Spatiotemporal variations in ecosystem services and their trade-offs and synergies against the background of the gully control and land consolidation project on the Loess Plateau,China

Studying the spatiotemporal variations in ecosystem services and their interrelationships on the Loess Plateau against the background of the gully control and land consolidation(GCLC)project has significant implications for ecological protection and quality development of the Yellow River Basin.Therefore,in this study,we took Yan'an City,Shaanxi Province of China,as the study area,selected four typical ecosystem services,including soil conservation service,water yield service,carbon storage service,and habitat quality service,and quantitatively evaluated the spatiotemporal variation characteristics and trade-offs and synergies of ecosystem services from 2010 to 2018 using the Integrated Valuation of Ecosystem Services and Trade-offs(InVEST)model.We also analysed the relationship between the GCLC project and regional ecosystem service changes in various regions(including 1 city,2 districts,and 10 counties)of Yan'an City and proposed a coordinated development strategy between the GCLC project and the ecological environment.The results showed that,from 2010 to 2018,soil conservation service decreased by 7.76%,while the other three ecosystem services changed relatively little,with water yield service increasing by 0.56% and carbon storage service and habitat quality service decreasing by 0.16% and 0.14%,respectively.The ecological environment of Yan'an City developed in a balanced way between 2010 and 2018,and the four ecosystem services showed synergistic relationships,among which the synergistic relationships between soil conservation service and water yield service and between carbon storage service and habitat quality service were significant.The GCLC project had a negative impact on the ecosystem services of Yan'an City,and the impact on carbon storage service was more significant.This study provides a theoretical basis for the scientific evaluation of the ecological benefits of the GCLC project and the realization of a win-win situation between food security and ecological security.

Spatiotemporal Characteristics of Typical Ecosystem Services and Their Spatial Responses to Driving Factors in Ecologically Fragile Areas in Upper Yellow River,China

The identification of dominant driving factors for different ecosystem services(ESs)is crucial for ecological conservation and sustainable development.However,the spatial heterogeneity of the dominant driving factors affecting various ESs has not been adequately elucidated,particularly in ecologically fragile regions.This study employed the integrated valuation of ESs and trade-offs(InVEST)model to evaluate four ESs,namely,water yield(WY),soil conservation(SC),habitat quality(HQ),and carbon storage(CS),and then to identify the dominant driving factors of spatiotemporal differentiation of ES and further to characterize the spatial heterogeneity characteristics of the dominant driving factors in the eco-fragile areas of the upper Yellow River,China from 2000 to 2020.The results demonstrated that WY exhibited northeast-high and northwest-low patterns in the upper Yellow River region,while high values of SC and CS were distributed in central forested areas and a high value of HQ was distributed in vast grassland areas.The CS,WY,and SC exhibited decreasing trends over time.The most critical factors affecting WY,SC,HQ,and CS were the actual evapotranspiration,precipitation,slope,and normalized difference vegetation index,respectively.In addition,the effects of different factors on various ESs exhibited spatial heterogeneity.These results could provide spatial decision support for eco-protection and rehabilitation in ecologically fragile areas.

Exploring the Spatiotemporal Changes and Driving Forces of Ecosystem Services of Zhejiang Coasts,China,Under Sustainable Development Goals

Ecosystem services(ESs)refer to the continuous provisioning of ecosystem goods and services that benefit human beings.Over recent decades,rapid urbanization has exerted significant pressure on coastal ecosystems,resulting in biodiversity and habitat loss,environmental pollution,and the depletion of natural resources.In response to these environmental challenges,the Sustainable Development Goals(SDGs)were proposed.Given the pressing need to address these issues,understanding the changes in ESs under the SDGs is crucial for formulating specific ecological strategies.In this study,we first analyzed land use and cover change in the Zhejiang coasts of China during 2000–2020.Then,we investigated the spatiotemporal configuration of ESs by integrating carbon storage(CS),soil retention(SR),habitat quality(HQ)and water yield(WY)using the Integrated Valuation of Ecosystem Services and Tradeoffs(InVEST)model.The driving mechanisms of ESs,which varied by space and time,were also explored using the Geo-detector method.The results revealed that,over the past two decades:1)the Zhejiang coasts have experienced a significant increase of 2783.72 km^(2) in built-up land areas and a continuous decrease in farmland areas due to rapid urbanization;2)owing to higher precipitation,extensive vegetation cover,and reduced anthropogenic disturbances,forests emerge as a crucial land use type for maintaining ecosystem services such as HQ,CS,WY,and SR;3)ESs have generally declined across the entire Zhejiang coasts,with a significant decrease observed in the northern areas and an increase in the southern areas spatially;4)the expansion of built-up land areas emerged as the primary factor affecting ecosystem services,while the vegetation factor has been increasingly significant and is expected to become predominant in the near future.Our study provides insights of understanding of ecosystem service theory and emphasizing the importance of preserving biodiversity for long-term sustainable development,and valuable scientific references to support the ecological management decision-making for local governments.

