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Urban areas are home to many people on the globe, and centres of industry. Emissions from cities contribute to atmospheric concentrations of greenhouse gases like CO2 and CH4, which influence the Earth’s energy budget. The Ruisdael Observatory is a Dutch research infrastructure to investigate the atmosphere over the Netherlands by bringing together measurements and high resolution modelling. One part of it is a semi-mobile trailer to be flexibly deployed as measurement station for targeted field measurements. Mounted on the roof of this trailer are a Bruker EM27/SUN (EM27) for columnar trace gas measurements and a Cimel for columnar aerosol measurements. A targeted field campaign was conducted in August and September 2022 to study Rotterdam, one of the biggest city in the Netherlands and the biggest harbour in Europe. Three EM27s were set up around Rotterdam in an upwind-downwind configuration. To ensure the comparability of the data, the instruments measured in parallel for three days before and after the measurement period, which showed good agreement between the instruments. Four different configurations of instrument locations were used during the three week campaign to account for changes in wind direction and investigate specific targets as well as separate between the influence of the harbour area and the city itself. Enhancements in the CO2 column were around 1-3 ppm across the harbour and about 1 ppm across the city. CH4 columnar concentrations were not significantly enhanced across the city, but increased by several ppb across the harbour area. The CO columnar concentrations increased across the harbour by up to 10 ppb and 5 ppb across the city area.

Greenhouse gases like CO2 and CH4 play an important role in the earth’s energy budget. Both local sources and long range transport can influence their concentration in the atmosphere. Within the Ruisdael project, which aims to map and understand the atmosphere over the Netherlands in a changing climate, a trailer was fitted with a range of instruments for flexible operations within the Ruisdael Observatory measurement network, among them an EM27/SUN, on which we will focus here. This instrument is a portable Fourier transformation infrared spectrometer to measure the columnar abundance of the trace gases CO2, CH4 and CO from the spectral absorption of direct sun light. The additional CO measurements can provide valuable information for attributing CO2 and CH4 enhancements to either biological processes or fuel burning. The instrument was equipped with a custom build rain cover that is fixed to the moving sun tracker and set up for remote operation, which greatly increased data coverage. It was then installed on the roof of the Ruisdael trailer, along with several in situ instruments inside.The EM27 was deployed in the Ruisdael trailer at the Cabauw tall tower site from May till September 2021. The RITA (Ruisdael Land-Atmosphere Interactions Intensive Trace-gas and Aerosol measurement campaign) campaign took place in and around the Cabauw tower in September 2021. During this time, additional measurements in the boundary layer by a mobile truck and an aircraft give the possibility of separating local and regional influences on the columnar trace gas abundance. Here, we present the results from the columnar trace gas measurements in the context of the large scale circulation and the in-situ measurements at the tower, with the mobile truck, and by aircraft. While the in situ measurements capture local pollution very well, only the larger pollution plumes are distinguishable in the EM27 data. The CO2 columnar abundance is mostly influenced by the large scale circulation. In the columnar abundance of CH4 and CO, larger pollution plumes are distinguishable as increases of up to several ppb. The presented measurements demonstrate how the EM27 can help to distinguish influences of local emissions and large scale transport in an urban monitoring network.

Fur „gute Sorge“ in Institutionen ist es wichtig, dass Machtfragen angesprochen werden und dass es einen „politischen Raum“ gibt, in dem Konflikte gelost werden konnen. Zahlreiche Widerspruche pragen das Pflegeheim als Organisation; der Widerspruch zwischen Autonomie und Fursorglichkeit ist einer der prominentesten. Wenn Widerspruche nicht ausgesprochen und nicht besprochen werden konnen, entstehen Konflikte. „Caring Institutions“ sind Organisationen, die die Bedurfnisse aller Mitglieder (d. h. die von Pflegebedurftigen und von Pflegenden) kennen und beachten. Dazu braucht es vor allem Orte, an denen widerspruchliche Bedurfnisse und Zielsetzungen bearbeitet werden konnen. Solche Ethikgesprache setzen einen Dialog auf „Augenhohe“ voraus. Letztendlich geht es also um einen Prozess der Demokratisierung von Institutionen, die Sorgeaufgaben ubernehmen.

