Hi, I'm up here again. This talk is really not about my work, but about other work that's going on at Red Hat. So I'm going to do my best. This is the gratuitous picture of my dog and my husband playing fetch, right? This talk is all about making it easier for Linux and Java to play well together. The issue is mostly I've joined Red Hat a few years ago. And a lot of the people I talk to look at Java as just this black box, right? They've got their Java source code. They run Java C. They get something. They don't know what's bytecode. And then they pass it to the Java command. And stuff happens in there. And they don't know what that is. And they really want to be able to use the kind of tools they're used to, like GDB and Perf and all of those things to see inside the JVM to see what's going on. So there are a couple of efforts that have been going on in the community to make that better. So what I'm going to do is I'm going to show some motivating examples why you might want to use the GDB Unwinder or the Perf Java tool. And that's going to take me about five minutes. And then I'll show you the demos of how they work. And you can see what's going on. But this should be a pretty short talk. So feel free to interrupt me and ask questions. I'm happy to take time. All right, so I'm going to motivate the GDB Unwinder with prime numbers. I like math.  And if you use the sieve of arachnids, you can cross off all the multiples of two and cross off all the multiples of three. Three is now prime. And now you can see that five is now prime. And you cross off all the multiples of five. So I wrote a Java Streams program to do this. And all you do is you generate a range. And then you generate the range from two to the square root of the number that you have here. And you see that if there's a remainder when you divide it. And so this will generate some nice, pretty prime numbers. And I'm going to do a reduction on them at the end just because I don't want to be printing out streams and streams of stuff when I show the demo. So the thing that's interesting here is if you've played with Java Streams at all, you can just add in a dot parallel there. And all of a sudden, your program that's generating prime numbers will use as many cores as you have on the box. So that's awesome, right? That's great. This is the promise of fortress, but put it back into Java. But as a low-level programmer, I want to know what's going on, right? What is that dot parallel really doing under the covers? So if you go into GDB now and you try and do a backtrace, you get something that looks like this, right? I don't know how many people have ever looked at that. When we were doing the read barriers and trying to debug them, I ended up looking at addresses like that and trying to go in by hand, translate them into methods. The Linux programmers don't really want to do that. They really want to see Java symbols there. So Andrew Haley wrote something called the GDB on Winder. Andrew Den, sorry, Andrew Den. And when you run that, you can see that this is just an interpreted. I halted it really quick and looked at it. And you can see up here that it all calls down into Java, UDL, concurrent fork join, which is what you kind of expected if you knew about the stuff at a low level. But if you're coming at this and you're just starting and you want to know what's going on, you can come and you can sort of see how this high-level streams program decomposes into actual Java method calls in a pleasant way. All right, you can't read this. But basically, I showed you the interpreted frames. But once they get compiled, you can see that in this case, the very low levels on the stack I'll show you in a minute are still interpreted. The stuff that's executed more often gets compiled like here. And some of the stuff up here gets inlined. And the GDB on Winder can handle all of that and show you what your Java program's doing in here. You can see all the interpreted methods because these are only getting executed once. And you can comment out the parallel. And you can go and you can look at the GDP output and see that, in fact, you're up here to evaluate sequential. And you never go to the fork join stuff. So yay, that's cool. Where can you get it? Andrew did put it up there. It's actually just a cute little script. It's a Python script that knows about GDB and it knows about how Java stores its symbols and goes and matches them up. You can read more about how it actually works in detail there and plans to try and get this upstreamed in some way there. Again, Andrew Dinn wrote this. So Perf, I don't know if you guys are Linux programmers or if you're Solaris or whatever, but Perf is a tool for measuring hardware counters and figuring out things like cache misses or TLB misses in your code.  So I just wanted to take a fun program on random numbers. If you want to try and debug your random number generator or figure out whether it's a good random number generator, what you can do is you can take the remainder. If I have three bins, I can take the remainder by three and see which bin it fits in and see if your bins are equally distributed. So if I got 91 as a random number, it would be in bin 1 or 17 because 15 minus 2 would be in bin 2. And so I wrote a program that does a really parallel random number test like this, but bangs it all into one array because I wanted to be able to show you Perf. So here are just a sample example. So if I ran with four bins and 10 threads for one second, you can see that Java random really does do a pretty good job of getting numbers equally distributed in the last bits. OK, get to the point. I've gone off on a tangent. But the idea is that by using many threads to write into this array of bins, I can cause some cache problems. And we should be able to see those with Perf. So without jitted symbols, if you just went to run Perf and look at L1 data cache misses, you get something that looks like this. And this is bad for several reasons, one of which is if you look over here, these are actually in the same method, but you don't know that. And you've got addresses that don't really help. If you use the Perf tool that I'm talking about, you can tell that 98% of your L1 cache misses actually happened in that code I was talking about. So where can you get Java Perf? It's supposed to be available in REL 74. And this was actually contributed by Google. But the libPerf stuff is actually a part of the lib JVMTI is going into the Linux kernel so that you should be able to do this from Linux. And the last one I'm showing is just Linux Perf bar. This has nothing to do with making Linux and Java play better, but it actually makes the next demo section go better. If any of you, I was an old time son person and I ran Solaris. And my favorite tool is the Perf bar. Because you can watch it, and you can watch your program running, and you can see if there are any problems. If you're not getting the scalability, if for some reason you're blocking. And so Doug Lee and then others have improved on it, have put a version of this out that you can play with. And this is sort of an idea of what it looks like. You can see that in this particular example, I've got an idle thread, some partially idle threads, and some fully engaged threads. It just gives you an idea. It gives you a visual example that for me is helpful to see how your program is running. All right, so let me actually show some stuff. Here's my Perf bar. I'm not doing anything right now. There's the GDB without the symbols, and it's not useful if you run with the Unwinder. And the reason I have this is I can tell when it's actually fully running the stuff. You can see that in fact it does work and you do have your Java symbols all available to you. Yes, it's only for Linux. I don't know. Is Perf available for AR64? This is the Unwinder. This is not the Perf tool. I'm sorry. All right, the question is, will this run on AR64, the GDB Unwinder? It is a Python script that goes and walks into the JVM and knows about GDB. So I don't know for sure, but I would put my money down that it would work on AR64. Andrew Dinn, who wrote this, also worked on the AR64 port. So I have to believe that if it's not there, it could be there if people ask for it. So if you need it and you don't have it, chf at redhat.com, tell me and I will see what needs to be done to make sure that it's