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Liverpool shop worker jailed for St Patrick’s Day sexual assault on woman seeking help

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Belfast Live

Yaaqob Saleh, 20, was sentenced to 12 months after sexually assaulting a customer who entered his Liverpool city centre shop seeking help to charge her phone

A retail employee has been imprisoned following his sexual assault on a customer who had taken shelter in his shop after becoming stranded in Liverpool city centre on a night out.

Yaaqob Saleh’s victim was left weeping and “curled up into a ball because she was so upset” following his relentless and predatory behaviour. While he had previously denied any wrongdoing, he now acknowledges he “let himself down” during the disturbing incident.

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However, a judge informed him his “very, very late expression of remorse” carried “very marginal weight” as he was sent to prison for his failure to “take no for an answer”.

Liverpool Crown Court was told this afternoon (Tuesday) that the complainant had been enjoying an evening with friends in Liverpool city centre celebrating St Patrick’s Day last March before attempting to get a taxi home by herself. Yet, with her mobile having died, she entered Liverpool One Newsagents and Convenience Store on Whitechapel requesting help.

Helen Chenery, prosecuting, outlined how Saleh, of Wendell Street in Toxteth, was manning the counter and permitted her to charge her phone so she could arrange a taxi. The 20-year-old defendant asked her to sit close to a heater on steps next to the till and, following serving a customer, positioned himself beside her.

Saleh, who was 19 at the time, proceeded to place his hand on her thigh and requested a kiss, which she rejected. Despite her refusal, he managed to kiss her cheek and, after attending to another customer, returned to his seat and placed his hand beneath her skirt, touching her vagina through her clothing.

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After Saleh rose to assist another shopper, the victim drew herself into a foetal position and wept. Once her mobile had charged sufficiently, she was able to ring a friend and departed the premises, reports the Liverpool Echo.

In her victim impact statement, she described: “Since this incident, I’ve experienced a wide and overwhelming range of emotions. Anxiety, depression and anger have been the most persistent.

“In the weeks and months following the assault, I began to struggle deeply with sleep. I still suffer from regular nightmares, which cause me frequently to wake throughout the night. These episodes have created a fear of sleep and a constant feeling of emotional exhaustion.

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“One of the most significant effects has been the loss of my independence. Before the assault, I was confident and self assured.

“I felt safe travelling alone, making decisions for myself and simply existing in the world. That sense of security has been stripped away.

“I now rely on my parents to meet me or accompany me when going out. I constantly feel as though what happened once could happen again. This loss of independence brought with it an overwhelming sense of grief. I felt as though a vital part of my identity had been taken away without my consent.

“My self worth deteriorated. I began to feel as though my body was somehow wrong or repulsive, and I blamed myself. These thoughts have spiralled into regular suicidal ideation and a serious dependency on self harm as a coping mechanism.

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“I became emotionally detached from reality and deeply distrustful of others. Even the people trying to help me felt suspicious.

“I also felt deep anger. I was angry at the perpetrator, but also angry at the world. I kept asking myself, why me? I never found a satisfying answer. That question stayed with me every day.

“In an attempt to cope, I began drinking excessively. I used alcohol to temporarily silence the pain and hatred I felt, but this only deepened my feelings of isolation and damaged many of my close relationships. I felt tired and unwell most days.

“Where I used to have energy and drive, I began to struggle to complete basic tasks or get out of bed. This incident has impacted almost every part of my life. It has changed the way I view the world and the way I view myself.”

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Saleh has no prior criminal record.

Defence solicitor Katie Lord addressed the court, stating: “It is, of course, serious offending, an offence which has had a serious impact on the complainant. He has been advised of the fact that the court will be considering all options, including custody. He is realistic.

“It is a case where, I concede, that the custody threshold has been passed. I am going ask your honour to step away from imposing immediate custody. He presents, as the Probation Service helpfully outline, with identifiable rehabilitative needs.

“In my submission, they can be addressed in the community if he has the option to be under close supervision. His youth and immaturity are material features. It is clear that those are factors which have led to his offending.

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“There is real work to be done in respect of the causative factors that have caused the defendant to act in the way he has. He tells me it is out of character and not in his nature. There is work to be done in understanding the reasoning. He has got family to support him. He seeks employment.

“A community based sentence, in my submission, would allow these necessary interventions. It is unlikely that he would have access to that level of rehabilitative intervention in prison. In my submission, society is best served by this defendant being subject to intensive supervision in the community, as opposed to a relatively short spell in custody.”