Spatiotemporal variations of ecosystem services and driving factors in the Tianchi Bogda Peak Natural Reserve of Xinjiang,China

Nature reserves play a significant role in providing ecosystem services and are key sites for biodiversity conservation.The Tianchi Bogda Peak Natural Reserve(TBPNR),located in Xinjiang Uygur Autonomous Region,China,is an important ecological barrier area in the temperate arid zone.The evaluation of its important ecosystem services is of great significance to improve the management level and ecological protection efficiency of the reserve.In the present study,we assessed the spatiotemporal variations of four ecosystem services(including net primary productivity(NPP),water yield,soil conservation,and habitat quality)in the TBPNR from 2000 to 2020 based on the environmental and social data using the Integrated Valuation of Ecosystem Services and Trade-offs(InVEST)model.In addition,the coldspot and hotspot areas of ecosystem services were identified by hotspot analysis,and the trade-off and synergistic relationships between ecosystem services were analyzed using factor analysis in a geographic detector.During the study period,NPP and soil conservation values in the reserve increased by 48.20%and 25.56%,respectively;conversely,water yield decreased by 16.56%,and there was no significant change in habitat quality.Spatially,both NPP and habitat quality values were higher in the northern part and lower in the southern part,whereas water yield showed an opposite trend.Correlation analysis revealed that NPP showed a synergistic relationship with habitat quality and soil conservation,and exhibited a trade-off relationship with water yield.Water yield and habitat quality also had a trade-off relationship.NPP and habitat quality were affected by annual average temperature and Normalized Difference Vegetation Index(NDVI),respectively,while water yield and soil conservation were more affected by digital elevation model(DEM).Therefore,attention should be paid to the spatial distribution and dynamics of trade-off and synergistic relationships between ecosystem services in future ecological management.The findings of the present study provide a reference that could facilitate the sustainable utilization of ecosystem services in the typical fragile areas of Northwest China.

Implementation Strategy of“Eight in One”of Integrated Medical and Care Service System in China:A Case Study of Anshan City of Liaoning

With the gradual intensification of aging in China,the issue of elderly care has become the primary issue that needs to be urgently solved in society.The construction of a reasonable and scientific integrated medical and care service system can not only efficiently allocate medical resources and services,but also better meet the needs of the elderly.Due to the involvement of multiple disciplines such as architecture,sociology,psychology,and behavioral science in the construction of the system,as well as the restriction of various objective factors such as medical capacity,spatial scale,and operating costs,the government and elderly care institutions have always been unable to find the best solution for how to scientifically and reasonably construct an integrated medical and care service system.This paper is based on Anshan City,Liaoning Province,which has prominent aging issues and distinct characteristics of the elderly population.Through extensive field research in elderly care institutions,and face-to-face communication with personnel from relevant government departments such as the Municipal Commission on Aging,the Civil Affairs Bureau,the Health Commission,the Medical Insurance Bureau,and the Human Resources and Social Security Bureau,it truly understands the problems that arise in the construction of the urban integrated medical and care service system.From three aspects:urban situation,institutional situation and the needs of the elderly,it is proposed to establish a clear departmental linkage mechanism with clear rights and responsibilities,a policy guarantee mechanism tailored to local conditions,a multi-measure operation mechanism,a technology first intelligent response mechanism,a warm and efficient service mechanism for the people,an overall layout mechanism,an evaluation and supervision mechanism for full process control,and a talent supply mechanism of external introduction and internal training.It aims to provide reference for the construction of an integrated medical and care service system in similar cities.