there. Go ahead. Yes. Right, it shows the native frames and the compiled frames and the interpreted frames. So you can deploy these tools in hotspots like to inspect, or in the debug version. Okay. And also, it's worth pointing out that if you have disassembly loaded, you'd also be able to look at the disassembly and all the source lines and all the rest of the stuff. That's true as well. So what I'm trying to do is make this, well, I'm trying to demo these two tools that I was told to demo, but what I'm also trying to say is that from a Linux perspective, these are giving you insight into what's going on in the JVM. There are other tools that experts would use. I'm sure there are other tools available, but these are simple and easy to use. Oh yeah, what is that? Well, now you know what's there. Yes? Are the what? Yes. We're gonna run perf. All right, this is gonna take a while. So I should have started this running while you guys were talking to me. But this is basically doing the random number testing into bins on my laptop. And it's using all, it's using 32 threads. So my eighth threaded laptop is all out working. If there are any other questions on GDB, now would be a great time. Or I could sing. What's your question? You say? This is the lib JVM TI is gonna be part of the Linux kernel. And perf is available in Linux. It is, it's available. You can do it in Fedora. Everything is in Fedora before it's in rel. I built the lib JVM TI myself. And if you go to the website that I showed for more information, they'll tell you how you can build your own lib JVM TI and install it. Yeah, it is actually in the main line already. The JVM TI is there in the ministry. Okay, it's in the main line, but it's not in rel yet. Yes. Okay, that's, okay. Do we have any other questions? Anybody wanna know, you know, what the weather's like in Massachusetts? Give us another second. I'm sorry, what does JVM TI do? This is just a way of finding the Java symbols of giving away for Linux tools to find the Java symbols. Yeah, so perf has digit support. In order to do this, it needs to know how to map the addresses to the symbols. You can actually point perf to the particular place saying this is the perf map for this particular process. It turns out that in Java, there is a standard, well, yes, standard way to figure this out. JVM TI actually has the events that say we are about to install the compiled code. These are the addresses of this code and this is the symbol number. So this JVM TI agent is like 100 lines of code that actually just intercept these events and construct the perf map and then perf takes over. That's it. No, I don't think so. I think perf actually does not support that. And actually the JVM TI is just for a Linux app. All right, so you have to do a separate step to actually inject the JIT.  And then you can actually just show the output. All right, and this is no surprise. This is what I showed you before, just that you can see that all of those L1 data cache misses happened in that one method that we expected them to. And that's really it. So this was a really short talk, but I wanted to let you guys know that, you know, there's efforts going on to make Linux more aware of Java. That's it.


Well, you've heard me say the purpose of food is to get olive oil into your mouth. And you've probably seen me take shots of olive oil right here on my YouTube channel or my Instagram. And you might know I even swish my teeth with olive oil for good health. So why am I so obsessed with olive oil? Well, the truth is olive oil is one of the absolute best things for your health. And I want to share the word with as many people as possible. So today I'm doing a little refresher course on all things olive oil and how you should be using it. Okay, let's get started. So what makes olive oil so great is that it's incredibly high in polyphenols.  So polyphenols, as you probably learned from my best seller unlocking the keto code, are one of the keys for promoting mitochondrial health. And mitochondria are those energy producing organelles in almost all of ourselves. And polyphenols are actually a way that plants protect their mitochondria, which are called chloroplasts. And polyphenols, for those of you that don't know, are those bright colored leaves that you're seeing now in the fall that are actually there all along that you don't see in the summer because of the green chlorophyll. But those polyphenols, when we eat them from polyphenol containing foods like olives or olive leaves, are what deliver these mitochondrial protective substances to us. We also know now that polyphenols are some of the favorite food for our gut buddies, our microbiome. And so polyphenols not only protect us, but also they are prebiotics for our gut microbiome. Now I've talked about this a lot, but I'm going to say it again. There's a very famous trial called the Predomet trial that was done in Spain. The Predomet trial randomized 65-year-old people with known coronary artery disease.  And they were randomized to three groups. One group had to use a liter of olive oil per week. It's about 10 to 12 tablespoons a day. The second group had the equivalent calories in walnuts, and the third group had a low fat diet. And they were followed for four to five years. What they found was that there was a dramatic reduction in the group using olive oil in terms of new coronary artery disease events, new heart attack, new stroke, new stent or bypass. Olive oil and the walnuts were very similar, but olive oil won that one. But what was fascinating was in terms of memory, both the olive oil and the walnut group had improved memory after four to five years, whereas the low fat diet group actually had decreased memory. So olive oil wins in multiple areas of health, and that's just one great example. It's no surprise that the Mediterranean, which has some of the longest living people in the world, multiple areas in the Mediterranean use a liter of olive oil per week. And it's because of this polyphenol content that gets the benefit.  In fact, he was a nutritionist from the University of Minnesota who actually devised our modern health pyramid. But oddly enough, Ansel Keys retired to southern Italy, south of Naples, and lived just above the village of Aciaroli that I've visited, home of the longest living people in the world, and he loved olive oil. So the original anti-fat guy actually loved olive oil, a mono-unsaturated fat, and he lived to 102. Not bad if you ask me.  If you actually consumed a liter of olive oil per week, it would never work. You'd gain so much weight that it's ridiculous.  And the polyphenols in olive oil, among other things, uncouple your mitochondria and allow you to lose weight. In fact, there are multiple studies showing that adding olive oil to the diet, in fact, makes you lose weight rather than gain weight. So once again, fat does not make you fat. Okay, so how do you use olive oil? Well, that's kind of the fun stuff. First of all, let's dispel one of the biggest myths there is. That olive oil clearly can't be cooked with because all that smoke when you heat olive oil means that the olive oil is oxidizing. In fact, that's not true at all. Olive oil actually has the least oxidizable properties of any oil. In fact, it oxidizes less than coconut oil. Yes, olive oil oxidizes less than coconut oil. But where does that smoke come from? Well, olive oil has a very low smoke point. That means as it heats, smoke comes up. But that smoke has nothing to do with oxidation. In fact, if olive oil was bad for you to cook with, it's been used for over 5,000 years as the primary cooking ingredient in Europe to cook food. And you would have thought that all these blue zones in Europe would have killed themselves long ago with the oxidized olive oil that they cook in. So that's one of the biggest myths there is. The second thing that I've learned spending so much time in Italy and France, southern France and Greece, is that olive oil is supposed to be brought to the table. That olive oil should be poured on anything that you're going to eat. So it's important to realize you don't just cook with it. You bring it fresh and pour it on the things you're going to eat. That way you get a double dose of olive oil with everything you eat. So put it on your vegetables, obviously use it in a salad dressing, or drink a shot of it straight every day like