Saleh, who required an interpreter throughout the proceedings, was convicted of one count of sexual assault after a trial at the magistrates’ court. He subsequently attempted to challenge his conviction at crown court but later withdrew his appeal.

Standing in the dock dressed in a black Under Armour tracksuit, Saleh received a 12-month sentence at a young offenders’ institution. He was also ordered to register as a sex offender for 10 years and given a four-year restraining order.

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During sentencing, Judge Dennis Watson KC stated: “She had been out celebrating St Patrick’s Day with friends, but, at the end of the evening, she came into a shop where you were working. She did that because her phone was dangerously short of charge and, indeed, ran out of charge.

“So it was that she came to you for assistance. She had been drinking and was on her own and vulnerable by reason of the circumstances in which she found herself. Very quickly, you decided to proposition her sexually.

“You tried to persuade her to come around the other side of the counter, where she would be warmer. You asked her for a kiss, touched her thigh. All the while, she was saying to you that she did not want to be kissed by you or touched by you.

“Even when a customer came in and you served the customer, you went back, because there is a real element of you not taking no for an answer. There is this other element of persistence by you. On this separate occasion, you touched her, as Ms Chenery put it, on her crotch, as the author of the pre-sentence report put it, on her vagina but over her clothing, which had the instant effect of causing her to curl up into a ball because she was so upset.

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“However young or immature you are, you would know that your behaviour, in doing what you did, was wrong. There was a trial at the magistrates’ court. You gave evidence and denied the offence. Very belatedly, you have written a letter saying you understand that your offending has consequences, that you have let yourself down and you have expressed remorse.

“This is a case, I regret, where the very, very late expression of remorse means that it has very marginal weight, particularly when you have given evidence and completely denied the offending at the magistrates’ court. I regret to inform you that I have concluded that the circumstances of this offence and everything I know about you means this that is an offence where only immediate imprisonment is the appropriate punishment.”

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Liverpool vs PSG LIVE: Latest updates from Champions League quarter-final at Anfield

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Liverpool vs PSG LIVE: Latest updates from Champions League quarter-final at Anfield

Liverpool 0-1 PSG

Another opening for PSG as Dembele lines up the effort from just inside the area, but it’s blocked well.

At the other end, Jones’s effort is deflected behind after a good pass from Wirtz.

PSG bring on Lucas Beraldo for Zaire-Emery.

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Chris Wilson14 April 2026 21:45

Liverpool 0-1 PSG

Almost a second for PSG as Barcola latches onto the through ball into the box and squares it to Dembele.

He manages to squeeze it past Mamardashvili but the space runs out and he can’t get a clear shot away.

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Chris Wilson14 April 2026 21:39

GOAL! Liverpool 0-1 PSG (agg. 0-3) (Dembele, 73′)

GOAL! And that will be that!

PSG counter and it’s worked wide to Barcola. He’s a little isolated but he finds Dembele just within the ‘D’.

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The Frenchman shimmies and cuts back away from Mac Allister before curling a lovely effort low and past Mamardashvili for 1-0!

Chris Wilson14 April 2026 21:38

Liverpool 0-0 PSG

The first real involvement for Ngumoha sees the teenager cut in before forcing a good low save from Safonov.

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Chris Wilson14 April 2026 21:35

Liverpool 0-0 PSG

The hosts really have their tails up now and PSG are once again struggling to keep the ball, with the latest Liverpool attack requiring another last-ditch block from a PSG defender.

Chris Wilson14 April 2026 21:34

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Liverpool 0-0 PSG

The latest thoughts of Richard Jolly, who’s in place at Anfield tonight…

“Liverpool have been better with Gakpo than Isak, with Salah than Ekitike. They have had more of a threat in the second half.”

Richard Jolly at Anfield14 April 2026 21:33

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Liverpool 0-0 PSG

Liverpool responded to that decision by bringing on Rio Ngumoha for Joe Gomez.

The youngster wins a corner and Mac Allister heads wide at the near post.

Chris Wilson14 April 2026 21:32

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PENALTY OVERTURNED! Liverpool 0-0 PSG

The penalty is overturned! That’s a surprising decision, as it didn’t seem a clear and obvious error and there was clear contact in the area.

