السبت، 4 أبريل 2020

Gwyneth Paltrow

Gwyneth Paltrow

Gwyneth Kate Paltrow[1] (/ˈpæltroʊ/; born September 27, 1972) is an American actress, singer, author, and businesswoman. She has received numerous accolades for her work, including an Academy Award, a Golden Globe Award, and a Primetime Emmy Award. Her films have grossed $3.3 billion at the U.S. box office and $8.8 billion worldwide.[2]

Paltrow gained very early notice for her work in films such as Seven (1995), Emma (1996), Sliding Doors (1998), and A Perfect Murder (1998). She garnered wider critical acclaim for her performance as Viola de Lesseps in the historical romance film Shakespeare in Love (1998) which won her several awards, including the Academy Award for Best Actress. This was followed by roles in The Talented Mr. Ripley (1999), The Royal Tenenbaums (2001), Shallow Hal (2001), and Sky Captain and the World of Tomorrow (2004).

After becoming a mother, Paltrow significantly reduced her film workload, making occasional appearances in films, such as Proof (2005), for which she earned a nomination for the Golden Globe Award for Best Actress in a Motion Picture – Drama. In 2009, Paltrow received a Grammy Award nomination for Best Spoken Word Album for Children for the children's audiobook Brown Bear and Friends and won the Primetime Emmy Award for Outstanding Guest Actress in a Comedy Series for her guest role as Holly Holliday on the Fox musical comedy-drama television series Glee in 2011. From 2008 to 2019, Paltrow portrayed Pepper Potts in the Marvel Cinematic Universe.

Since 2005, Paltrow has been the face of Estée Lauder's Pleasures perfume. She is also the face of American fashion brand Coach,[3] owner of a lifestyle company, Goop, and author of several cookbooks. Paltrow has received severe criticism from the scientific community and medical professionals for promoting harmful treatments based on pseudoscience through her company Goop.
Early life
Gwyneth Kate Paltrow was born on September 27, 1972 in Los Angeles, the daughter of actress Blythe Danner and film producer-director Bruce Paltrow.[5] She has a younger brother, Jake, who is a director and screenwriter.[6] Paltrow's father was Jewish,[7] while her mother is from a Christian background.[8] She was raised celebrating "both Jewish and Christian holidays."[9] Her brother had a traditional bar mitzvah when he turned 13.[10][11] Her father's Ashkenazi Jewish family emigrated from Belarus and Poland,[12][13][14][15][16] while her mother has Pennsylvania Dutch (German), Irish, and some English ancestry.[17][18][19] Paltrow's paternal great-great-grandfather was a rabbi in Nowogród, Poland, and a descendant of the well-known Paltrowicz family of rabbis from Kraków.[20][21] She is a half-cousin of actress Katherine Moennig, through her mother, and a second cousin of former U.S. Congresswoman Gabby Giffords (AZ-08), through her father.[22] Her uncle is opera singer and actor Harry Danner, whose daughter, actress Hillary Danner,[23] is Paltrow's cousin and close friend. Paltrow recalls their family gatherings: "Hillary and I always had this in common, and do to this day [...] cooking for people we love, eating, hanging out as a family. It's how we were raised. It's what we do."[24] Another cousin is Rebekah Paltrow Neumann, whose spouse is the Israeli-American millionaire Adam Neumann, founder of WeWork.

Her godfather is director Steven Spielberg.[25][26][27]

Paltrow was raised in Santa Monica, California, where she attended Crossroads School, before enrolling in the Spence School, a private girls' school in New York City.[28] Later, she briefly studied anthropology at the University of California, Santa Barbara, before dropping out to act.[29] She is an "adopted daughter" of Talavera de la Reina (Spain), where at 15, she spent a year as an exchange student and learned to speak Spanish.[30][31][32] She is also conversant in French.[33]

Career
1989–1995: Early acting work
Her acting debut was in High (1989), a TV film her father directed, and after spending several summers watching her mother perform at the Williamstown Theatre Festival in Massachusetts, Paltrow made her professional stage debut there in 1990.[34] Her film debut followed with the musical romance film Shout (1991), starring John Travolta, and she was cast by Steven Spielberg in the commercially successful adventure feature Hook (1991) as the young Wendy Darling.[34] Paltrow's next roles were in the made-for-television movies Cruel Doubt (1992) and Deadly Relations (1993). Her first plum feature film role was in the noir drama Flesh and Bone (1993) as the much-younger girlfriend of James Caan. Janet Maslin of The New York Times described Paltrow as a scene-stealer "who is Blythe Danner's daughter and has her mother's way of making a camera fall in love with her."[35] In 1995, she starred in the thriller Se7en, as the wife of a young detective (Brad Pitt), who is partnered with the retiring William Somerset (Morgan Freeman) and soon tasked with tracking down a serial killer who uses the seven deadly sins as tropes in his murders. The seventh-highest-grossing film of the year,[36] Seven also earned her a nomination for the Saturn Award for Best Supporting Actress. She appeared in Moonlight and Valentino, as a grieving chain-smoker, and in Jefferson in Paris, portraying Martha Jefferson Randolph.[37][38]

1996–2001: Emma and film stardom
In 1996, Paltrow played the title character in the period film adaptation Emma, based on the 1815 novel of the same name by Jane Austen. Director Douglas McGrath decided to bring in Paltrow to audition for the part of Emma Woodhouse, after a suggestion from his agent and after seeing her performance in Flesh and Bone.[39] On his decision to cast the actress, McGrath revealed: "The thing that actually sold me on her playing a young English girl was that she did a perfect Texas accent. I know that wouldn't recommend her to most people [...] I knew she had theater training, so she could carry herself. We had many actresses, big and small, who wanted to play this part. The minute she started the read-through, the very first line, I thought, 'Everything is going to be fine; she's going to be brilliant.'"[39] While she recovered from wisdom-tooth surgery, Paltrow had a month to herself do her own research for the part;[40] she studied horsemanship, dancing, singing, archery and the "highly stylized" manners and dialect during a three-week rehearsal period.[40] The film was released to critical acclaim and commercial success through arthouse cinemas.[41] Variety proclaimed: "Gwyneth Paltrow shines brightly as Jane Austen's most endearing character, the disastrously self-assured matchmaker Emma Woodhouse. A fine cast, speedy pacing and playful direction make this a solid contender for the Austen sweepstakes."[42]

1998 marked a turning point in Paltrow's career as she took on leading roles in five high-profile film releases in the year—Great Expectations, Sliding Doors, Hush, A Perfect Murder and Shakespeare in Love. In the adaptation of the Charles Dickens novel Great Expectations, also starring Ethan Hawke, Robert De Niro, Anne Bancroft and Chris Cooper, she played the unrequited and haughty childhood love of a New York City painter. The British drama Sliding Doors saw her star as a woman whose life could take two central paths depending on whether or not she catches a train, causing different outcomes. Great Expectations and Sliding Doors both grossed over US$55 million worldwide.[43][44] Paltrow starred opposite Jessica Lange in the thriller Hush, as an unsuspecting woman living with her psychotic mother-in-law. The film made US$13.5 million domestically and was generally panned by critics.[45][46] In another thriller, A Perfect Murder, inspired by Alfred Hitchcock's 1954 film, Dial M for Murder, Paltrow starred alongside Michael Douglas, playing Emily Taylor, who was based on Grace Kelly's character from the original film. Despite a mixed critical response towards A Perfect Murder, the film grossed US$128 million globally.[47] She was also considered for the role of Rose DeWitt Bukater in the 1997 film Titanic.[48]
Her most critically acclaimed role in the year was that of the fictional lover of William Shakespeare in Shakespeare in Love, opposite Joseph Fiennes in the titular part. Entertainment Weekly commented, "Best of all is Gwyneth Paltrow, who, at long last, has a movie to star in that's as radiant as she is."[49] The New York Times summed up her performance as Viola thus: "Gwyneth Paltrow, in her first great, fully realized starring performance, makes a heroine so breathtaking that she seems utterly plausible as the playwright's guiding light."[50] Shakespeare in Love made US$289 million in box office receipts,[51][52] and earned Paltrow the Screen Actors Guild Award for Outstanding Performance by a Female Actor in a Leading Role,[53] Golden Globe Award for Best Actress in a Motion Picture – Comedy or Musical,[53] and Academy Award for Best Actress, among other honors.[52] Her pink Ralph Lauren dress worn at the 71st Academy Awards in collecting her Oscar was extremely popular and was credited for bringing pink back into fashion.[54]

