Pregnancy Planning and Diabetes:A Qualitative Exploration of Women's Attitudes Toward Preconception Care

Introduction: Seeking preconception care is recognized as an important health behavior for women with preexisting diabetes. Yet many women with diabetes do not seek care or advice until after they are pregnant, and many enter pregnancy with suboptimal glycemic control. This study explored the attitudes about pregnancy and preconception care seeking in a group of nonpregnant women with type 1 diabetes mellitus. Methods: In-depth semistructured interviews were completed with 14 nonpregnant women with type 1 diabetes. Results: Analysis of the interview data revealed 4 main themes: 1) the emotional complexity of childbearing decisions, 2) preferences for information related to pregnancy, 3) the importance of being known by your health professional, and 4) frustrations with the medical model of care. Discussion: These findings raise questions about how preconception care should be provided to women with diabetes and highlight the pivotal importance of supportive, familiar relationships between health professionals and women with diabetes in the provision of individualized care and advice. By improving the quality of relationships and communication between health care providers and patients, we will be better able to provide care and advice that is perceived as relevant to the individual, whatever her stage of family planning. © 2012 by the American College of Nurse-Midwives.

A Collaborative Multiagent Framework based on Online Risk-Aware Planning and Decision-Making

Planning is an essential process in teams of multiple agents pursuing a common goal. When the effects of actions undertaken by agents are uncertain, evaluating the potential risk of such actions alongside their utility might lead to more rational decisions upon planning. This challenge has been recently tackled for single agent settings, yet domains with multiple agents that present diverse viewpoints towards risk still necessitate comprehensive decision making mechanisms that balance the utility and risk of actions. In this work, we propose a novel collaborative multi-agent planning framework that integrates (i) a team-level online planner under uncertainty that extends the classical UCT approximate algorithm, and (ii) a preference modeling and multicriteria group decision making approach that allows agents to find accepted and rational solutions for planning problems, predicated on the attitude each agent adopts towards risk. When utilised in risk-pervaded scenarios, the proposed framework can reduce the cost of reaching the common goal sought and increase effectiveness, before making collective decisions by appropriately balancing risk and utility of actions. 

Morality, Power and the Planning Subject

Ethical issues are at the heart of planning. Thus, planning theory has long displayed an interest in debating both the ethical justification for planning and how the activity of planning can be rendered more ethically sensitive. However, comparatively little attention has been shown to how the very constitution of the planner as a ‘moral subject’ may be ethically problematic for planning practice. This article addresses this lacuna through an engagement with the philosophy of Michel Foucault. In contrast to how his work is normally applied, this article accords with Foucault’s own direction that his later examination of ethics be used as a lens through which to read his earlier analysis of power and knowledge. Accordingly, the article first outlines Foucault’s innovative reinterpretation of how power and knowledge operate in society before setting this within his novel reconception of ethics. This theoretical exposition is then employed to interpret the material drawn from in-depth qualitative interviews with 20 planning officers working in a range of different contexts. The article subsequently employs Foucault’s ethically informed reading of power and knowledge to identify ethical issues arising from the approaches used by practitioners to justify their planning activities. The article concludes by suggesting how such issues can be resolved.