Spatiotemporal Characteristics and Future Scenario Simulation of the Trade-offs and Synergies of Mountain Ecosystem Services: A Case Study of the Dabie Mountains Area, China

Mountain ecosystems play an essential role in supporting regional sustainable development and improving local ecological environments. However, economic development in mountainous areas has long been lagging, and multiple conflicts related to resource assurance, ecological protection, and economic development have emerged. An accurate grasp of the current status and evolutionary trends of mountain ecosystems is essential to enhance the overall benefits of ecosystem services and maintain regional ecological security. Based on the In VEST(Integrated Valuation of Ecosystem Services and Trade-offs) model, this study analyzed the spatiotemporal evolution patterns and the trade-offs and synergies among ecosystem services(ES) in the Dabie Mountains Area(DMA) of eastern China. The Markov-PLUS(Patch-generating Land Use Simulation) model was used to conduct a multi-scenario simulation of the area's future development. Water yield(WY) and soil conservation(SC) had overall increasing trends during 2000-2020, carbon storage(CS)decreased overall but slowed with time, and habitat quality(HQ) increased and then decreased. The ecological protection scenario is the best scenario for improving ES in the DMA by 2030;compared to 2020, the total WY would decrease by 3.77 × 10^(8) m^(3), SC would increase by 0.65 × 10^(6) t, CS would increase by 1.33 × 10^(6) t, and HQ would increase by 0.06%. The comprehensive development scenario is the second-most effective scenario for ecological improvement, while the natural development scenario did not have a significant effect. However, as the comprehensive development scenario considers both environmental protection and economic development, which are both vital for the sustainable development of the mountainous areas, this scenario is considered the most suitable path for future development. There are trade-offs between WY, CS, and HQ, while there are synergies between SC, CS, and HQ. Spatially, the DMA's central core district is the main strong synergistic area, the marginal zone is the weak synergistic area, and trade-offs are mainly distributed in the transition zone.

Spatio-temporal Changes in Water Conservation Ecosystem Service During 1990–2019 in the Tumen River Basin, Northeast China

The water conservation(WC) function of ecosystems is related to regional ecological security and the sustainable development of water resources, and the assessment of WC and its influencing factors is crucial for ecological and water resource management.The Tumen River Basin(TRB) is located in the core of the Northeast Asian ecological network and has been experiencing severe ecological crises and water shortages in recent years due to climate change and human activities. However, these crises have not been fully revealed to the extent that corresponding scientific measures are lacking. This study analyzed the spatial and temporal evolution characteristics and drivers of WC in the TRB from 1990 to 2019 based on the water yield module of the Integrated Valuation of Ecosystem Services and Tradeoffs(InVEST) model. The results showed that: 1) under the combined effect of nature and socioeconomics, the WC depth of the TRB has slowly increased at a rate of 0.11 mm/yr in the past 30 years, with an average WC depth of 36.14 mm. 2) The main driving factor of the spatial variation in WC is precipitation, there is a significant interaction between precipitation and velocity, the interaction between each factor is higher than the contribution of a single factor, and the interactions between factors all have nonlinear enhancement and two-factor enhancement. 3) Among the seven counties and municipalities in the study area, the southern part of Helong City and the southeastern part of Longjing City are extremely important areas for WC(> 75 mm), and they should be regarded as regional water resources and ecological priority protection areas. It is foreseen that under extreme climate conditions in the future, the WC of the watershed is under great potential threat, and protection measures such as afforestation and forestation should begin immediately. Furthermore, the great interannual fluctuations in WC depth may place more stringent requirements on the choice of time scales in the ecosystem service assessment process.