The concept of the good death has been widely considered. However, the perspectives of those affected have not received sufficient attention. In our empirical study, we conducted interviews with 32 people who were confronted with dying; these people were either terminally ill, elderly or else were bereaved carers. The findings show that for this group of people, dying is not just a physical process, but also a psychological, social and spiritual one. From the perspective of those affected, dying is never beautiful, in particular because of the associated pain and suffering. At the same time, people confronted with dying do experience beautiful moments. In the stories they tell of these beautiful moments, it is a beauty emanating from a sense of elevated emotion – of moral emotion – rather than any aesthetic beauty. We conclude that good care of the dying enables beautiful moments and creates reflective spaces for those affected to express what beauty means to them. We show that the public discourse differs significantly from the perspective of those affected and more efforts need to be made to include their voices. Version of record

Background People with dementia and their informal caregivers get in touch with the healthcare system predominantly via contacts with primary care providers. Among these, community pharmacists have been denominated as the health professionals most accessible to the public. Communication with and counselling people with dementia and their informal caregivers present particular challenges to pharmacists. Aim This study aims to research the challenges faced and strategies used by community pharmacists who deal with people living with dementia and their informal caregivers. Methods Within the context of two workshops with 74 participants, 15 small groups were formed, each of which generated and discussed a small story. Fourteen of those narratives were reported, tape recorded and transcribed. In these 14 narratives, community pharmacists reflected on their experiences with people with dementia or their informal caregivers. The narratives were systematically analysed and interpreted. Findings Among the main challenges reported by the workshop participants are the difficulty of identifying a person with dementia; the question of what appropriate communication is; the only partially successful networking with doctors, nursing personnel and support institutions; unsuccessful counselling; and the tension between the economic situation and the care for people with dementia and their informal caregivers. In general, strategies for dealing with people with dementia are characterised by uncertainty whereas communication with informal caregivers is well rehearsed and effective. Conclusions Community pharmacies require possibilities to retreat for counselling as well as the possibility for pharmacists to take time for people with dementia and their informal caregivers in everyday pharmacy life. Reflective spaces for narrations about difficult situations provide relief for staff in community pharmacies.

The need for integrated, accessible and person-centred care for people with dementia to foster quality of life and facilitate life in the community has been voiced by health policy. Pharmacies have the potential to provide easily accessible information and support for people with dementia, caregivers and the public. The ‘Dementia-friendly Pharmacy’ programme aimed at re-orienting community pharmacy in Austria, focusing on stronger inclusion of professional counselling into core services. It followed principles of health promotion and person-centred care, aiming at empowering all actors involved, and at fostering quality of life. Methodologically, the programme was based on participatory health research, thus involving all relevant actors and consolidating their perspectives on issues related to dementia care. In the course of the programme, a workshop series covering topics relevant for dementia care in community pharmacy, as well as prototypes for small-scale projects were developed, and measures were taken for securing sustainability. Findings related to programme development and implementation encompass pharmacy staff’s motivation to participate in the programme, counselling knowledge and skills development, experience with building community partnerships and cross-organizational development and sustainability. Furthermore, effectiveness of the programme has been established. These findings are discussed against the background of re-orienting pharmacies.

Zusammenfassung Hintergrund In den letzten Jahren beobachten wir in Österreich einen lebendigen öffentlichen Diskurs zu Fragen des Ausbaus der Palliativversorgung. International erfährt die Frage nach dem erwünschten Versorgungsort große Beachtung. Ziel Der Beitrag geht der Frage nach dem ‚guten Sterben‘ aus der Perspektive der Betroffenen im österreichischen Bundesland Kärnten nach. Methodik Wir haben 11 qualitative, narrative und problemzentrierte Interviews mit Menschen am Lebensende und deren Angehörigen sowie eine Gruppendiskussion mit professionell Sorgenden in Kärnten durchgeführt und mittels qualitativer Inhaltsanalyse ausgewertet. Ergebnisse Unsere Interviewpartner und -partnerinnen denken in den Gesprächen über das ‚gute Sterben‘ deutlich mehr über soziale Beziehungen als über konkrete Sterbeorte nach. Gutes Sterben bedeutet für die Betroffenen, in familiale, zivilgesellschaftliche und professionelle Sorgenetzwerke eingebettet zu sein. Schlussfolgerung Im Sinne der Betroffenen unterstützen Caring Communities die Entwicklung von familialen, zivilgesellschaftlichen und professionellen Sorgenetzwerken.