I do. Now I have tons of recipes for olive oil right here on my YouTube page, including olive oil cake. And it's really one of my favorite. In fact, when we celebrate my birthday here at Gundry MD, we have my famous olive oil cake to celebrate. You can have your cake and eat it too, particularly if it's made with olive oil. Now before you head to the grocery store, there's something you need to know. Most olive oil on the shelves today might actually do more harm than good for your body. Many olive oil products are actually fake and they're laced with seed oils that could spell big trouble for your health. I'm not saying that they're all fake, but results from investigations from 60 Minutes have shown that many of the olive oils that you trust in, in fact, are not so much olive oil at all. Now there's things you should look for. In general, the darker the color, the greener the color, the more golden the color, that's undoubtedly a higher quality just based on color. That color is actually from the polyphenols. Now in general, more bitter is more better. Really strong olive oil should almost make you cough when you eat it and drink it and that's a sign of those polyphenols. Alright, so you've passed the taste test. What about the color of the bottle? Well olive oil oxidizes very easily in sunlight, so a good quality olive oil should always be in a dark colored bottle. And please don't put the olive oil on the kitchen counter where it can be exposed to sunlight. Keep it in a cabinet where sunlight can't get to it. Now are there other keys? Well, first of all you want to look for first cold press. And usually if you see the words by only mechanical means, that means that they used an olive pressing stone or other mechanical devices to crush and press the olives. First cold press, believe it or not, once they get that run off from the first pressing, they then run it through again. And again, and finally they can actually crush the olive seed that produces an oil called pumice. Now there's no requirement, they tell you which of these pressings is going into your olive oil. So look for the words first cold press, hopefully you'll see by mechanical means only. The second thing to look for is extra virgin.  It actually has to do with the amount of acid that's detected. Now that's not an assurance of quality, but it is an assurance that there is a standard of acid level that determines whether something is extra virgin or not. I'd much rather you see first cold press than extra virgin. Third thing is, don't look for a cell by date. Look for the pressing date. Now it may have two years because many olives, particularly in the Mediterranean, are harvested in the late fall and maybe even in early January. So you may see harvest date 2022 slash 2023. On the other hand, if you see a single date, that's even better. Now how long is it good for? In Italy, most olive oil is considered safe to use within a year of pressing. Maximum two years, but here's the deal. Once you open that bottle of olive oil, it's now exposed to oxygen and it will begin to go bad more rapidly. That's why, for instance, here at Gundry MD, our high polyphenol olive oil is packed in small bottles. That way I know you're probably going to use it up quickly before it goes rancid. That's why don't go to a big box store and buy the two gallon plastic sized organic olive oil. Number one, it shouldn't be in plastic. Number two, it shouldn't be clear. And number three, it'll go bad long before you use it up. So buy the smaller bottles and use it up. Beware of a cell by date. Now unlike wine, olive oil does not get better with age. It's really only going to last a couple of months once you've opened it up. Okay, so do I love my polyphenol rich olive oil? Absolutely. It contains 30 times more polyphenols than most conventional olive oil that's tested in labs. Now two tablespoons of my olive oil yields the same benefit as one liter of conventional olive oil. So a little goes a long way. Now if you want to have more, be my guest. You can never overdo the polyphenols in olive oil. But even if you don't use mine, you can find quality oils in any grocery store if you carefully read the labels like I've talked about today. You can even find them in Trader Joe's and Costco. Look for the dark colored bottles. Look for the smaller bottles, not the giant jugs. And look for a pressing date. And that will keep you safe. And don't be afraid to try different olive oils and seek out the ones that have that really rich, bitter, sometimes buttery taste and use them wherever you eat. I carry my olive oil to restaurants because a lot of restaurants, I don't know where they got their olive oil. And we always have a good time joking, but it goes right on to the table and no one's ever stopping. I think you're going to love this one. The next time you're worried that you're not drinking enough water and yet you swear you're having a lot of water, think about eating your water instead.


Hey everybody, Dr. Gendry here. What happens if you stop eating sugar for 30 days? Well, I'll tell you sugar is everywhere. It's not just in things like candies and desserts but it's hiding in so-called healthy foods too like bagels, flavored yogurts and instant oatmeal and it's absolutely detrimental to your health. But what if you could cut out sugar for a full 30 days? Well, I'll tell you this. You would notice some remarkable changes to your health and your appearance. For starters, it would be doing your gut a huge favor. Let me give you an example in terms of health. Years ago, there was a study in which participants were asked to take about a hundred grams of sugar. Now, that sounds like a lot but it's actually far less than is typical for an American diet. One group of participants actually had to have some glucose. Another group had to have some fructose, fruit sugar. Another group had to have a glass of orange juice. Healthy, right?  And lo and behold, for up to six hours after having sugar, including a healthy glass of orange juice that everybody thinks improves your immune system, it completely blocked the ability of white blood cells to eat bacteria and viruses. The very things that are threatening our health. So imagine that that healthy glass of orange juice that you were doing to improve your immune health actually did the exact opposite. It sabotaged your health. Now, bad bacteria in your gut absolutely loves simple sugars. They have the ability to use them to grow and crowd out the good bacteria in your gut that actually can't use simple sugars. So the more simple sugars in your diet, the more bad gut bacteria proliferate and push away the good bacteria that really you need. If you really want to see what happens when bad bacteria get a hold of sugar, you can actually watch my science experiment right here on your YouTube channel. In which we actually show the effect of giving bacteria and other denizens in your gut the sugar you want. It's quite dramatic and I hope you'll tune in and watch it. So when you see what's happening with bacteria and other denizens of your gut eating sugar and see the bloating and the gas at this cause, it's no wonder that sugar many times is actually the cause of irritable bowel syndrome, IBS, and other leaky gut issues. Remember, Hippocrates knew this 2,500 years ago. For those of you who don't know, Hippocrates is the father of medicine. And he always said 2,500 years ago that all disease begins in the gut. So knowing this, and he was right, by the way, we want to give our friendly bacteria the foods they want and deny the bad bacteria, the foods they want, and it's simple as sugar. Now, another important point, when you're looking at labels and looking for sugar, stop looking at sugar. What you want to look at is total carbohydrates. Take total carbohydrates, take away the fiber. That's the next line down. Total carbohydrates minus the fiber will give you the amount of sugar in that serving. And here's the shocker. It won't have anything to do with what it says sugar on the bottom. This was changed by the federal government to hide the amount of sugar. For example, a bagel has about 300 calories and it says zero sugar. But in fact, there's anywhere from 11 to 13 teaspoons in a bagel. There's four teaspoons of sugar in one piece of bread, even though it doesn't taste sweet. That's because refined grains like wheat are so pulverized into fine particles that they instantly become sugar. In fact, a piece of wool wheat bread has a higher glycemic index than table sugar. It's that effective as a sugar source.  