Hope and trust in diagnostic imaging contexts - Constituting technology and liminal patients.

INTRODUCTION: This study investigates patients' experience of selected imaging examinations and how human experiences are transformed through technological mediation. METHOD: A qualitative study of patients' experiences during selected imaging examinations, centering on human-technology relations, was conducted. Data was gathered in two Danish hospitals, through semi-structured interviews and participant observations. The study included fifteen diagnostic imaging examination cases, distributed over three Computed Tomography (CT)-guided lung biopsy interventions, seven conventional CT examinations, and five Positron Emission Tomography CT examinations. The participating patients were undergoing investigation for cancer within Fast Track Cancer Referral Programs (FTCRP). The study has a philosophical approach to practice grounded in Postphenomenology and draws on anthropological studies of healthcare practice as its theoretical and analytical framework. RESULTS: Diagnostic imaging technologies were found to have existential implications creating hope and trust in patients. Patients demonstrated technological readiness, in their willingness to comply with examination criteria and the professional's instructions. The patient's primary concern was achieving a good examination result, for which they were prepared to push themselves beyond their usual limits. Participating in diagnostic imaging examinations may be viewed as a life crisis ritual, wherein patients are constituted as liminal beings, existing between healthy and sick. CONCLUSIONS: The existential implications of an imaging examination were clear in terms of hope and trust. Hope is related to life and death in two temporal perspectives: A future hope of surviving cancer and a present hope of being cancer-free. Hope was linked to avoiding despair and rested on trusting oneself to technology, thus, forming a circle of interrelated concepts. IMPLICATIONS FOR PRACTICE: Professionals need to recognize the patients' liminal passings yet, unnoticed transformative and existential implications, to perform better patient-centered care.

The video window: How video consultation technology reveals and redefines the art of medicine in Danish specialist practice.

In the contemporary landscape of technologically mediated healthcare, video consultations introduce a dynamic interplay of challenges and opportunities. Taking the notion of 'the art of medicine' as an analytical frame, and drawing on interviews with medical specialists as well as participant observation of video consultations with patients (carried out between February 2022 and January 2023), this article investigates how video consultation technology changes the practices of medical specialists in the Danish healthcare system. Informed by post-phenomenology, we approach video consultations metaphorically as 'windows' between medical specialists and patients, unveiling three pivotal dimensions characterizing these changes. First, the shift from a physical to a virtual consultation room requires a reevaluation of the authoritative nature of the clinic, emphasizing the need for negotiating and staging the clinical space online. Second, while video consultations limit doctors' ability to rely on traditional non-verbal cues such as body language, they offer glimpses into patients' home environments, exposing the influence of social preconceptions on medical evaluations. Third, the adoption of video consultations introduces new conditions for doctors' use of senses, accentuating the importance of reflecting on the roles of different sensory impressions in the art of medicine. Our study illuminates how video consultation technology simultaneously expands and constrains the engagement between medical specialists and patients. Despite their inherent limitations, video consultations bring medical specialists closer to some of the intricacies of patients' lives. This proximity offers new insights and renders visible the roles of caregivers and relatives in the patient's care. The metaphor of 'the video window' encapsulates this tension between distance and closeness in video consultations, portraying the patient as both fragmented and socially situated. Our study extends beyond traditional patient and provider satisfaction evaluations, providing nuanced insights into how video consultations reconfigure the art of medicine.

Adapting Ourselves, Instead of the Environment: An Inquiry into Human Enhancement for Function and Beyond.

Technology enables humans not only to adapt their environment to their needs but also to modify themselves. Means of Human Enhancement - embodied technologies to improve the human body's capabilities or to create a new one - are the designated means of adapting ourselves instead of the environment. The debate about these technologies is typically fought on ethical soil. However, alarmist, utopian, and science fiction scenarios distract from the fact that Human Enhancement is a historical and pervasive phenomenon incorporated into many everyday practices. In the vein of disentangling conceptual difficulties, we claim that means of Human Enhancement are either physiologically or psychologically embodied, rendering the merging with the human user their most defining aspect. To fulfill its purpose, an enhancement must pass the test-in-the-world, i.e., assisting with effective engagement with a dynamic world. Even if failing in this regard: Human Enhancement is the fundamental and semi-targeted process of changing the users relationship with the world through the physical or psychological embodiment of a hitherto external object and/or change of one's body. This can potentially change the notion of being human. Drawing on a rich body of theoretical and empirical literature, we aim to provide a nuanced analysis of the transformative nature of this phenomenon in close proximity to human practice. Stakeholders are invited to apply the theory presented here to interrogate their perspective on technology in general and Human Enhancement in particular.

