lifespan. So I guess I would just like to keep in mind the importance of social relationships, companionship and caregiving, both at the beginning of life in terms of caring for children, but as we live into our hundreds, what are gonna be the marriage patterns? I mean, we're in a society now where people in their 30s increasingly aren't getting married, people who are having children increasingly aren't getting married. So like, my mom, is she an outlier? What are they gonna be the patterns that emerge as people live? How are we gonna ensure that these people who have cared for us and extended our lifespans and eventually ourselves are gonna continue to have the human companionship and the caregiving that will make their lives happy as they get old? So let's start with Sonia. Where are we going? How are we gonna ensure that people could continue to have companionship and as they move into these, Gloria? I think it depends on what scenario we're talking about. And I think that was really useful, Joel, that you had those four different scenarios up there. In my book, 100 plus, I take a look at the scenario C, basically. What happens when human beings can roughly double their life expectancy? Again, it's already been done. And not just life expectancy, but like you say, health expectancy. People are healthy for longer periods of time. How does that change the world? And that's essentially what my book looks at. And I have a chapter on a family where it's like I take a look at how, I go back in time and say, what happened the last time we roughly doubled life expectancy? Well, what happened is age at first marriage went up. Age at first birth went up. But it hasn't gone up as much as you would expect. So in 1950, age at first marriage was around 20 for women. Today it's around 27. So it's gone up about seven years. And longevity has gone up quite a bit since then. I mean, in 1943, sorry, in 1950, I'm trying to get my longevity numbers here. I feel like there's too many numbers going around in my head. That's my question. So we've gone essentially from 43 years to 80 years. So we've roughly doubled life expectancy. But you think that age at first marriage will go up higher and you think that people would have children later, but it hasn't as much as you would expect. And I think the reason for that is because of fertility has stayed stuck, right? I mean, even with IVF, women are having children later, but not, you know, there's still this point at, you know, between 40 and 50 where fertility really starts to tank. And by 50 it's over if you want to have your own biological children.  And so the question really is what happens to fertility over the long run, I think. And, you know, if fertility can be extended, then age at first marriage is really gonna pop up quite a bit. But what has gone up is unmarriage. Yes, right, yes. Almost a straight line parallel with the increase in the average lifespan over the last 100 or 150 years has gone the rate of divorce. And since 1990, the rate of divorce of people over 50 has doubled. And so that's, I think, what we really need to deal with at this point. Not so much the age at which we get married, but how long we stay married. And that's the real difficulty that I see because why are people getting divorced more?  And if we live to be 150, how many people in this room would wanna stay married for 100 years? I mean, it's really, you know, now we don't wanna say that to our wives who are sitting next to us or our husbands, but in the general population, that's gonna be a real problem. And Sonya, you've really dealt with that, haven't you? And you've talked a little bit about remarriage. Sure, yeah. I mean, you can expect this, I think, in the future to see much more serial relationships, marriages, divorces, or even not getting married and just having a whole bunch of serial relationships much more than we see today. So serial cohabitation into, once, hundreds. Right, and then if fertility pops up where women can have children post-50, you can imagine the different family types as well where a woman might have a child in her late 20s and then have another one in her 60s and have different types of families and the extended family looks a lot different in that scenario. But you know, your first story was so important, I think, to frame the discussion because here's a relationship that is enduring past infirmity and real difficulty and it's so important to those two people. And we can talk about, well, serial relationships and you have a contract for 30 years or 25 years and move on, but that's difficult. I mean, it's not as easy as it sounds. Not as easy as it sounds, yeah. These are intimate, important relationships and it's important that we have these relationships. And I'm not sure if it would be the same thing to be married for 30 years and to go into it knowing that in 30 years you're gonna be choosing somebody else or having to decide whether to stay with this or go, and these are humanly difficult kinds of concerns that I'm not sure how we're going to. Right, and actually, with this wonderful man, Dave Kendall, we had this conversation because, I mean, as people are able to live longer with chronic illnesses, this is the marital caregiving is becoming more common and it was his absolute conviction that he was in it. But there are actually support groups for people who are in these long-term care of giving situations and I think most of the people in his support group felt, you know, actually when you're in an acute situation like this, having a relationship on the side is okay. That wasn't his view. His view was I married to her until death to his part. I think he departed actually from a lot of the people he was in a support group with about sort of what is the marital contract mean when one person is as infirm as his wife was. You know, you brought up the idea that if we lived to be 150, we could have children generations apart and that really is gonna change what the family looks like. Currently, it's pretty rare to have five generations alive at the same time. I know