And what would you notice? Well, the first thing you'd notice is that your digestion would change dramatically. The second thing you'd notice is your skin. Now, why would you notice your skin? Well, first of all, the gut and your skin are exactly the same cells. Your gut is basically your skin turned inside out. And what happens on the surface of the gut is reflected on the skin. In fact, there's good correlation between sugar consumption and acne breakouts. For example, but more importantly, sugar is the key component to what are called advanced glycation end products, which are appropriately named ages.  And this makes one of the strongest chemical bonds that's ever been described. It's called the Mallard reaction. That chemical bond stiffens things, stiffens your skin, stiffens wrinkles, and is actually the cause of dark spots on your skin. Some people call them sunspots. Some people call them liver spots. These are actually advanced glycation end products that are deposited in your skin. By the way, they're also deposited in your brain. They're deposited in your heart.  So what happens when you remove sugar? People are absolutely shocked when their dark spots start going away. And in fact, one of my famous patients was driving from Oregon to Palm Springs after doing this for six months. And he was driving his RV and his wife said, George, look at your hands. And he turned the steering wheel to look at his hands and almost ran off the road. And what she was pointing out to him that all of his liver spots at dark spots had disappeared in six months time because he had stopped eating sugar causing advanced glycation end products.  If you want to age slowly, stop eating sugar. Your skin will thank you. You will shock your friends on how much younger you look just by eliminating sugar. Last but not least, weight loss. Sugar is absolutely one of the leading causes of obesity in the United States. It's full of empty calories that offer no nutritional value. It actually stimulates your body to create extra fat. And it actually tricks your brain into craving more of it. In fact, studies in rats show that rats will preferably push a lever to get sugar instead of either heroin or cocaine. Now, think about that pushing a lever to get sugar instead of heroin or cocaine.  Finally, we now know that the sugar industry for many years paid prestigious institutions like Harvard to tell people and write papers that sugar had no effect on health, had no effect on weight loss, even though the evidence was overwhelming that it did. These professors and researchers took big sugar money to lie to us. And this made big news a few years ago. So the point is, if you stop sugar for 30 days, your gut health would improve, your skin would improve and your weight would most likely improve. Now, these are just some of the many benefits you could experience without having sugar in your diet. Now, I know it's easier said than done. That's why I put together a video on how to kick your sugar addiction in just four easy steps. And you can check it out right here on my YouTube channel because I'm Dr. Gundry and I'm always looking out for you. I hope you enjoyed this episode of the Dr. Gundry podcast. Make sure to check out the next one here. Don't look at quitting sugar as a restriction. Look at it as an opportunity to get creative in the kitchen, to learn to love new flavors and to take control of your health.


I think every student should do a rural placement because of the diverse clinical caseload that you get to see while on a rural placement. I think you get to see from, you know, your littlies up into your adults and then through to your elderly, as well as working in such a range of clinical settings. Back in first year I remember the speech pathology academic from the Department of Rural Health coming into one of my first year lectures and right from then I remember it was something that I wanted to keep in the back of my mind for a placement in the future while studying speech path. What I love most about OT is it allows me to see the best potential in everyone. I'm really passionate about rural health and really wanted to do my practice in a rural area. I really enjoyed my placement in Armadale. It gave me the opportunity to see somewhere that I wouldn't normally go. There's a lot more connectedness with the community and the pharmacists so it's actually quite a lot more rewarding I think in rural areas. No one day ever looks the same. In Coffs Harbour I was actually based out 40 minutes out of Coffs Harbour at a rural placement site there at a hospital and then also in the community with aged care. And then out at Maury again it was a little bit different. We had some outreach clinic days and then some days at the community health centre as well as visiting some preschools and some schools. I did a community placement. Pharmacists play a bit more of a front line role than they do in city areas. Rural you definitely see a lot more interesting in varied cases. I was able to engage in some community home visits which was really great not only to see the area but to practice within people's homes. In the Teddy Bear Clinic we got to go to one of the local school and teach them how a central line works as one of the children had one in the class so it was good that all the kids could know about it and understand why this little child had it and it was really positive. I had so much support from the department and that involved financials so the accommodation was subsidised as well as having close academic support which was great to know that I always had someone that I could reach out to if I had questions or even recommendations from the best coffee in town. So my rural placements I was able to be a part of a huge range of interprofessional learning activities. So this was like the healthcare team challenge that I was a part of and a few tutorials and workshops where I was not just with speech pathology students but with physiotherapy, OT, nutrition and dietetics and just a huge range of other students. I didn't know that University of Newcastle and the Department of Rural Health could also support students from other universities such as us from ACU in Sydney and it's provided a great opportunity where we're able to be offered accommodation while we're here and you get to stay with other students from different universities. The Manning Education Centre has been really impressive. We came here for our first day orientation. It was a meeting point where we got to meet all the other students that would be starting on the same journey as us which was nice. That made us feel more at home. I was drawn to study nutrition and dietetics because I am a massive foodie. I love all things food and nutrition and I also love helping people. The year-long rural immersion program lets me do all of my placements in one spot so I don't have to travel around to get to all my placement. Living with other students has been really great not only to get a bit of an insight into what they do on their placements but just making new friends and doing things together like going for coffee or walks. Over the past year in Port Macquarie I've really fallen in love with the area. There's so many gorgeous beaches. We were really excited to come and explore Tari. This is an opportunity that you wouldn't usually get just to be able to live somewhere for four weeks. In Kos Harbour I think you have the beautiful beaches which for me I absolutely love. This is a great little town. A lot of things I did in my spare time in Tamworth consisted of bush forks, going to cafes, going down the main street, hanging out with other students who are on placement in Tamworth. I think a rural placement is great for your social life. As a smaller rural town you're able to build some really good relationships. I would recommend doing a rural placement. You're going to end up with more skills.  You're forced to kind of step outside of what you're used to and what you know and forces you to become a better student. The extra opportunities, the social activities and I think just the variety in the clinical caseloads that are offered is why I found a rural placement so exciting.


