Iran’s supreme leader warns US of ‘unforgettable lessons’
Iran’s supreme leader has warned the US that it will face “unforgettable lessons” if it continues its military campaign against the Islamic Republic.
In remarks broadcast on Iranian state television and attributed to Mojtaba Khamenei, the supreme leader also described president Donald Trump’s signature as “worthless and invalid”.
Khamenei said any response would come not only from Iran but also from its regional allies, referring to the so-called “Axis of Resistance”, signalling that Tehran could draw on proxy groups across the Middle East as the conflict intensifies.
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A woman holds a portrait of Iran’s Supreme Leader Mojtaba Khamenei and Iran’s late Supreme Leader Ayatollah Ali Khamenei (Reuters)
Shahana Yasmin19 July 2026 04:45
Iran says it is no longer bound by interim US agreement
Iran has announced that it is suspending its commitments under an interim agreement with the United States, accusing Washington of violating the deal through its continued military campaign.
Kazem Gharibabadi, Iran’s deputy foreign minister, told state television that Tehran was “no longer implementing” the agreement, which had been signed about a month ago in an effort to permanently end the fighting.
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Asked about Iran’s decision, Donald Trump dismissed the move, telling NewsNation he “couldn’t care less”. He added that Washington remained focused on “never allowing Iran to have a nuclear weapon”.
Shahana Yasmin19 July 2026 04:35
US strikes reported near Shadegan and on Qeshm Island
Fresh US airstrikes have hit areas near the southwestern Iranian city of Shadegan and on Qeshm Island in the Strait of Hormuz, according to Iranian officials and state media.
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Khuzestan’s deputy governor for security, quoted by Tasnim news agency, said emergency teams had been deployed near Shadegan and that further information on the extent of the damage would be released later.
On Qeshm Island, Tasnim reported that at least two explosions were heard after another round of US attacks. Emergency, security and operational teams were sent to assess the locations struck and determine whether there were any casualties or damage.
Shahana Yasmin19 July 2026 04:25
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Trump calls deaths of US troops in Jordan ‘a very sad thing’
US president Donald Trump described the deaths of two American service members in Jordan as “a very sad thing” after they were killed while defending against Iranian missile and drone attacks.
Trump told NewsNation that the troops had died “in service of our country” and repeated that the conflict’s central objective was “never allowing Iran to have a nuclear weapon”.
On Iran’s announcement that it would no longer abide by a US-Iran memorandum of understanding, Trump replied: “I couldn’t care less.”
US president Donald Trump described the deaths of two American service members in Jordan as ‘a very sad thing’ (AFP/Getty)
Shahana Yasmin19 July 2026 04:10
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US launches fresh strikes on Iran after deaths of 2 service members
The US military launched a new wave of airstrikes on Iran on Sunday, saying the attacks were intended to “swiftly punish” the country’s Islamic Revolutionary Guard Corps (IRGC) after an Iranian drone and missile attack on a base in Jordan killed two American service members, left another missing and wounded four others.
US Central Command said the strikes were aimed at further degrading Iran’s ability to disrupt shipping through the Strait of Hormuz, where Tehran has stepped up maritime operations in recent days.
The US confirmed its first troop deaths from direct Iranian fire since the opening days of the war. Since the conflict began, 16 US service members have been killed and more than 430 wounded, according to the Pentagon.
Shahana Yasmin19 July 2026 04:00
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UAE calls for ‘utmost restraint’ as it seeks to de-escalate US-Iran conflict
The United Arab Emirates has called for “the utmost restraint” and expressed “deep concern” over the escalation of conflict between the US and Iran.
In a statement on Saturday, the UAE’s ministry of foreign affairs “called for an immediate end to hostilities and a swift return to negotiations and stressed the importance of ensuring safe, uninterrupted navigation through the Strait of Hormuz, calling it vital to the global economy.”
Holly Bancroft19 July 2026 03:45
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Qatar condemns Iran attacks on Jordan, Bahrain and Kuwait
Qatar’s ministry of foreign affairs has condemned Iran’s attacks on Jordan, Bahrain and Kuwait, saying they are “a flagrant violation of the sovereignty and territorial integrity of the targeted countries and a blatant breach of international law”.
In a post of social media platform X, the ministry of foreign affairs said that the “targeting [of] electricity and water desalination plants in the State of Kuwait crosses all red lines”.
