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Mathematical Analysis Of Monkeypox Transmission Dynamics With Control Strategie, Singo Juma Singo, Furaha Michael Chuma, Zubeda Seif Mussa

Tanzania Journal of Science

This study develops a mathematical model to analyze the transmission dynamics of Monkeypox and evaluate the effectiveness of control strategies. The model is formulated as a system of nonlinear differential equations, capturing key factors such as human-to-human transmission, zoonotic reservoirs, and control measures like vaccination, culling, personal hygiene and treatment. The model's equilibrium points, including the disease-free and endemic equilibria, are determined and analyzed for stability using the effective reproduction number, Re. Conditions under which Re<1 ensure the elimination of Monkeypox, while Re>1 indicates sustained transmission. A sensitivity analysis is performed to identify parameters that significantly influence Re​, such as the contact rate, effectiveness of control …

Predicting Tuberculosis Vulnerability Based On Environmental Factors Using Multi-Criteria Analysis In Bukittinggi, Eka Budi Satria, Indang Dewata, Iswandi Umar, Nurhasan Syah, Linda Handayuni, Evi Hasnita

Media Kesehatan Masyarakat Indonesia

Tuberculosis is still an infectious disease problem and the main cause of death in Indonesia, where there was an increase in cases from 301 per 100,000 population (2020) to 354,000 per 100,000 population (2021), with the death rate increasing by 55%. This research aims to determine the TB vulnerability cluster influenced by the main risk factors, namely TB prevalence, cure rate, immunization, population density, and population arrivals in Bukittinggi, using the Weight Product (WP) analysis method, and then describe them by mapping tuberculosis vulnerability. The findings indicate that four sub-districts exhibit the highest levels of tuberculosis vulnerability: Tarok Dipo (0.0379), …

Determinants Of Wasting Among Children Aged 6–23 Months In Indonesia, R. Trikoriyanto E. Koritelu, Ahmad Syauqy, Ani Margawati

Media Kesehatan Masyarakat Indonesia

Wasting is a form of malnutrition that is a significant concern globally, including in Indonesia. It has a detrimental impact on children's health, the quality of human resources, and a country's overall development. This study aims to examine the prevalence and risk factors associated with wasting in children aged 6–23 months in Indonesia. The study design is cross-sectional, utilizing secondary data from the 2022 Indonesian Nutrition Status Survey. Data collection was conducted throughout Indonesia between March and December 2022. The sample size for this study was 70,414 children aged between 6 and 23 months. Bivariate analysis (χ² test) was …

Building Hope: Program For Handling Psychosocial Problems Of People Living With Hiv/Aids In Denpasar, Fitasya Khairunnisa, Oman Sukmana, Zaenal Abidin, Juli Astutik

Media Kesehatan Masyarakat Indonesia

The research aims to describe the forms of Psychosocial Problems Experienced by People Living with HIV/AIDS (PLWHA) and the programs of the Spirit Paramacitta Foundation to overcome the psychosocial problems of PLWHA. The research location was the Spirit Paramacitta Foundation Denpasar, Bali Province. The research uses a qualitative descriptive. The data collection techniques are through observation, interviews, and documentation. Research subjects and informants were determined purposively. Data analysis techniques refer to the perspective of Miles, Huberman, and Saldana, which includes the processes: data collection, data condensation, data presentation, and conclusion and verification. The data validity techniques used are extended observations …

Total Polyphenol Content, Antioxidant Potential, Antibacterial And Antifungal Properties Of Ferula L. Species Growing In Tajikistan, Saidbeg Satorov, Sulkhya Mavlonazarova, Salomuddin Yusufi, Vyacheslav Dushenkov

Publications and Research

The plants of the genus Ferula L. have long been recognized for their significant roles in traditional medicine in the Middle East and Asia, a heritage that we deeply respect and appreciate. A diverse array of biologically active compounds, particularly concentrated in the roots of various Ferula species, accounts for their broad range of medicinal properties and applications in folk medicine. Many species within this genus are noted for their high content of phenolic compounds, which exhibit potent antioxidant activity and demonstrate substantial antimicrobial and antifungal properties.