Use of Component Integration Services in Multidatabase Systems: A Feasible Solution for Integrating Academic Institutions or Commercial Industries

The book chapter is an extended version of the research paper entitled “Use of Component Integration Services in Multidatabase Systems”, which is presented and published by the 13th ISITA, the National Conference of Recent Trends in Mathematical and Computer Sciences, T.M.B. University, Bhagalpur, India, January 3-4, 2015. Information is widely distributed across many remote, distributed, and autonomous databases (local component databases) in heterogeneous formats. The integration of heterogeneous remote databases is a difficult task, and it has already been addressed by several projects to certain extents. In this chapter, we have discussed how to integrate heterogeneous distributed local relational databases because of their simplicity, excellent security, performance, power, flexibility, data independence, support for new hardware technologies, and spread across the globe. We have also discussed how to constitute a global conceptual schema in the multidatabase system using Sybase Adaptive Server Enterprise’s Component Integration Services (CIS) and OmniConnect. This is feasible for higher education institutions and commercial industries as well. Considering the higher educational institutions, the CIS will improve IT integration for educational institutions with their subsidiaries or with other institutions within the country and abroad in terms of educational management, teaching, learning, and research, including promoting international students’ academic integration, collaboration, and governance. This will prove an innovative strategy to support the modernization and large expansion of academic institutions. This will be considered IT-institutional alignment within a higher education context. This will also support achieving one of the sustainable development goals set by the United Nations: “Goal 4: ensure inclusive and quality education for all and promote lifelong learning”. However, the process of IT integration into higher educational institutions must be thoroughly evaluated, identifying the vital data access points. In this chapter, Section 1 provides an introduction, including the evolution of various database systems, data models, and the emergence of multidatabase systems and their importance. Section 2 discusses component integration services (CIS), OmniConnect and considering heterogeneous relational distributed local databases from the perspective of academics, Section 3 discusses the Sybase Adaptive Server Enterprise (ASE), Section 4 discusses the role of component integration services and OmniConnect of Sybase ASE under the Multidatabase System, Section 5 shows the database architectural framework, Section 6 provides an implementation overview of the global conceptual schema in the multidatabase system, Section 7 discusses query processing in the CIS, and finally, Section 8 concludes the chapter. The chapter will help our students a lot, as we have discussed well the evolution of databases and data models and the emergence of multidatabases. Since some additional useful information is cited, the source of information for each citation is properly mentioned in the references column.

Response of ecosystem carbon storage to land use change from 1985 to 2050 in the Ningxia Section of Yellow River Basin,China

Regional sustainable development necessitates a holistic understanding of spatiotemporal variations in ecosystem carbon storage(ECS),particularly in ecologically sensitive areas with arid and semi-arid climate.In this study,we calculated the ECS in the Ningxia Section of Yellow River Basin,China from 1985 to 2020 using the Integrated Valuation of Ecosystem Services and Tradeoffs(InVEST)model based on land use data.We further predicted the spatial distribution of ECS in 2050 under four land use scenarios:natural development scenario(NDS),ecological protection scenario(EPS),cultivated land protection scenario(CPS),and urban development scenario(UDS)using the patch-generating land use simulation(PLUS)model,and quantified the influences of natural and human factors on the spatial differentiation of ECS using the geographical detector(Geodetector).Results showed that the total ECS of the study area initially increased from 1985 until reaching a peak at 402.36×10^(6) t in 2010,followed by a decreasing trend to 2050.The spatial distribution of ECS was characterized by high values in the eastern and southern parts of the study area,and low values in the western and northern parts.Between 1985 and 2020,land use changes occurred mainly through the expansion of cultivated land,woodland,and construction land at the expense of unused land.The total ECS in 2050 under different land use scenarios(ranked as EPS>CPS>NDS>UDS)would be lower than that in 2020.Nighttime light was the largest contributor to the spatial differentiation of ECS,with soil type and annual mean temperature being the major natural driving factors.Findings of this study could provide guidance on the ecological construction and high-quality development in arid and semi-arid areas.

Study on Lightning Protection Integrated Service Management Platform in Yantai City

Via database technology, a perfect lightning protection integrated service work platform is established, thereby realizing paperless data management of routine business.

