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Unorthodox Parenteral {beta}-Lactam and {beta}-Lactamase Inhibitor Combinations: Flouting Antimicrobial Stewardship and Compromising Patient Care [Commentary]

In India and China, indigenous drug manufacturers market arbitrarily combined parenteral β-lactam and β-lactamase inhibitors (BL-BLIs). In these fixed-dose combinations, sulbactam or tazobactam is indiscriminately combined with parenteral cephalosporins, with BLI doses kept in ratios similar to those for the approved BL-BLIs. Such combinations have been introduced into clinical practice without mandatory drug development studies involving pharmacokinetic/pharmacodynamic, safety, and efficacy assessments being undertaken. Such unorthodox combinations compromise clinical outcomes and also potentially contribute to resistance development.




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Leadership

By Sr. Joan L. Roccasalvo, C.S.J.

Everyone has a theory about leadership, but all of us want strong, effective, and moral leaders. They’re in great demand but hard to find. Families and schools, sports teams, businesses, and faith traditions rise or fall on leadership. Governments, armies, and nations rise or fall on leadership. According to James MacGregor Burns, historian and political scientist, leadership is “the process by which groups, organizations, and societies attempt to achieve common goals.”

Political leadership is a matter of personality, and it concerns the relation of authority and power with the people. Yet, within this definition lies a mysterious and mercurial quality known as temperament—the most difficult characteristic to gauge in a leader, the most challenging to pin down.  Different leadership styles and different temperaments produce varying degrees of success or failure, a topic requiring lengthy discussions.

In this essay, we will consider three aspects of leadership: personal and professional qualities of leaders, vision, and decision-making.

Personal and Professional Qualities of Leaders

To paraphrase the Hallmark motto: The nation should care enough to elect the very best men and women with proven effective leadership, strength of character, and moral probity.

Character

Leaders should reflect on a key question: Who must I be, and what must I do to bring about and advance the vision I have for the common good?  Having learned the art of self-discipline, strong leaders are master listeners, master communicators, and masters of their emotions.  Honesty lives at the core of their moral compass; it undergirds and supports the public trust. Strong, effective, and moral leaders speak the truth to themselves and to others without shaving it.  

On the eve of Britain’s entrance into World War II, Winston Churchill delivered the stark and sobering truth to a nation in distress:  “I have nothing to offer you but blood, toil, tears, and sweat.”  

George Washington was acclaimed for his integrity, wisdom, and astounding courage on the battlefield, and Nelson Mandela, as a “colossus of unimpeachable character.”

Rose Kennedy was not a public figure but the matriarch of a family of political leaders.  She inspired thousands of men and women through her courage in the face of so many family tragedies.

The Burmese-Myanmar politician, statesperson, and author Aung San Suu Kyi has inspired women throughout the world for her courage to withstand fifteen years of house arrest by the authorities who considered her an enemy of the state.  She writes in Freedom from Fear: “It is not power that corrupts but fear.  Fear of losing power corrupts those who wield it, and fear of the scourge of power corrupts those who are subject to it.”  

Communication Skills

Effective leaders have the ability to communicate clearly and persuasively. President Franklin D. Roosevelt was a charismatic patrician. With his clear sense of noblesse oblige, he led the country through the Great Depression.  From his struggle with polio, he learned to empathize with others.  Roosevelt’s fireside chats gave him a direct, personal, and immediate contact with the country.  He simplified his grand-scale programs capped by the motto, “The New Deal” which gave jobs to the millions of unemployed roaming the streets in despair.

As a sickly child and young adult, President John F. Kennedy spent many solitary hours with books.  The breadth of his reading history and politics, literature, science, travel, and biography served as one source of his eloquence, whether in prepared speeches or presented spontaneously.  His press conferences became the stuff of conversation pieces in Washington. The press corps was riveted as much on Kennedy’s oratory as on his responses to questions. Here was a master communicator thoroughly enjoying his own press conferences.