Patient involvement and expectations during CT scans. Tinkering to involve patients and offer care in radiographic practice.

INTRODUCTION: This study investigated how patients expected and experienced to be put first and cared for in diagnostic imaging settings and how putting the patient first was operationalized in practice. METHODS: A qualitative field study was conducted in two Danish hospitals to investigate patients' expectations and experiences of care and involvement during CT examinations. Data collection methods included semi-structured interviews and participant observations of five examination cases. Three Computed Tomography (CT) guided lung biopsy intervention studies and two conventional CT studies of the chest of patients being investigated for lung cancer in Fast Track Cancer Referral Programs (FTCRP) were included. RESULTS: Patients reported low expectations of receiving care and being involved during examinations. Perceptions of receiving care predominantly consisted of being received in a kind, personalized manner. Expectations of involvement in the procedure were reported in terms of readiness to do as they were told, complying with requests put to each patient. Concepts of care and involvement were challenged in their formal meanings and found to be entangled in complex interactions within sociotechnical boundaries. CONCLUSION: Patient's expectations of receiving care and being involved in the diagnostic imaging procedures, were expressed in noncommittal terms, and were overshadowed by patients' focus on getting through the examination, in order to get an answer to their tentative diagnose. The concepts of care and patient involvement were negotiated and reconceptualized within the sociotechnical framework of the diagnostic imaging situation of the individual patient. The concept of "tinkering" is suggested as a means of understanding how patientcare is performed during diagnostic imaging procedures. IMPLICATIONS FOR PRACTICE: Issues were identified that may help professionals to put "the patient first", thus, improving patient centered care.

The multistability of predictive technology in nuclear disasters.

Postphenomenological studies have explored technological mediation between the human body and the world by analysing the bodily experience of the world. Applying this analytical perspective to predictive technology requires some expansions because humans cannot directly experience the future world. I conceptualize pre-spectival focus, which refers to how human attention is directed to the making-future-present process, and which features or aspects of its process are foregrounded or backgrounded. Through the concept of pre-spectival focus and actor-network theory (ANT), this article examines the case of System for the Prediction of Environmental Emergency Dose Information (SPEEDI), a Japanese technology used to simulate the atmospheric dispersion of radionuclides released from nuclear reactors. SPEEDI provides prediction maps representing radiological consequences and was expected to support evacuation decisions during nuclear emergencies. However, this was not the case with the Fukushima disaster, which led to a socio-technical controversy regarding SPEEDI's usage. Based on bibliographic surveys and several interviews, I encapsulate four multistable uses of SPEEDI: prediction as supporting advice, prediction as a tool for evacuation drills, prediction as self-protection, and prediction as a source of misunderstanding. Relevant actors perceive the predictions of a nuclear disaster in each stability depending on the diversity of their pre-spectival foci, which is also related to the forms of life nourished through their professional and daily lives. A distinct rivalry can be observed between the two actor-networks around nuclear emergency management in which SPEEDI is differently enrolled: the social control network and self-determination network. In the former, the residents are constituted as passive selves who obediently follow governmental instructions; in the latter, residents are included as autonomous subjects who can actively decide protective actions. Moreover, I discuss future postphenomenology-ANT studies on predictive technologies based on these analyses.

Ethical Consequences of Technological Mediation on Parental Decision-Making Experiences in the Neonatal Intensive Care Unit.

The neonatal intensive care unit (NICU) is a morally charged space in which parents may be confronted with difficult decisions about the treatment of their newborns, decisions often complicated and created by the increasing use of technologies. This paper adopts a postphenomenological approach to explore the ethical consequences of technological mediation on parental treatment decision-making in the NICU. Semi-structured interviews were conducted with parents of children who received invasive technological support in the NICU to better understand how they made treatment decisions or decisions about specific interventions during their child's hospitalization. The findings suggest that technological mediation-or the various ways in which humans can interact with their world via technologies-contributes to experiences of ambiguity, ambivalence, and alienation in parental decision-making. The ambiguity of invasive NICU technologies can create uncertainty in a decision, which can then lead to internal ambivalence about which decision to make. Ultimately, this ambiguity and ambivalence may lead to alienation from one's child, as parents are disconnected physically and emotionally from the decision and thus their child. Articulating the effects of technological mediation on parental decision-making is a key step in addressing decisional conflict in neonatal intensive care settings and better supporting parents in their decision-making roles.