In 1999, Paltrow co-starred alongside Jude Law, Matt Damon and Cate Blanchett in the psychological thriller The Talented Mr. Ripley, as the fiancée of a rich and spoiled millionaire playboy (Law) whose identity is adopted by a con artist (Damon). While The Guardian, noting the "very underwritten" female roles in the story, found her to be "peaky and pallid",[55] the film received positive reviews and earned $80 million in North America.[56] She showcased her singing ability in 2000s Duets, which was directed by her father and co-starred singer Huey Lewis. In the film, about "the little known world of karaoke competitions and the wayward characters who inhabit it", she portrayed the estranged daughter of a hustler (Lewis). She performed a cover version of Smokey Robinson's "Cruisin', which was released as a single and went to number one in Australia, while her rendition of the Kim Carnes classic "Bette Davis Eyes" reached number three.[57] Also in 2000, Paltrow co-starred with Ben Affleck in the moderately successful romantic drama Bounce as Abby Janello.

She starred with Jack Black in the comedy Shallow Hal (2001), about a shallow man falling in love with an overweight woman. To play her role, she had to wear a specially designed 25-pound fatsuit and heavy make-up. Shallow Hal opened with US$22.5 million and grossed US$70.7 million in North America and US$141.1 million around the globe.[58] Roger Ebert remarked that she was "truly touching" in the film, which he described as "often very funny, but [...] also surprisingly moving at times."[59] In the Wes Anderson dramedy The Royal Tenenbaums (2001), co-starring Gene Hackman, Anjelica Huston, Ben Stiller and Luke Wilson, Paltrow took on the role of the adopted daughter in an estranged family of former child prodigies reuniting with their father. A positive critical response greeted the film upon its release, and it made US$71.4 million worldwide.[60]

2002–2007: Mixed critical work and hiatus
By 2004, it was observed that since the Oscar for Shakespeare in Love, Paltrow's film career had been less noteworthy and critical acclaim had waned.[61] She said she was unequipped for the pressure, leading to several bad movie choices,[62] agreeing with peers who believe the win is, in some ways, a curse.[63] During this time, Paltrow rarely appeared in films, having taken a hiatus to raise her two children.[28] In The Guardian, she said she divided her career into movies for love and films for money: The Royal Tenenbaums, Proof, and Sylvia fell into the former category, while she signed on to View from the Top and Shallow Hal for the latter.[32]

In 2002, Paltrow made small appearances in the documentary Searching for Debra Winger and the action satire comedy Austin Powers in Goldmember, while she starred in the thriller-drama Possession with Aaron Eckhart as a couple of literary scholars who unearth the amorous secret of two Victorian poets as they find themselves falling under a deepening connection. The film made a lukewarm US$14.8 million worldwide.[64] In the following year, she headlined the romantic comedy View from the Top, where she obtained the part of woman from a small town who sets out to fulfill her dream of becoming a flight attendant. Budgeted at US$30 million, the film only earned US$7 million in its opening weekend; it eventually grossed US$15.6 domestically and US$19,526,014 worldwide.[65] She herself later disparaged the film, calling it "terrible."[66] Paltrow starred as the titular role in Sylvia (2003), a British biographical drama directed by Christine Jeffs and co-starring Daniel Craig chronicling the romance between prominent poets Sylvia Plath and Ted Hughes. Distributed for a limited release in most markets, Sylvia made US$2.9 million internationally.[67] The New York Times, in its review for the film, wrote that "her performance goes well beyond mimicry. She has a vivid, passionate presence, even when her lively features have gone slack with depression and her bright blue eyes have glazed over."[68]

In 2004, she starred with her The Talented Mr. Ripley co-star Jude Law and Angelina Jolie in the science-fiction film Sky Captain and the World of Tomorrow. Her role in the film was Polly Perkins, a reporter for the fictional New York Chronicle. Law became one of the producers of the film and used his clout to get Paltrow involved. Once she had been suggested for the role, Law did not remember "any other name coming up. It just seems that she was perfect. She was as enthusiastic about the script and about the visual references that were sort of put to her, and jumped on board."[69] She said in an interview, "I thought that this is the time to do a movie like this where it's kind of breaking into new territory and it's not your basic formulaic action-adventure movie."[69] While critical response was positive, with a budget of US$70 million, Sky Captain only grossed US$58 million at the international box office.[70] Also in 2004, she was recognized as an outstanding woman in entertainment by Women in Film Los Angeles with the Crystal Award.[71]

In the drama Proof (2005), she starred as the depressed daughter of a brilliant, eccentric mathematician (played by Anthony Hopkins). The film was based on the play of the same name, in which Paltrow also played the same character at London's Donmar Warehouse between May and June 2002. On her portrayal in the film version, Eye for Film remarked: "As she has already shown in Sylvia, The Royal Tenenbaums and even Sliding Doors, Paltrow has an uncanny talent for playing women who are coming apart at the seams and her [character] veers from lovably eccentric to more disturbingly unhinged and back again with fluent ease. The scenes, which she and Hopkins share, as two difficult people bound together by affection, dependency and mutual respect, are entirely believable and all the more touching for it."[72] For her performance, Paltrow earned her second Golden Globe Award nomination for Best Actress in a Motion Picture – Drama.

Paltrow filmed small roles for the 2006 films Love and Other Disasters, Running with Scissors and Infamous, where she sang Cole Porter's "What Is This Thing Called Love?" Her brother Jake Paltrow directed her in his feature debut, the romantic comedy The Good Night (2007), in which she starred opposite Penélope Cruz, Martin Freeman, Danny DeVito and Simon Pegg as the wife of a former keyboard player (Freeman). The film received a two-theater run in North America and garnered mixed reviews from critics.[73] View London felt the actress was "clearly only playing her part as a courtesy to her director brother and it just makes you wish she'd go back to playing lead roles again."[74]

2008–2013: Iron Man and return to prominence
Paltrow saw a resurgence in her career in 2008, when she was cast in Iron Man as Pepper Potts, Tony Stark's personal assistant, closest friend, and budding love interest.[75] First hesitant to appear in a big-budget project, Paltrow asked Marvel to send her any comics they would consider relevant to her understanding of the character, who she considered to be very smart, levelheaded, and grounded. She said she liked "the fact that there's a sexuality that's not blatant." Director Jon Favreau wanted Potts' and Stark's relationship to be reminiscent of a 1940s screwball comedy, something which Paltrow considered to be fun in an "innocent yet sexy" way.[76] Iron Man was favorably received by critics, and with a worldwide gross of US$585 million, it became Paltrow's highest-grossing film until The Avengers (2012).[77] She reprised her role in the sequels Iron Man 2 (2010) and Iron Man 3 (2013). While the second film made US$623.9 million internationally,[78] the third entry went on to gross US$1.215 billion.[79] She also reprised the role in Spider-Man: Homecoming (2017), Avengers: Infinity War (2018) and Avengers: Endgame (2019).