Winston Churchill’s strongest quality as a leader was his ability to inspire others, despite the ominous circumstances Britain was facing during his tenure as Prime Minister.  The source of this ability lay in his own character—and of course his ability to find the right words to fit the country’s mood.  On the eve of World War II in 1940, Churchill declared before the House of Commons: “We shall go on to the end.  We shall fight in France, we shall fight on the seas and oceans, we shall fight with growing confidence and growing strength in the air, we shall defend our island, whatever the cost may be.  We shall fight in the fields and in the streets, we shall fight in the hills; we shall never surrender.”  Labor MP Josiah Wedgwood promptly responded:  “That was worth 1,000 guns, and the speeches of 1,000 years.”  

In April 1963, when President Kennedy made Churchill an Honorary Citizen of the United States—Churchill’s mother was an American—the President offered this word of praise: “He mobilized the English language and sent it into battle.”  

Sense of Humor

Strong leaders have a developed sense of humor that may enhance their Office.  “I am the man who accompanied Jacqueline Kennedy to Paris, and I have enjoyed it,” declared the President in the spring of 1961 on their visit to France.  

Acerbic wit was never far from President Lincoln’s lips or from Winston Churchill’s.  In a letter to his good friend, Joshua F. Speed, Lincoln wrote, “When the Know-Nothings get control, it [the Declaration of Independence] will read: 'All men are created equal except negroes, foreigners and Catholics.' When it comes to this I should prefer emigrating to some country where they make no pretense of loving liberty—to Russia, for instance, where despotism can be taken pure, and without the base alloy of hypocrisy.”  Regarding his pro-slavery opponents Lincoln declared, “Whenever I hear anyone arguing for slavery, I feel a strong impulse to see it tried on him personally.”

One evening as a tired and wobbly Churchill was leaving the House of Commons, the Labor MP Bessie Braddock accused him of being disgustingly drunk.” He replied: “Bessie, my dear, . . . you are disgustingly ugly.  But tomorrow I shall be sober, and you will still be disgustingly ugly.”

Vision

Leaders have vision, a quality that conceives of an idea or sees a picture into the future before others can visualize it.  St. Ignatius of Loyola chose and trained leaders who would be affable, attractive, and persuasive messengers of his vision and not those who were rich or powerful.  

In Back to Methuselah, George Bernard Shaw wrote: “You dream dreams and say “Why?”  But I dream dreams that never were and say “Why not?”  His words were paraphrased by Robert F. Kennedy in his 1968 campaign for the presidential nomination.    Transformative leaders can rouse a nation to action when their goals are persuasive. They articulate a shared raison d’être in words such as the Rev. Martin L. King, Jr. orated in his “I have a dream” speech.”  He asked men and women to dream today and tomorrow of a better America.

In his inaugural address, John F. Kennedy put his vision this way: “And so my fellow Americans, ask not what your country can do for you—ask what you can do for your country.” He simplified this vision in the motto: “The New Frontier.”  This phrase encompassed pursuits in science and the arts, foreign affairs, race and inequality.  He invited the country to become pioneers on this noble quest.  Soon the Peace Corps appealed to the generosity and self-sacrifice of American youth to serve all over the world.    

It is no small thing for leaders to touch our hearts and minds by appealing to “the better angels of our nature,” a phrase of Charles Dickens which Lincoln quoted in his First Inaugural Address.

Decision-Making

Leaders make decisions throughout the course of a day or over a longer period of time.  Some decisions are so consequential they can change the public image of an organization.  Such was the case with a decision taken at Vatican II regarding the fate of Gregorian chant.  At the close of the Council, it was hastily whisked away from parish Masses in North America, though it was kept alive in a few monasteries. Popular songs, accompanied by thumping guitars and percussive bongo drums, hastily replaced it.  Latin gave way to the vernacular.

The pros and cons cannot be debated here, but music scholars were shocked at the sudden change. Gustav Reese, a noted expert on Gregorian chant, could barely contain himself at the hierarchy’s decision.  In a passionate cry, he exclaimed:  ‘What have you done to the chant!’

To avoid open criticism of the Church, other scholars described the drastic changes in neutral and measured language as the most dramatic and consequential of all the changes made at Vatican II. Internal struggle was marked by “defiance versus intractability.”  This struggle “has sapped the church of its vitality not to mention the effect it continues to have on matters that are “aesthetic, political, sociological, or even purely technical.”    