(AP)

Chris Wilson14 April 2026 21:30

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Liverpool 0-0 PSG

The referee has been instructed to head to the monitor, and we know what that means…

Chris Wilson14 April 2026 21:29

PENALTY TO LIVERPOOL! Liverpool 0-0 PSG

PENALTY TO LIVERPOOL! The hosts are awarded a penalty as Mac Allister latches onto a loose ball in the area and gets his body across Pacho before being clipped by the defender!

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Chris Wilson14 April 2026 21:28

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Newscast – Can We Afford To Keep The UK Safe?

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Newscast - Epstein Files: New Mandelson and Andrew Allegations

Available for over a year

Today, a former Nato chief has said that the UK’s security and safety is “in peril” and Sir Keir Starmer’s government has shown “corrosive complacency” towards defence.

In a directly political intervention, Lord Robertson – who is now a key government adviser – says “We cannot defend Britain with an ever-expanding welfare budget.”

It comes on the day the IMF has warned the energy shock from the Iran war will hit the UK the hardest of the world’s advanced economies.

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Adam and Chris are joined by Ben Chu from BBC Verify and Helen Miller from the Institute for Fiscal Studies.

You can now listen to Newscast on a smart speaker. If you want to listen, just say “Ask BBC Sounds to play Newscast”. It works on most smart speakers.

You can join our Newscast online community here: https://bbc.in/newscastdiscord

Get in touch with Newscast by emailing newscast@bbc.co.uk or send us a WhatsApp on +44 0330 123 9480.

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New episodes released every day. If you’re in the UK, for more News and Current Affairs podcasts from the BBC, listen on BBC Sounds: https://bbc.in/4guXgXd

Newscast brings you daily analysis of the latest political news stories from the BBC. The presenter was Adam Fleming. It was made by Jack Maclaren with Shiler Mahmoudi and Anna Harris. The social producer was Gabriel Purcell-Davis. The technical producer was Jonathan Greer . The assistant editor is Chris Gray. The senior news editor is Sam Bonham.

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I’m A Celebrity fans ‘crying’ over ITV schedule shake-up

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Wales Online

Viewers took to social media to share their frustration after an ITV scheduling shake-up.

I’m A Celebrity… South Africa viewers were left fuming just seconds into the ITV programme’s timeslot tonight, after they realised it would be airing 10 minutes later than usual.

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The Ant and Dec-fronted series has returned with another batch of celebrities returning to take on some stomach-churning bushtucker trials.

This year, the likes of Ashley Roberts and Gemma Collins are joining Adam Thomas, Harry Redknapp, Scarlett Moffatt, David Haye, Beverley Callard and Sir Mo Farah.

Seann Walsh, Sinitta, Craig Charles, Jimmy Bullard and Adam Thomas complete the line-up for the highly anticipated series.

The series is well underway, but tonight’s show sparked outrage from fans when they realised it would be airing at the slightly later time of 9.10pm rather than 9pm.

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READ MORE: BBC star hints at Celebrity Race Across The World stint after filming admissionREAD MORE: BBC drops first look at ‘poignant’ new drama based on best-selling book

The weeknightly show, which has been pre-recorded, was pushed back due to ITV’s coverage of the Women’s World Cup Qualifiers.

Taking to X to share their frustration before the episode even properly began, one viewer fumed: “Why the f*** is football on I’m crying.” Another slammed: “F off pointless football,” while someone else wrote: “It’s #ImACeleb 0’clock.”

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Someone else shared an eye-rolling meme, writing: “Omg Im a celeb being delayed by football.” Another person shared an image of the pundits on ITV, saying: “Can these people talk faster? Wrap it up… #ImACeleb.”

Yet another echoed: “The only people watching b****y football are waiting for #ImACeleb.”

Someone else saw the brighter side of things, writing: “People moaning about a match which delayed it by 10 minutes yet it started 2 mins earlier than the delayed time.”

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As the programme returned tonight, several others took to social media to bemoan David Haye’s comments from a previous episode. The boxer sparked outrage over a rant about “ugly birds”, while talking about his partner Sian.

He had first called her “lovely”, but then horrified his campmates when he carried on: “She’s got the personality of a proper ugly bird.”

He went on: “She has, honestly. Most ugly girls realise they’ve gotta have a personality and the banter to tell jokes and s**t, so people overlook the fact that they’re not aesthetically amazing straight away.” He didn’t stop there, going on: “It’s called ugly duckling syndrome.”

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As his campmates listened in shock, he went on: “Where girls are ugly when they start off, then they get pretty as they get older, but they’ve still got the personality of when they were ugly.”