Paltrow starred with Joaquin Phoenix in the romantic drama Two Lovers (2008), playing the beautiful but volatile new neighbor of a depressed bachelor. Two Lovers premiered in competition at the 2008 Cannes Film Festival in May, receiving largely positive reviews,[80][81] especially for Phoenix and Paltrow's performances; Los Angeles Times felt that "Phoenix is at his best with Paltrow's bruised sparrow of a girl; he's desperate to take care of her when he can't even take care of himself. She is one of those actresses who understands the power of a look, and the one of regret and then resignation that overtakes her when Leonard professes his love is steeped in sadness."[82] The film was an arthouse success, grossing US$16 million worldwide.[83]
In the musical drama Country Strong (2010), she starred as an emotionally unstable country music star who attempts to resurrect her career. She recorded the song "Country Strong" for the film's soundtrack,[84] and it was released to country radio stations in August 2010.[85] The film received mediocre reviews and grossed a modest US$20.2 million in North America.[86] The consensus of review-aggregation website Rotten Tomatoes was: "The cast gives it their all, and Paltrow handles her songs with aplomb, but Country Strong's cliched, disjointed screenplay hits too many bum notes."[87] At the 83rd Academy Awards, Paltrow performed another song from the movie, "Coming Home," which was nominated for Best Original Song.[88]

Paltrow made her first scripted television appearance[89] on Fox's Glee, as substitute teacher Holly Holliday, who fills in for Matthew Morrison's character when he falls ill. Her role was developed by co-creator Ryan Murphy, a personal friend of Paltrow's, who suggested that she showcase her vocal and dancing abilities ahead of the release of Country Strong.[90] In her first episode, "The Substitute," she sang "Nowadays" from the musical Chicago with Lea Michele, CeeLo Green's "Forget You", and a mash-up of "Singin' In the Rain" and Rihanna's "Umbrella" with Morrison and the rest of the cast.[91] Her debut in Glee attracted significant buzz and positive commentary from critics; she earned a Primetime Emmy Award for Outstanding Guest Actress in a Comedy Series.[92] Indeed, at the time, Entertainment Weekly's Tim Stack and E! Online's Kristin dos Santos called her appearance Emmy-worthy, with the former rating it among her best performances, and the latter stating that Holly received "some of Glee's best-ever one-liners."[93][94]

She later performed "Forget You" with CeeLo Green himself and several puppet characters provided by The Jim Henson Company at the 2011 Grammy Awards.[95] She reprised her role twice more that season, performing "Do You Wanna Touch Me (Oh Yeah)" by Gary Glitter, an acoustic version of "Landslide" by Fleetwood Mac, "Kiss" by Prince, and Adele's "Turning Tables." Paltrow was briefly featured in Glee: The 3D Concert Movie after being filmed while she performed "Forget You" as Holly in the 2011 Glee Live! In Concert! tour performances of June 16 and 17, 2011.[96] Later that year, Paltrow appeared in Steven Soderbergh's film Contagion, featuring an ensemble cast consisting of Marion Cotillard, Kate Winslet and her The Talented Mr. Ripley co-stars Matt Damon and Jude Law. The thriller follows the rapid progress of a lethal indirect contact transmission virus that kills within days.[97] Paltrow portrayed Elizabeth Emhoff, a "working mom" and one of the virus' first victims.[98] Contagion received positive reviews and opened atop at the North American box office with US$23.1 million; it went on to gross US$75.6 million domestically and US$135.4 million worldwide.[99]

She reprised her role of Pepper Potts in The Avengers (2012), which set numerous box office records, including the biggest opening weekend in North America; it grossed over $1.5 billion worldwide, becoming Paltrow's most widely seen film.[100] Also in 2012, she starred in the independent romantic dramedy Thanks for Sharing, opposite Mark Ruffalo as people learning to face a challenging and confusing road as they struggle together against sex addiction. Distributed for a limited release in certain parts of the United States, the film garnered mixed reviews and grossed US$1 million domestically.[101] Paste magazine noted that her role "exhibits some of the same obsessive diet and exercise habits that Paltrow herself has been accused of—a kind of meta character trait that balances the power in [the main roles'] budding relationship."[102] In April 2013, Paltrow was named People magazine's annual "Most Beautiful Woman."[103]

2014–present
In 2014, she had a two-episode arc in the improvised online series Web Therapy, as Maya Ganesh, "a new-age caricature."[104] In 2015, she starred in Mortdecai,[105] alongside Johnny Depp, Olivia Munn, and Paul Bettany. In it, she portrayed the wife of an unscrupulous art dealer and swindler (Depp). Budgeted at US$60 million, the film only grossed US$7.7 million in North America and US$47.3 million internationally.[106] Paltrow was featured on the track "Everglow", which was included in Coldplay's seventh studio album A Head Full of Dreams (2015).[107] In June 2017, Paltrow announced that she would take a break from acting to focus on her business Goop, stating: "I'm still going to do a little bit here and there, but [the company] really requires almost all of my time."[108]

In 2019, Paltrow reprised her role as Pepper Potts in Avengers: Endgame,[109] The film received positive reviews from film critics and grossed over $2 billion at the box office.[110][111] Paltrow announced the film would be her final major appearance as Potts, but expressed interest in returning for a cameo or a flashback in future films.[112] That same year, she appeared in the Netflix comedy-drama series The Politician, playing the mother of Ben Platt's character.[113] The series received mixed reviews from critics, with Paltrow's performance receiving praise.[114][115]

Other projects
Activism

Watford General Hospital

Watford General Hospital

Watford General Hospital is a 521-bed acute District General Hospital situated on Vicarage Road, Watford, Hertfordshire. Together with Hemel Hempstead Hospital and St Albans City Hospital, it is operated by West Hertfordshire Hospitals NHS Trust
Watford General was formed at the foundation of the National Health Service utilising buildings which were formerly the Watford workhouse and, from 1929, Shrodells Public Assistance Institution.[3] The facility also incorporated Watford's Peace Memorial Hospital which was transferred to the Shrodells site when the Peace Memorial Hospital closed in 1985.[4][5] The Peace Hospice is situated on the former Peace Memorial site.[5][6] The Princess Michael of Kent Wing at the Shrodells site was opened by Princess Michael of Kent in 1986[7][8] and an acute admissions unit was opened by Andy Burnham, the Secretary of State for Health, in February 2010.[7]

The hospital manages beyond its safe capacity with A&E having been designed for around 30,000 attendances per year but receiving over 88,000. The hospital was designated "inadequate" in its 2015 CQC inspection, but was upgraded to "requires improvement" in January 2018.[1]

Outline planning permission to redevelop the hospital and create the Watford Health Campus was granted in 2008. Section 106 agreements which will provide £3 million for infrastructure around the Vicarage Road site, including education and transport, were signed on 26 March 2010.[9] In August 2012 Kier Property was selected to carry out the development programme.[10] It will take 15–20 years to complete.[11]

Facilities
A new road has been built to improve linking the hospital to the town centre and the M1. Given the name, Thomas Sawyer Way, it is the main access for the hospital.[12][13][14]

The hospital is well-served by Watford buses running between the town centre and Rickmansworth