Qatar warned that the latest strikes were a “dangerous escalation” that would undermine peace efforts.
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Holly Bancroft19 July 2026 03:26
Photos show smoke billowing from oil facility in Kuwait
The most significant damage from Iranian strikes on Saturday occurred in Kuwait, where a water desalination plant and an oil facility were hit, according to the Kuwait authorities and the Kuwait Petroleum Corporation. Both declined to provide locations.
Photos shared through Reuters showed smoke billowing near an oil facility in Ahmadi Governorate, and near the oil facility in Mangaf, Kuwait. The strikes injured several people at the oil facility and caused a fire at the desalination plant, forcing several power generation units offline. It was the second attack against a desalination plant in two days in the tiny desert nation that depends on desalination for 90 per cent of its drinking water.
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A satellite image shows smoke billowing near an oil facility in Ahmadi Governorate, Kuwait, July 18, 2026. (Reuters)
Smoke billows near the oil facility in Mangaf, Kuwait, July 18, 2026, in this screen grab obtained from a social media video (Reuters)
Holly Bancroft19 July 2026 02:22
Oil prices climb to their highest level in more than a month on Friday
Oil prices rose more than 4 per cent on Friday to their highest level in more than a month after resumed strikes between the US and Iran.
On Friday, the US said that it would enforce a naval blockade while Iran said it targeted vessels that violated its rules on navigating the Strait of Hormuz, the vital waterway for one-fifth of the world’s oil supply.
A power generation and water desalination plant in Kuwait was hit in an Iranian attack, the country’s Electricity, Water and Renewable Energy Ministry said in a statement. It was the second attack on Kuwaiti water desalination sites in two days.
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Kuwait’s Foreign Ministry said Iran’s targeting of vital infrastructure endangered civilians and violated international law, adding it held Tehran fully responsible for the attacks.
Vessels at the Strait of Hormuz, as seen from Musandam (Reuters)
Holly Bancroft19 July 2026 01:25
Recap: Iran ‘suspends’ interim deal with US
Iran has said the US has “violated and suspended all of its commitments” within the interim deal agreed in Pakistan.
In comments reported by Fars news agency on Saturday, deputy foreign minister Kazem Gharibabadi said that, as a result, Tehran has “likewise suspended all our own commitments” agreed in the US memorandum.
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Mr Gharibabadi said Iran was now “busy defending the country”.
The World Cup Final between Spain and Argentina is being shown on both ITV and the BBC, with Post Malone and IShowSpeed among those performing at the closing ceremony
20:39, 19 Jul 2026Updated 20:54, 19 Jul 2026
Fans settling in for Sunday’s World Cup final between Spain and Argentina were thrilled to see Post Malone performing at the opening ceremony.
The two nations are locked in battle for the sport’s most coveted trophy at New York/New Jersey Stadium in the United States, with the final being broadcast live on both the BBC and ITV.
Supporters from across the globe settled in to watch the final, but it wasn’t long before many flocked to social media to express their thoughts about the closing ceremony, which featured Post Malone and IShowSpeed, reports the Mirror.
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And while some were not impressed, others could not praise Post Malone enough, saying, “Post Malone!! The damn mic is onnnn.”
Meanwhile, another viewer added: “So good to see Posty can still rap!!”
“Yes, Post Malone is the GOAT. He looks amazing,” another went on.
However, one unimpressed viewer wrote on X, “The World Cup closing show was terrible.” While a third added, “It probably was the worst one.”
“It must have been the worst closing ceremony for a World Cup ever. And the playback, what a shame. #worldcup,” another agreed.
Spain secured their spot in the showpiece after delivering a commanding 2-0 triumph over France in the semi-finals, while Argentina sealed their place by narrowly defeating England 2-1 in a fiercely fought clash.
Following weeks of drama across the United States, Canada, and Mexico, the tournament boils down to one ultimate showdown as two of international football’s giants vie to be crowned world champions.
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This year’s final is also making history beyond the on-field drama. For the first time in World Cup history, FIFA has unveiled a Super Bowl-style half-time show, a move that has split opinion amongst supporters.
The entertainment has been organised by Coldplay frontman Chris Martin and includes performances from Shakira and Burna Boy, who co-wrote the official anthem for the tournament.