“You get a girl who was pretty from day one, everyone tells her she’s amazing, so she grows up thinking ‘I’m amazing, everyone loves me, I can open up any door, I can go anywhere I want’. They don’t have to have a personality because most super pretty girls are idiots.

“But their ugly friend, they’ve got to work a bit harder. They’ve got to be more personable, they’ve got to be nicer to everyone.”

David’s shocking comments sparked outrage from fans and celebrities alike, with Susanna Reid on Good Morning Britain dismissing them, as she said: “I just don’t think it bears scrutiny.”

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I’m A Celebrity… South Africa airs weeknights at 9pm on ITV1 and ITVX.

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Durham council urged to prioritise its own children’s homes

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151 council workers on more than £100k in North East

Councillors in County Durham warned the local authority is “lining millionaires’ pockets” by using services provided by private companies due to increased demand. 

Private companies operate four-fifths of children’s homes across the country, as the price of adults’ and children’s social care continues to rise. 

Councillor James Pickard, Reform member for Sacriston and Witton Gilbert, said the council should resist using homes linked to external providers. 

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He added: “We are essentially lining millionaires pockets at the expense of our children. 

“Private firms are good at fleecing councils, that’s always going to happen, but when children are concerned, we need to move away from that and do better.

“It will have a positive impact on the children if you put more emphasis on your own homes, instead of paying private firms.”

Members of Durham County Council’s children and young people scrutiny committee were told that the local authority is having to balance an increasing demand but limited supply of accommodation. 

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The number of beds in local authority-run children’s homes is set to double from 26 to 52 through the development of new homes across the region. 

And Cllr Rob Crute said that should be the priority going forward. 

“I understand the private sector can sometimes fill in gaps, but we need to look at what we can do to bring more services in-house,” he told the committee. 

The Labour member for Blackhalls and Hesledens added: “Providers have us over a barrel and they are taking every penny they can get. If we can take more of that capacity in-house, it can reduce costs. There will be savings in the long run. 

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“We need to look at what we can do as an authority to cut the private sector out as much as we can.”

Last October, the Reform-led local authority moved to reduce the number of children in care and improve accommodation by agreeing a new sufficiency strategy to tackle the issue. 

It comes as the council revealed that the cost of children’s care placements has increased by £58 million over four years due to rising demand. 

Lindsey Herring, commissioning project manager, said: “We have a really ambitious programme with new homes being developed, and they are more specialist for children with more complex needs, with a higher cost of care. 

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“There is also a lot of work taking place nationally by Ofsted on private providers who charge an arm and a leg for children’s care provision.”

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Liverpool vs PSG LIVE: Champions League latest score, goal updates, match stream and fan reaction

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Liverpool vs PSG LIVE: Champions League latest score, goal updates, match stream and fan reaction

Liverpool were, of course, in action at the weekend, breezing past an uninspired Fulham side to secure a 2-0 win and continue in their quest to qualify for next season’s competition. The 17-year-old wonderkid Rio Ngumoha produced another superb performance in that match and Slot had nothing but good things to say about him after the fact, suggesting his star power could be called upon tonight.

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Former film actor and prisoner dies suddenly aged 55

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Former film actor and prisoner dies suddenly aged 55

Heavily-tattooed Jason Hoganson was photographed raising a thumb as he was released early from the city’s jail in September 2024, in a bid to cut prison overcrowding.

He had served half of an 18-month jail sentence for assaulting his ex-partner and breaching a restraining order.

Jordan Hoganson (Image: PA)

The following day he was arrested in Newcastle’s West End after going to his ex-partner’s flat and slapping her.

Hoganson had a leading role in the 1987 cult film Empire State, starring as a drifter called Pete, but he became caught up in drink, drugs and crime.

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Former film actor turned prisoner who once starred Hollywood film Jason Hoganson has died suddenly aged 55. (Image: PA)

A notice by funeral directors RW Barrett and Son said Mr Hoganson, a father of five, died “unexpectedly” on April 4.

A funeral service will be held at West Road Crematorium, Newcastle, on April 28.

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Car ploughs into JD Gym in Bury as two injured and driver arrested

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Car ploughs into JD Gym in Bury as two injured and driver arrested

The incident happened at JD Gyms on George Street, with police, fire crews and paramedics all attending the scene.

What happened

According to Greater Manchester Police, officers were called at around 4.45pm following reports that a car had driven through the wall of the gym.

A spokesman for GMP said: “Officers responded to an incident at 4.45pm today at JD Gym on George Street, Bury, with the assistance of NWAS and the Greater Manchester Fire Service.