Paddy Power

Paddy Power

Paddy Power is an Irish bookmaker founded in 1988 in Dublin, Ireland. The company conducts business through a chain of licensed betting shops in Ireland and the United Kingdom, and by operating Ireland's largest telephone betting service. On the internet, it offers sports betting, online poker, online bingo, online casino and online games. It merged with Betfair to create Paddy Power Betfair now Flutter Entertainment on 2 February 2016.
Paddy Power was founded in 1988, by the merger of the forty shops of three Irish bookmakers: Stewart Kenny, David Power, and John Corcoran.[2] Stewart Kenny and Vincent O'Reilly had sold Kenny O'Reilly bookmakers to Coral in 1986, and then opened ten shops of their own by 1988; Kenny was group CEO from 1988 to 2002, and chairman from 2002 to 2003.[3] John Corcoran's shops had traded as Patrick Corcoran.[4]

David Power was a son of Richard Power and one of several inheritors trading under the Richard Power name.[3]

The Power name was considered the strongest brand among the merged shops, while the "Paddy" name and green colouring emphasised the chain's Irishness at a time when the fragmented Irish industry was facing competition from British betting chains entering the market in response to changes in the Irish tax code.[4][5]

Paddy Power had an aggressive expansion strategy involving opening prominent shops in most Irish towns, rather than side streets previously favoured.[5] The firm's novelty bets broadened its media coverage beyond the horseracing news.[5] Its share of the Irish off course betting market grew from 8% in 1988 to 33% in 2001.[6]

Power Lesiure, parent company of Paddy Power PLC, listed on the London Stock Exchange in December 2000, to fund an expansion in the United Kingdom.[2][7][8]

At the end of 2005, Paddy Power operated 195 outlets (150 in Ireland and 45 in the United Kingdom). The total number of employees was 1,374. On 27 May 2008, it acquired Northern Ireland independent bookmaker McGranaghan Racing, bringing Paddy Power's shop count to 191 in Ireland. In February 2010, the chain had 356 shops with 209 in Ireland, 8 in Northern Ireland and 139 in Great Britain.[9]

The bookmaker is known for offering odds on controversial markets in order to garner publicity, e.g., in November 2008, 16–1 was laid that United States President Barack Obama 'would not finish' his first term (this was widely interpreted as his odds of assassination).[10]

After English Premier League new entrants Stoke City lost their opening game of the 2008–09 season 3–1 to Bolton Wanderers, Paddy Power controversially paid out on bets on them being relegated. When the club finished in mid-table at the end of the season the company took out a full page advert in The Sentinel apologising to the club and its supporters.[11]

In December 2007, Paddy Power began offering online bingo games. The original "Paddy Power Bingo" used Parlay's bingo software. In 2009, Paddy Power moved their bingo operations from Parlay to Playtech's Virtue Fusion software platform.[12]

In July 2010, the company took the unusual step of refunding bets placed on Felipe Massa to win the 2010 Germany Grand Prix, following the notorious "team orders" incident, which led to Fernando Alonso being allowed to win the race, despite Massa's clear lead.[13]

In October 2011, the company paid out early on New Zealand winning the Rugby Union World Cup, four days before the final against France on 23 October 2011. The company boss said: 'New Zealand have left all of their opposition so far feeling black and blue and it's inevitable us bookies will be taking a hammering from them on Sunday too, so punters might as well collect now.'[14]

The All Blacks were Paddy Power's 4/6 tournament favourites and were 1/9 odds on to win with France 13/2.[14] As of November 2011, Paddy Power was the largest bookmaker in Europe by total share value.[15] Its group income was €444m in 2010.[16]

On 14 May 2010, Paddy Power acquired a majority stake in Australian bookmaker Sportsbet.com.au.[17] Paddy Power was placed 6th in the 2011 Management Today list of "Britain's Most Admired Companies".[18]

Paddy Power and British rival Betfair agreed terms for a merger in September 2015. The transaction was structured as an acquisition of Betfair by Paddy Power[19] and the enlarged entity, named Paddy Power Betfair, is based in Dublin.[20] The merger was completed in February 2016.[21]

Paddy Power CEO Andy McCue became COO of Paddy Power Betfair, with Breon Corcoran, CEO of Betfair, becoming CEO of the combined group and Paddy Power's Gary McGann becoming chairman.[22] Andy McCue left the company in April 2016, to pursue other opportunities.[23]

Criticism
Paddy Power has drawn criticism in the past for offering controversial markets, such as odds on the first species to be driven to extinction by the BP oil spill in the Gulf of Mexico,[24] on an assassination of United States President Barack Obama,[25][26] and on the potential extinction of the polar bear in December 2009.[27]

Paddy Power's advertising campaigns have also been criticised. One showed sight-impaired footballers kicking a cat, for which the Advertising Standards Authority (ASA) received 400 complaints.[28] Another involved the model Imogen Thomas alongside a tagline using a double entendre.[29]

Paddy Power has also been criticised for not paying out on bets with large odds. In May 2009, when Shane Lowry won the Irish Open, it stated that it would not pay out on the 3000/1 odds which had mistakenly been offered and instead reached 'an arrangement' with those involved.[30][31]

Paddy Power also received hundreds of complaints in February 2012 when the company released an advertising campaign to distinguish "the stallions from the mares" by placing transgender women in the crowds at the Cheltenham Festival. The ASA ruled that the advert could not be broadcast in the United Kingdom.[32][33]

The following month, Paddy Power released a controversial YouTube advert depicting a middle aged man shooting tranquiliser darts at chavs at a horse racing ground and featuring a tagline stating that people can "enjoy a chav free Cheltenham". This was inspired by a comment from a user on Paddy Power's Facebook page stating, "Hope the chavs don't ruin Cheltenham like they did Ascot", referring to a brawl on Ladies' Day 2011.[34]

During a UEFA Euro 2012 match between Denmark and Portugal on 13 June 2012, Danish forward Nicklas Bendtner celebrated his second goal by lowering his shorts and lifting his shirt to reveal a pair of Paddy Power underpants, to the disgust of the national team's sponsor Ladbrokes and tournament organisers UEFA. Bendtner was fined €100,000 by UEFA and banned for one game. He later described his actions as being regrettable and not premeditated.[35][36][37]

In early March 2014, 5,525 complaints, the most ever in history, were made to the United Kingdom Advertising Standards Authority (ASA) via an online petition launched for Paddy Power to withdraw an offer for betting on the outcome of the South African trial of Oscar Pistorius for murder of his girlfriend.[38] On 19 March 2014, the ASA upheld all 5,525 complaints that the advertisement was insensitive, made light of disability, made light of the death of a woman, made light of a murder trial, and brought advertising itself into disrepute.[39][40] The advert was discussed on an episode of The Last Leg, where Adam Hills made an impassioned speech condemning it.[41]

Prior to the 2014 FIFA World Cup, Paddy Power posted a photo on its Twitter account, sourced from Reddit, allegedly showing an overhead view of a Brazilian rainforest with the message "C'MON ENGLAND PP" spelled out by the former locations of trees that had been cut down. Following major criticisms over the advert from users, it was revealed on 8 June 2014 that the images were fake, and part of a campaign by Paddy Power to promote its anti deforestation charity effort. The company stated that "we knew we’d drop off a fair few Christmas card lists yesterday, but we couldn’t resist a bit of fake twitter mischief to highlight an important issue to football fans as our World Cup warm up. At least it gave people something to get animated about during last night’s England–Honduras bore fest."[42]

In July 2014, Paddy Power was criticised by the Information Commissioner's Office for its response to an incident in 2010, where a hacker was able to obtain personal information of more than 649,000 people from its website. The data included addresses, email addresses, phone numbers, dates of birth and security questions and answers. Paddy Power did not inform the Information Commissioner's Office until four years later.[43]

In September 2017, Paddy Power offered odds on a dead footballer, Ugo Ehiogu, to become the new manager of Birmingham City F.C. The company said it had made an error.[44] For the 2018 FIFA World Cup, Paddy Power was criticised for its controversial polar bear graffiti stunt, with a Russian polar bear being emblazoned with an England flag. Paddy Power claims the stunt is for awareness of the plight of polar bears in the Russian Arctic.[45]

In October 2018, Paddy Power Betfair received a £2.2 million fine from the UK Gambling Commission, after an investigation revealed that the gaming giant broke the commission's rules regarding social responsibility and anti money laundering.[46]

In December 2018, Paddy Power and William Hill faced further criticism after allegations that they allowed a gambling addict to wager thousands of pounds in stolen cash. Victims of the theft seek £965,000 from Paddy Power that has not been compensated after the £2.2m fine from October 2018.