in my own family, a young cousin, four times removed, I guess, has a great, great grandmother. So I thought four generations. But when you extend that a little bit further, the family tree begins to look really top-heavy. I mean, if you have four generations, you have what, 16, 32 great, great, great grandparents and then one more generation, you have 64. And so this family tree looks like this. And what do you do when, no, you need to send out graduation announcements or, I mean, we're gonna need a new set of etiquette books to be able to resolve these problems of how we bring people together, who we bring together, who's part of the family and who's not part of the family. And just one more point. I think the further we get in age from those who came before us, the less intimacy there is in those relationships. I mean, how you relate to your great, great, great grandmother is really gonna be different from how you relate to your grandmother. And this is all new stuff for us. So we think of the human pattern of descendants as being sort of, you know, we're descended from a common ancestor and then it goes like this. But you're talking about a situation where it's like this. Yeah, you have a young person here with two parents and each of those has two and each of those has two and it goes up exponentially and it's not long. I think six generations and you have 64 great, great, great grandparents. Right, right. I mean, I can see how that plays out in my own family. I mean, I have younger half siblings, but now with my mother's remarriage, my daughter was talking to me yesterday and she made, she said something about your sister. And I thought, what are you talking about? What sister are you talking about? And she meant the adult children of my stepfather some of whom we've met, not all of whom we've met. And it is, I mean, on the one hand, it's wonderful. We really like this family. But it is a whole new set of relationships to navigate. So as we potentially, you know, as we have this really long adult period of our life and then sort of the super adult period, yeah, we can move through serial relationships, but it does, we end up with a horizontal family that can grow and then the family is growing vertically as well. And it is a lot to navigate. If we have three or four marriages and we have children with each of those, I mean, if we slow the rate of human aging so that we live longer, I guess the period of fertility would last longer, although we don't know for sure. But it's possible to have brothers and sisters from three or four different marriages. And what is that relationship gonna be like? The sibling relationship is, especially when you spread them apart by 60 years or so it's gonna be very, very different. Right. You know, it struck me actually also coming in that we haven't had, there was a period in the sort of mid-oughts where we were having a lot of world's oldest mother news stories.  And it's been kind of quiet on the world's oldest mother front for a while. It's a good thought. And I'm not sure why that is. There are always a couple of fertility doctors, rogue fertility doctors who are willing to really push it. And I actually, I actually wrote about reproductive technologies and one of my first book, and it was really an extraordinary thing. I mean, in the realm of reproductive technology, doctors really were winging it. And I mean, one of the case studies that was so shocking was they were really not sure whether you could bring a woman out of menopause by giving her hormones and then using egg donation. And they really didn't know, they were like, let's try it. And so they did. And one of the case studies I read that was shocking was quadruplets in a 54-year-old mother. And that was a case where selective reduction was used at least to create a more manageable pregnancy for a woman in her mid-50s. And the way in which the fertility industry has pushed that and been willing to sort of wing it and experimentally see what's possible was leading to these cases of 72-year-old mother of twins. And yet, and I'm not quite sure why this is. We just, I'm waiting for a new one to kind of, maybe we reached our limit with, I don't know what the upper age was. I don't remember if it was 68 or 72, but maybe we've sort of pushed that as far as we can. Or maybe it doesn't really seem that interesting anymore and it's sort of happening and it's not being reported on all that much. Maybe, maybe, yeah. And there are consequences.  And then you do have cases of children who become sort of marooned and potentially parentless. Yeah, well Carmen Boussada, she was sort of one of the first older mothers who had, she was in Spain who had twins at 66, which seemed really quite old until the 70-year-old came along. And her mother lived past 100 and so she thought she was going to too. Two years after she had those twins, she died of stomach cancer. So it doesn't always quite work out. She was a little ahead of her time. Right, right. But again, I guess I do wonder sort of in terms of social policy, what we do, I mean, we have countries like Japan where you have traditionally, when a woman married, it was the expectation that she would become the sort of caregiver, not only for her husband, but for her extended family. And so in countries in traditional societies like that, you've had these aging populations, you have women who no longer wanna enter into that marriage contract because they don't wanna have the responsibility for taking care of extended generations. We don't necessarily have those expectations in our society, but how is it gonna play out as people, not only in terms of marriage, but just as people get old, I mean, it's great to think that they're gonna be able to spit into something and extend their own lifespans, but they're going to need to be cared for and are we gonna have institutional care or are we gonna have family-based care and how are we gonna manage that? How are we gonna get ourselves where do we wanna be? I know one of my biggest concerns as I'm now just retiring and facing older age is toward the end of life who's gonna take care of me. Fortunately, I have a younger wife so she can do that very good while. But yeah, but I think that as there are more people without people to help take care of them, our institutions will have to develop. I mean, assisted living is sort of a new industry now and it's been a great move from my own father who just died at 95 a few months ago. And so I think the private sector will develop new institutions to help take care of people. It'll have to be done. So that's what it's gonna be. It's gonna be the private sector assisted living facilities. It would be nice if we could have 100-year marriages where people would continue to take but I don't think that's gonna happen. It seems a fantasy. It all depends on what the scenario looks like. I mean, I feel like we're popping back and forth between different scenarios.  