Re: Viewing Observation. The Philosophy of Medical Imaging.

Visualisation and observation are distinct, though interrelated activities. Observation involves the sensing of data. Visualisation renders data tractable to the specific sense of vision. There is no visualisation without observation, and some observation requires visualisation for it to happen at all. Visualisation and observation have long been understood as critical underpinnings of theory formation, as well as practice.Over time, a series of debates have prised apart the supposed strict division between looking and theorising, as well as the assumed passivity of looking. These challenges replaced the assertion of independence with claims of causal influence running in both directions.Earlier discussion has focussed on the role of human observers, with the understanding that instrumentation played a mere enabling role, enhancing observation through technology for visualisation and visual enhancement. But new approaches in the philosophy of technology have also questioned this assumption.Postphenomenology, the set of practices leading to contemporary philosophy of technology, encompasses a set of approaches for re-evaluating the role of technology in observation, and with it reassessing the impact of observation on theory formation and clinical practice. With reference to ideas from postphenomenology, we consider the contours of a biophilosophical theory of visual observation.

Bridge or barrier: technology, well-being, and blindness.

PURPOSE OF THE ARTICLE: This study explored the impact of assistive technology on the well-being of legally blind adults. MATERIALS AND METHODS: In this mixed-method study, a convenience sample of 86 legally blind adults took an electronic survey. The questionnaire was comprised of demographics, use patterns, and an instrument called TENS-Interface that measured the impact of technology on well-being categories of autonomy, competence, and relatedness. Descriptive statistics, reliability, power analysis and bivariate correlations were calculated using SPSS statistical software. Three participants completed follow up semi-structured interviews, which were analysed for themes of technological mediation using NVivo 12 software. RESULTS: The TENS-Interface was validated for use with a legally blind population. Descriptive statistics showed a higher mean for autonomy than competence or relatedness. Braille was positively correlated to both autonomy and competence, while screen reader proficiency was related to competence. Daily use of social media, email, instant messaging, and video calls were correlated to relatedness. The technological devices used by interview participants were analysed for technological mediation. Training was identified as an additional theme. CONCLUSIONS: Recommendations for practice include providing training to legally blind adults in screen reader use and braille use to support well-being via competence and autonomy. Training is also recommended for this population in the use of social media, email, and video calls to promote well-being through opportunities for relatedness. Further research is recommended to explore instructional methods that are not only efficient, but also meaningful for older adults in the position of losing their vision.IMPLICATIONS FOR REHABILITATIONProviding access to braille instruction and braille assistive technology equipment can promote legally blind adults' well-being by supporting their basic needs for both competence and autonomy.Providing training in screen reader use can promote legally blind adults' well-being by supporting their basic need for competence.Providing training in use of email, social media, video calls, and instant messaging can promote legally blind adults' well-being by supporting their basic need for relatedness.A consideration of technological mediation can allow practitioners to make recommendations that take into account not only efficient task completion, but issues related to meaning and social context.Instruction for adults losing their vision adventitiously needs to address not only efficient task performance, but also meaning and social context.

A Postphenomenological Perspective On the Changing Nature of Work.

In this essay, I take a postphenomenological perspective on tracing work transformation during the pandemic, arguing that this perspective helps develop novel sensitivities to the nature of work. Postphenomenology brings into high relief the view on work as reliant on sensory performances and embodied relations, complementing already rich accounts of work being reliant on discursive interactions, social order, and spatiality. The focus of postphenomenology on 'non-neutrality' and the multistability of technology provides a useful lens for revealing a multiplicity of changes, encompassing both augmentations and reductions of work experiences and evaluating their consequences for the actors involved. Finally, its attention to the transparency of technology amidst the embodied experiences gives a handle on the role of materiality in the performance of work and may be taken up as informing design efforts. A case study vignette of physiotherapy work during lockdown is offered as an illustration of applying some of the postphenomenological ideas.

A post-phenomenological analysis of using menstruation tracking apps for the management of premenstrual syndrome.