An integrated approach to evaluation on ecological service functions for urban green space and its application

This methodological investigation deals with measurement and valuation of ecological service functions for urban green space. Social, economic and ecological dimensions for such types of function were analyzed and a concept “integrated ecological service functions” (IESF) was put forward for evaluation. Based upon this conceptual approach, an index system for measuring IESF for urban green space was established. With a methodological integration of fuzzy mathematics, decision making analysis and Delphi method, an AHP fuzzy evaluation techniques for IESF for urban green space, called AFIFUG method, was developed. Such a method has been directly applied to the land use strategic planning of Tianjin out ring green belt(TOGB), and its analysis results have been successfully put into operation.

Research on the Construction of Intelligence Community Integrated Information Service platform

With the constructions of ＂intelligence city＂, intelligent life quietly came to the people. As the ＂cell＂ of the city, the construction of intelligence community arises. Resident service system and e-government application system have been used in the traditional information community, but these systems are independent of each other, lack of interconnectedness, which results in the phenomenon of information isolated island. Intelligence community integrated information service platform can integrate information service resources and provide residents with efficient and convenient life. From the meaning, operation mode, we can design the cooperative, open and extensible system architecture.

Ontological Model for Cohesive Smart Health Services Management

Health care has become an essential social-economic concern for all stakeholders(e.g.,patients,doctors,hospitals etc.),health needs,private care and the elderly class of society.The massive increase in the usage of health care Internet of things(IoT)applications has great technological evolvement in human life.There are various smart health care services like remote patient monitoring,diagnostic,disease-specific remote treatments and telemedicine.These applications are available in a split fashion and provide solutions for variant diseases,medical resources and remote service management.The main objective of this research is to provide a management platform where all these services work as a single unit to facilitate the users.The ontological model of integrated healthcare services is proposed by getting requirements from various existing healthcare services.There were 26 smart health care services and 26 smart health care services to classify the knowledge-based ontological model.The proposed ontological model is derived from different classes,relationships,and constraints to integrate health care services.This model is developed using Protégébased on each interrelated/correlated health care service having different values.Semantic querying SPARQL protocol and RDF query language(SPARQL)were used for knowledge acquisition.The Pellet Reasoner is used to check the validity and relations coherency of the proposed ontology model.Comparative to other smart health care services integration systems,the proposed ontological model provides more cohesiveness.

Evaluation and Quantitative Attribution Analysis of Water Yield Services in the Peak-cluster Depression Basins in Southwest of Guangxi,China

Karst environmental issues have become one of the hot spots in contemporary international geological research. The same problem of water shortage is one of the hot spots of global concern. The peak-cluster depression basins in southwest of Guangxi is an important water connotation and ecological barrier areas in the Pearl River Basin of China. Thus, studying the spatial and temporal variations and the influencing factors of its water yield services is critical to achieve the sustainable development of water resources and ecological environmental protection in this region. As such, this paper uses the Integrated Valuation of Ecosystem Services and Tradeoffs(InVEST) model to assess the spatial and temporal variabilities of water yield services and its trends in the peak-cluster depression basins in southwest of Guangxi from 2000 to 2020. This work also integrates precipitation(Pre), reference evapotranspiration(ET), temperature(Tem), digital elevation model(DEM), slope, normalized difference vegetation index(NDVI), land use/land cover(LULC) and soil type to reveal the main factors that influence water yield services with the help of Geodetector. Results show that: 1) in time scale,the total annual water yield in the study area show a fluctuating and increasing trend from 2000 to 2020, with a growth rate of 7.3753 × 10^(8)m^(3)/yr, and its multi-year average water yield was 538.07 mm;2) in spatial pattern, with high yield areas mainly distributed in the south of the study area(mainly including Shangsi County, Pingxiang City, Ningming County, Longzhou County and Jingxi County), and low yield areas mainly distributed in Baise City and Nanning City;3) the dominant factor of water yield within karst and non-karst landforms is not necessarily controlled by precipitation, and the explanation degree of DEM factors in karst areas is significantly higher than that in non-karst areas;4) amongst the climatic factors, Pre, ET and Tem are dominant in the spatial pattern of region water yield capacity. among which Pre has the highest explanatory power for the spatial heterogeneity of annual water production, with q values above0.8, and each driver showed a significant interaction on the spatial distribution of water yield, with Pre exhibiting the strongest interaction with LULC.