You don't need a caregiver at that point. But if you're looking at different scenario like scenario B or A, then caregivers are really important. And so, you know, which scenario is it? And you know, we're thinking about radically extending the lifespan. If we would do that, I would think by slowing down the rate of human aging and also what's telling us about what causes aging and how to slow it down is also telling us what causes age-related diseases. And so if we live to be 150, excuse me, it's not that we'll just keep getting older and more frail and sicker and sicker. We'll be healthy for most of that time. At least that's the hope. And it does depend on what technology allows human beings to live longer and healthier lives, right? I mean, even if we buy into scenario C, how does it happen and how quickly does it happen? I mean, the gold standard, I mean, the best way to do that would be to slow down aging, maybe through some genetic tweak. But that's a long way off.  So somebody has a heart disease, today we manage it through pharmaceuticals and lifestyle and all that kind of thing. I mean, the future scientists, and this really isn't that far off, we'll be able to grow brand new heart parts or an entire new heart for somebody. And then they're just repaired. And so that fixes the heart, but then they keep living and then maybe they go Alzheimer's. And then, so, and will we be at the point where we can also fix our brain right away? Unclear. So it kind of depends on which technology you win and how quickly it happens, right? The thing that I keep thinking though is that if we're looking at people who are paired and we're presumably a pair of bonding species, one person might be healthy. You're gonna be really lucky if you both track on as healthy as each other going forward. But I still think there's always gonna be a scenario if you're in a relationship where one person might be healthier than the other person and they're gonna be caring or the families, somebody's gonna have to be taking you to these heart replacement appointments. It's never gonna be something I think that you're doing on your own. So why don't we go ahead and open it up to questions because I suspect that there will be quite a few. Okay, you had the first hand on? Oh, is there, there's a mic coming around. Sorry, I thought there was. Hello, I'm Dale Doucette. I live in DuPont Circle. I'm 82 years old. I went to an internment at my church, St. Mark's Capitol Hill last week and we interned one of my ex-girlfriends. And it ended up that she had had three husbands. I did not know that when I dated her. And all three showed up. And I thought this was a real good sociological study because she had three sons who did very well from the first husband. She had three more children from her second. And each of her ex-husbands had gone on and remarried and had families. And I was thinking, this was a large internment. There were a lot of people there that had never met each other. And they got along beautifully. And so I asked two of the husbands because one sat on one side of me and one sat on the other side of me. And they liked each other and they said what a great person she was. And I was thinking, this is the new world we live in. But you talk about multiples. When you take her children, her ex's children and their children, you got an enormous number of grandchildren from her. I can't remember, it's like 16 or 18 and her great-grandchildren jump to us astronomical figure. So that's the new world we live in. And what age did she die? What age was she when she died? In her 70. I'm sorry? So I think that's gonna become the norm. And who your relatives are is gonna become an extremely complicated because we were trying to figure out how do you explain relatives? And there are no terms out there. Exactly. For this. We don't have a lot of ideas. The Emily Post. The other thing which was more important is I live in DuPont Circle. I am president of the board of directors of an organization that puts DuPont Circle together. And one of the organizations in DuPont Circle is called The Village. Now let me just, before I explain this, how many people know what a village is? That's pretty good because you talked about going to these retirement homes. This is a concept that's going to, I think in the long run, replace that. So you got a whole new concept to start thinking about. A village is you stay in your home. You get the same services that you get at a retirement home.  And you keep the same friendships. And those friendships are really, really, really important. And it gives a whole new concept of aging in place. Right. That's a great comment. I'm gonna just say my undergraduate college has just finished building a village that has all those advantages you just talked about. Plus a college, a vibrant college across the street where people can go and sit in on courses and keep alive. I think it's a wonderful idea. Sonia, did you have a comment also in response to this? Well, I loved your comment about how there were so many different husbands and different people and that really is the beginning of the future. And you're 82, it's funny, because normally when I go around and give talks on my book, I like to ask the audience how long they think they wanna live. Life expectancy in America is generally around 80 years. Would you, who here wants to live to 80 years? We know you wanna live longer, right? And who wants to live to 150? Or indefinitely. 