It's my pleasure to introduce Minavi Honda, who has been a registered midwife in Toronto, Canada for the past two decades. She's an associate professor at Ryerson University in the Midwifery Education Program. Minavi has focused her midwifery practice on care for marginalized women, particularly newcomers, refugees, and those without legal immigration status. Minavi has been head midwife at two hospitals and has sat on numerous local and national committees. Her research interests include midwifery and bioethics, vaginal birth after cesarean and homebirth, midwives as abortion providers, and cannabis use in pregnancy. Minavi, I'm going to turn control over to you, and we're eager to hear your presentation. Thank you so much. It's such a pleasure and honor to be part of the Virtual International Day of the Midwives Conference. I spoke at the first conference many years ago, and so it's a pleasure to be a keynote speaker. I'm going to be talking today about my perspective on care for Syrian refugees when they came to Toronto. So, just to give you a bit of an overview of the presentation, it's an experiential presentation. It's not research-based, so it's very much about my experience. I'm going to give you an overview of the first two days of my work with Syrian refugees, because those first two days really represented all of the systemic issues that were present. I'm going to talk a little bit about the political context in Canada at the time, the health care response, what the setting was at the refugee receiving hotel where I provided care, midwifery involvement, and then I'll give you an overview of a few cases and the lessons learned from those cases. So, everything from systemic issues to population insights and midwifery lessons that were learned, and then I'll talk a little bit about future applications and the role for midwives. So, just a bit of a disclaimer, this presentation demonstrates multiple systemic issues that arose in Canada in the care for Syrian refugees. This is for future learning. It's not at all a criticism about taking in refugees. I have a very strong political position on Canada as humanitarian country, and in general of Western and higher resource countries taking in refugees. So, I don't want anyone to take away from this that I don't think we should take refugees in. We really did try our very best, but as you will see, we didn't do very well actually in caring for Syrian refugees. We did, but not as well as we could have. And really, I'm talking about the experience of myself as one midwife. I volunteered to provide care to all pregnant clients at Canada's largest Syrian refugee receiving hotel. So, just a little bit of a political context. This is a presentation about what happened at the end of 2015 in the beginning of 2016. The Syrian refugee crisis was seen as the largest humanitarian refugee crisis since World War II. So, Syrian refugees were a major Canadian election issue at the end of 2015. The previous government that we had in power before the end of 2015 was very politically conservative, very similar to the current American government. So, they were very reluctant to take refugees into Canada, and there was a lot of rhetoric about terrorism and screening for refugees. There was a new government established in October 2015 that was much more liberal, and they promised to take in 25,000 Syrian refugees by the end of 2015. So, in a very short period, within two months, they wanted to take 25,000 people into the country. There were two pretty seminal events that happened right before Syrian refugees were taken into Canada. And this might be new for some of you, or it might be a little bit of a review. So, at the end of 2015, there was the San Bernardino terrorism shootings in California. So, it was a mass shooting, 14 people were killed, 22 were seriously injured. The perpetrators were a married couple that met online. So, one legally immigrated to the U.S., and one was born and raised in the U.S. There was a lot of FBI rhetoric about homegrown violent extremists being inspired by foreign terrorists. And for those of you who might not remember this particular shooting, because, unfortunately, there are many mass shootings in the U.S., this was the shooting where the FBI petitioned the government to unlock, petitioned Apple to unlock the iPhone that they thought there was seminal information on. At the same time, within a couple of weeks, there was the case of Alan Curdie. So, you see these very tragic pictures on the right-hand side. These images became a global symbol of the Syrian refugee crisis. So, these are pictures of a three-year-old child's death while fleeing Syria at sea. And you can see this child being carried by his father, and the father was Alan Curdie. This family actually was previously refused refugee status in Canada. So, this family story really became representative of the refugee crisis in Syria overall, and also Canada's role. And for the first time in many decades, Canada was globally criticized for its lack of response in the refugee crisis by the U.N. and many other countries across the globe. So, the refugee crisis of Syria was really seen as a major issue with respect to Canadian identity and reputation as a humanitarian country. So, the Canadian government response, there were very mixed feelings at the time among Canadians about taking Syrian refugees. So, there was a large response of wanting to be humanitarian and continue with Canada's humanitarian reputation. And at the same time, there were a lot of fears about the rhetoric of terrorism, especially from Islamic countries. It was very important to the new government profile to take in asylum seekers. They really promised to renew Canada's commitment to asylum seekers. So, the compromise between this Canada wanting to be humanitarian but also wanting to be careful about quote-unquote terrorism, and I put that in quotes for many reasons. They decided to only take in two parent families with children. So, there's very heterosexual gender normativity implied in this decision, and this will be reflected in the language that I use in this presentation. The idea is that families with children, there was less concern about radicalization. So, this San Bernardino case, there were two single people who were quote-unquote radicalized and met online, so they didn't want to take single people, particularly men. And there was a big rush to fulfill the election promise of taking a large number of refugees within a short period of time. So, because of this, intake was not well planned at all. So, the healthcare response. As soon as the government said that they were going to take Syrian refugees in a considerable number, so 25,000 within about two months, there were a lot of discussions within the healthcare setting with settlement, within the settlement community and public health agencies. It was interesting because a lot of the focus, I'm just going to ask if people are not on mute to put their speakers on mute. I'm just getting a lot of background noise if that's okay. Anyway, so there was a lot of public health concern, there was a lot of discussion about vaccinations, post-traumatic stress syndrome and acute health issues. There were a lot of meetings at the national and provincial level in Canada as well as the local level, among primary care providers. And as a midwife who works a lot with refugee communities, I was involved in a lot of these discussion boards. A lot of them were on Facebook or through email and it was very interesting. There was virtually no midwifery presence even though we were talking about primary care providers. It was very much unknown where, when or how many refugees would arrive and there were rumors all over the place. So, there were rumors that refugees would be settled in military bases, which doesn't sound like the best place for refugees to be, who are leaving a war torn country to rural areas, to cities. There was really no one had an idea where people were going to be landing, but knew they were going to be coming very soon. So, this really shows systemic issues about the lack of communication between immigration agencies and healthcare agencies. And this question about what about the pregnant women? So, on these discussion boards, I kept asking, what about pregnant women? And nobody was talking about people who might be pregnant. They were talking about vaccinations, they were talking about public health concerns, but there was literally no conversation about pregnancy or reproductive care. So, the initial plan was that 10,000 refugees were planned to land in Toronto, which is Toronto's Canada's biggest city, and to be housed at local hotels. Within days of this government announcement, refugees started arriving at the largest receiving hotel. There was very little time for planning. So, community agencies, health networks, independent clinics in the city were all activated to develop a plan. There were 28 clinics in Toronto staffed and ready to take in families, which sounds great, but it didn't actually work out and I'll explain why. They were on site at the hotel. So, these people came literally from the airport and went straight to a hotel within 10 kilometres of the airport. There were multiple volunteers and agencies on site and nobody was really in charge. So, it was actually chaos. And the idea of doing a cute triage on site was very contentious. So, there were these 28 clinics that were activated and ready to take people, but they were not on site. And there was a lot of criticism about people who were on site undermining the work of those clinics that were waiting to receive refugees. So, just to give you an idea of what was happening at the hotel. So, it just so happens that I was very involved with the planning around refugees coming in and this hotel, which was the largest Syrian refugee receiving hotel, was within 2 kilometres of my midwifery practice. So, that was very fortunate. 