BACKGROUND: Nursing homes are confronted with a significant change in their client structure. Palliative care gains importance in caring for residents until the end of their life. Relatives play a crucial role in caring for older people in nursing homes, especially in palliative care. As the perspective of relatives on palliative care culture in nursing homes has not yet been studied extensively, research in this field still has an exploratory character. AIM: The aim of the paper is to highlight some of the most important insights into themes and issues that relatives of persons having died in a nursing home find essential, with a view to fostering a well-established palliative care culture. METHODS: Within a qualitative approach, four focus group interviews were conducted. FINDINGS: Findings indicate that good communication is a core element of a well-established palliative care culture. Direct contact with relatives, talking about death and dying and the opportunity to be involved in decision-making all support a good palliative care culture. The fact that residents have a diverse range of social backgrounds, for example, regarding ethnicity, gender and living with dementia, influences palliative care in nursing homes and has to be taken into account. CONCLUSIONS: To create a good palliative care culture, management has to support this approach, continuously develop appropriate structures and act in a competent way.

In today's industrial societies, many people die receiving professional care. Although specialist palliative and hospice care have often been identified as ideal care approaches to promote good dying, more people die receiving generalist palliative care. This integrative review examines how professional caregivers providing generalist palliative care in hospitals, nursing or private homes define good dying. Furthermore, through comparative analysis of existing empirical studies, it explores conceptual aspects in researching good dying that better reflect the social complexity of this phenomenon. Three databases (Scopus, MEDLINE, and CINAHL) were searched for peer-reviewed studies published between January 2000 and April 2020. Studies were selected if they presented original empirical findings from qualitative or quantitative studies on the perspective of professional caregivers in generalist palliative care (nurses, physicians, surgeons, clergy, and other staff) on good dying or related concepts (e.g., good death, dignity in dying, or quality of life at the end of life). 42 studies were included in the review. They identified good dying as expected, accepted and prepared dying, as free from pain and suffering, as socially embedded, as being at peace with one's life and situation, as supported with individualised and holistic care, as based upon professional cooperation and communication, and as in a peaceful and private environment. The paper concludes that the perspective of professional caregivers in generalist palliative care shares many elements of good dying with societal and specialist palliative care discourses around good dying. Through comparing the different studies, the review found that studies that explicated who benefitted from ideals and practices of good dying, questioned the dichotomous categorisation of good/bad dying, or discussed the compatibility of elements of good dying, provided more nuanced perspectives on this topic. Thus, the review calls for a more systematic analysis of these aspects in research of good dying.

The Midlatitude Cirrus experiment (ML-CIRRUS) deployed the High Altitude and Long Range Research Aircraft (HALO) to obtain new insights into nucleation, life cycle, and climate impact of natural cirrus and aircraft-induced contrail cirrus. Direct observations of cirrus properties and their variability are still incomplete, currently limiting our understanding of the clouds’ impact on climate. Also, dynamical effects on clouds and feedbacks are not adequately represented in today’s weather prediction models. Here, we present the rationale, objectives, and selected scientific highlights of ML-CIRRUS using the G-550 aircraft of the German atmospheric science community. The first combined in situ–remote sensing cloud mission with HALO united state-of-the-art cloud probes, a lidar and novel ice residual, aerosol, trace gas, and radiation instrumentation. The aircraft observations were accompanied by remote sensing from satellite and ground and by numerical simulations. In spring 2014, HALO performed 16 flights above Europe with a focus on anthropogenic contrail cirrus and midlatitude cirrus induced by frontal systems including warm conveyor belts and other dynamical regimes (jet streams, mountain waves, and convection). Highlights from ML-CIRRUS include 1) new observations of microphysical and radiative cirrus properties and their variability in meteorological regimes typical for midlatitudes, 2) insights into occurrence of in situ–formed and lifted liquid-origin cirrus, 3) validation of cloud forecasts and satellite products, 4) assessment of contrail predictability, and 5) direct observations of contrail cirrus and their distinction from natural cirrus. Hence, ML-CIRRUS provides a comprehensive dataset on cirrus in the densely populated European midlatitudes with the scope to enhance our understanding of cirrus clouds and their role for climate and weather.