100, yes. Yeah, so it's interesting, because usually if we hadn't had an 82-year-old speak, a lot of people say, oh yeah, 80 years sounds good. Until we're thinking out. Yeah, at least 100. Yeah. So next question, the gentleman here. Go get the mic. Oh, I'm sorry. Yes, right here, sorry. Good morning, I'm John Rother. I've spent a lot of time working at ARP. So two facts and a observation. Fact number one is most people who will need support in old age are widows. And we can't really look to the spouses for them. The men may be more fortunate, particularly if you have a younger, healthier spouse, but statistically we're talking about widows. Second observation is that the studies I've been familiar with that look at quality of life and length of life show, unfortunately, that spousal caregiving is a major risk factor for shortening your life. The stress is huge. And the lack of support from policy. So my observation is people who are going to increasingly be facing this need alone are going to have to look to their communities and to public policy, not just their families, for all of the reasons we've been talking about. Right, right, thank you. Question, do you wanna pick somebody from the back? Good morning, I'm Alan Abel from the Toronto National Post. Once I asked John Smart, who was one of the founders of the idea of the singularity of a computer whose processing speed exceeds that of a human brain, how do you think supercomputers will deal with us? And he said, we'll be their houseplants. My thought is what you would think, why would we think, if you extrapolate how dependent we are now on our phones, on Facebook, on art technology, think of a six year old with his handheld video games, why assume that we'll need human companionship at all? If you look at the New York Times magazine story a couple of weeks ago about the new poker machines that virtually can replicate any scenario of a human interaction over a hand of poker, why not assume that Google will take care of that also? Why I think there'll be any need for that. So there'll be something to hold you or somebody to hold your hand. There'll be something which can speak and interact and have memories and all that. Why not assume no need for human interaction? Okay. So I think John Smart probably made that comment assuming that computing power would become more intelligent without our input. And I'm not sure that that's really an accurate way of viewing the future.  It gets created because we need it because there's a use for it and we want it. Now John Smart might say something like, well at some point computers will just get so smart that they'll start developing themselves and we'll be out of the equation and you can talk about that. But I mean I don't think that's anywhere in the near future and before we get there, we're gonna get to living to 150 before we get to his scenario. And the technology that we develop is gonna be technology that we want that keeps us healthier longer and that integrates with our lives. And in that sense, nothing will change from the perspective of we do like companionship and we like to be around other people. So Chris, what do you think? I mean, are we gonna get to a point where all these widows, they're gonna be able to play, you know, solitaire, I mean they're gonna be able to play Scrabble with other widows and so it's gonna or poker or whatever and so the social networking is gonna actually solve this need for human companionship later on. Well, we certainly need human companionship in addition to our computers and I think we always will. And I wouldn't say it has to be between men and women. I mean any human, close human intimate relationship is very important. I don't know if I answered you correctly. Well, the question is, will we be able to get it through our computers? So we won't need to have the proximity in it. That raises an old philosophical issue about the, could artificial intelligence have emotions as well as intelligence and I can't read anything really to that. It's a big literature about that. Okay. How about up here at the front? Sorry, I'm making you walk back and forth. I'm trying to be. Hello, I'm William Angel and given, if we look at scenario C where over the next 17 to 20 years, life expectancy jumps between 60 and 80 years, do you think that that rapid increase in growth would not affect the current trend of delayed marriage? Or do you think that it would, that sudden increase more so than the quarter of a year we've had for a long time, do you think that that would drastically change the current trend of delayed marriage? I think what will happen, I mean, it does depend on how quickly people start to live longer and healthier lives, right? I mean, if it comes on really fast, I think people won't know what to do right away and they'll keep following whatever patterns they're following. You know, I think in the, what it really means in the future is that we're gonna have a lot more diversity in relationships and in, you know, when people get married. I mean, they'll, even when it's established that people can live to 150 in a healthy state, there's still going to be people who get married at 20 and then divorce at 25 and keep going, right? I mean, they'll just have more time to do that. But then they'll also be the people, I think probably a more general trend because what we've seen in the past is age of first marriage keeps going up. Probably it'll, instead of being 27, it'll pop up to, you know, 35 maybe, something like that and keep growing. And I think age of first marriage will continue to increase for sure. Especially if fertility, I think it's really linked to fertility because a lot of women feel pressure to get married and have kids so they can meet that 40 year mark. And I'm speaking for personal experience here. Although increasingly we have egg freezing and sperm donation in ways that women can push it. You can push it, but not your own biological kids.  