“It was reported that a car had driven through the wall of JD Gym, resulting in structural damage of the building.

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“In the incident a man in his 60s has been struck by the car whilst inside the gym and has sustained non-life changing injuries.

“A woman in her 40s has been arrested on suspicion of causing injury by dangerous driving, she remains in hospital at this time.

“If you have any information, please contact officers on 101 or LiveChat quoting log 2424 of 14/04/2026.”

The vehicle appears to have driven directly through the brick wall.The vehicle appears to have driven directly through the brick wall. (Image: Phil Taylor)

Emergency response

Greater Manchester Fire and Rescue Service confirmed crews were called just before 5pm.

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A spokesperson said: “Just before 5pm on Tuesday (April 14), fire crews were called to reports of a road traffic collision on George Street, Bury.

“Two fire engines from Bury and Whitefield stations, as well as the technical rescue unit from Ashton, were quickly mobilised to the incident, which involved a car colliding with a commercial building.

“Firefighters extricated a woman from the car, while another man inside the building was also injured in the collision.

“They were treated at the scene by paramedics and then taken to hospital by North West Ambulance Service.

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“Firefighters helped make the area safe before handing the scene over to Greater Manchester Police.

“Our crews were in attendance for about an hour and a half.”

Police in the areaBury town centre was brought to a halt this evening (Image: Phil Taylor)

Inside the scene

Footage shared online showed the aftermath inside the gym, with debris scattered across the floor and part of the vehicle visible through the damaged wall.

Gymgoers were escorted out of the building, while emergency services surrounded the scene. An air ambulance was also seen circling overhead.

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The vehicle appears to have driven directly through the brick wall, leaving its rear protruding from the building beneath the gym’s signage.

Crime scene investigators were later seen examining the car, which remained embedded in the wall.

Injuries and arrests

A man in his 60s who was inside the gym was struck by the vehicle and suffered injuries described as non-life changing.

The driver, a woman in her 40s, has been arrested on suspicion of causing injury by dangerous driving and remains in hospital.

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Police on sceneCSI on scene (Image: Phil Taylor)

Road closures and travel disruption

Road closures were put in place around the busy junction following the crash, causing disruption in the area.

A spokesman for Bury Council said: “Emergency services are currently dealing with an incident at Rochdale Road in Bury town centre.

“Rochdale Road, at its junction with Derby Way, and Clarke Street at its junction with Angouleme Way, are closed in both directions with diversions in place.”

Motorists were warned to expect delays throughout the evening.

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Recovery teams are en route as the response continues.

Police on sceneMotorists were redirected (Image: Phil Taylor)

Gym statement

In a statement, the gym said: “Earlier today an incident occurred at JD Gyms involving a vehicle making contact with the exterior of the building, which resulted in damage to part of the gym.

“As a precaution and in the interest of everyone’s safety, the gym will remain closed until further notice.

“Our team are on it straight away and building surveyors are due to attend in the morning.

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“We will know more following their visit and will update here.

“If you are a member, you have automatically been granted multi-site access.

“Your JD Gyms app will now scan you in at a neighbouring JD Gyms location of your choice.

“We will be back open ASAP. Thank you for your patience.”

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We will continue to bring you updates as this breaking incident unfolds.

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Government survives confidence vote as opposition TDs blast protests response

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Government survives confidence vote as opposition TDs blast protests response

Holly Cairns, the leader of the Social Democrats, said her party did not support blockades, but said: “People have watched while you’ve wasted countless billions, failed to deliver critical public services, housing and infrastructure, all while giving sermons about the importance of fiscal prudence – that is the backdrop to these protests.”

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Atletico Madrid vs Barcelona LIVE: Champions League latest score, match stream, goal updates and fan reaction

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Barcelona vs Atletico Madrid: Prediction, kick-off time, TV, live stream, team news, h2h results, odds

Diego Simeone masterminded the unlikeliest of victories last week, although his side were aided by a sending off for Pau Cubarsi, who was dismissed for a pull on Simeone’s son Giuliano, who was deemed to have been clean through on goal. Now, it means that Hansi Flick will be without one of his first-choice central defenders this evening, and instead he will likely have to plump for Ronald Araujo or shift Eric Garcia, the former Man City man, back into his natural berth having been playing in midfield.