We present new data sets of black carbon (BC) aerosol mass mixing ratio (MMR) obtained from aircraft missions over North America, Europe, the Arctic, and the outflow region of Saharan Africa before and after trans-Atlantic transport. The data, collected from 2011 to 2013 with single-particle soot photometers, provide new insight into the variability and distribution of BC over global scales and refine understanding of AeroCom global model ensemble performance. The results indicate extensive global-scale longitudinal mixing of BC above altitude pressures as low as 400hPa. They also constrain the absolute and temporal variability of upper tropospheric BC MMR and point to opportunities for new tests of global aerosol models in the upper troposphere. A comparison to the AeroCom Phase II results generally reinforces previous estimates of the ensemble performance, except that it also strengthens confidence that the ensemble actually is biased high in the Arctic in all seasons.

During the Deep Convective Clouds and Chemistry (DC3) experiment in summer 2012, airborne measurements were performed in the anvil inflow/outflow of thunderstorms over the Central U.S. by three research aircraft. A general overview of Deutsches Zentrum fur Luft- und Raumfahrt (DLR)-Falcon in situ measurements (CO, O3, SO2, CH4, NO, NOx, and black carbon) is presented. In addition, a joint flight on 29 May 2012 in a convective line of isolated supercell storms over Oklahoma is described based on Falcon, National Science Foundation/National Center for Atmospheric Research Gulfstream-V (NSF/NCAR-GV), and NASA-DC8 trace species in situ and lidar measurements.

Partizipation von Menschen mit Demenz am sozialen Leben, am Leben in der Community, an der Gestaltung von Diensten und Angeboten und an der Forschung ist nicht nur erwunscht, sie ist auch zu fordern. Denn Partizipation wirkt nicht nur der Stigmatisierung entgegen, sie fordert auch die Gesundheit von Menschen mit Demenz. In unserem Beitrag zeigen wir die Zusammenhange zwischen Gesundheitsforderung und Partizipation auf und gehen den besonderen Herausforderungen der Partizipation fur Menschen mit Demenz nach. Wir analysieren ausgewahlte Forschungsprojekte der Autorinnen anhand des Stufenmodells der Partizipation in der Gesundheitsforderung. Wie wir mit und uber Menschen mit Demenz sprechen und ob uns als Gesellschaft wertschatzende Diskurse und ein person-zentrierter Zugang zu den Betroffenen gelingt, ist entscheidend dafur, ob das Leben mit Demenz als lebenswert erlebt wird. Die Moglichkeit zur gesellschaftlichen Teilhabe spielt dabei eine zentrale Rolle fur Gesundheitsforderung und Pravention.

Fur partizipativ orientierte Forschungs-Bildungs-Kooperationen sind systemische Spannungsfelder zwischen Universitat und Schule geradezu konstituierend. Aufgelost werden konnen sie aber nicht. Am Beispiel von Forschungserfahrungen im Projekt „Who Cares?“ werden solcherart Spannungsfelder benannt, analysiert und in einem weiteren Schritt Moglichkeiten beschrieben, wie mit ihnen (z. B. Lernen zwischen Reproduktion und Innovation, Umgang mit knapper Zeit, Partizipation unter hierarchischen Bedingungen, Freiwilligkeit und Pflichtunterricht, Mehrsprachigkeit) umgegangen werden kann. „Gleichberechtigte Teilnahme“, „dialogisches Erzahlen“ und das „Konzipieren von machbaren Projekten“ werden als Methoden dargestellt, die zum Gelingen trotz widerspruchlicher Systembedingungen beitragen konnen. Ein zentrales Ergebnis des partizipativen Interventionsprojektes stellt „Empowerment durch die Erfahrung von Partizipation“ dar, das gerade fur den gesellschaftlich nach wie vor abgewerteten Bereich von Care relevant ist. SchulerInnen konnten im Rahmen des Projektes Selbstwirksamkeit erfahren und eine forschende Haltung einuben.