Influence of Human Activity Intensity on Habitat Quality in Hainan Tropical Rainforest National Park,China

Due to long-term human activity interference,the Hainan Tropical Rainforest National Park(HTRNP)of China has experienced ecological problems such as habitat fragmentation and biodiversity loss,and with the expanding scope and intensity of human activity impact,the regional ecological security is facing serious challenges.A scientific assessment of the interrelationship between human activity intensity and habitat quality in the HTRNP is a prerequisite for achieving effective management of ecological disturbances caused by human activities and can also provide scientific strategies for the sustainable development of the region.Based on the land use change data in 2000,2010,and 2020,the spatial and temporal variations and the relationship between habitat quality(HQ)and human activity intensity(HAI)in the HTRNP were explored using the integrated valuation of ecosystem services and trade-offs(InVEST)model.System dynamics and land use simulation models were also combined to conduct multi-scenario simulations of their relationships.The results showed that during 2000–2020,the habitat quality of the HTRNP improved,the intensity of human activities decreased each year,and there was a negative correlation between the two.Second,the system dynamic model could be well coupled with the land use simulation model by combining socio-economic and natural factors.The simulation scenarios of the coupling model showed that the harmonious development(HD)scenario is effective in curbing the increasing trend of human activity intensity and decreasing trend of habitat quality,with a weaker trade-off between the two compared with the baseline development(BD)and investment priority oriented(IPO)scenarios.To maintain the authenticity and integrity of the HTRNP,effective measures such as ecological corridor construction,ecological restoration,and the implementation of ecological compensation policies need to be strengthened.

Bi-Level Bidding and Multi-Energy Retail Packages for Integrated Energy Service Providers Considering Multi-Energy Demand Elasticity

How to effectively use the multi-energy demand elasticity of users to bid in the multi-energy market and formulate multi-energy retail packages is an urgent problem which needs to be solved by integrated energy service providers(IESPs)to attract more users and reduce operating costs.This paper presents a unified clearing of electricity and natural gas based on a bi-level bidding and multi-energy retail price formulation method for IESPs considering multi-energy demand elasticity.First,we propose an operating structure of IESPs in the wholesale and retail energy markets.The multi-energy demand elasticity model of retail-side users and a retail price model for electricity,gas,heat and cooling are established.Secondly,a bi-level bidding model for IESPs considering multi-energy demand elasticity is established to provide IESPs with wholesale-side bidding decisions and retail-side energy retail price decisions.Finally,an example is given to verify the proposed method.The results show that the method improves the total social welfare of the electricity and natural gas markets by 7.99%and the profit of IESPs by 1.40%.It can reduce the variance of the electricity,gas,and cooling load curves,especially the reduction of the variance of the electricity load curve can which reach 79.90%.It can be seen that the research in this paper has a positive effect on repairing the limitations of integrated energy trading research and improving the economics of the operation of IESPs.

Spatiotemporal evolution of water conservation function and its driving factors in the Huangshui River Basin, China

The Grain for Green project has had a substantial influence on water conservation in the Huangshui River Basin,China through afforestation and grassland restoration over the past two decades.However,a comprehensive understanding of the spatiotemporal evolution of water conservation function and its driving factors remains incomplete in this basin.In this study,we utilized the Integrated Valuation of Ecosystem Services and Tradeoffs(InVEST)model to examine the spatiotemporal evolution of water conservation function in the Huangshui River Basin from 2000 to 2020.Additionally,we employed the random forest model,Pearson correlation analysis,and geographical detector(Geodetector)techniques to investigate the primary factors and factor interactions affecting the spatial differentiation of water conservation function.The findings revealed several key points.First,the high-latitude northern region of the study area experienced a significant increase in water conservation over the 21-a period.Second,the Grain for Green project has played a substantial role in improving water conservation function.Third,precipitation,plant available water content(PAWC),grassland,gross domestic product(GDP),and forest land were primary factors influencing the water conservation function.Finally,the spatial differentiation of water conservation function was determined by the interactions among geographical conditions,climatic factors,vegetation biophysical factors,and socio-economic factors.The findings have significant implications for advancing ecological protection and restoration initiatives,enhancing regional water supply capabilities,and safeguarding ecosystem health and stability in the Huangshui River Basin.