Pop superstars Madonna and Justin Bieber are also expected to grace the stage during the break.
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England, meanwhile, concluded their campaign on a positive note on Saturday by beating France 6-4 in a captivating Bronze Final.
While failing to reach the final will remain painful, England departs North America with a medal after concluding the competition on an uplifting note.
The president briefly appeared on MetLife Stadium’s scoreboard screen, where he was seen standing in a secured area behind protective glass with FIFA’s president Gianni Infantino and first lady Melania Trump. There was no discernible reaction from the crowd, according to White House pool reporters.
A staffer held out the FIFA trophy for the president to inspect, which Trump patted before it was whisked away. He watched the remainder of the match from the box with Infantino as well as the Canadian Prime Minister Mark Carney and Mexican President Claudia Sheinbaum.
His youngest son, Barron, was also in attendance, along with other Trump family members including his son Eric Trump and his wife Lara Trump, daughter Ivanka Trump and her husband Jared Kushner, and daughter Tiffany Trump and her husband Michael Boulos.
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Trump said he would bring up the idea of hosting the championship again during a Friday press conference with Infantino. Hosting rights for the next two World Cups have already been decided. Trump and Infantino attended Sunday’s match together, and their friendship has added another political layer to the global tournament.
Donald Trump and Gianna Infantino attend the World Cup Final (Reuters)
“It turned out we were a soccer country, and I think it’s going to remain,” Trump said Friday during an event at Trump Tower in New York. “This has really brought the world together.”
Trump, his wife Melania, and FIFA’s president listen to the National Anthem’s performance before Sunday’s game (AFP/Getty)
The president left his Bedminster, New Jersey club via Marine One around 1 p.m. Sunday, and reporters were quickly ushered onto the field for pre-game events.
Trump’s helicopter completed a brief flyover, which went largely unnoticed by the crowd, according to reporters in the stadium. Marine One then touched down outside the arena.
He also spoke to reporters on the Fox Sports pregame show ahead of Sunday’s game.
His attendance came amid a reignition of his administration’s war with Iran, with the two countries trading strikes over the weekend and news breaking a day earlier that two U.S. servicemembers were killed in an attack on a base in Jordan on Friday.
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A third service member was killed Saturday after the controlled detonation of an unexploded Iranian drone, military officials announced Sunday.
Trump is set to present the trophy to the winning team after the game. He isn’t outright backing Argentina, but he told Fox reporters earlier in the day: “It’s hard to bet against [Lionel] Messi.”
“I thought about it a lot. I knew that was a question. I hate to get involved, even though politically, it doesn’t matter so much. The head of Argentina is a friend of mine, he’s done a terrific job. But I would say that it’s hard to bet against Messi,” Trump told Fox’s Jenny Taft. “I won’t pick sides. I just think it’s very hard to bet against Messi. He’s great.”
Trump gave a pre-game shoutout to Lionel Messi ahead of Sunday’s final (Reuters)
“I said: ‘You have to do two countries. So announce us for next time, and then announce another country after that and it’ll take out some of the anger and the shock!’ Now I think it’s a great idea,” Trump said. “Based on the numbers, we will be requesting it again immediately. I said, to take out the shock, you could announce another country for the next one… but we have to do this again.”
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The president sparked anger among football (soccer) fans after he called on Infantino to overturn a referee’s red card against a player on the U.S. team before their elimination earlier this month.
That incident put a sour note over what has generally been a successful effort by the U.S. to host the World Cup, which played out in more than a dozen stadiums across the U.S., Canada and Mexico this year. Roughly 10 million people were projected to travel to the three countries to witness the games.t
The next FIFA World Cup tournament will be primarily hosted by Morocco, Portugal, and Spain, and the 2034 event will be held in Saudi Arabia.
The earliest the U.S. could conceivably host the next World Cup would be 2038, or nine years after Trump leaves office.
Olympic middle-distance runner Ciara Mageean has opened up about her love of Gaelic games and how GAA shaped her as an athlete and a person, speaking at the All-Ireland Senior Hurling Championship final as she continues her battle with stage four bowel cancer.
21:44, 19 Jul 2026Updated 21:49, 19 Jul 2026
Ciara Mageean has opened up about her passion for Gaelic games and their influence in moulding both her athletic career and character.