During the ACCESS airborne campaign in July 2012, extensive boreal forest fires resulted in significant aerosol transport to the Arctic. A 10-day episode combining intense biomass burning over Siberia and low-pressure systems over the Arctic Ocean resulted in efficient transport of plumes containing black carbon (BC) towards the Arctic, mostly in the upper troposphere (6–8 km). A combination of in situ observations (DLR Falcon aircraft), satellite analysis and WRF-Chem simulations is used to understand the vertical and horizontal transport mechanisms of BC with a focus on the role of wet removal. Between the northwestern Norwegian coast and the Svalbard archipelago, the Falcon aircraft sampled plumes with enhanced CO concentrations up to 200 ppbv and BC mixing ratios up to 25 ng kg−1. During transport to the Arctic region, a large fraction of BC particles are scavenged by two wet deposition processes, namely wet removal by large-scale precipitation and removal in wet convective updrafts, with both processes contributing almost equally to the total accumulated deposition of BC. Our results underline that applying a finer horizontal resolution (40 instead of 100 km) improves the model performance, as it significantly reduces the overestimation of BC levels observed at a coarser resolution in the mid-troposphere. According to the simulations at 40 km, the transport efficiency of BC (TEBC) in biomass burning plumes was larger (60 %), because it was impacted by small accumulated precipitation along trajectory (1 mm). In contrast TEBC was small (BC due to large-scale precipitation is responsible for a sharp meridional gradient in the distribution of BC concentrations. Wet removal in cumulus clouds is the cause of modeled vertical gradient of TEBC, especially in the mid-latitudes, reflecting the distribution of convective precipitation, but is dominated in the Arctic region by the large-scale wet removal associated with the formation of stratocumulus clouds in the planetary boundary layer (PBL) that produce frequent drizzle.

International audience; During the ACCESS airborne campaign in July 2012, extensive boreal forest fires resulted in significant aerosol transport to the Arctic. A 10 day episode combining intense biomass burning over Siberia and low-pressure systems over the Arctic Ocean resulted in efficient transport of plumes containing black carbon (BC) towards the Arctic, mostly in the upper troposphere. A combination of in situ airborne observations, satellite analysis and WRF- Chem simulations are used to understand the vertical and horizontal transport mechanisms of BC with a focus on the role of wet removal.During transport to the Arctic region, a large fraction of BC particles are scavenged by two wet deposition processes, namely wet removal by large-scale precipitation and removal in wet convective updrafts, with both processes contributing almost equally to the total accumulated deposition of BC. Our results underline that applying a finer horizontal resolution (40 vs 100km) improves the model performance, as it significantlyreduces the overestimation of BC levels observed at a coarser resolution in the mid- troposphere. According to the simulations at 40km, the transport efficiency of BC (TEBC) in biomass burning plumes is about 60%, which is impacted by small accumulated precipitation along trajectory (APT) (1mm). In contrast TEBC is very small (

"Doing gender" plays an important role in nursing interactions in long-term care settings.The aim of this article is to focus on the experiences of staff and management in a long-term care setting on the social categorization of gender and to reflect and discuss these findings against already existing research.Within a qualitative study, one to one interviews and group discussions with a total of 28 participants were conducted.The results show how "doing gender" as a social practice effects interactions with residents, within the working team and in the context of management and hierarchy in the long-term care setting. In interactions with residents, gender-specific behavior can be observed. Within the working team gender-specific differences with respect to division of labor and working hours are reported. Concerning management and hierarchy it can be observed that male executives react more strongly in correspondence with the expectations of their gender role whereas female executives show more discrepancies between the expectations towards their position and gender role.