Yes, but egg freezing doesn't work very well because eggs have a high water content and when it frees it breaks. They don't freeze well. The cellar with embryos can be done. There is new technology now where scientists can freeze pieces of ovarian tissue.  And we've always known that. The problem that scientists had after that is how do you get these immature eggs that are in the ovarian tissue?  And that breakthrough actually happened a couple of years ago. And it's now we're at the point. Under the skin so that they can be. Yes, right. It can be. And in fact, anyway, there was just a news hit a couple of months ago. So ovarian tissue, if you take it out and then re-implant it within the woman, the eggs mature on their own just naturally. But it was always thought that you had to put it back like where the ovaries were. But just like a month ago or something, it was, they took that tissue and implanted it just in the stomach. And it still worked. So biology is sort of magical that way. And then you can solve your work-life balance problems because you can go ahead and work and then you can have your children when you're retiring and then the whole concept of well, not, I mean. You know what, this kind of technology brings up an issue that we haven't talked about yet and that a few people have mentioned to me when I talk about this technology is, you know, baby factories. If you can take out immature eggs, and that's a crazy kind of term, but if you can take out immature eggs and mature them in the lab, which is possible, then maybe you can just like create the whole thing outside of someone's body and then women don't have to be responsible for it anymore. I mean, that would change a lot. You could even have a deceased father, sperm donor, and have a deceased mother who has donated the eggs and have a baby born and incubated in a little box they're being developed so that the baby can be, so that it can be incubated outside the body and have a baby born with no father and no mother. Have we done something good or not? Question, I'm sorry, you've had your hand up for quite some time, right here in the, yes, in the Ova College, yes. Hi, thank you, Don Kaley. You've talked a lot about the quantitative regarding marriage, but my question is about the qualitative. It seems to me that when we were agrarian and early industrial, it was really an economic institution. It was something that we relied on for our own longevity. It's shifted in the last 50 years, you could tell me better than I know, into more an emotional institution where people do it for pleasure or for their enjoyment. Is it gonna shift again to something different than that or is that going to mature in a way that we haven't been able to observe yet? I'm just curious about your thoughts. Thank you. I think you're right that the reason for getting married has changed. It used to be a religious commitment or a social or a family kind of thing to bring families together and property, right? Now it's for personal happiness, I think in almost, at least in countries like ours. And as the purpose of marriage is personal happiness, as people become unhappy and have longer periods to become unhappy, you have unmarriage or divorce. That was the trend we began with and I think that maybe helps explain it. I think the big change because of that is there will be a throwback to the past, it'll be a throwback to the extended family, which we haven't seen that much of, but the more that people get married and we see different families being created and they're all together, their families just get bigger and more diverse. And that was part of the same-sex marriage debate also was what is the purpose of marriage and part of the opposition to same-sex marriage would say, well, that got this procreated purpose and then you can point to these older marriages and say, obviously it doesn't. I mean, obviously for many people it's about companionship and happiness and that was a big part of the debate. So I think we have time for maybe one more question. James saying, life expectancy is a number derived from a distribution. As you talk about life expectancy getting longer, do you expect the whole distribution that we have right now just to shift upwards with a fixed variance? Or could you imagine that, for example, this room might represent a small peak at one end and a large tail going down and if that's the case, what kind of social pressures would you expect? I'm sorry, what do you mean by distribution? What do you mean by distribution? The average of that. And I can expect, I can imagine a situation. In fact, you sort of talked about that in scenario B where there's a small group of people who benefit from all the technology that very long lives. And then I think there was one guy who died before everything happened because he smoked and stuff like that. And so you wind up with a bimodal distribution or else a distribution with a peak at one end, people just from maybe because they looked pretty affluent. And then a long tail going down and maybe even a peak that hasn't moved at all from now. And I'm wondering what the social implications that would be. Right, if there's a longevity divide where you have some people in society living a lot longer than other people, which we already have today, by the way, within the US there's a 30 year gap between some of the people who, I think it's North Dakota, a Native American man, there lives to be around 50. And in New Jersey, an Asian American woman can live to be 91. And so there's already big gaps within our own country and internationally they're even bigger. It's like a 50 year gap internationally. So if that gap continues to grow, I mean the question is, is how quickly does technology roll out, right?  