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Would you save more lives or more years of life? A global study reveals how people really think

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Would you save more lives or more years of life? A global study reveals how people really think

Imagine a stark choice. You can save one person who is likely to live another 30 years. Or you can save several people who may each live another ten years.

Should we prioritise saving more lives – or more years of life? This kind of trade-off sits at the heart of how health systems make decisions.

Yet do people actually agree with that principle? A new international study – based on what people told us during the COVID pandemic – suggests the answer is more complicated than this simple trade-off suggests.

Across many countries, decisions about healthcare spending are guided by a concept known as the quality-adjusted life year, or Qaly. In simple terms, this approach aims to maximise the total number of years of healthy life generated by a healthcare system.

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That often means prioritising treatments that deliver more life-years overall. Saving someone with more years ahead of them is typically seen as creating more value than saving someone with fewer remaining years. In practice, this can mean prioritising younger patients over older ones.

This kind of reasoning is used by Nice in the UK – and other healthchare advisory agencies, globally – to decide which medicines should be funded. But it rests on an implicit ethical assumption: that maximising total life-years is the right goal.

Our research asked a simple question: do ordinary people actually agree?

To find out, we conducted a large survey experiment with more than 14,000 people across 12 countries, including the UK, US, China, Brazil and Uganda.

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Participants were asked to imagine a life-saving vaccine that could only be given to one group. They had to choose between vaccinating a 55-year-old person (with about 30 years left to live) or one or more 75-year-olds (with about ten years left each).

The scenarios were framed around COVID, but the underlying question was broader: how should we trade off saving lives versus saving life-years?

By varying the number of older people, we could estimate how many lives participants were willing to “trade” to save one younger person.

The results reveal a clear pattern – and one not entirely consistent with the Qaly-based values that underpin many healthcare funding decisions.

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People don’t think in purely mathematical terms

Most people did favour saving the younger person. Around two-thirds of respondents chose to vaccinate the 55-year-old rather than a single 75-year-old.

However, when forced to make tougher trade-offs, people did not behave as if they were trying to maximise life-years. If they were, they would have been willing to sacrifice about three 75-year-olds to save one 55-year-old (since 30 years versus ten years is a 3:1 ratio). In practice, they were willing to trade fewer.

On average, across countries, people were willing to trade about two and a half older lives to save one younger life. In other words, public preferences sit somewhere between treating all lives as equal, and strictly maximising total life-years. They don’t fully align with either.

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How many 75-year-olds people would trade to save one 55-year-old, by country. A value of three (dotted line) reflects strict life-year maximisation. Most countries fall below this, suggesting people are less willing to trade lives than this benchmark implies. Adapted from Parra-Mujica, F., Roope, L.S.J., Violato, M., Duch, R.M. and Clarke, P.M.

The story becomes even more interesting when we look beyond age. In some versions of the experiment, we also varied whether the hypothetical people were working. This turned out to matter a lot. When both people had the same employment status, one 55-year-old was considered roughly equivalent to just over two 75-year-olds.

Yet when the younger person was working and the older person was not, the trade-off shifted dramatically – people were willing to sacrifice more than three older lives to save the younger worker. And when the situation was reversed – the older person working and the younger not – many respondents preferred saving the older person.

This suggests that people are not just thinking about life expectancy. They are also considering broader social factors, such as contribution, perceived need or fairness.

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A gap between policy and public values

These findings raise an uncomfortable question. If health systems are designed to maximise life-years, but the public values something more nuanced, is there a mismatch between policy and societal preferences?

Our results suggest there is. People do care about life expectancy – younger lives are generally prioritised. However, they also place weight on fairness, context and social roles. Their preferences are more nuanced than the strict “maximise life-years” rule embedded in many healthcare decision frameworks.

This doesn’t mean that healthcare decisions should simply follow public opinion. These are complex ethical choices, and expert judgment remains essential.

Nevertheless, ignoring public values entirely may also be problematic. Policies that feel intuitively unfair can undermine trust, which is essential for the sustainability of policies and institutions.

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Rather than abandon existing approaches like Qalys, one option may be to complement them. Decision-makers could more clearly include the public’s views by using things like discussion groups, citizen panels or other methods that balance efficiency with fairness.

Another possibility is to recognise that there is no single correct answer. Different societies may reasonably draw the line in different places – and even within countries, views vary by age, politics and experience.

Our study shows that people do not see these decisions in simple mathematical terms. When faced with real trade-offs, they weigh lives, years and social context together. Ultimately, that may be a more realistic reflection of the ethical complexity at the heart of healthcare.

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