The Portaferry-born middle-distance runner attended Sunday’s All-Ireland Senior Hurling Championship final between Galway and Limerick as a BBC guest, where she reflected on how her sporting journey started on GAA pitches.
“That was where my first love for sport began. It taught me how to channel that aggression into passion on a field,” Mageean revealed.
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“It taught me so much about the athlete I was going to become but probably more importantly the person that I was going to become, the person that I am.
“Whenever you look around here today, as we spoke about the passion out there on that field, I had that when I put the Portaferry jersey on and then when I put the Irish vest on my back and I feel so fortunate to be from a community like this.”, reports the Irish Mirror.
Mageean has courageously discussed her fight following a stage four bowel cancer diagnosis.
“Stressing and worrying about it isn’t going to change it,” she told the Irish Times last month. “You’re so entitled to those emotions obviously. But you could lose yourself to it.
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“I don’t know what this journey is going to look like. I don’t know at what point I’m going to get sick. As soon as I got that diagnosis, I felt like the grim reaper was on my shoulder and I didn’t know if I was going to be dead in a matter of months.
“[Her long term partner] Tommy and I are engaged but we’ve never had any rush on the wedding. But now I was like, ‘Do we need to get a move on here?’”.
“Because I don’t want to be that girl who looks like a skeleton on her wedding day. Or having to be in a hospital bed with Tommy beside me and me in a wedding dress in the hospital bed. I want it to be a normal day.”
The 34-year-old added: “I’ll be sitting on the couch and I’ll be like, ‘F**k. I might be dead in two years.’ I certainly won’t … well, I don’t want to say certainly but I probably won’t make my 40th birthday. Like, that’s f**king rough.
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“But we’re planning this wedding and I can’t help but think, ‘The poor lad’s going to be left a widower in his 30s.’ And then I’m like, ‘Sure then he’s going to be a bit old! It’s going to be hard for him to find a new partner!’ I say to him, ‘Here, you can’t move on from me too fast …’”.
People have reacted with surprise and fury after the World Cup Final was transformed into a showbiz extravaganza at half time.
With the final between Spain and Argentina goaless, the pitch at the MetLife Stadium in New York was transformed into a stage and suddenly the rather drab first half became a distant memory.
Madonna, Justin Bieber and even Kermit the Frog were among the performers – but online not everyone was impressed.
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BBC pundit and Manchester United legend Wayne Rooney told millions of TV viewers: “I like a lot of those artists but I thought it was crap. I did, honestly, it just didn’t get me going, I wanted the football to come back on.”
The best moment was ‘when it finished’, he said.
Liam Gallagher also weighed in, tweeting: “This is like a bad trip.” He added later: “It’s a good job I’ve got my spiritual socks on or that halftime entertainment could have tipped me over the edge.”
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He did seem to enjoy Bieber, though, saying “Justin rules”.
Coldplay lead singer Chris Martin curated the half-time show and assembled a star-studded cast of co-headliners. Shakira and Burna Boy, who co-wrote the anthem for this World Cup, will both feature.
And there is also time in the jam-packed show for pop legends Madonna and Justin Bieber, K-pop sensations BTS and Venezuelan orchestra conductor Gustavo Dudamel, of the prestigious New York Philharmonic, to perform.
The reaction was also rather spiky online. “Actually the half time show was more fun than the game,” said one poster on X while another said: “Absolute pants..terrible show, football doesn’t do half time shows. Football has 15mins to get to the loo, grab a snack & drink.. bum back on seat, so simple.”
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The organisers were turning the spectacle ‘into the Super Bowl’, said another.
While FIFA’s decision to allow this year’s final to have an extended half time interval caused controversy – and broke rules – it has been brought in to allow a huge roster and music talent entertain the MetLife Stadium crowd and the millions watching at home.
And before the action between the sides got underway, the likes of Post Malone put on an energetic show. However, IShowSpeed’s efforts divided fans, with some questioning if he was really singing live.
Argentina and Spain will fight it out to be crowned world champions – but many tuned in to see the music talent at work. With an impressive closing ceremony planned, the extended half-time show is also eagerly anticipated.