And if there's a slower period of time, then there will be those big gaps and I think there will be big social gaps, differences between groups and that could be really destabilizing. And differences across national boundaries too because in wealthy countries such as ours, it may be rather widely available but in sub-Saharan Africa or Southeast Asia it's not gonna be and that is potential for really destabilized world order. It's gonna take that seriously. Well, on that note. Yeah. Well, thank you so much. Did you have a comment that you wanted to make? Really, I was just gonna say we've talked about marriage and the family to this point but the current political situation makes me realize that our politicians would live longer too and we would have members of Congress sitting on committees for maybe 40, 50, 60 years or Supreme Court justices. This is a life appointment. We may have to face constitutional issues at a certain point because we wouldn't want people sitting for that long. Oh, how interesting, yes, thank you. Yes, the quarreling could just go on forever. Yeah, okay. Thank you so much. This has been a great panel. Thank you all so much.


Most of the time those heat press normal multivitamins do almost nothing and it's very unfortunate. A lot of people don't really understand the way this works. I've heard a lot of people say this throughout the years that their multivitamins don't work and I kind of wanted to make a video for people to show them mistakes that you're making with multivitamins. I know some people are against supplements, against natural supplements, against all these kind of things but it's my personal belief that there's always some natural supplement that you can be taking in some capacity that's going to give you some benefit. That's just me. Most supplements are either pills or a drink mix. So I'm going to go over the problems with each. I'm going to kind of give you a little bit of solutions and ways to avoid all these problems and get you the best thing possible. I'm going to go over specific filler ingredients in the pills and in the powders. Every supplement pretty much has filler ingredients and you could be allergic to certain ones. Certain ones could be worse than other ones. More often than not the cheaper supplements use the cheaper stuff. So it's always worth noting to look what those extra filler ingredients are and make sure they're not that bad for you. I'm going to go over some specific ones here. Drink mix issues. Now you're taking a supplement. You pretty much want only the active ingredients. You don't want anything else. When you're getting a drink mix, you have colors, sweeteners and anti-clump at least. It's nice to have something taste good but it's absolutely not necessary. You just want the ingredients in there. So having the sweetener in there, maybe it's going to mess up your stomach. Maybe it's going to mess up your blood sugar. Maybe it's going to do a bunch of different things. When you have the artificial colors in there, a lot of people don't care about them. A lot of people are bothered by the colors. And it's just my opinion that I don't mind colors every now and again, but if I'm going to take 30 servings of a supplement, I would prefer it not to have anything extra in it, anything that could be worse like the artificial colors, especially when you're spending a lot of money. So anti-clump and preservatives, those are just kind of general fillers. But the colors in the sweeteners, anytime you have a drink mix, you're going to have those problems and those problems could provide you issues. You're not taking those ingredients. You're taking the ingredients plus the colors in the sweeteners. So you're taking an impure form of a supplement. I'm just letting everybody know. The main problems with pills is that pills need high doses. So an example is a pre-workout usually has 6 to 8 grams per scoop. If you were to take 6 to 8 grams and put that in a capsule, that comes out to 9 to 16 pills. So most of the time, pill supplements are very much underdosed unless the ingredients that you need are actually in a low dose. But most of the time, I found that natural ingredients, you need about half gram to a gram and then a few different ingredients. So you're looking at maybe 3 to 4 grams or so to get a normal style dose and you'd have to be taking tons of pills. Most of the time, supplements are 60 to 90 pills. So few supplements are going to be effective on such a small dose. So that's the main problem with pills.  They'll put colors in the capsules. I don't know why they do this. I literally take those capsules out and I have to replace them with my own capsules that I waste by time.  I just don't get it. And then the last thing with pills is the heat press. Anything that's in a tablet form has been heat pressed. Now, heat press is going to destroy any sort of sensitive ingredients such as probiotics, extracts in there. All these little small living ingredients are going to get destroyed and very few things will sustain through the heat pressing. I know amino acids will, but not very many other things. So when I see something like digestive enzymes in a heat press pill, I'm like those digestive enzymes are dead. It's just kind of pointless. So I recommend not getting heat press pills at all. I always wonder what I'm actually getting with the heat press pill and they don't seem to work as much either. Then the next thing is personalized vitamins ingredients. Now you need to get specific ingredients for the specific problems that you have. So let's give some examples. Let's say you're getting really older. You're going to probably want something with hormone support, something to balance your hormones naturally. If you're somebody who drinks every day, you're going to probably want something to help your mood. It's help the GABA in the morning and probably something to help your liver. If you're bodybuilding and stuff, you're going to probably want something with higher doses of stuff to give you more vitamins because you're using more stuff in your body. It's everything is tailored. You can't just buy a multivitamin and have it cover your issues. Most of the time those heat press normal multivitamins do almost nothing and it's very unfortunate. Search