500 people arrived within 2 to 3 days and healthcare providers were notified on the day of arrival. So, we didn't know when people landed at the airport. They were all in the hotel and we were notified people are here and they need healthcare. There were two community health staff on site. So, one was a nurse practitioner, one was a nurse. There was one volunteer pediatrician and I say volunteer because this pediatrician was volunteering her time, but she did have the ability to bill for services. Everybody who came in on arrival had full access to healthcare. And that's an important piece that this person was volunteering their time, but they actually were getting paid for their services. There were very large families that arrived. So, the average family size was 7, so 2 parents and 5 children. Again, remembering that we only decided as a country to take in people who were coupled with children. There were very low levels of literacy, zero English. I didn't mean anybody in the time that I was there who spoke English. The most common professions were farming and truck driving. So, these were really some of the last refugees to be able to leave Syria. We're very impoverished and very different from previous Syrian refugees that we had worked with that were generally pretty upper to middle class, very well educated, had good rates of literacy. So, again, what about the pregnant women? There was no discussion about care for pregnant women. And the kind of other care providers' insights or comments that I was told when I kept asking, what are we going to do with all the pregnant women, was how many pregnant women do you think there will be? Or they don't seem to be that many women whose health records indicate they're pregnant. And this was a big one. Pregnancy is not a medical emergency. And I kept saying, people who have gone through war and finally leave and are safe are concerned about the health of their children, including the children that might be in their belly. One of the issues I also talked about was termination. And the comment I got was we're dealing with religious Muslim women here. They're not going to be wanting termination. So, in terms of systemic overarching issues, there was really a lack of knowledge or understanding of women's reproductive issues. There was a lack of understanding of the importance of pregnancy care and the importance of the family unit and resettlement and what the effects of pregnancy could be on that process. Just a very brief note about setting the stage for midwifery involvement. So, for people who are trying to replicate similar services in other areas, I got in touch with our provincial bodies, so the Association of Ontario Midwives. They were really a hub of information. We were writing blogs and updating midwives about when refugees might be coming, what they might be able to do within their own communities. We involved risk management. So, midwifery in Canada is very, or midwifery in Ontario is very specific in terms of its scope. So, I knew I would be working within midwifery scope, but not necessarily providing our major tenants of care, including continuity of care. So, I knew I'd be caring for women in the hotel, but not necessarily in the interpartum period. So, we had to get the insurance company to agree to that and they were very amenable. And the College of Midwives of Ontario, which regulates our scope of practice, they were ready to put an alternate practice arrangement in place in case we needed to do things that were not within midwifery scope. So, while women physicals for people who are not pregnant is not within the scope in Ontario, neither are vaccinations for families. And so, they put some things in place in case that was what was needed at the hotel. And really in terms of communication, communication with the health centers and coalitions was really to keep midwives involved and to keep midwives involved in mind. So, I kept staying involved to remind people that midwives were able to provide care for pregnant women, even though nobody was interested in pregnant women at the time. So, the first day, I decided I would just come to the hotel and see what was needed. The community agency staff informed clients through translators that I was coming, so that a midwife was coming. Only one woman disclosed pregnancy and just to give you an idea of the setting, really it was a hotel that was not at all, I mean it was adequate, but it was not a nice fancy hotel by any means. I was given a storage closet with boxes all over and that was where I was able to run my clinic for the evening. So, that storage closet was transformed into a clinic room. There was no paper, no pens, no desk, no fax, no files, nothing. There wasn't even a bed. We ended up getting a massage table as a bed so I could at least palpate people's bellies not on the floor. And I thought I was very prepared. I came with my prenatal bag and realized I didn't have a pen, I didn't have anti-natal records. And just to understand the scene, the lobby really was like a town square. It was very, surprisingly it was very joyful. There were lots of people, like probably 500 people sitting in the lobby of the hotel and children everywhere. And I really was looking around at these women and would see families with a five-year-old, a four-year-old, a three-year-old, a two-year-old, a one-year-old. And then looking at these women and thinking there's a bigger chance there's a baby in your belly. And so I really believe in bonding with people through humor so I learned the word for pregnancy would just hamel and the word for midwife would just kabela. So I walked around with a translator to groups of women and I just pointed at them and said hamel, are you pregnant? And then pointed at myself and said kabela. And then the translator would say this is a midwife. You can see anyone who's pregnant and literally within half an hour, I had about six pregnant women disclose that they were pregnant and that I saw on the first day, which really speaks to the importance I think of personal relationships because the community agency had asked who was pregnant and only one person came forward. But when people could see my face and have a bit of a rapport, there was many who came forward. And I say many because I really I think I approached about 15 women and six of them were pregnant and so that was all I could deal with on the first day. So the pregnancy needs at the hotel overall, I thought I would be there for two weeks, but I was there for actually 16 weeks, not 12 weeks. I did about 60 to 80 visits in that time, 30 were with pregnant women. Many visits were for pregnancy tests, so people who thought they were pregnant, many clients for IUD placement. There was a very strange rumor and I don't know if it was true or not, but people really seem to think IUDs were a very common form of birth control and people seem to think that going through multiple airport X-ray machines had dislocated their IUDs. So many people were concerned that their IUDs were not in the right place and many people came for contraception. They were not accommodated and I'll talk to you a little bit about that in a minute. So now I'm going to go through a few case studies that really I think there's just four case studies that really show the overall are the overarching issues that happened with care at the hotel. So the case case one, this was the only client to initially come forward. So this was the one disclosed pregnancy to the community health center. This client was actually a previous health care provider. She was a labor and delivery nurse herself. She was the only one with health records. She had diagnosed dichlorionic-diamnionic twins and she was in the third trimester. She had had three previous caesarean sections and had no operative reports. So she was definitely not a good candidate for VBAC and she actually didn't want to VBAC. So she needed an OB referral and part of the issue was that we were unsure where permanent housing would be found. So I needed an OB who could see her in the community until she moved and then another OB who could see her in the community where she moved. The second case was a 28-year-old G5 P4. So again, remember the average family, there were five children. So this was not uncommon. It