Objectives: Menstruation tracking digital applications (MTA) are a popular technology, yet there is a lacuna of research on how women use this technology for the management of PMS. Theoretical frameworks for understanding users' experiences are also underdeveloped in this nascent field. The objectives of the study were therefore twofold, to propose a theoretical framework for understanding women's use of MTA and apply it to the analysis of users' experiences in the management of PMS. Method: A novel theoretical framework was proposed, informed by post-phenomenology, postfeminist healthism, feminist new materialism and digital health technologies as public pedagogy. This framework focuses analytic attention on affective relationships between subjectivity, bodily sensations, digital technology, and discourse. It was used to structure the analysis of five in-depth timeline interviews with women in Aotearoa New Zealand who experienced benefits from using MTA to manage PMS symptoms. Results: Three pedagogical relationships were identified: a pedagogy of empowerment, where users learnt to control, predict and manage their PMS symptoms in line with healthism; a pedagogy of appreciation, where users learnt to understand their menstruating bodies as amazing, a valued part of them, and awe-inspiring that radically overturned past internalised stigma; and an 'untrustworthy teacher' who eroded this affirmative learning through inaccuracy, positioning users in dis-preferred categories, or being 'creepy'. Conclusions: MTA offers huge possibilities for challenging menstrual stigma that need to be nurtured, developed, and protected; and there are benefits for analysing MTA within wider scholarship on postfeminist healthism.

Digital Intimacy in China and Japan: A Phenomenological and Postphenomenological Perspective on Love Relationships at the Time of Digital Technologies in China and Japan.

This paper aims to show a possible path to address the introduction of intimate digital technologies through a phenomenological and postphenomenological perspective in relation to Japanese and Chinese contexts. Digital technologies are becoming intimate, and, in Japan and China, there are already many advanced digital technologies that provide digital companions for love relationships. Phenomenology has extensive research on how love relationships and intimacy shape the subjects. At the same time, postphenomenology provides a sound framework on how technologies shape the values and meanings we have. Thus, this paper introduces two digital technologies in Japan and China (Love Plus and XiaoIce chatbot), and it analyses according to the elements proposed by phenomenology and postphenomenology. In conclusion, this paper shows how digital companions like Love Plus and XiaoIce chatbot change who we are and the values and meanings we have according to the phenomenological and postphenomenological framework. These entities might not be human, but they shape who we are as human beings and the meanings and value we give to love.

Living in the Flesh: Technologically Mediated Chiasmic Relationships (in Times of a Pandemic).

During the Corona pandemic, it became clear that people are vulnerable to potentially harmful nonhuman agents, as well as that our own biological existence potentially poses a threat to others, and vice versa. This suggests a certain reciprocity in our relations with both humans and nonhumans. In his The Visible and the Invisible, Merleau-Ponty introduces the notion of the flesh to capture this reciprocity. Building on this idea, he proposes to understand our relationships with other humans, as well as those with nonhuman beings as having a chiasmic structure: to sense, or perceive another entity in a particular way simultaneously implies to be sensed or perceived in a particular way by this other entity. In this paper, we show how a postphenomenological perspective expands on Merleau-Ponty: first, it more radically interprets Merleau-Ponty's notion of flesh by not only considering it to be a medium that is the condition of possibility for vision but as pointing to the constitution of an intercorporeal field in which entities-both human and nonhuman-mutually sense one another. Second, it augments Merleau-Ponty's thought by drawing attention to how technologies mediate chiasmic relations. This is clarified through the example of the facemask, which (1) reveals the chiasmic structure of our relation with nonhuman entities, and (2) shows that technologies co-constitute interpersonal relationships by making humans present to one another in a particular way. We suggest that these aspects are not unique to the facemask, but point to a general technologically mediated chiasmic structure of human-world relations.

A Matter of Trust: Online Proctored Exams and the Integration of Technologies of Assessment in Medical Education.