In times of crisis how do leaders make decisions?  Some leaders make decisions without consultation, while others call for collegiality. Collegial leaders point the way forward to advance the purpose of the organization.  Still, the personality of the leader plays an important role in this model. Whereas strong leaders get the best and brightest to execute their vision by delegating responsibility, weak leaders fear initiative and creativity from their workers.  They lack trust in the abilities of others.

To sum up this complex topic, St. Paul exhorts leaders of the community “to lead their lives worthy their calling” (Eph. 4:1).



  • CNA Columns: The Way of Beauty

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Alaska Reporter Will Study Rural Education as 2nd Chronister Fellowship Recipient

Victoria Petersen, of the Peninsula Clarion on the Kenai Peninsula, will report on the challenges of rural education, especially in a state as vast as Alaska.




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Hungry for fellowship

Sylvia discovers how eager believers in rural Bangladeshi villages are for fellowship.




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Delaware Homeownership Relief Expands Outreach

The Delaware State Housing Authority (DSHA) and the Delaware Attorney General’s Office joined forces to launch “Delaware Homeowner Relief”, an initiative created using a portion of funds Delaware received through the Multistate Mortgage Foreclosure Settlement between the federal government and five of the nation’s largest mortgage-servicing banks.




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Tax Credit Takes Center Stage During Homeownership Month Celebration

Governor Jack Markell today joined Delaware State Housing Authority Director Anas Ben Addi and other federal, state, and local officials to celebrate Delaware Homeownership Month and to announce the extension of a program that allows first-time homebuyers to claim a credit on their federal income taxes.




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Free! Lunch & Learn About Homeownership Programs and Foreclosure Prevention

Delaware State Housing Authority (DSHA) and the Delaware Council of Faith-Based Partnerships will be hosting a free Lunch & Learn on Tuesday, March 3, 2015 in the Carvel State Office Building, 3rd Floor Conference Room, at 820 N. French Street, Wilmington, Delaware.




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Delaware Celebrates Homeownership Month

Governor Jack Markell today joined Delaware State Housing Authority, Habitat for Humanity, Delaware Americorps, Delaware Association of Realtors, Home Builders Association of Delaware, and Delaware Health and Social Services to proclaim June as Homeownership Month.




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DSHA Launches New Homeownership Website

DOVER, DE – For anyone in Delaware looking to buy a home, Delaware State Housing Authority (DSHA) has launched a new website that provides convenient and detailed information about the authority’s homeownership programs and the home-buying process. The website, www.kissyourlandlordgoodbye.com, connects potential homebuyers in the state with resources on low interest mortgage loans, down payment […]




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DSHA Launches Homeownership Program for Recent College Graduates

DOVER – Governor John Carney and Delaware State Housing Authority (DSHA) Director Anas Ben Addi announced the launch of a new homeownership program for recent college graduates at an event recognizing Homeownership Month. The new program, Homes for Grads, will offer discounted rates on DSHA’s down payment assistance loans for homebuyers who have graduated college […]




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Servant leadership at TeenStreet

Leader of OM Germany serves in the kitchen during TeenStreet, OM’s annual week-long international youth congress that started on Saturday.




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Industrial engineering students receive scholarships for academic excellence

Three students received scholarships in industrial and mechanical engineering from the Material Handling Education Foundation for the 2020-21 academic year.




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Engineering alumnus endows graduate fellowship in memory of late wife

Mark Alpert made a generous gift $200,000 in memory of his late wife, Claire, to establish the Mark E. and Claire L. Alpert Graduate Fellowship in the Department of Civil and Environmental Engineering at Penn State.




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Penn State planning to freeze 2020-21 tuition to help ease COVID-19 hardships

Due to the economic challenges facing Pennsylvania and the nation, Penn State President Eric J. Barron announced plans today (April 23) to freeze tuition rates for all students University-wide for the 2020-21 academic year. The plan, which will be presented to the University’s Board of Trustees for final approval at its July meeting, would mark the third consecutive year that Penn State has held tuition rates flat for Pennsylvania resident students.