was early pregnancy. There was severe nausea and vomiting to the extent that the client was actually planning to go to the emergency room the same day for her nausea and vomiting. And she had had such severe nausea and vomiting in previous pregnancies that she actually was planning a termination with support from her partner. Not pressure, but really they were new to the country and decided this wasn't a good time to have a baby. Which goes back to that comment that one of the practitioners had said where I said we need termination services and they said but we're dealing with a Muslim religious population, they're not going to want termination. So that really speaks to kind of a lack of understanding about women's reproductive health needs. And also the importance of on-site care, which was really important to avoid expensive and unnecessary use of hospital emergency rooms. If I wasn't there she would have gone to an emergency room and really she just needed a prescription for anti-imetics, which I gave her and worked out quite well. So case number three, this was a 19-year-old G1 P0. She was 28 weeks pregnant and she had had previous care and was quite certain of her dates. One of the things that was very interesting about this population is everyone who was coming from a refugee camp had care in pregnancy. So almost all of people who knew they were pregnant had at least an ultrasound and blood work. None of them had their pregnancy records with them and this was very deliberate in getting to know the population and talking to women. There was a lot of fear that if it was disclosed they were pregnant they would not be able to get immigration. So people did not disclose their pregnancy and they did not bring their pregnancy records with them. So they had health records for the entire family. They did have pregnancy records and they deliberately chose to leave them behind. So this client had been trying to get pregnant for five years. So yes, she was trying to get pregnant since she got married at the age of 14 and the average age of marriage in this population at the hotel was 15 years old. Her fundal height was 21 and she palpated as having severe IUGR. She was also married to her first cousin. Consanguinuity was very high in this population. Many people were married to first or second cousins and she was referred to a tertiary care center. So case number four and we'll come back to this case because this is kind of my most favorite case. This is a G11 P10. There was a very limited time at this point and so I kind of had to group my questions about her obstetrical history. So I would say things like what was your longest labor? What was your shortest labor? What was your longest pregnancy? What was your earliest baby? This client had very low literacy even in Arabic. Her and her partner had no written literacy in Arabic. No formal education for either parent. I think she had gone to school until grade three and her partner, I don't think actually had any formal education. It was very difficult to discern a pregnancy history. She had anywhere from one to four preterm births. She was one of the people who was unsure of her due date. She was maybe 32 weeks and it was unclear whether she had a history of precipitous birth. So it became obvious when seeing this population that everybody I'm presenting to hospital essentially was augmented with oxytocin. So because hospital beds were so scarce as soon as people arrived, they were augmented so they would deliver and get out of the hospital bed quickly. So it was unclear when I asked her how long her longest or shortest labors were. She said her longest labor was an hour and I thought that was a miscommunication. So I said, no, not your shortest labor. I mean your longest and she said, no, I don't really feel anything.  And this ends up being really important later on. So I'll revisit this case in a minute. So the wrap up and follow up to day one just to get an idea of what it was like. I had planned to be there for five hours. I left after nine hours and then I went to clinic for about two or three hours. I made labels. I sent off labs. I arranged ultrasounds for all of the patients. I arranged OB referrals. So for the IUGR patients, I arranged tertiary care for the client presenting with twins. I arranged care at a twin clinic. I sent off blood work for all of the patients. This ends up being quite humorous, but all of the patients are told when to return by me writing down in English on a piece of paper when they should come back to see me. I arranged for my practice to receive all of the lab results. And I thought I was being really smart. So I did a Google search on material about pregnancy in Arabic. And I printed out these 20 page booklets that I, it's quite humorous, but I thought I was being very smart. And it was information on preterm labor and preeclampsia, fetal movement, nutrition, all of the kind of regular stuff we would want pregnant people to know. So day one kind of lessons and issues. There was no communication at all between healthcare providers and the settlement agency. They were about five doors away from each other at the hotel. So I'm taking women's names and writing them down on the anti-natals. And I have pieces of paper saying Sarah Alhamoud has an ultrasound in three days at 10 o'clock in the morning. And I found out that all of the families by the settlement agency were written down by the name of the head of the family, which is the husband. And that Syrian married couples, certainly in this demographic, they do not have the same last name. So what would happen is they would write down the head of the family. So as an example, Ahmed Alhamoud plus wife age 19 plus six children age eight, six, five, four, three, one. So I had no way of finding all of these women that I had seen who I had just arranged all of these ultrasounds and follow-up visits for. So it just speaks to the importance of good communication and did not even dawn on me that I wouldn't be able to find these clients later. And the written information in Arabic was irrelevant. There were no except for that one client who was a health care provider. Nobody actually was literate in Arabic enough to read any of the booklets that I thought I was so smart in producing. So just to revisit case four from day one. So the second day I arrived and there are many families waiting for the midwife, which was great. I felt like it was a great success. And like at least people knew there was a midwife there. They wanted to come see the midwife. And this translator said to me, this woman is bleeding. So this is the G11 P10 woman from the previous time I was there. She was now almost 34 weeks gestation.  And again, she might have had a history of preterm labor or might have had a history of precipitous birth. So she said to me, I said, are you having contractions? And she said, no, but I'm having my baby today. So I did a vaginal exam. She was about eight centimeters dilated, great grand multiboss. I could stretch her to anything. And this really speaks to the importance of continuity and knowing the client history. So I knew that she had a history of precipitous birth and maybe silent birth and maybe preterm labor. And that was really useful. So I got her in an ambulance right away, got her to go see. I called the midwife at my practice and have them meet her at the hospital and called the obstetrician. So she had appropriate follow up care. So the outcome of that case, she delivered within five hours of arrival. The baby was fine at delivery. And as preemies often do, she had a 34 week baby that destabilized on day three and ended up being sent to a tertiary care center for sepsis. It was very interesting to me, there was a lot of media attention about this case. There was news all over and it was a real feel good story, which was great. It was a feel good story. But on day five, we realized that this client had been pumping for days and that her premature child in a high resource country like Canada was not had not received any of her breast milk yet. And that again really speaks to the importance of ongoing midwifery care. The midwives who were involved, basically their role was to take these parents to the downtown tertiary care center so that they could see their child and actually deliver breast milk to the baby. And it also shows the importance of involvement with other agencies. So the settlement agency, the healthcare agency, the tertiary care center, nobody was in communication with each other. And transportation was a huge issue. It was organized by the settlement agency, not the healthcare provider. So they were expecting this client to go two hours across town in a bus at three days postpartum, which just didn't make any sense. So this is just a little clip from the newspaper about how this story was taken up. So it was a feel good story and people were really happy that this was the first baby of this group of Syrian refugees delivered in Canada. So people were very happy about that. Minavi? Yeah. Oh, it looks like you're coming to the end because you have about four minutes and that