ISSUE:  Technology is pervasive in medicine, but we too rarely examine how it shapes assessment, learning, knowledge, and performance. Cultures of assessment also shape identities, social relations, and the knowledge and behavior recognized as legitimate by a profession. Therefore, the combination of technology and assessment within medical education is worthy of review. Online proctoring services have become more prevalent during the Covid-19 pandemic, as a means of continuing high-stakes invigilated examinations online. With criticisms about increased surveillance, discrimination, and the outsourcing of control to commercial vendors, is this simply "moving exams online", or are there more serious implications? What can this extreme example tell us about how our technologies of assessment influence relationships between trainees and medical education institutions? EVIDENCE:  We combine postdigital and postphenomenology approaches to analyze the written component of the 2020 online proctored United Kingdom Royal College of Physicians (MRCP) membership exam. We examine the scripts, norms, and trust relations produced through this example of online proctoring, and then locate them in historical and economic contexts. We find that the proctoring service projects a false objectivity that is undermined by the tight script with which examinees must comply in an intensified norm of surveillance, and by the interpretation of digital data by unseen human proctors. Nonetheless, such proctoring services are promoted by an image of data-driven innovation, a rhetoric of necessity in response to a growing problem of online cheating, and an aversion, within medical education institutions, to changing assessment formats (and thus the need to accept different forms of knowledge as legitimate). IMPLICATIONS:  The use of online proctoring technology by medical education institutions intensifies established norms, already present within examinations, of surveillance and distrust. Moreover, it exacerbates tensions between conflicting agendas of commercialization, accountability, and the education of trustworthy professionals. Our analysis provides an example of why it is important to stop and consider the holistic implications of introducing technological "solutions", and to interrogate the intersection of technology and assessment practices in relation to the wider goals of medical education.

Necessity, Entailment, Shared Agonism.

This short paper offers a series of responses to Jochem Zwier and Timothy Barker's comments on my extended paper 'Taking Exception: Philosophy of Technology as a Multidimensional Problem Space.' Part one responds to questions concerning the modality of the renewed understanding of the theme of the transcendental that was argued for in my initial paper: I argue for the deep contingency of such a move, against any sense that it is necessary. Part two takes this consideration of modality further, considering the possibilities that a renewal of the theme of the transcendental stands to offer philosophy of technology today. I argue that the contingency of our contemporary sense of the transcendental can be precisely what makes it valuable. Whereas parts one and two turn on incisive questions posed by Zwier, part three closes by reconsidering the claims for a 'multidimensional problem space' offered in my initial paper. In response to an acute insight from Barker, I close by arguing that philosophy of technology's problem space should be explored in terms of a notion of 'shared agonism'.

"It's no good but at least I've always got it round my neck": A postphenomenological analysis of reassurance in assistive technology use by older people.

The provision of reassurance is seen as a goal and benefit of the use of assistive technology (AT) in supporting people to manage their health and care needs at a distance. Conceptually, reassurance in health and care settings remains under-theorised with the benefits of experiencing reassurance through technology use assumed rather than understood. UK health and social care service goals of managing safety and risk have largely been equated with providing reassurance to users of AT and their carers. What has not been explored is how reassurance is experienced variably by users of different types of technology-enabled care. We present data from 3 case studies of different technologies in use in health and social care provision, analysed through a postphenomenology and sociomaterial lens. Our findings point to reassurance as an important facet of AT provision but the intended functions and uses of technological devices alone did not account for people's experiences of reassurance. Participant narratives referred variously to the comfort of being monitored, having their illness/wellness verified by the device, feeling reassured by the promise of help if needed, and imbuing the device with symbolic meaning (when the user associated the device with meanings and functions other than its technical capabilities). The different ways in which reassurance was experienced provides a useful way of understanding the potential tensions with AT policy goals as well as the positive meaning attributed to devices in some cases. This study reaffirms the importance of AT implementation being anchored in what matters to the user.

Selective adoption of therapeutic devices among people with type 1 diabetes.

This paper contributes to the debate regarding the adoption/rejection of technologies by focusing on the selective use of therapeutic devices among people with type 1 diabetes. I show that patients often refuse to use a device (either insulin pumps or sensors for glycaemic control), despite suggestions from diabetologists. The study was conducted in Italy in 2019. Theoretically, the paper relied on a perspective that amalgamates actor-network theory and postphenomenology around the key concept of multistability. I then detected the three main features of stabilities that explain device use/non-use: relation to embodied users, contextual embedment (within larger social assemblages), concrete tailoring. Findings helped to stress the relevance of not only focusing on the type of device and its technical functioning, but also unveiling the underlying ongoing and situated socio-technical processes. Selective adoption of devices should be investigated at the level of the whole patient-device assemblage in order to assess the diverse stabilities that may arise from such networks.

Transformations of practice in online exercise training for patients with COPD led by physiotherapists - a qualitative study.