Background: Caring for and caring about people with dementia require specific communication skills. Healthcare professionals and family caregivers usually receive little training to enable them to meet the communicative needs of people with dementia. This review identifies existent interventions to enhance communication in dementia care in various care settings.Methods: We searched MEDLINE, AMED, EMBASE, PsychINFO, CINAHL, The Cochrane Library, Gerolit, and Web of Science for scientific articles reporting interventions in both English and German. An intervention was defined as communication skills training by means of face-to-face interaction with the aim of improving basic communicative skills. Both professional and family caregivers were included. The effectiveness of such training was analyzed. Different types of training were defined. Didactic methods, training content, and additional organizational features were qualitatively examined.Results: This review included 12 trials totaling 831 persons with dementia, 519 professional caregivers, and 162 family caregivers. Most studies were carried out in the USA, the UK, and Germany. Eight studies took place in nursing homes; four studies were located in a home-care setting. No studies could be found in an acute-care setting. We provide a list of basic communicative principles for good communication in dementia care. Didactic methods included lectures, hands-on training, group discussions, and role-play.Conclusion: This review shows that communication skills training in dementia care significantly improves the quality of life and wellbeing of people with dementia and increases positive interactions in various care settings. Communication skills training shows significant impact on professional and family caregivers’ communication skills, competencies, and knowledge. Additional organizational features improve the sustainability of communication interventions.

Validation nach Naomi Feil als Ansatz zur Kommunikation mit desorientierten, alten Menschen, vorwiegend fur Menschen mit Demenz eingesetzt, gewinnt angesichts demographischer Entwicklungen in der Pflegepraxis zunehmend an Bedeutung, wenngleich ihre Wirksamkeit bisher noch nicht zweifelsfrei nachgewiesen werden konnte. Wissenschaftliche Artikel und Studien zur Validation gelten als rar. In ihr theoretisches Konstrukt sind Annahmen verschiedenster TheoretikerInnen eingeflochten, wobei nicht immer klar ersichtlich ist, welche Inhalte auf welche dieser TheoretikerInnen zuruckgehen. Zu den Zielen dieser Arbeit gehort das Herstellen eines Bezugs zwischen theoretischem Material zur Validation nach Feil und der Theorie zur klientenzentrierten Gesprachspsychotherapie nach Rogers, der ein Theoretiker ist, auf den Feil sich bezieht. Der Bezug zwischen Rogers und Feil wird uber die Untersuchung des Konzepts ‚Empathie‘ bei beiden AutorInnen hergestellt, das in beiden Ansatzen einen engen Zusammenhang zur Grundhaltung in der Beziehung zum Gegenuber aufweist. Dazu wird entlang der qualitativen Methode ‚Explikation bzw. Kontextanalyse nach Mayring‘ vorgegangen. Es folgt ein systematischer Vergleich der Ergebnisse der Explikationen, um dadurch Hinweise auf Ubereinstimmung und Verschiedenheit der beiden Konzeptionen von Empathie sichtbar zu machen. Der Vergleich zeigt, dass es bei beiden AutorInnen sowohl Inhalte gibt, die fur eine Ubereinstimmung der Grundhaltung in der Beziehung zum Gegenuber sprechen, als auch solche, die dagegen sprechen. Die Autorin schliest aus den Ergebnissen, dass diese insgesamt fur eine Ubereinstimmung der Grundhaltung in der Beziehung zum Gegenuber zwischen Rogers und Feil sprechen.

Unique in situ measurements of CO, O3, SO2, CH4, NO, NOx, NOy, VOC, CN, and rBC were carried out with the German Deutsches Zentrum fur Luft- und Raumfahrt (DLR)-Falcon aircraft in the central U.S. thunderstorms during the Deep Convective Clouds and Chemistry experiment in summer 2012. Fresh and aged anvil outflow (9–12 km) from supercells, mesoscale convective systems, mesoscale convective complexes, and squall lines were probed over Oklahoma, Texas, Colorado, and Kansas. For three case studies (30 May and 8 and 12 June) a combination of trace species, radar, lightning, and satellite information, as well as model results, were used to analyze and design schematics of major trace gas transport pathways within and in the vicinity of the probed thunderstorms.

