74 vignettes were completed (36%). The means scores for attitudes were 2.62 ± 2.06 (v1), 1.88 ± 1.54 (v2), 4.54 ± 1.67 (v3), and 4.75 ± 1.71 (v4). General linear model analyses indicated that only the type of suffering had a significant impact on the attitude towards sedation (F = 33.92, df = 1, p = 0.000). Significance of the results: The French Swiss physicians' attitude toward palliative sedation is more favorable in case of physical suffering than in existential suffering. These results are in line with those found in the study of Blondeau et al. with Canadian physicians and will be discussed in light of the arguments given by physicians to explain their decisions.
In Switzerland, where assisted suicide but not euthanasia is permitted, the authors sought to understand how physicians integrate palliative sedation in their practice and how they reflect on existential suffering and death hastening. They interviewed 31 physicians from different care settings. Five major attitudes emerged. Among specialized palliative care physicians, convinced, cautious and doubtful attitudes were evident. Within unspecialized settings, palliative sedation was more likely to be considered as death hastening: clinicians either avoid it with an inexperienced attitude or practice it with an ambiguous attitude, raising the issue of unskilled and abusive uses of sedatives at the end of life.
The attitudes of physicians from Quebec and Switzerland toward palliative sedation, particularly regarding prognosis and type of suffering, seem similar. However, the results suggest that physicians from Quebec could be slightly more open to palliative sedation, even though most were not in favor of this practice as an answer to end-of-life existential suffering.
Aim
Assess the potential of new predictors (land use, edaphic factors and high‐resolution (HR) topographic and climatic variables, i.e. topo‐climatic) to improve the prediction of plant community functional traits (specific leaf area, vegetative height and seed mass) and species richness in models of mountain grasslands.
Location
The western Swiss Alps.
Methods
Using 912 grassland plots, we constructed predictive models for community‐weighted means of plant traits and species richness using HR (25 m) topo‐climatic predictors traditionally used in previous modelling studies in this area. In addition, 78 new plots were sampled for evaluation and error assessment in four narrower sets of homogenous conditions based on predictions by the topo‐climatic models within two elevational belts (montane and alpine). New, finer‐scale predictors were generated from direct field measurements or very high‐resolution (VHR; 5 m) numerical data. We then used multimodel inference to test the capacity of these finer predictors to explain part of the residual variance in the initial topo‐climatic models.
Results
We showed that the finer‐scale predictors explained up to 44% of the residual variance in the classical topo‐climatic models. The VHR topographic position, soil C/N ratio and pH performed notably well in our analysis. Land use (farming intensity) was highlighted as potentially important in montane grasslands, but improvements were only significant for species richness predictions.
Main conclusions
Compared with previously used topo‐climatic models, the new, finer‐scale predictors significantly improved the prediction of all traits and species richness in alpine plant communities and that of specific leaf area and richness in montane grasslands. The differences in the importance of the predictors, dependent on both trait and position along the elevational gradient, highlight the different factors that shape the distribution of species and communities along elevational gradients.
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