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Friendship culture

Three Brazilian women use cultural connections to make friendships around the Muslim world.




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'Freedom to grow in ministry and leadership'

Brazil’s mission training programme provides practical experience and cross-cultural knowledge for participants heading overseas.




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Connecting to worship in Central Asia

An app of praise and worship songs is allowing Central Asian believers to share and access music in their heart languages.




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Inspiring creativity and worship

A new recording studio aims to bring Central Asian musicians together for collaboration and worship.




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Discipleship on a daily basis

God uses OMers to show His love to local believers, who then spread that love to their own communities.




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Fellowship through football

OM Chile's newly-created sports ministry experiences God's faithfulness in its first football game.




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Strengthening relationships through supper

In an effort to strengthen relationships with local churches, OM Chile recently held a dinner for local pastors that featured international flavours and testimonies.




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Fellowship beyond borders

Marloes Achterveld, from the Netherlands, shares about falling in love with the people of Curarrehue in southern Chile during OM Chile's Intensive Missions Training.




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Equity-Focused Leadership Is Risky. Do It Anyway

As superintendents, we must make the system work for all students—however socially, politically, and professionally dangerous it may be, writes Demond A. Means.




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Healthy Parent-Teacher Relationships Start With Healthy Student-Teacher Ones

Teacher Adrianne G. Williams cultivates an environment where she focuses on students' interpersonal qualities as well as their academic ones. The students see her effort, she says, and the parents follow.




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Delaware Division of the Arts Announces 2018 Individual Artist Fellowship Awardees

DELAWARE DIVISION OF THE ARTS ANNOUNCES  2018 INDIVIDUAL ARTIST FELLOWSHIP AWARDEES Seventeen Delaware artists are being recognized by the Division for the high quality of their artwork. Work samples from 124 Delaware choreographers, composers, musicians, writers, folk and visual artists were reviewed by out-of-state arts professionals, considering demonstrated creativity and skill in their art form. […]





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“An Immigrant Story: Crossing the Atlantic in a 17th Century Sailing Ship” at the New Castle Court House Museum

Program will explore what life would be like for a two-month crossing of the Atlantic Ocean from Europe to the New World.




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The Mezzanine Gallery to Exhibit “Ship of Theseus” by Lauren E. Peters

On view from December 7-28, 2018 Free opening reception on Friday, December 7 at 5 p.m. Wilmington, Del. (November 28, 2018) – Ship of Theseus, an exhibition of self-portraits by painter Lauren E. Peters, will be on view in the Mezzanine Gallery from December 7-28, 2018. Peters received a 2018 Individual Artist Fellowship in Painting. […]




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Delaware Division of the Arts Announces 2019 Individual Artist Fellowship Awardees

Twenty Delaware artists and three Honorable Mentions to receive recognition Wilmington, Del. (January 14, 2019) – Twenty Delaware artists are being recognized by the Division for the high quality of their artwork. Work samples from 136 Delaware choreographers, composers, musicians, writers, folk and visual artists were reviewed by out-of-state arts professionals, considering demonstrated creativity and skill […]






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Delaware Division of the Arts Announces 2020 Individual Artist Fellowship Awardees

Nineteen Delaware artists and two Honorable Mentions to receive recognition Wilmington, Del. (January 14, 2020) – Nineteen Delaware artists are being recognized by the Division for the high quality of their artwork. Work samples from 139 Delaware choreographers, composers, musicians, writers, folk and visual artists were reviewed by out-of-state arts professionals, considering demonstrated creativity and […]




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Mahindra Introduces New Online Retail Channel Integrating Its Dealerships

The new website provides a 360-degree solution catering to the entire purchasing procedure which includes finance, insurance, exchange as well as accessories so that customers don't have to step out...




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Interview for Internship - The virtuoso needed

Legal Internships, Interview for legal Internships, Tips to successfully land a legal internship. Internship for law students, interview for law internships.