Fragen nach der angemessenen Unterstutzung und Sorge fur hochaltrige, demenziell veranderte und sterbende Menschen sind immer in ihrer grundsatzlichen gesellschaftspolitischen Bedeutung zu reflektieren und zu verstehen. Die Zukunft einer „sorgenden Gesellschaft“ (Caring Society) hangt wesentlich von der ethischen Verantwortlichkeit der Politik ab. Die pluralen Wertorientierungen und Lebensentwurfe der spaten Moderne erfordern die Entwicklung von politischen Prozessen, die den ethischen Diskurs zur Organisation gesellschaftlicher Sorge fordern. Eine solcherart gestaltete „Politik der Sorge“ nimmt sich Fragen des gerechten Zugangs zu Sorgeleistungen, der gesellschaftlichen Verteilung von Sorgearbeit, der Sorgeokonomie und damit der erforderlichen Rahmenbedingungen einer „Demokratisierung der Sorge“ an. Wir sehen es als Aufgabe der Wissenschaft diese Fragen in unseren partizipativen Forschungsprojekten in Palliative- und Dementia Care aufzunehmen und in den gesellschaftspolitischen Diskurs einzubringen. Entlang von drei konkreten Forschungszusammenhangen werden die Moglichkeiten und Grenzen dieses Anliegens diskutiert. Fur die zukunftige Gestaltung partizipativer Forschungsprozesse in Palliative- und Dementia Care leitet sich daraus ab, die zivilgesellschaftliche Beteiligung zu starken, sowie die Interventionen in politische Diskurse zu intensivieren. Damit verbunden ist ein Paradigmenwechsel im Verstandnis gesellschaftlicher Problemlosungsstrategien: Von der Hoffnung in die Entwicklung von ExpertInnenorganisationen und spezialisierten Professionen hin zum Vertrauen in die Potentiale zivilgesellschaftlicher Beteiligungs- und Demokratisierungsprozesse.

In den letzten Jahren wurden im gesamten deutschsprachigen Raum zahlreiche Modellprojekte zur Umsetzung von Palliative Care in Pflegeheimen durchgefuhrt. Diese Modellprojekte machen deutlich, dass es bei der Umsetzung von Palliative Care im Pflegeheim nicht darum geht, Fachwissen in „flachendeckenden“ Fortbildungen zu vermitteln. Sie zeigen vielmehr auf, dass es um komplexe Prozesse geht, in deren Zentrum ein Wandel der Organisationskultur hin zu einer palliativen Kultur in der stationaren Altenhilfe steht. Die Veranderung der Organisationskultur muss von allen Beteiligten in der Einrichtung gewollt und getragen werden. Von zentraler Bedeutung dafur ist die Bereitschaft, in einer Organisationsdiagnose das zu wurdigen, was bereits gelingt und gleichzeitig Veranderungspotentiale aufzunehmen. Gutes Projektmanagement, der klare Auftrag der Leitung und ein „langer Atem“ gehoren zu den wichtigsten Erfolgsfaktoren.

This chapter focuses on communities, their resources and organizational structures, and their procedures aiming at 'increasing their community's resilience, support, and openness toward those affected by death, dying, and loss'. It describes issue of dementia-friendly community pharmacies, as a frame of reference. The main responsibility of a community pharmacy is to provide medicines to the general population, which includes the management of pharmacotherapy, health education and counselling. The chapter overviews situation of community-based dementia care in German-speaking countries, as well as on the health and social care system in Austria and its uptake of issues related to dementia. Palliative care plays an important role in dementia care. The chapter speaks about 'direct participation' when for example caregivers and pharmacy staff meet in person to speak for themselves. It concludes by discussing some implications for further engagement of healthcare settings like community pharmacies in the development of compassionate communities.