دبنهامز

دبنهامز

ديبنهامز (بالإنجليزية: Debenhams)‏؛ هي شركة عالمية متخصصة للبيع بالتجزئة. الشركة تأسست قديماً عام 1778 في إنجلترا وتغير الاسم أكثر من مرة نظرا لتداخل الشراكة وتمتلك الشركة فروعاً في أكثر من 21 دولة وتمتلك الشركة واسعة الانتشار 153 فرعاً في إنجلترا وأيرلندا فقط.
الفروع العالمية
مصر
دبنهامز - مصر - الاسكندريه.jpg
كان بدايه وخطوة جديده لتوسع شركه Debenhams ديبنهامز العالمية للازياء والموضة سيكون ديبنهامز الإسكندرية أول فرع للشركه في مصر وأفريقيا بتوكيل من شركه الشايع للاستيراد مصر (محمد حمود الشايع الكويت) وهي واحده من توكيلات كثيرة استحوذت عليها الشركة في منطقه الشرق الأوسط والخليج مثل h&m.american eagle. starbucks.the body shop والمتجر مبني علي مساحه 1500 مترا. وهو متواجد بسيتى سنتر الأسكندريه

فروع أخرى
إيران
ماليزيا
الكويت
قطر
السعودية
تركيا
الإمارات العربية المتحدة
أيرلندا
الهند
الأردن
البحرين

الهلال الاحمر السعودي

الهلال الاحمر السعودي

هيئة الهلال الأحمر السعودي (بالإنجليزية: Saudi Red Crescent Authority)‏ هي جمعية الإسعاف الخيري الأولى لتقديم الخدمة الطبية الاسعافية بالمملكة العربية السعودية. تأسست سنة 1353 هـ.
نشأة الخدمات الاسعافية الطارئة بالمملكة
في العام 1353هـ ولدت فكرة إنشاء جمعية الإسعاف الخيري بالمملكة، كأولِ تنظيمٍ حكومي لتقديم الخدمة الطبية الاسعافية بالمملكة، ومنذ ذلك التاريخ وحتى هذا اليوم والخدمات الطبية الاسعافية الطارئة تتنقل خلال مراحل التطور والبناء التي واكبت النهضة التي تشهدها المملكة في كافة جوانبها الصحية والتعليمية.

جمعية الهلال الأحمر والحج
أُنشئت جمعية الهلال الأحمر في عهد الملك عبدالعزيز عام 1345هـ تحت اسم جمعية الإسعاف الخيري، وقامت بتوفير كافة الأسعافات الأولية وسيارات الأسعاف لخدمة الحجاج والمصابين في حوادث المرور، وفي عام 1383هـ أمر الملك عبدالعزيز آل سعود من خلال المرسوم الملكي الذي يحمل رقم م/14 وبتاريخ 12 ربيع الثاني 1386هـ بتحويلها إلى مؤسسة عامة أسمها جمعية الهلال الأحمر السعودية، وكانت المهام الرئيسية لجمعية الهلال الأحمر السعودي تقديم الخدمات الصحية الطبية لحجاج بيت الله الحرام ورعايتهم صحياً بالتعاون مع الإدارات المختصة، وتقدم جمعية الهلال الأحمر خدماتها للحجاج من خلال 109 مراكز إسعافية، وقد انتشرت في مواقع استراتيجية في أماكن تواجد الحجاج، والتي تتطلب توفر الخدمات الطبية والإسعافية في أماكن عبور الحجاج وزوار المسجد النبوي الشريف في كل من مكة المكرمة والمدينة المنورة، فعلى سبيل المثال خلال موسم حج عام 1418هـ بلغت الخدمات الإسعافية 17،515 خدمة، منها 13،803 حالات مرضى تم تقديم الخدمة لهم، ونقلوا إلى المستشفيات والمستوصفات والمراكز الصحية، ومنها 3،14 حالة تم إسعافها في الموقع، و568 حالة قامت بمراجعة مراكز إسعاف الجمعية لتلقي الإسعافات الأولية دون الحاجة إلى النقل للمستشفيات.

الإسعاف الخيري
صدر الأمر السامي رقم 3306 بتاريخ 2 /3 /1354 هـ في عهد الملك فيصل بن عبد العزيز، وكانت البداية بإنشاءِ أول هيئةٍ مستقلة تقوم على تقديم الخدمة الطبية الاسعافية الطارئة بالمملكة، تحت مسمى (جمعية الإسعاف الخيري). وتضمن المرسوم الملكي الكريم ستة فصول:

تأسيس الجمعية وواجباتها.
موارد الجمعية.
أعضاء الجمعية.
الجمعية العمومية.
مجلس الإدارة.
مواد عامة.
أعضاء هيئة الاسعاف الخيري
الرئيس الأول - الشيخ عبد الله الشيبي
الرئيس الثاني - الشيخ محمد شطا
العضو الشيخ حامد عبد المنان
العضو الشيخ عبد الحميد الحديدي
العضو الشيخ أحمد إبراهيم غزاوي
العضو الشيخ محمد صدقة عبد الغني
العضو الشيخ عبد الله عراقي
العضو الشيخ محمد هرساني
العضو الشيخ عبد الوهاب آشي
العضو الشيخ عرابي سجيني
عضو وأمين صندوق الشيخ عبد الرحمن مظهر
العضو الشيخ عبد الوهاب نائب الحرم
العضو الشيخ علي كتبي
العضو الشيخ محمد نور فطاني
العضو الشيخ مهدي بيك مدير الشرطة العام
العضو الشيخ محمد حمدي بيك مدير الصحة العام
العضو الشيخ محمد آشي
العضو الشيخ عبد الله حجازي
العضو الشيخ محمود قطان
العضو الشيخ صالح محجوب
العضو الشيخ عبد الله آشي.
وتقدم خدماتها وفق ما ورد في المرسوم الملكي :

تقديم الإسعافات الطبية السريعة لضحايا الأخطار والجرحى والمصابين بعاهاتٍ أو ضعفٍ أو عجزٍ ينتابهم في الطرق أو في أية جهة كانت، ونقلهم بعد إجراء العلاجات الأولية.
مد يد المساعدة بكل الوسائل الموجودة لديها في حال انتشار الأوبئة أو حلول كارثة كبرى كالحريق وغيرة والتعاون مع مديرية الصحة فيما يتعلق بالأمور الصحية.
تعضيد كل عمل أو هيئة من نوع هذه الجمعية يكون غرضها إنسانياً محضاً.
تقوم الجمعية بأعمالها باسم الإنسانية بدون أدنى تدخل في المواضيع السياسية.
وتباشر أعمالها بالوسائل التالية :