Despite breaking rules, FIFA said: “Echoing the spirit of the opening ceremonies, which welcomed the world to the greatest stage in Canada, Mexico and the United States, the closing ceremony will bring the FIFA World Cup 2026 full circle through music, culture and football, before we kick off the highly anticipated match that will crown the champions of this groundbreaking tournament.”
The World Cup final half-time show featured a number of A-listers
21:32, 19 Jul 2026Updated 21:39, 19 Jul 2026
The World Cup half-time show has divided the opinion of the viewing public, with a star-studded performers’ list entertaining the crowd during the break of the final.
With Spain and Argentina playing out a rather turgid first 45 minutes in New Jersey, the game ended 0-0 at the interval and all eyes quickly turned to the much-publicised half-time show.
Football’s governing body FIFA had organised a Super Bowl-style show for the break, with a star-studded line-up of music acts set to perform.
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Curated by Coldplay frontman Chris Martin, the show saw Madonna, Justin Bieber, Shakira and K-pop band BTS all take to the stage in front of the 82,500-capacity crowd at the MetLife Stadium and the billions watching around the world.
Earlier this week, FIFA faced backlash after it was reported that the half-time show could last up to 30 minutes, in what would be a breach of the International Football Association Board’s (IFAB) Laws of the Game.
In the end they were forced to cut it down to 17 minutes long.
It began with music legend Madonna dancing to a melody of her old hits, bizarrely accompanied by Brazilian football stars Ronaldo and Ronaldinho.
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Then came BTS with their song Dynamite, before Ted Lasso actor Jason Sudeikis, in character, introduced Bieber.
The show then came to an end with Colombian legend Shakira, performing Dai Dai with Burna Boy, the official song of the World Cup 2026.
The official anthem, as with previous tracks from the tournament, has been celebrated over the last few weeks, bringing nations from across the world together for one occasion.
Coldplay star Martin and the Muppets then rounded things off on the pitch with Venezuelan orchestra conductor Gustavo Dudamel, of the prestigious New York Philharmonic.
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The show, naturally, saw viewers torn, with may expressing their opinions online.
One said: “That was actually alright, you know.”
Another added: “This feels a bit like that Simpsons episode when Bart and Milhouse eat too many sweets.”
A third said: “This doesn’t feel like the World Cup final. It’s all very weird. Just feels like some football is occasionally taking place around some random nonsense and shouting.”
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Hollywood actor Hugh Grant said: “If football was processed cheese.”
Wayne Rooney, meanwhile, in the BBC studio, was pretty blunt in his own assessment.
“I like a lot of those artists, but I thought it was cr*p,” he said, prompting laughs from Micah Richards, Joe Hart and host Gabby Logan.
“Mine was when it finished,” he said of his favourite part. Rooney added: “I like a lot of those artists but I thought it was cr*p. I did, honestly, it just didn’t get me going, I wanted the football to come back on.”
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He later explained that he believed Justin Bieber’s performance was “flat”.
“I liked Burna Boy, I like Bieber, I like Shakira but that was too flat,” he fumed.
David and Victoria Beckham are joined by sons Romeo and Cruz and their girlfriends Kim Turnbull and Jackie Apostel as they arrive at the World Cup final
David and Victoria Beckham were joined by their sons Romeo and Cruz and their girlfriends once again as the family took their seats ahead of the World Cup Final at MetLife Stadium in New Jersey on Sunday night.
David was once again in a full suit as he stood beside a stylish Victoria, who had missed fellow Spice Girl Mel C‘s wedding over in the UK for the game.
The youngest Beckham son, 21, was joined by his girlfriend Jackie Apostel, 30, who opted for a bright red dress for the occasion.
Meanwhile Romeo, 23, was sat beside Kim Turnbull, 25, who kept it stylish in a black high collared top.
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Elsewhere Brooklyn Beckham watched the World Cup final from his sofa at home as Nicola Peltz shared a snap of the back of Brooklyn’s head as he tuned into the Spain vs Argentina game.
On Wednesday the former footballer, 51, and his wife Victoria, 52, were seen with their heads in their hands after the Three Lions lost 2-1 in the semi-final against Argentina.
And despite the result not being what the Beckham clan had hoped, they were back to watch the final game between Spain and Argentina.