The Experiences Of Nurses Caring For Patients During The Initial Outbreak Of The Covid-19 Pandemic In The Maldives: A Phenomenological Study, Khadiyya Simany, Asiya Ibrahim

Manipal Journal of Nursing and Health Sciences

The experience of nurses caring for patients with COVID-19 in the Maldives may have been unique and at the same time similar to the global nursing situation during the initial outbreak of the COVID-19 pandemic. This research aimed to explore nurses’ experiences in providing nursing care for COVID-19 patients in one of the facilities in the Maldives. A descriptive phenomenological approach of inquiry was employed to explore the new phenomenon of the nursing experience during the early COVID-19 pandemic. Using purposive convenience sampling, six nurses were interviewed in depth via semi-structured face‒to-face interviews. The interviews were analysed through modified principles …

Global Standards And Protocols For Oral Care In Pediatric Cancer Patients: Systematic Review Protocol, Meghna Pandit, Baby S. Nayak, Vasudeva K. Bhat, Suneel C. Mundkur, Judith A. Noronha, Sridhar N

Manipal Journal of Nursing and Health Sciences

Introduction Childhood cancer is a global health challenge, with over 275,000 cases annually among individuals under 19 years. Cancer treatments such as chemotherapy and radiation therapy lead to significant oral complications, including mucositis, xerostomia, and infections, adversely affecting treatment adherence and quality of life. Effective oral care is essential for mitigating these complications, particularly in resource-limited settings like India.

Objectives This systematic review aims to identify, assess, and summarize global guidelines and protocols for oral care in pediatric cancer patients, focusing on the prevention and management of oral complications during treatment.

Methods The protocol adheres to PRISMA-P guidelines and is …

Understanding Women, Infant And Children Feeding Decisions In Emergencies: The Case Of Covid-19 And The Formula Shortage, Davida Mensah, Edmund F. Agyemang, Constance Gewa

School of Mathematical & Statistical Sciences Faculty Publications

Background: The advantages of breastfeeding and its role in emergencies are undeniable. Studies show that many women in developed countries choose formula over breastmilk, even in emergencies. Nevertheless, no one knows if postpartum women under the Women, Infants and Children (WIC) program turned out to breastfeed or re-lactate their infants during these crises. This study aims to better understand WIC participants' perceptions about breastfeeding their babies in emergencies.

Methods: A chi-square test of independence was used to assess the association between breastfeeding choice and demographic characteristics and potential covariates of respondents. A post hoc analysis using Dunn's multiple comparisons test …

Transition To Enteral Triazole Antifungal Therapy For Pediatric Invasive Candidiasis: Secondary Analysis Of A Multicenter Cohort Study Conducted By The Pediatric Fungal Network, Robert F T Bucayu, Craig L K Boge, Inci Yildirim, Martha Avilés-Robles, Surabhi B Vora, David M Berman, Tanvi S Sharma, Lillian Sung, Elio Castagnola, Debra L Palazzi, Lara Danziger-Isakov, Dwight E Yin, Emmanuel Roilides, Gabriela Maron, Alison C Tribble, Pere Soler-Palacin, Eduardo López-Medina, José Romero, Kiran Belani, Antonio C Arrieta, Fabianne Carlesse, Dawn Nolt, Natasha Halasa, Daniel Dulek, Sujatha Rajan, William J Muller, Monica I Ardura, Alice Pong, Blanca E Gonzalez, Christine M Salvatore, Anna R Huppler, Catherine Aftandilian, Mark J Abzug, Arunaloke Chakrabarti, Michael Green, Irja Lutsar, Elizabeth D Knackstedt, Sarah K Johnson, William J Steinbach, Brian T Fisher, Rachel L Wattier

Faculty, Staff and Students Publications

Of 319 children with invasive candidiasis, 67 (21%) transitioned from intravenous to enteral antifungal therapy. Eight (12%) transitioned back to intravenous antifungal therapy, one due to perceived treatment failure defined by clinical progression or worsening. Global treatment response at study completion was successful in 66 participants who transitioned to enteral therapy.