مركز رئيسي في كل مدينة يحتوى على العاملين الصحيين والتجهيزات الطبية والأدوات اللازمة لتقديم الإسعاف السريع للمصابين والجرحى والمرضى.
تشكيل فرق متطوعة مستديمة بموجب نظام الجمعية الداخلي.
يوجد في مدينة الرياض 54 مركز 41 منها يحتوي على سيارتا إسعاف و13 مركز تحتوي على سيارة إسعاف واحدة ، وما يزيد عن 250 مسعف وأخصائي وطبيب .
تناط بالجمعية العمل بنظام المناوبات في المجالات المخصصة لهذا الغرض.
نشر أعمالها بإيجاد معاهد إنسانية كالمستوصفات والمستشفيات.
يمنح كل فرع بعد تأسيسه الاستقلالية في إدارة شؤونه الداخلية ويقيد بإتباع القانون فيما يختص بمبدأ الجمعية وغايتها ويحق لكل فرع أن ينشئ مراكز تابعة له بموافقة مجلس الإدارة.
وتم تحديد مسمى الجمعية الرسمي بحيث يكون (جمعية الإسعاف الخيري الوطني بالمملكة العربية السعودية)، كما تم تحديد لون علم الجمعية باللونين (الأخضر والأحمر).

برنامج الإغاثة في جمعية الهلال الأحمر السعودية
تنقسم أعمال الإغاثة لجمعية الهلال الأحمر السعودي إلى الأقسام التالية:

غذائية
إيوائية
دوائية
وتُقدم المساعدات حسب ما يقتضيه الحال على طريقتين: الطريقة الأولى مساعدات طويلة الأجل حيث تعتمد على قيام الجمعية بتنفيذ برامج ومشاريع اغاثية مباشرة لتخفيف آثار ضرر الكارثة قد تستمر إلى سنوات كمساعدة المملكة عن طريق تشكيل لجان محلية لجمع التبرعات النقدية والعينية من خلال شحن المواد الإغاثية المتنوعة بكافة الوسائل جواً وبحراً وبراً، كما يتم إنشاء مراكز إغاثية في الدول المتضررة ومكاتب إشرافية لتوزيع المساعدات، وتنفيذ البرامج التي يحتاجها المتضررون كما حصل في افريقيا اثناء المجاعة ،وكوسوفا، والشيشان، وافغانستان، وفلسطين. الطريقة الثانية المساعدات العاجلة حيث يُصدر فيها أوامر سامية لمساعدة بلد من البلدان العربية أو الإسلامية أو الصديقة من خلال التنسيق مع الجهات الحكومية المعنية لتأمين وشحن هذه المساعدة ومن ثم تقديمها للبلدان المتضررة على وجه السرعة.

الخدمات الطبية الطارئة في ثوبها الجديد
حَمَلت جمعية الإسعاف الخيري لواء الخدمات الاسعافية بالمملكة العربية السعودية لمدة تسعة وعشرين عاماً، ومع النمو السريع للمملكة في كافة القطاعات ولمواكبة هذا التغيير والتطور فقد حذت الخدمات الاسعافية حذوَ القطاعات الأخرى , وتحولت جمعية الإسعاف الخيري الوطني إلى جمعية الهلال الأحمر السعودي في العام 1383 هـ. كما حذت القطاعات الحكومية الأخرى حذو الجمعية بإنشاءِ أقسامٍ وإدارة للخدمات الطبية الطارئة تعمل ضمن منظومتها سواءً كانت عسكرية أو مدنية، هذا بالإضافة إلى صدور التوجيهات للقطاعات الخاصة المشغلة للأنظمة الصحية بضرورة إيجاد وسائل نقل للمرضى والمصابين كتنظيم يساعد في تغطية المملكة بهذه الخدمة.

أنظمة الإسعاف والطوارئ الطبية
997 هو الرقم الموحد للخدمة الاسعافية الطارئة بالمملكة (الإسعاف)، ويقوم بالاستجابة إلى كافة النداءات الخاصة بالطوارئ الطبية والكوارث والإصابات المتعددة.
الوحدات الاسعافية (مراكز الإسعاف) بالقطاعات العسكرية (الحرس الوطني، القوات المسلحة)، تعتبر وحدات مساندة للعمل الاسعافي الأهلي، وتعمل جنباً إلى جنب في خدمة المواطن عند الطلب.
الوحدات الاسعافية بالمستشفيات ومراكز الرعاية التابعة لوزارة الصحة، تعمل على نقل الحالات المرضية والإصابات من مركزٍ صحي أو مستشفى إلى مستشفى أخر ومن مدينة إلى أخرى عند الحاجة لعملية النقل وفق حالة المصاب أو المريض.
الوحدات الاسعافية بالمستشفيات الخاصة والمراكز الطبية المتخصصة، تقوم بالمشاركة في الخدمة الطبية الطارئة في حالة الكوارث، وتقوم بعملها اليومي بمقابلٍ مالي.
الإخلاء الطبي يتم بواسطة مستشفيات القوات المسلحة.
الإنقاذ الجوي يتم من قبل الدفاع المدني.
وبهذا التنوع في الخدمة المقدمة وبالتنسيق المشترك أصبح بالإمكان تحقيق مستويات مختلفة من العناية للمواطنين في ظروف صحية وبيئية متباينة. إن الدور الريادي الذي تقوم به الجمعية كمقدمٍ رئيسي للخدمة الطبية الاسعافية بالمملكة جعل منها محط أنظار المسؤولين عن تقديم العناية الطبية الطارئة للمواطنين. لذا فإن التعرف على هذا القطاع عن كثب كمثالٍ لأحد أهم مقدمي الخدمة الطبية الاسعافية يُعدُ ضرورياً.

الهدف الرئيسي للهيئة
السعي لتخفيف حدة المصائب والآلام البشرية دون التمييز أو التفرقة في المعاملة لأي سببٍ.

نطاق عمل الهيئة
تعتبر هيئة الهلال الأحمر السعودي الهيئة الوحيدة في المملكة العربية السعودية التي تعمل وفقاً للقواعد المنصوص عليها في الاتفاقيات الدولية والمقبولة في زمن الحرب كهيئةٍ مساعدة للإدارات الطبية بالقوات المسلحة السعودية، كما تتمتع الهيئة بجميع المزايا والحصانات الواردة في اتفاقيات جنيف.
ولتحقيق الحيادية لنطاق عمل الهيئة فقد نص نظام الهيئة الأساسي على عدم جواز دخول الهيئة في مضاربات مالية أو التدخل في الأمور السياسية أو الدينية.
مهام الهيئة الرئيسية
الاستعداد والعمل في زمن السلم والحرب بصفتها مساعدة للإدارات الطبية في القوات المسلحة على سبيل التعاون والتكامل لصالح جميع ضحايا الحرب المدنيين والعسكريين في جميع الأحوال المنصوص عليها في اتفاقيات جنيف، وعلى الأخص نقل المرضى والمصابين والجرحى وإنشاء مستشفيات الهلال الأحمر في المواقع التي تُحددها القيادات الحربية.
تخزين معدات الإيواء والأدوية وجميع ما يلزم لعلاج المرضى والجرحى والعناية بالأسرى.
توفير الإسعافات العاجلة الضرورية لضحايا الحوادث والكوارث والنكبات العامة.
نقل المرضى والمصابين في الحوادث والمساهمة في علاجهم والاشتراك في محاربة الأوبئة وتقديم الخدمات الطبية والاشتراك في نشر الثقافة الصحية وإنشاء وإدارة المستشفيات والمستوصفات والعيادات والصيدليات ومراكز الإسعاف ونقل الدم.
تقديم الخدمات الصحية والمساعدات الطبية لحجاج بيت الله الحرام ورعايتهم صحياً بالتعاون مع الإدارات المختصة.
النهوض بمهنة التمريض والعمل على تدبير الممرضين والممرضات، وتدريبهم على أعمال المستشفيات والطوارئ وكذلك الأخصائيين والمساعدين الاجتماعيين وغيرهم ممن يحتاج إليهم لتحقيق أغراضها سواءً كانوا متفرغين أو من المتطوعين، ويكون ذلك على الأخص إما بدوراتٍ تدريبية أو بإنشاء مدارس الإسعاف والتمريض أو المساعدة في إنشائها.
تأمين وسائل الإسعاف الأولي في مكان الحادث ونقل المرضى والمصابين إلى مراكز العلاج.
المساهمة في الخدمات الإنسانية والاجتماعية بما يتفق ورسالة الهلال الأحمر.
نشر أغراض الهلال الأحمر ومبادئه الإنسانية.
توثيق الصلات وتبادل المعونات الممكنة بينها وبين جمعيات الهلال والصليب الأحمر الدولية وغيرها من الهيئات المماثلة.
القيام بغير ما تقدم ذِكرَهُ من إعمالٍ في زمن السلم وفي زمن الحرب وفقاً لما تقتضيه الظروف وطبقاً لأهداف الهلال الأحمر.
هيئة الهلال الأحمر السعودي
صدر عن مجلس الوزراء ليوم الاثنين الموافق 24/12/1429هـ قراراً يقضي بتحويل مسمى جمعية الهلال الأحمر السعودي إلى هيئة الهلال الأحمر السعودي Saudi Red Crescent Authority.

