Abstract
Telemedicine was introduced in Virginia’s healthcare system as a means of combating the endemic regional healthcare disparity affecting citizens in Virginia’s Appalachian region. Telemedicine is a technology that provides a means of connecting patients geographically separated from adequate healthcare with physicians. As a technology with significant momentum in Virginia’s healthcare system, it is necessary to consider and identify underlying social factors and actors present in the implementation of telemedicine. Actor Network Theory (ANT) is utilized as a framework for investigating the actor network inherent to telemedicine, using methods of network analysis and historical case studies to demonstrate key actants and events that represent enforcement of social factors resulting from implementation of telemedicine in Virginia. Through the mapping of telemedicine’s network, this research reveals insights to social factors and marginalized groups that are affected by telemedicine. As a framework that identifies social factors inherent to telemedicine, this research serves as evidence for advising modifications in telemedicine in Virginia and other regions.
A knee effusion is an abnormal accumulation of synovial fluid within the knee joint, resulting in pain and swelling. To treat and diagnose knee effusions, physicians aspirate the excess fluid into a syringe in a procedure known as arthrocentesis. Arthrocentesis is cumbersome for the physician, as it requires the physician to use two hands to aspirate the synovial fluid into the syringe, while also needing a free hand to maneuver the fluid to facilitate removal. The goal of this research was to create a medical device that facilitates arthrocentesis, making the procedure faster and more comfortable for both the physician and patient. Our goal was to design an ergonomic device that could be operated using one hand, generate 10 pounds of force with mechanical or electrical assist, and was compatible with a 60-cc syringe. The mechanical model was designed in 3D modeling software and prototyped using a 3D printer. Multiple iterations were developed of the mechanical model, with improvements made for syringe compatibility and mechanism functionality. The final prototype failed to generate enough force, but we hypothesize higher quality material, such as polypropylene, will allow for more force generation. Finite element analysis was performed on a polypropylene model to test the structural integrity. This analysis revealed a small area prone to deformation, informing future design considerations to reinforce this area with an alternate material. A motorized device was designed in 3D modeling software and electronic components and layout were designed and, although this device did not make it to the prototyping and testing phase. Future work includes refining material selection for the mechanical model, prototyping the motorized device and testing and comparing the two designs.