for supplements for what you need. Don't just like buy multivitamin, take it and say it doesn't work. Of course it's not going to work. The way to avoid all these and then I am not sponsored by anything but the way to avoid all these problems is to buy bulk powders and then buy capsules like right here. I have a thousand things of capsules. This cost me about $10. What I like doing the powders is you get such an unbelievable value. I'm talking about I would say first buy supplements and capsules but then I would say once you move on the powders it's just amazing how much you get. I could spend probably $20 or $25 and I get a year's worth of a supplement. No, if I spend $20 or $25 I'll maybe get one to two months in capsules and if I were to say go on a road trip or relocate I mean I would just have access to all these supplements for so long and when you have the powders you get rid of all the other problems. You don't have any artificial colors. You don't have any sweeteners. You don't have any preservatives. You don't have to worry about heat press pills. You don't have to worry about all these multitude of things and there's a lot of supplements out there that are guilty of like multiple things. They're you know big popular supplements. I kind of don't want to like put them on blast but there's just one supplement that I have that's heat pressed that has mint flavor which lowers testosterone that has caramel color on the outside. It's supposed to be good for me but the people don't have enough of outcry to say we don't want these ingredients so they put them in there anyway and they're ruining the supplements. So I would say find the best supplements that you like and buy big powdered versions of them. It's absolutely the best. It is a little bit messy and you're not really worried about the dollar amount if you want to take you know two or three or four grams because you have so much for so cheap. I feel like you could actually use it on your body. Every time I buy like pills or something I always worried about how much I paid for it and I don't want to take like a bunch at once. That's been my little rant today on why your multivitamins don't work, why your supplements don't work. Some of these supplements will fail all of them and very few will pass almost all the tests. I'm hoping that the supplement companies in the future can you know improve on this. So anyways guys that's just my two cents on the issue. What do you think about supplements? What supplement issues do you have? What supplement recommendations do you have? Do you have a recommendation that I forgot to list here? I'd be very interested to see down below. We're on the road of 25,000 subscribers and I couldn't do without any of you guys. I hope you guys are the best. I'm having a great day out here. Hopefully having a great day at home. See you all in the next video. Peace.


Γεια σας! Ευχαριστώ για την παρακολουθή σας! My name is Giorgio Cetidis, I am a PhD candidate at the University of Ioannina and in this talk I will present graphical tools for visualizing the results of network meta-analysis of multi-component interventions. Network meta-analysis is an established statistical method for synthesizing evidence from studies that compare multiple interventions. Networks usually include interventions that consist of multiple and possible iterative components, such as the characteristics of the intervention, the mode of delivery if it is delivered face-to-face or remotely, individually or in groups, the type of provider, the location, etc. These interventions are referred in the literature as multi-component or complex. When they are present, the interest usually lies on the identification of the best component. To answer this question, the component network meta-analysis is commonly used. However, component network meta-analysis assumes auditivity for the component's effects in multi-component interventions. This is a strong assumption and sometimes is hard to defend. It is even harder when the network is sparse and this is because the summary estimates of network meta-analysis are mainly informed by direct evidence and are prone to confounding. The objective of this work was to develop novel ways of visualizing the network meta-analysis results of multi-component interventions in order to help the analyst to identify which components work or do not work more easily. Also, we intended to explore the behavior of the components in order to identify the most promising ones. This was done by associating the presence or the absence of components with efficacy or effectiveness. Due to time constraints, I will only present 5 out of the 8 visualization tools that we have developed. To demonstrate the usage of the suggested tools, we will use an example of a network that compares the effectiveness of self-management interventions on reducing the levels of dedicated hemoglobin. Interventions are masked as these results will be submitted soon to a medical journal and cannot be reviewed beforehand. The network consists of 461 studies and includes 97 nodes and 11 components. Moreover, most comparisons involves node A, which is a control group and it will be used as a reference in the network with analysis model. As you can see from the network plot, there are many nodes, many comparisons, but few head-to-head studies. Therefore, the assumptions of network meta-analysis and component network meta-analysis will be challenged due to the sparsity of the network. Exploring the geometry of the network is essential, especially when you are dealing with large networks with complex structure. Components in descriptive analysis can assist in achieving this goal. By visualizing the components frequency in a colored cross-table, the analyst can easily identify the most frequent components or combination of components in the study arms. Its element denotes the number of study arms where the corresponding component or combination is part of the intervention. Diagonal elements refer to components and in parentheses the proportion of study arms that include the