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David and Victoria Beckham were joined by sons Romeo and Cruz and their girlfriends Kim Turnbull and Jackie Apostel as they arrived at the World Cup final on Sunday
The youngest Beckham son, 21, was joined by his girlfriend Jackie Apostel, 30, who opted for a bright red dress for the occasion
Romeo, 23, was sat beside Kim Turnbull, 25, who kept it stylish in a black high collared top
Asked who he thought would take home the trophy, David refused to pick a winner as he sat on the fence due to his loyalties to both Spain and Lionel Messi, who plays for his Inter Miami team.
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He said: ‘Oh my goodness. Obviously I played in Spain, so I have a huge affection for Spain as a country and obviously for their football team. I think they’ve done an exceptional job this World Cup and they deserve to be in the final.
‘And with Argentina, they have Lionel (Messi). Like I speak about Ricardo (Kaka), I’ll speak exactly the same about Lionel because he’s an exceptional player, but an exceptional person with the right values and he treats everyone the way they should be treated. I’m going around the houses…’
As he was pushed for an answer, Beckham replied: ‘I’m going to sit on the fence. I don’t know who’s going to win. I want Lionel to do incredibly well because he’s an exceptional person and player. But Spain are going to be tough to play against.
‘I’m not going to say who I think is going to win. I’m just going to sit on the fence and enjoy the game.’
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The crowd then booed in David’s direction, with the former midfielder and Kaka both laughing off the jeers.
The star then joked: ‘I haven’t been booed for a while. I’ve got booed a little bit the other night. I wasn’t expecting it here.’
On Wednesday David looked heartbroken as Argentina knocked England out of the World Cup in Atlanta, Georgia.
David’s son Cruz, 21, consoled his weeping father following a game of mixed emotions in the stands.
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Brooklyn Beckham watched the World Cup final from his sofa at home as his entire family supported from the MetLife Stadium on Sunday night
The former footballer, 51, and his wife Victoria, 52, were seen with their heads in their hands after the Three Lions lost 2-1 in the semi-final against Argentina
The couple looked heartbroken after the Three Lions lost 2-1 in the semi-final
David and Victoria watched the devastating semi-final with their children Romeo, 23, Harper, 15, Cruz and his girlfriend Jackie Apostel, 30.
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The Three Lions had been leading 1-0 when Antony Gordon snuck the ball into the back of the net in the 55th minute.
But just when fans were thinking the job was almost done, Argentina staged a late comeback with both Enzo Fernández and Lautaro Martinez scoring goals just seven minutes apart.
Earlier in the game, Victoria leaped into David’s arms as she celebrated England’s goal in the second half.
Posh Spice made sure to celebrate this time round after she was ridiculed for failing to react to Jude Bellingham’s goal in the quarter-finals last week.
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The legendary footballer poked fun at his wife becoming an instant meme and insisted she was ‘celebrating on the inside’ after her subdued reaction went viral.
Victoria jumped out of her seat as David roared with victory after Gordon put England 1-0 up against Argentina.
David followed the Three Lions around the US in the hope they would finally take home the World Cup trophy.
The family joined England fans singing the national anthem, only to be drowned out by Argentina fans booing loudly.
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David had to face watching his beloved country’s team go against his good friend Lionel Messi, who is part of his Inter Miami team.
Welcome to our live coverage for the 2026 Belgian Grand Prix from Spa-Francorchamps. The story of yesterday and in fact the weekend was of everyone trying to dislodge Kimi Antonelli from the top of the timesheets. Spoiler alert if you did not watch qualifying: they failed.
That is not to say the fight wasn’t a half-decent one. Max Verstappen and Red Bull were the closest challengers in the end, demonstrating an element of revival during a tricky season. Whether that will continue during the race is hard to know. Verstappen certainly thought he would have been further down the field without the tremendous tow he received from Isack Hadjar, his Red Bull team-mate, in the final sector.
Lando Norris also pushed Verstappen, though was almost half a second down on Antonelli’s time in the end. Unfortunately he will not be able to take advantage of a start from third place because he takes a 10-place grid penalty. George Russell, who has managed to reduce his Mercedes team-mate’s advantage to just 25 points in the past few rounds, was fourth and will start third. He did however, have a difficult session once again, finishing more than half a second off his team-mate.
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He was at a loss to explain this. Well, he knows where he lost most of the time: on the straights. But he still does not understand exactly why it is happening. The good news for him is that third place is often the most optimal starting position at this track.
