King's Inns

On Friday, May 14, 2021, the Health Service Executive, the organization providing public health services in the Republic of Ireland, was the victim of a significant cyberattack on its information technology systems. All systems were subsequently shut down to prevent further damage and to allow cybersecurity experts to investigate the attack. As a result, oncology services were severely disrupted, with the cessation of radiation therapy treatments in all public radiation therapy departments. Ireland has 5 large public and 6 smaller private radiation therapy centers in total. Because of the widespread adoption of electronic medical records in radiation therapy departments, it wasn't possible to retrieve patient details of those who were undergoing radiation therapy at the time of the cyberattack. In total, 513 patients nationally had their radiation therapy interrupted.A national radiation therapy cyberattack response team was formed immediately to oversee the response to the attack. The immediate concerns were radiation therapy emergencies and category 1 patients where gaps in treatment would have an adverse effect on outcome. Communication with patients and the public was also established as a priority and agreements were reached with the private sector for the treatment of patients affected by the cyberattack. The national media was used to alert patients of the need to communicate with their radiation therapy department. Dedicated phone lines were established. Locally, radiation therapy departments held daily crisis meetings with key staff members, including information technology personnel. Individual centers employed different technologies for treatment planning and data storage, so local solutions to the cyberattack to reestablish radiation therapy for patients were developed. In addition, national documentation on prioritization of patients to resume treatment was produced and a national approach was made to compensate for gaps in treatment caused by the attack. All 5 centers had reestablished radiation therapy by May 30, although there has been a long aftermath to the cyberattack. In this article, we provide an overview of the effects of the cyberattack on our national radiation therapy service and our strategy to resume patient treatment in a timely fashion.

BreastCheck, the National Breast Screening Programme in the Republic of Ireland, invites women aged between 50 and 64 years biennially. A pilot intervention trial of invitation for screening of women not attending the previous appointment [previous nonattender (PNA)] was carried out that aimed at maximizing the efficiency of resources in terms of radiographer workload and scheduled appointment slots. The trial was conducted during screening round 5 at two of the regional units. The intervention arm implemented an alternative process for inviting PNA women, in which they were sent a letter inviting them to phone their screening unit to make an appointment at a convenient date/time. The control arm continued usual practice - that is, all PNA women were sent a single invitation letter with a scheduled appointment slot at a predetermined date/time. In the intervention arm, fewer PNAs took up their appointments (15.5%) compared with the control arm (18.3%; P<0.001). Uptake among PNAs fell in both arms between screening rounds 4 and 5 (intervention arm: 22.0% OSR 4, 15.5% OSR 5; control arm: 21.4% OSR 4, 18.3% OSR 5). There was a significant increase in mobile unit screening days saved because of the intervention and a significant improvement in the percentage of women reinvited for screening within 27 months in the intervention arm (85.5%). PNA recall and cancer detection rates were significantly higher compared with the general screened population. This trial showed an improvement in the efficiency of resource use. However, there was a higher cancer detection rate in PNA women. This trial provides important evidence for invitation policy for screening.

The popularity of crime scene dramas provides an opportunity for educators to engage students in science. Solving mock crimes helps students develop critical thinking skills and reinforces the importance of the scientific method. The expertise required in forensic science is extremely broad and includes mathematics and statistics, physics, chemistry, earth science, and biology (Funkhouser & Deslich, 2000). Numerous excellent reports for mock crime scene investigations integrated into general science units are available (Johnson, 1997; Hurley, 1995; Hein, 2003). Projects specific to biology include a forensic entomology simulation (Carloye, 2003) and several that outline methods for Restriction Fragment Length Polymorphism (RFLP) as the basis for genetic identification (Guilfoile & Plum, 1998; Pallandino & Cosentino, 2001; Reed, 2001). Since the O.J. Simpson trial, the techniques for DNA fingerprinting no longer rely on RFLP analysis, which requires a relatively large amount of non-degraded DNA for success. The standard developed by the FBI is now a PCR-based, fluorescently-labeled amplification of microsatellite markers, followed by capillary electrophoresis. Although this technique requires specialized instrumentation and expensive reagents, it is an excellent method to teach students Mendelian genetics and genome organization. We describe a method to introduce students to the state-of-the art genetic profiling technique by forming partnerships with high school teachers, forensic science centers, and universities. Many biology instructors include biotechnology principles and applications within the greater topic of molecular genetics. However, the sophistication of biotechnology education programs varies, as do the objectives, resources, and opportunities of instructors and institutions. Secondary biology courses introduce students to the concepts of restriction enzyme digestion, gel electrophoresis, DNA fingerprinting, and genetic engineering. The activities at this level are primarily designed for exposure and can take the form of either simulation-based dry labs or actual wet labs. Advanced Placement biology and college level biology courses emphasize gel electrophoresis, recombinant DNA technology, the gene libraries, PCR (polymerase chain reaction), determination of Alu insertions (Bloom et al., 1996b), and sometimes mitochondrial gene sequencing in expanded coverage of genetics and biotechnology. Students learn the science behind the concepts through the use of specialized kits designed for educators. The latest method of DNA profiling relies on a form of microsatellite DNA called small tandem repeats (STRs). The technology is appropriate for biology students at the advanced secondary or introductory college level, and for teachers having prior experience with biotechnology. We have conducted a DNA profiling unit as a one-week summer mini-course, however the activities can be arranged to complement a genetics or biotechnology unit within a regular semester. Students genotype themselves first to learn the technique, then recover DNA from saliva left at a fictitious crime scene and from suspects for comparison. After a simple DNA isolation technique, they use PCR to amplify target DNA fragments, followed by capillary electrophoretic separation of the fragments and their identification with specific fluorescently-labeled probes. This lab is novel in that students work with the analytical reagents and instruments themselves made possible by partnerships with local college research labs, forensic science labs, biotechnology companies, and granting agencies. In New Mexico, we have established this lab through collaborative efforts between secondary schools, the New Mexico Institute of Mining and Technology in Socorro, and the Metropolitan Forensic Science Center in Albuquerque. The purpose of this article is to share our experiences in developing a forensic genotyping lab. We will review information on DNA profiling and the related biotechnology; explain how to obtain the necessary reagents and equipment; offer suggestions for establishing partnerships with local universities, crime labs, or biotechnology firms; and discuss appropriate forensic scenarios and course content. …

The Modern Law ReviewVolume 27, Issue 5 p. 540-545 Free Access Forbearance to Sue and Forbearance to Defend J. M. Kelly, J. M. Kelly M.A., B.LITT., DR.JUR.; Barrister-at-Law (King's Inns, Dublin), Fellow and Lecturer in Law, Trinity College, Oxford.Search for more papers by this author J. M. Kelly, J. M. Kelly M.A., B.LITT., DR.JUR.; Barrister-at-Law (King's Inns, Dublin), Fellow and Lecturer in Law, Trinity College, Oxford.Search for more papers by this author First published: September 1964 https://doi.org/10.1111/j.1468-2230.1964.tb02241.xAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat Volume27, Issue5September 1964Pages 540-545 RelatedInformation