would give us five minutes for questions. Yeah, that's perfect. Great, thanks. So the lessons were learned really there were systemic issues so contraception access was a big issue. There were many women who were presenting to clinic that were looking for contraception and contraception is not within the scope of midwives of Ontario. So there was a big issue around transportation and coordination issues and I'm really sad to say that none of these clients that I saw were adequately able to access contraception. And nobody really recognized that as a settlement issue like how many unplanned pregnancies resulted from this and what are the implications of that during settlement and the initial stages of a family being integrated into a new country. They were systemic issues so really women's reproductive health was not prioritized or seen as important. There was a really big missed opportunity for contraception and family planning education. Not one of the women I saw had previously had a pap test or breast exam. So I did do well women physicals but no pap tests. There were two women with breast lumps that were detected and sent for follow up. But research really shows that immigrant communities, especially from the Middle East and South Asia don't often have breast or cervical cancer screening and I feel like this was a big missed opportunity. There were a lot of interagency issues so a lot of importance of talking to the media and giving political reassurance about how well things were running but really on the ground they were not running well at all. There was a lot of issues around transportation so clients were given tokens for the bus but not explained how to take the bus. Again remember this is a very low literacy population. This speaks to the systemic issue that there really needed to be a systems coordinator. Metson Saint Frontier always has a systems coordinator and that would have been really important that there was no understanding of the population in terms of just the cold weather. It was January in Toronto it was freezing. There was no literacy. This is a population that did not know how to deal with the cold. They did not have any knowledge of the community and there was no rationale. Sorry there was no teaching around how to move around the community with the rationale that these people were going to be housed permanently somewhere different. I think there was a lot of victim blaming. They are in a new country they need to learn how to be here and make their way around without the appropriate education. I think that really spoke to provider exhaustion and just how difficult it was to actually get people from one appointment to another. I am just going to move forward and talk a little bit about midwifery lessons. It is really important in these cases to make midwifery visible and relevant when it is not on the national health care agenda. To be prepared as midwives to get involved, OB consultants must be available and in place. It was very useful that I was within my own community because I was able to set up ultrasounds and know the population. I was able to set up lab appointments quite easily and obstetric community health care provider appointments. I really believe care needed to be on site because these were people who did not have the ability for transportation and also had large families without childcare. And just some bottom lines, reproductive health care needs of women including contraception must be seen as critical during settlement. There needs to be immediate care and ongoing care. We need to look at reproductive health care as a settlement issue. And midwifery must be seen as integral to the care of refugees. And that's it. Thank you so much Manavi. Those are lessons that will be with us sometime as we all learn how to share the planet. Are there questions for Manavi? You can type them in the chat box. We have just about four minutes left. So Manavi, here's a question. Has there been any policy change from above since then? So that's a really good question. There has not and I think one of the most important policy changes would be for midwives to have a mechanism to be paid. When they step in during emergency public health issues. And I would never change it. I love the work I did there, but I worked for 16 weeks for free because I thought care to this community was really important. And unfortunately, I don't think there have been any policy changes. Although there have been a number of papers written nationally that did actually admit how much we kind of failed this population. So I hope that that means there will be policy change in the future. You know, for many years I worked in the state of Florida, which was regularly devastated by hurricanes. And Florida has emergency health provision laws so that when there are emergencies, health care providers can work out of network, be paid, write prescriptions, work to the fullest extent of their scope of practice. And that's exactly what we should have had. We don't have emergency care provision and midwives must be included in that. Yeah. Thank you so much Manavi. Thank you.


Hello everybody! This video will show you what to do if starting a game like GTA San Andreas, GTA 4, Warcraft, League of Legends, World of Tanks, Assassin's Creed, FIFA, Sims, Fallout or others, you encounter an error. The program can't start because DLL is missing from your computer, try reinstalling the problem, the program to fix this problem. There is no exact list of possible missing DLL files because there are so many of them. For the most widespread ones are D3D DX943DLL, XInput 13DLL, D3DX931DLL, D3DX934DLL, XInput 12DLL, D3D11DLL and others. Several of the most popular DLL filenames will also be given in the description of this video. To begin with, don't hurry to search the web for the missing DLL filename and copy it to your computer. It doesn't always work and it is not the right solution for the problem. First of all, a missing DLL file error means problems with the DirectX installed in your PC. Every version of Windows is installed with its own DirectX version, which we can see in the official Microsoft website. Windows 10 with DirectX 11.3 and 12. Windows 8 with DirectX 11.1 and 11.2 Windows 7 with DirectX 11 and 11.1 Windows Vista with DirectX 10, 10.1 and 11 Windows XP with DirectX 9 Find this link in the description. To update DirectX to a version newer than currently installed, except for cases of upgrading to another compatible version, it is necessary to update the operating system or install a newer version of Windows. That is, you won't be able to update or install DirectX 12 for Windows 7. Windows doesn't have an opportunity to roll back to the previous version of DirectX either. You can learn the version of DirectX installed in your PC by running a diagnostic utility. To do it, press Windows plus R, enter dxdiaj, DirectX diagnostic tool will open. The DirectX version is shown in the corresponding line. As we can see, Windows 10 comes equipped with DirectX 12 package by default. Further downloading and updating packages takes place with Windows Update. In the same way, DirectX should update in Windows 7 and 8. If you encounter the error, the program can't start because DLL is missing from your computer. Try reinstalling the program to fix this problem. When starting software or games, which is more often the case, then you should start solving it with updating DirectX drivers. You will have to install an official Microsoft utility – dxwebsetup.exe, which you can download from its official website. And you can find this link in the description of this video. After installation, it will automatically download and install the missing DirectX components to your computer, if it has Windows 7, Windows 8 or Windows 10. Download, cancel and continue, save as, save it. Start the downloaded utility – dxwebsetup.exe. Select the license agreement and click Next. Uncheck the box. To install Bing Panel. After that, the installation starts. As my computer has the latest version of DirectX, the system notifies me about that. In your case, the updated version of DirectX will be installed on your computer. DirectX issues can also arise when trying to start an old game which requires an older DirectX version. And this is often the case with Windows 10. To solve this problem, do the following. Go to Programs and Features. Turn Windows Features on or off. Find legacy components on the list. Check the box next to DirectPlay. OK. Installation begins. Applying changes. Windows has applied the necessary changes. So you close this window. After that, restart the computer for DirectPlay to take effect and start your game once more. If the game or program asking for an older version of DirectX still refuses to run, try starting it in the compatibility mode. Watch one of our videos in our channel to learn how to start programs in the compatibility mode. You can find the link in the description. That is all for now. If you liked this video, click the Like button below and subscribe to our channel to see more. Ask questions in comments. Thank you for watching. Good luck!