رسالة الهيئة
تقوم الهيئة بتقديم الخدمات الطبية الإسعافية الطارئة والسريعة بكفائة وفاعلية للمواطنين والمقيمين في المملكة في الظروف العادية والكوارث، والاسهام في رفع مستوى الوعى الصحي. وتشارك الهيئة في اعمال الإغاثه داخل المملكة وخارجها. وتقدم الهيئة خدماتها بما يتفق مع القيم والتعاليم الإسلامية والاصول المهنية ونظامها الأساسي، وتحرص الهيئة على ابراز دورها الإنسانى وتوطيد العلاقة مع الجمهور والجهات الحكومية والاهلية ذات العلاقة بنشاط الهيئة محلياً وعالمياً. وتهتم الهيئة بالحفاظ على منسوبيها بتدريبهم وتأهيلهم وتحفيزهم.

إحصائيات الخدمات الإسعافية لهيئة الهلال الأحمر السعودي لعام 2018
هي مجموع الخدمات الإسعافية الأرضية والجوية التي تقدمها هيئة الهلال الأحمر السعودي للمصابين والمرضى ما قبل المستشفى والبالغ عددها 568682 خدمة اسعافية، شاملة جميع المراكز في جميع مناطق المملكة البالغ عددها 444 مركزًا موزعة على 13 منطقة، وتشمل الخدمات الاسعافية السعوديين والمقيمين والزائرين.

Ivermectin

Ivermectin

Ivermectin is a medication used to treat many types of parasite infestations.[1] This includes head lice, scabies, river blindness (onchocerciasis), strongyloidiasis, trichuriasis, ascariasis, and lymphatic filariasis.[1][2][3][4] It can be taken by mouth or applied to the skin for external infestations.[1][5] Use in the eyes should be avoided.[1]

Common side effects include red eyes, dry skin, and burning skin.[1] It is unclear if it is safe for use during pregnancy, but is probably acceptable for use during breastfeeding.[6] It belongs to the avermectin family of medications.[1] It works by causing the parasite's cell membrane to increase in permeability, resulting in paralysis and death.[1]

Ivermectin was discovered in 1975 and came into medical use in 1981.[7][8] It is on the World Health Organization's List of Essential Medicines, the safest and most effective medicines needed in a health system.[9] The wholesale cost in the developing world for the tablets is about US$0.12 for a course of treatment.[10] In the United States, the costs is less than US$50.[11][12] In other animals it is used to prevent and treat heartworm among other diseases
Medical uses
Pinworm
Ivermectin is as effective as albendazole or alternative antinematode drugs for treatment of pinworm infection (enterobiasis).[13]

River blindness
Ivermectin is used for prevention, treatment, and control of river blindness (onchocerciasis) in populations where the disease is common. However, ivermectin is contraindicated in persons with a high burden of loiasis (e.g., >20,000 Loa loa microfilariae per mL), due to risk of ivermectin-associated severe inflammatory events.[14]

A single dose of ivermectin reduces microfilaridermia by 98–99% after 1–2 months.[15] Ivermectin does not kill adult worms. A single oral dose of ivermectin, taken once or twice a year for the 10–15-year lifespan of the adult worms, is required to protect the individual from river blindness.[16]

A 2012 Cochrane review found weak evidence suggesting that ivermectin could result in the reduction of chorioretinal lesions and prevent loss of vision in people with river blindness.[17] Moxidectin has been approved by the FDA for use in people with river blindness, has a longer half-life than ivermectin, and may eventually supplant ivermectin, as it is a more potent microfilaricide, but there is a need for additional clinical trials, with long-term follow-up, to assess whether moxidectin is safe and effective for treatment of nematode infection in children and women of childbearing potential.[18][19]

Loa loa filariasis
A single dose of ivermectin gives a rapid and durable decrease in body burden of eyeworm (Loa loa). The risk of ivermectin-associated severe adverse drug events is very low in persons with less than 20,000 microfilariae per mL of blood.[20]

Threadworm
Ivermectin is more effective than albendazole and equally as effective as thiabendazole for treatment of threadworm (strongyloidiasis). Ivermectin has fewer adverse effects than does thiabendazole and is at least as well tolerated as albendazole.[21] An analysis based on an economic model suggests that it is cost effective for people moving to Europe from areas where threadworm is common to be given a single-dose of ivermectin on arrival so as to cure presumptive infection with threadworm.[22] Persons who are immunocompromised or who will receive immunosuppressive treatment and who have confirmed or presumptive threadworm infestation are likely to benefit from treatment with ivermectin.[23]

Whipworm
Combination therapy with ivermectin plus albendazole is effective for treatment of whipworm (Trichuris trichiura) and the rate of Mazzotti reaction is no higher than for albendazole alone.[24]

Lymphatic filariasis
Combination therapy with ivermectin plus albendazole is effective for treatment of Lymphatic filariasis due to Wuchereria bancrofti,[25] Brugia malayi, or Brugia timori.[26]

Arthropod
Evidence supports its use against parasitic arthropods and insects:

Mites such as scabies:[27][28][29] It is usually limited to cases that prove to be resistant to topical treatments or that present in an advanced state (such as Norwegian scabies).[29] One review found that the efficacy of permethrin is similar to that of systemic or topical ivermectin.[30] A separate review found that although oral ivermectin is usually effective for treatment of scabies, it does have a higher treatment failure rate than topical permethrin.[31] Another review found that oral ivermectin provided a reasonable balance between efficacy and safety.[32] Since ivermectin is more convenient than permethrin,[33] many have turned to veterinary sources of the drug to obtain assurance of a cure at an affordable price.[34]
Lice:[35][36] Ivermectin lotion (0.5%) is FDA-approved for patients six months of age and older.[37] After a single, 10-minute application of this formulation on dry hair, 78% of subjects were found to be free of lice after two weeks.[38] This level of effectiveness is equivalent to other pediculicide treatments requiring two applications.[39]
Bedbugs: There is tentative evidence that ivermectin kills bedbugs, as part of integrated pest management for bedbug infestations.[40][41][42] Such use however may required a prolonged course of treatment which is of unclear safety.[43]
Malaria-bearing mosquitos, such as Anopheles gambiae: Mass drug administration of a population with ivermectin for purposes of treating/preventing nematode infestation is effective for eliminating malaria-bearing mosquitos and thereby reducing infection with residual malaria parasites.[44]
Rosacea
A review found that ivermectin was effective for treatment of rosacea.[45] An ivermectin cream has been approved by the FDA, as well as in Europe, for the treatment of inflammatory lesions of rosacea. The treatment is based upon the hypothesis that parasitic mites of the genus Demodex play a role in rosacea.[46] In a clinical study, ivermectin reduced lesions by 83% over 4 months, as compared to 74% under a metronidazole standard therapy.[47][48]

