Survey of overwintering Halyomorpha halys (Hemiptera: Pentatomidae) in ports of export and natural landscapes surrounding the ports in Republic of Korea.

Halyomorpha halys (Hemiptera: Pentatomidae), an important agricultural and nuisance pest, is highly invasive with peculiar hiding behavior in human-made structures for overwintering. To evaluate the contamination risk of overwintering H. halys in non-agricultural export goods, we conducted a two-year field survey in Republic of Korea to locate overwintering H. halys in two major ports of export, Ulsan and Pyeongtaek ports, and monitored both active and overwintering H. halys population levels with varying distances from the ports ranging from 1 km to 48 km. First, we deployed wooden shelters in the two ports to catch dispersing H. halys for overwintering and conducted visual inspections for human-made structures in the ports to locate overwintering H. halys. In addition, we sampled dead trees to find overwintering H. halys in wooded areas. Second, we monitored active H. halys populations using pheromone traps with varying distances from the ports. From the survey of overwintering populations, no H. halys was collected from wooden shelters deployed in the two ports. However, we found four adults overwintering in human-made structures in Pyeongtaek port in the first year of survey. One dead adult was also found from a dead tree located in a wooded area adjacent to Pyeongtaek port in the second year. For active populations, results of pheromone trapping indicated that H. halys populations were present during autumn dispersal period not only in agricultural areas, but also in wooded areas adjacent to the two ports. This study reports for the first time that overwintering H. halys were found from the inside the port of export in its native areas with a low density. The results were discussed for evaluating contamination risk of overwintering H. halys in export goods shipping from the Republic of Korea.

Characterization of overwintering sites of Haemaphysalis longicornis (Acari: Ixodidae) and tick infection rate with severe fever with thrombocytopenia syndrome virus from eight provinces in South Korea.

Haemaphysalis longicornis (Acari: Ixodidae) is an important vector of pathogens causing tick-borne diseases such as severe fever with thrombocytopenia syndrome (SFTS) in eastern Asia. Although an understanding of the overwintering ecology of ticks is fundamental to management of this vector, its winter biology remains unclear. Therefore, we conducted a field survey from eight provinces in South Korea to characterize overwintering sites of H. longicornis and investigate their SFTS virus infection rates. First, we conducted flagging which consists of horizontal sweeping of a 1 m2 cloth back-and-forth to collect ticks that may exhibit questing behaviors in four different landscapes: grassland, shrub, coniferous forest, and deciduous forest. From 640 sweeps of flagging (where each sweep covered 3.8 m2), we collected five unfed ixodid ticks. However, H. longicornis was not found. After the flagging, to locate overwintering ticks, we inspected a total of 679 samples consisting of three different structures: ground (leaf litter, soil surface, and topsoil layer), rocks, and dead trees. From the samples inspected, 85 unfed overwintering ixodid ticks were found. Haemaphysalis longicornis was the dominant species (88 %), and mostly nymphs were collected (94 %). This species was collected from ground samples, especially from the topsoil layer. Most H. longicornis were found in herbaceous landscapes such as grassland (46 %) and shrub (52 %). SFTS virus was found in 3 out of 38 pools of unfed nymphs (minimal infection rate: 4 %). Our results can serve as baseline information for the development of vector management programs.

The ED-PACT Tool Initiative: Communicating Veterans' Care Needs After Emergency Department Visits.

BACKGROUND: Communication failures between providers threaten patient safety. PURPOSE: We developed, implemented, and formatively evaluated the ED-PACT Tool, which uses the Veterans Health Administration's (VA) electronic health record to send messages from emergency department (ED) providers to primary care patient-aligned care team (PACT) registered nurses (RNs) for Veterans discharged home from the ED with urgent or specific follow-up needs. METHODS: We used Plan-Do-Study-Act quality improvement methodology. RESULTS: Between November 1, 2015, and November 30, 2017, the tool was used to send 4,899 messages in one local VA healthcare system (ED and associated primary care clinics). Formative evaluation revealed that providers and RNs perceive the tool as providing substantial benefit for coordinating post-ED care. Patient-aligned care team leaders reported that RN training and "buy-in" facilitated tool implementation, while insufficient staffing posed a barrier. Emergency department providers noted the advantage of having a standardized and reliable system for communicating with PACTs. CONCLUSIONS/IMPLICATIONS: The ED-PACT Tool encapsulates several best practices (standardized processes, "closed-loop" communication, embedding into workflow) to facilitate communication between VA ED and follow-up care providers. Our development process illustrates key lessons in quality improvement and innovation implementation including the value of using rapid-cycle improvement methodology, with interprofessional collaboration and representatives from intended spread sites.