PURPOSE: The aim of this study was to characterize the practice of telemediated training for patients with very severe Chronic Obstructive Pulmonary Disease (COPD) and to inform the development of clinical/professional practice. METHODS: Inspired by ethnographic methodology, participating observation, informal and formal interviews were conducted with patients (11), their partners (4), and physiotherapists (6) at sites where the telemediated training was practiced. Postphenomenology was used as theoretical and analytical framework. RESULTS: Telemediated training in the homes of the patients takes place where most daily activities happen, and together with activities in the rehabilitation units they are included in the training in a reduced or amplified version that may compromise the privacy of the patients. The mediated image and sound challenge the training and communication activities and the possibility for the physiotherapists to estimate the condition of the patients. Consequently, the physiotherapists lower how much they push the patients in the exercises. CONCLUSIONS: Making training accessible to very severely ill patients with COPD through homebased telemediation comes with several trade-offs. This study can be used to educate clinical practice before and during the practicing of telemediated services, which need to be organized in a way that allows continuous adjustment.IMPLICATIONS FOR PRACTICEThe technology itself is not a neutral device in online health care provision. Health professionals should therefore:Play an active role in structuring the content, communication, and inclusion of the patients' context during online health care provision.Receive training in how to spot ways in which online health care provision transforms traditional practice and to how to work around its limitations.Organize online health care practices in ways that allow for continuous adjustment (for which they need back up from management).

Becoming data. Patient perspectives on using an eTool in physiotherapy sessions.

The purpose of this investigation was to gain insights into how patients experience using an electronic tool as part of their physiotherapy assessment, goal setting, and treatment planning.The research data were generated through close observation of eight clinical encounters in primary health care, where the electronic tool was used. Observations were followed by interviews with physiotherapists and patients involved. This manuscript elaborates on the patient informants' perspectives. The analyses, inspired by postphenomenological theory and research, sheds light on patients' concerns whether reliance on what they perceive as fragmented and incomplete data generated from PROM tools will obscure health matters rather than provide health benefits.By various means, including translations, adaptions, and editing together with their physiotherapist, patients were often able to manage their data into, for them, an acceptable, recognizable form.The investigation highlights that for patients to have confidence in this technology, and particularly the methodology of PROMs, they need to trust the way data is handled and interpreted.

Re-imagining world: From human health in the world to 'all-world health'.

This article explores the concept of 'world' as it frequently appears across health studies; specifically largely humanistic and phenomenological variations in use of 'the world' and 'lifeworld' are considered as they have helped cast knowledge on health and care. Looking forward, it is argued that world might be reimagined post-humanistically and post-phenomenologically as a vital emergent material entity and property. This is a reimagination that pays dividends by drawing attention to all-world processes and productions, hence to 'all-world health'. On one level, all-world health involves consideration of the healths of all the world's material and biological entities (all parts of the world). On another level, all-world health involves understanding what an entity gains from its total surround as it moves through life (all parts of its world). Together these levels provide a more processual, relational and holistic understanding of health than that provided by traditional notions of human health states, determinants or meanings, and even by some environmental (ist) ideas on health. All-world health arguably provides a vision of interrelatedness on which greater unity, cooperation and care might be built.

Interpreting fitness: self-tracking with fitness apps through a postphenomenology lens.

Fitness apps on mobile devices are gaining popularity, as more people are engaging in self-tracking activities to record their status of fitness and exercise routines. These technologies also evolved from simply recording steps and offering exercise suggestions to an integrated lifestyle guide for physical wellbeing, thus exemplify a new era of "quantified self" in the context of health as individual responsibility. There is a considerable amount of literature in science, technology and society (STS) studies looking at this phenomenon from different perspectives, linking it with the sociology of self-surveillance and neoliberal regimes of health. However, the human-technology interface, through which the micro- (behavioral) and macro- (social) aspects converge, still calls for extensive examination. This paper approaches this topic from the postphenomenological perspective, in combination with empirical studies of design analysis and interviews of fitness apps, to reveal the human-technology link between the design elements and people's perception through the direct experiences and interpretations of technology. It argues that the intentionality of self-tracking fitness app designs mediates the human-technology relations by "guiding" people into a quantified knowledge regime. It shapes the perceptions of fitness and health with representations of meanings about a "good life" of individual success and management. This paper also gives a critique of current individual, performance-oriented fitness app designs and offers the possibility of seeking alternatives through the multistable nature of human-technology relations-how altering interpretation and meaning of the design with a cultural or social context could change the form of technological embodiment.