Contraindications
Ivermectin is contraindicated in children under the age of five or those who weigh less than 15 kilograms (33 pounds)[35], women who are breastfeeding, and individuals with liver or kidney disease.[49]

Adverse effects
The main concern is neurotoxicity, which in most mammalian species may manifest as central nervous system depression, and consequent ataxia, as might be expected from potentiation of inhibitory GABA-ergic synapses.

Dogs with defects in the P-glycoprotein gene (MDR1), often collie-like herding dogs, can be severely poisoned by ivermectin. The mnemonic "white feet, don't treat" refers to Scotch collies that are vulnerable to ivermectin.[50]

Since drugs that inhibit the enzyme CYP3A4 often also inhibit P-glycoprotein transport, the risk of increased absorption past the blood-brain barrier exists when ivermectin is administered along with other CYP3A4 inhibitors. These drugs include statins, HIV protease inhibitors, many calcium channel blockers, lidocaine, the benzodiazepines, and glucocorticoids such as dexamethasone.[51]

For dogs, the insecticide spinosad may have the effect of increasing the potency of ivermectin.[52]

Pharmacology
Pharmacodynamics
Ivermectin and other avermectins (insecticides most frequently used in home-use ant baits) are macrocyclic lactones derived from the bacterium Streptomyces avermitilis. Ivermectin kills by interfering with nervous system and muscle function, in particular by enhancing inhibitory neurotransmission.

The drug binds to glutamate-gated chloride channels (GluCls) in the membranes of invertebrate nerve and muscle cells, causing increased permeability to chloride ions, resulting in cellular hyper-polarization, followed by paralysis and death.[1][53] GluCls are invertebrate-specific members of the Cys-loop family of ligand-gated ion channels present in neurons and myocytes.

Pharmacokinetics
Ivermectin can be given by mouth, topically, or via injection. It does not readily cross the blood–brain barrier of mammals due to the presence of P-glycoprotein,[54] (the MDR1 gene mutation affects function of this protein). Crossing may still become significant if ivermectin is given at high doses (in which case, brain levels peak 2–5 hours after administration). In contrast to mammals, ivermectin can cross the blood–brain barrier in tortoises, often with fatal consequences.

Ecotoxicity
Field studies have demonstrated the dung of animals treated with ivermectin supports a significantly reduced diversity of invertebrates, and the dung persists longer.[55]

History
The discovery of the avermectin family of compounds, from which ivermectin is chemically derived, was made by Satoshi Ōmura of Kitasato University, Tokyo and William C. Campbell of the Merck Institute for Therapeutic research. Ōmura identified avermectin from the bacterium Streptomyces avermitilis. Campbell purified avermectin from cultures obtained from Ōmura and led efforts leading to the discovery of ivermectin, a derivative of greater potency and lower toxicity.[56] Ivermectin was introduced in 1981.[57] Half of the 2015 Nobel Prize in Physiology or Medicine was awarded jointly to Campbell and Ōmura for discovering avermectin, "the derivatives of which have radically lowered the incidence of river blindness and lymphatic filariasis, as well as showing efficacy against an expanding number of other parasitic diseases".[58]

Society and culture
Cost
The wholesale cost in the developing world is about US$0.12 for a course of treatment as of 2014.[10] This is down from an initial cost of US$6 proposed by Merck in 1987.[59] The company however has donated 100s of millions of courses of treatments since 1988 in more than 30 countries.[59] Between 1995 and 2010 the program using donated ivermectin to prevent river blindness is estimated to have prevented 7 million years of disability well costing US$257 million.[60]

In the United States a course of treatment with pills costs about US$25–50 for a typical adult.[11] As of 2019 ivermectin tablets were the least expensive treatment option for lice in children at about US$10.[61] The hair lotion, however, is about US$300 for a course of treatment.[61]

Brand names
Ivermectin is available as a generic prescription drug in the U.S. in a 3 mg tablet formulation.[62] It is also sold under the brand names Heartgard, Sklice[63] and Stromectol[64] in the United States, Ivomec worldwide by Merial Animal Health, Mectizan in Canada by Merck, Iver-DT[65] in Nepal by Alive Pharmaceutical and Ivexterm in Mexico by Valeant Pharmaceuticals International. In Southeast Asian countries, it is marketed by Delta Pharma Ltd. under the trade name Scabo 6. The formulation for rosacea treatment is sold as Soolantra. While in development, it was assigned the code MK-933 by Merck.[66]

Veterinary use
Ivermectin is routinely used to control parasitic worms in the gastrointestinal tract of ruminant animals. These parasites normally enter the animal when it is grazing, pass the bowel and set and mature in the intestines, after which they produce eggs which leave the animal via its droppings and can infest new pastures. Ivermectin is effective in killing some, but not all, of these parasites.[citation needed]

Some dog breeds (especially the Rough Collie, the Smooth Collie, the Shetland Sheepdog, and the Australian Shepherd), though, have a high incidence of a certain mutation within the MDR1 gene (coding for P-glycoprotein); affected animals are particularly sensitive to the toxic effects of ivermectin.[67][68] Clinical evidence suggests kittens are susceptible to ivermectin toxicity.[69] A 0.01% ivermectin topical preparation for treating ear mites in cats is available.[70]

Ivermectin is sometimes used as an acaricide in reptiles, both by injection and as a diluted spray. While this works well in some cases, care must be taken, as several species of reptiles are very sensitive to ivermectin. Use in turtles is particularly contraindicated.[71]

Research
Ivermectin is also being studied as a potential antiviral agent against the chikungunya and yellow fever.[72]

In 2013, this antiparasitic drug was demonstrated as a novel ligand of farnesoid X receptor (FXR),[73][74] a therapeutic target for Nonalcoholic Fatty Liver Disease.[75]

Ivermectin is also of interest in the prevention of malaria, as it is toxic to both the malaria plasmodium itself, and the mosquitos that carry it.[76][77]

Australian scientists discovered in early April 2020 that Ivermectin is an inhibitor of SARS-CoV-2, the causative agent of COVID-19, in vitro. A single treatment was able to effect a roughly 5000 fold reduction in virus cell culture at 48 hours. Studies and tests to determine viability, safety, and dosage are still required.

رؤوف غبور

رؤوف غبور

الدكتور رؤوف كمال حنا غبور راجل اعمال مصرى ,ريس مجموعة شركات غبور والعضو المنتدب فى مصر ورئيس مجلس ادارة شركة جي بي غبور أوتو اللى اتأسست سنة 1985، وهو عضو الهيئة العليا لحزب المصريين الأحرار أولاده نادر رؤوف كمال غبور عضو مجلس الاداره وكمال رؤوف كمال غبور وزوجته الراحله علا لطفي زكي وهبه.

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