“I think you always believe it’s never going to happen to me.” That is how one parent described learning that their newborn baby had been identified as being at possible risk of a rare genetic condition through routine newborn screening.
Known as the newborn blood spot test, or heel prick test, this involves taking a small blood sample from a baby’s heel to check whether they may have one of several rare but serious conditions. These are conditions where early treatment can make a major difference.
The test has transformed thousands of children’s lives by identifying serious, treatable conditions before symptoms appear.
But screening also brings challenges. The UK National Screening Committee recommends screening only when the benefits outweigh possible harms, including false alarms, missed cases, treatment that is not needed, uncertain findings and anxiety.
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For most families, screening happens during the overwhelming first days of caring for a newborn. Pregnancy scans and routine tests may not have identified any concerns. Research suggests it is not always clear to parents that this screening is designed to identify rare conditions in babies who appear completely healthy.
This is because screening reverses the usual route to finding out that something may be wrong. Typically, symptoms appear first and parents seek medical advice. With newborn screening, the possibility of a serious condition may be raised before symptoms appear. This can make the result feel, as one parent described it, “a complete bolt from the blue”.
Most parents have no family history of the condition identified. They simply do not imagine their baby could be affected. The routine nature of screening can also mask this possibility – it can seem like something “everyone does” for reassurance, rather than something that could bring life-changing news.
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Screening is only the start
Many parents expect screening to give simple yes-or-no answers: either everything is normal, or their baby definitely has a condition. In reality, screening is more complex.
A negative result means the condition is not suspected – although in rare cases, this can turn out to be false. A positive result means the baby may have the condition, and further tests are needed.
Screening is the start of a process, rather than a definitive answer. But when parents are told their baby has a positive screening result, they may hear it as a diagnosis, even though further tests are often needed.
The first conversation with healthcare professionals can shape how parents understand what is happening. Studies suggest that who communicates screening results, how they do it, and where the conversation takes place can all strongly influence parents’ early response. For some families, it marks the beginning of a long-term relationship with specialist healthcare teams.
Research we have conducted with parents points to several ways this experience can be improved. Where possible, parents prefer to receive the information together, so both hear the same information at the same time and neither has to relay complex news.
Parents also value hearing from healthcare professionals with expertise in the suspected condition. Although non-specialist clinicians may sometimes be able to deliver results faster, our recent research on attitudes to newborn screening for spinal muscular atrophy found that speaking with someone who can answer immediate questions, explain what happens next and acknowledge uncertainty can help reduce anxiety.
Clinicians, meanwhile, need to give parents enough information to help them understand the result and make decisions, without overwhelming families who are already distressed. Structured approaches to communicating screening results can help clinicians strike this balance.
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Spinal muscular atrophy
These communication challenges are becoming more urgent as newborn screening expands. We will explore them further in a new evaluation study focusing on newborn screening for spinal muscular atrophy, known as SMA, in England.
SMA is a rare genetic condition that causes progressive muscle weakness. It affects the nerves that control movement, so babies and children can have difficulty moving, swallowing and breathing. Its most severe infant form, type 1 SMA, was historically often fatal before the age of two without treatment. Today, newer treatments are dramatically improving prospects, especially when started early.
Our study will explore how much information parents want about their child’s screening result, when they want to receive it, and who they would prefer to hear it from. This will help shape how results are communicated if screening is expanded.
Newborn screening remains a vital public health programme, with strong support from parents and healthcare professionals. As screening programmes evolve to include more conditions, communication with families needs the same level of attention as the science behind the tests.
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The Generation Study, a research programme led by Genomics England in partnership with NHS England, is exploring newborn genomic screening. This means looking at a baby’s DNA to identify rare conditions that may benefit from early treatment.
The study aims to sequence the genomes of up to 100,000 newborn babies in England, and is looking for changes linked to more than 200 rare genetic conditions.
Parents need to know that newborn screening can bring reassuring results – but that it can also raise difficult possibilities. They need clear information before screening, and careful communication if a result suggests their baby may have a serious condition.
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A screening result is more than a laboratory finding. For parents, the first contact with clinicians can be one of the most significant conversations of their lives. How that conversation is handled can shape their early experience of the healthcare system, and the trust they place in it.
Timely, accurate and compassionate communication is essential if newborn screening is to deliver its full promise.
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