Innovation and Practice of Teaching Methods in Digital and Adaptive Learning:Taking Communication Engineering Major as an Example

This paper proposes teaching reforms in communication engineering majors,emphasizing the implementation of digital and adaptive teaching methodologies,integrating emerging technologies,breaking free from the constraints of traditional education,and fostering high-caliber talents.The reform measures encompass fundamental data collection,recognition of individual characteristics,recommendation of adaptive learning resources,process-oriented teaching management,adaptive student guidance and early warning systems,personalized evaluation,and the construction of an integrated service platform.These measures,when combined,form a comprehensive system that is expected to enhance teaching quality and efficiency,and facilitate student development.

Satisfaction of Village Doctors with the Township and Village Health Services Integration Policy in the Western Minority-inhabited Areas of China

Township and Village Health Services Integration Management（TVHSIM） is an essential form of China＇s two-tiered health service integration plan at the township and village level. Its main purpose, also one of the target goals in China＇s new healthcare reform, is to gradually integrate rural health services and appropriately allocate rural health resources. This study aims to assess the village doctors＇ satisfaction with the TVHSIM and provide scientific base to further improve TVHSIM. A cross-sectional study was carried out in which 162 village doctors from Qinghai, Inner Mongolia and Xinjiang in western China were interviewed. Descriptive analysis, independent t-test, one-way ANOVA, Spearman rank correlation and multiple linear regression were used to analyze the difference and relevance between village doctors＇ personal characteristics and their satisfaction with TVHSIM and six subscales. Village doctors with different years of practice, social insurance status and essential medical knowledge level showed statistically significant differences in their satisfaction levels（all P〈0.05）. Age（P〈0.05） and years of practice（P〈0.01） were negatively correlated with Drug and Medical Device Management and Financing Management. Essential medical knowledge level（P〈0.05） was negatively correlated with Operations Management as well. However, social insurance status（P〈0.05） was positively correlated with Human Resources Management and Drug and Medical Device management. Gender, age and years of practice respectively had significant influence on village doctors＇ satisfaction with TVHSIM（P〈0.01）. In conclusion, in order to further promote TVHSIM policy in rural China, a well-rounded social insurance model for village doctors is urgently needed. In addition, the development of TVHSIM is regionally imbalanced. Efficient and effective measures aiming at rationalizing gender and age structure and enhancing essential medical training should be carefully considered.

An Integrated Approach to Syrian Refugees’ Health Care in Lebanon

The purpose of this paper is to learn from the integrated health care approach for the Syrian Armenian refugees by the HKCC （Howard Karagheusian Commemorative Corporation） in Burj Hammoud in Lebanon from the perspective of the beneficiaries themselves, i.e. the Syrian Armenian refugees. One hundred families who had been residing in Burj Hammoud and who had been regularly benefiting from the health services of the HKCC for at least one year were interviewed. The interviewees used a semi-structured questionnaire. Data were analyzed and emerging themes were mapped. The Syrian Armenian refugees who participated in this study generally expressed their satisfaction with the equitable access afforded by the HKCC’s integrated health care approach. There were several reasons why the HKCC’s integrated approach to serve refugees and the local population on equal footing was given positive reviews by the sampled refugees. Based on the responses of the refugees, these reasons are mainly （a） the convenient location of the center, which is walking distance for most refugees; （b） the ability of the treating doctors to communicate with the refugees in Armenian, which facilitates diagnosis and understanding of the health problems; （c） suitable opening hours; （d） friendly staff; and （e） thorough doctors. The results do not statistically represent the overall refugee population that is served by the HKCC; due to the study’s limited demographic scope, the results cannot be generalized. This limitation was due to lack of funding to cover the whole beneficiary Syrian Armenian refugee population. The HKCC’s approach has helped in providing access to treatment and preventive measures to a refugee population that was in need of it; as a consequence, it may have improved the health outcomes of this refugee population, especially in regard to the immunization of children. An integrated approach to healthcare which provides “equal ability by refugees and host nationals to access the same healthcare resources from the same providers” seemed to have been successful in the case of the HKCC. This paper provided first exploration of an integrated health approach for refugee healthcare provision in Lebanon.