underlying component is presented. Of diagonal elements refer to combination of components and in parentheses the proportion of study arms with both components out of those study arms that include the component in the row is presented. For example, the element that corresponds to column E and row H indicates that 133 study arms include these components, but also that component E is always included in the interventions that include component H. To identify more easily the most frequent combinations, the table is colored based on the relative frequencies. The more it tends the color, the larger the percentage in the parentheses. Therefore, dark red colors indicate large percentages. From this figure you can see that the most dark red colors were observed in the color E. This indicates that component E was almost always part of the intervention. We can also explore whether the inclusion or inclusion of a specific component impacts on the outcome. The live one component out scatter plot identifies a pair of interventions that differ by one specific component. Here is a scatter plot for the set of interventions that differed by component B. AXY displays the NMA effect estimate for the interventions that do not include component B, and AXX when component B is included. Dots close to the line of equality signify no impact on the outcome. Dots above this line indicates that the NMA effect estimates are larger when the component is not included in the intervention. Therefore, for beneficial outcomes in which small values are considered as bad values, dots above the line indicate that the inclusion of a component hampers the intervention effect, while dots below this line signify a component that decreases efficacy. The opposite holds for harmful outcomes. Another feature of the scatter plot is that we can visually evaluate the activity and assumption. Additivity implies that the inclusion or exclusion of a component has the same impact on interventions that differ by one specific component. This is expressed in the scatter plot by a line parallel to the line of equality. In our example we do not observe any parallel line, which indicates that the activity assumption in CNMA may not hold. For a better understanding of the NMA results, it is recommended to apply the live one component out scatter plot for each component. This tool can be also extended to interventions that differ by a specific component combination and adjusted to use it values instead of relative effects. An alternative to the live one component out scatter plot is the waterfall plot, which is also displayed in interventions that differ by one specific component. The differences in the relative effects of the interventions with and without the specific component are displayed in order to explore if the extra component has a positive or negative impact on the outcome. The direction of the impact, positive or negative, depends on the outcome's nature, beneficial or harmful. Another visualization tool that could help on identifying the most promising component is a component heat plot, which visualizes the co-efficacy of the two measures component combinations. More specifically, each element summarizes the NMA estimates where the corresponding component combination was observed. As a summary measure, the media nor the mean can be used. The number of nodes that include the corresponding component combination is also provided in the parentheses of each cell. Letter X is used to highlight any combination of components that are not observed in the network. To identify more easily the most promising components, each element was colored according to the magnitude of each effect. Green color is used to reflect an effect estimate on the desired direction while red color is used to reflect an effect estimate on the opposite direction. In this example, most elements are green indicating that the component reduces the level of glicated hemoglobin compared to the control group. However, we are moderately confident about the results because of the uncertainty in the estimates, which is reflected by the size of the gray boxes. The smaller the box, the more confident we are about finding. Components heat plot can be also adjusted to display Z values instead of relative effects. Similar to the components heat plot is a value plot in which each violin displays a distribution of the NMA relative effects based on the nodes that include the corresponding component. Therefore, by comparing the violins, we can identify if there are components that are associated with larger effects. The precision of the NMA estimates is certainly reflected by the size of the dots. The violin plot can be adjusted to use Z scores and can be extended also to components combinations. Furthermore, by constructing the violins based on the number of components that are included in the nodes, we can explore if the efficacy of the intervention is affected by the number of components. Include, we are a view of contacting both network analysis and component network analysis when multi-component interventions are present. Also, to supplement the component network analysis and strengthen the network network analysis, we can use the proposed tools which can offer valuable insight on identifying patterns between components and exploring their behavior. The implementation of the proposed visualization tools can be performed by using our recently published art packets, namely VSCO, which is available on C-RUN and also on GitHub. More details about the visualization tools can be found on the original arcticty, graphical tools for visualizing the results of network metanalysis of multi-component interventions, published on research indices methods. Lastly, I would like to thank my colleagues for their valuable contribution and my supervisor Dimitris Mavridis. Also, the project was supported by the European Union's Horizon 2020 Research and Innovation Program. So, that's it. Thank you for your attention. I'm happy to answer any questions or comments and of course any ideas or suggestions are model welcome. Bye-bye.