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Delaware Dept. of Labor, Vo-Techs Host Adult Education Apprenticeship Open House for National Apprenticeship Week

WILMINGTON, DE – The Delaware Department of Labor will be celebrating the Fifth Annual National Apprenticeship Week (NAW) with three open house events, one in each county throughout the state from 6 – 7 pm to showcase the value of apprenticeship in the community. Secretary Cerron Cade from The Delaware Department of Labor will be […]




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Delaware Forestry Association holds annual meeting, offers forestry scholarship

The Delaware Forestry Association will present its annual "Tree Farmer of the Year" award at its annual meeting at the Felton Fire Hall located at 9 E. Main Street, Felton, DE 19943 on Thursday, March 12, 2015. Tickets are $27 for adults, $12.50 for children ages 6 to 12, and free for those under age 6. Reservations are kindly requested by March 2, and more information is available by contacting Steve Ditmer at (410) 896-9283. The Delaware Forestry Association is now accepting applications through April 1, 2015 for its annual $1,000 forestry scholarship award. The scholarship will be awarded to a full-time student who must choose forestry as their studies major and be accepted or enrolled in a two-year or four-year accredited school program.



  • Department of Agriculture
  • Forest Service
  • Delaware Forest Service
  • Delaware Forestry Association
  • Delaware Tree Farm Committee
  • Tree Farmer of the Year Award

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Care is urged after imported fire ants found in palm tree shipment

State authorities are alerting local businesses and purchasers of tropical nursery stock of the recent detection of fire ants in a shipment of palm trees imported from Florida. The red imported fire ants were detected during a routine check at a Sussex County business by the Delaware Department of Agriculture's Plant Industries nursery inspection team. They were eradicated and do not pose a threat.




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Marydel farmer receives Environmental Stewardship Award

Poultry farmer Chris Lesniowski of Marydel has been recognized for his efforts to improve water quality and reduce nutrient runoff with the 2015 Delaware Environmental Stewardship Award.



  • Department of Agriculture

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Milford farmers receive Environmental Stewardship Award

Poultry farmers Ted Layton and Scott Willey have been recognized for their efforts to improve water quality and reduce nutrient runoff with the 2016 Delaware Environmental Stewardship Award.



  • Department of Agriculture

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Gov. Markell recognizes leadership, service of Delaware agriculture leaders

Gov. Jack Markell has presented the Order of the First State to two noted Delaware agricultural leaders and public servants, Bob Garey of Felton and Bill Vanderwende of Bridgeville.



  • Department of Agriculture
  • Former Governor Jack Markell (2009-2017)
  • Office of the Governor

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Delaware Forestry Association holds annual meeting on March 23 in Bridgeville; offers $1,000 forestry scholarship

Celebrating its 35th anniversary, the Delaware Forestry Association (DFA) will present its 2017 “Tree Farmer of the Year” award on Thursday, March 23 at its annual banquet and meeting at the Bridgeville Fire Hall, 311 Market Street, Bridgeville, Delaware 19933, (302) 337-7272. Tickets are $27 for adults and free for children under 12. Reservations are kindly requested by March 17. Forms are available at delawareforest.com




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Care is urged after red imported fire ants found in palm tree shipment

Red imported fire ants were detected during a routine check at a Sussex County business by the Delaware Department of Agriculture's Plant Industries nursery inspection team. A Hold and Control Order was promptly issued, and a treatment program to eliminate the fire ants is underway. "Buyers of tropical nursery stock - such as palm trees - should carefully inspect their plants for small, aggressive red stinging ants," said Stephen Hauss, Cooperative Agricultural Pest Survey Coordinator for the Department of Agriculture. "We need these to be reported quickly and promptly to keep them from spreading or staying in Delaware over the winter."



  • Department of Agriculture
  • DDA Plant Industries
  • Delaware Department of Agriculture
  • Sussex County

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Houston poultry farmers receive Environmental Stewardship Award

Poultry farmers Randy and Jordan McCloskey were recognized during Delaware Ag Week for their efforts to improve water quality and reduce nutrient runoff with the 2017 Delaware Environmental Stewardship Award.



  • Department of Agriculture
  • Delaware Department of Agriculture
  • farmer
  • poultry

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Delaware Forestry Association annual meeting is March 22 in Bridgeville; Scholarship applications due by April 1.

The Delaware Forestry Association (DFA) will present its 2018 “Tree Farmer of the Year” award on Thursday, March 22, at its annual banquet and meeting at the Bridgeville Fire Hall, 311 Market Street, Bridgeville, Delaware 19933, (302) 337-7272. Tickets are $27 for adults, $13.50 for children ages 6 to 12, and free for children 6 and under. Reservations are kindly requested by March 16. The Delaware Forestry Association is also offering its annual $1000 scholarship to a student who chooses forestry or a related major at a two-year or four-year accredited college or university. Applications are due by April 1 and the winner will be notified by May 1.




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Police partnership key to reopening historic pavilion at Redden State Forest

A partnership with the Delaware State Police and the Fish & Wildlife Natural Resources Police is helping the Delaware Forest Service reopen its historic picnic pavilion at Redden State Forest that was closed in early 2017 due to persistent illegal activity. The parking lot and rest area – popular with hikers and horseback riders – now features bright lighting, 24-hour video surveillance, and regular patrols by both marked and undercover law enforcement personnel. Along with these enhanced security measures, new signage reminds visitors that the site is closed from dusk to dawn.



  • Delaware State Police
  • Department of Agriculture
  • Department of Natural Resources and Environmental Control
  • Department of Safety and Homeland Security
  • Division of Fish and Wildlife
  • Forest Service
  • Sussex County
  • Delaware Forest Service
  • delaware state police
  • fish & wildlife natural resources police
  • Redden State Forest

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Sussex Tech’s Mitchell earns DFA forestry scholarship

Shawn Patrick Mitchell of Greenwood, a recent graduate of Sussex Tech who plans to study wildlife and fisheries at Frostburg State University, received the Delaware Forestry Association's 2018 scholarship at the Delaware State Fair last week. Agriculture Secretary Michael T. Scuse and Governor John C. Carney were there to present the ceremonial check to Mitchell as his parents David and Melissa looked on. Once he earns his bachelor's of science degree, Mitchell hopes to be a game warden or park ranger one day.




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DNREC’s Nonpoint Source Program offering free trees to Delaware residents in partnership with DDA’s Forest Service

DNREC’s Division of Watershed Stewardship Nonpoint Source Program is offering a free tree to Delaware residents in partnership with the Delaware Forest Service’s Urban and Community Forestry program within the Department of Agriculture.




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Four Delaware farm families honored for 100 years of farm ownership

The Delaware Department of Agriculture honored four Delaware’s farm families for their continued commitment to farming the same land for a century or more. The Delaware Century Farm Program was established in 1987 to honor farming families who have owned and farmed their land for at least 100 years. The farms must include at least 10 acres of the original parcel or gross more than $10,000 annually in agricultural sales. Including this year’s inductees, the program has honored 143 farms throughout Delaware.



  • Department of Agriculture
  • Century Farm
  • Century Farm Award
  • Delaware Department of Agriculture
  • Delaware Secretary of Agriculture Michael T. Scuse
  • Deputy Secretary of Agriculture Austin Short
  • farm
  • farm families
  • Sussex County

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Organic poultry farm located in Harrington receives Environmental Stewardship Award

Poultry farmers John and Linda Brown were recognized during Delaware Ag Week for their efforts to improve water quality and reduce nutrient runoff with the 2018 Delaware Environmental Stewardship Award.



  • Department of Agriculture
  • Delaware Ag Week
  • Delaware Department of Agriculture
  • Delaware Nutrient Management Commission
  • Environmental Stewardship Awards

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Delaware forestry banquet is March 21 in Felton; College scholarship offered

The Delaware Forestry Association’s 2019 Annual Meeting and Banquet will be Thursday, March 21 at the Felton Fire Hall. Highlights include the Delaware Tree Farm Committee's 2019 “Tree Farmer of the Year” Award and recognition of 25-Year Delaware Tree Farmers. The DFA is also offering its annual forestry scholarship. Application deadline is April 1. Details can be found at http://delawareforest.com