Refereed Research: A Sufficientarian Approach To Consumption Ethics In The Face Of Climate Change, Srinivas Venugopal, Ronika Chakrabarti

Subsistence Marketplaces

In this paper, we adopt a sufficientarian ethics approach to study the concern of consumption inadequacy engendered by climate change in subsistence communities. The sufficientarian approach to consumption ethics dictates that in the face of climate change, priority should be afforded to establishing and maintaining consumption adequacy in low-income settings. We elaborate on the basic principles underlying sufficientarian ethics and compare it to alternative approaches such as utilitarian ethics and prioritarian ethics. Subsequently, we turn our attention toward specifying how poverty and the deleterious impact of climate change combine to render subsistence communities more vulnerable to consumption inadequacies as compared …

Degradation Of Cyanobacteria And Microalgae Using Ultraviolet Radiation At 222 Nm And Its Application In The Bleaching Of Lampenflora On Cave Rock Surfaces, Keisuke Naito, Shuji Watanabe, Masuo Komukai, Takehiro Kazama, Masayuki Itoh, Masahiro Kawasaki

International Journal of Speleology

Cyanobacterial and microalgae blooms negatively affect ecological environments. One of the emerging problems of these blooms occurs in calcareous caves, where visible lighting systems in tourist caves induce the formation of photosynthetic biofilms known as lampenflora on rock surfaces. In this study, we evaluated the inactivation effect of ultraviolet (UV) light irradiation at 222 nm (rare gas halide lamp) and 254 nm (mercury lamp) on cyanobacteria and microalgae in a laboratory and on lampenflora in Ryusenshindo Cave in Japan. Based on the laboratory experiments, irradiation at 222-nm was more effective than that at 254-nm for degrading plants. The photosensitivity of …

Effect Of Improving Food Security On Parenting Practices And Caregiver–Adolescent Relationships: Qualitative Findings Of An Income-Generating Agricultural Intervention In Rural Kenya, Maricianah A. Onono, Lila Sheira, Edward A. Frongillo Jr., Gladys Odhiambo, Pauline Wekesa, Amy Conroy, Elizabeth A. Bukusi, Craig R. Cohen, Sheri D. Weiser

Faculty Publications

Background

Despite the recognised links between food insecurity and parenting, few studies have evaluated the perceived impacts of livelihood or food security interventions on parental practices, intra-household functioning, adolescent behaviour and psychosocial outcomes in HIV-affected households in sub-Saharan Africa.

Aims

The study aimed to understand the perceived effects of food security on parenting practices and how this was experienced by both adolescent girls (aged 13–19 years) and their caregivers in rural Kenya.

Method

We conducted semi-structured, individual interviews with 62 caregiver–adolescent dyads who were participants in the adolescent Shamba Maisha (NCT03741634), a sub-study of adolescent girls and caregivers with a …

Immune Checkpoint Inhibitor-Associated Cutaneous Adverse Events: Mechanisms Of Occurrence, Abdulaziz M. Eshaq, Thomas W. Flanagan, Abdulqader A. Ba Abbad, Zain Alabden A. Makarem, Mohammed S. Bokir, Ahmed K. Alasheq, Sara A. Al Asheikh, Abdullah M. Almashhor, Faroq Binyamani, Waleed A. Al-Amoudi, Abdulaziz S. Bawzir, Youssef Haikel, Mossad Megahed, Mohamed Hassan

School of Medicine Faculty Publications

Immunotherapy, particularly that based on blocking checkpoint proteins in many tumors, including melanoma, Merkel cell carcinoma, non-small cell lung cancer (NSCLC), triple-negative breast (TNB cancer), renal cancer, and gastrointestinal and endometrial neoplasms, is a therapeutic alternative to chemotherapy. Immune checkpoint inhibitor (ICI)-based therapies have the potential to target different pathways leading to the destruction of cancer cells. Although ICIs are an effective treatment strategy for patients with highly immune-infiltrated cancers, the development of different adverse effects including cutaneous adverse effects during and after the treatment with ICIs is common. ICI-associated cutaneous adverse effects include mostly inflammatory and bullous dermatoses, as …

Retrospective Analysis Of Senecavirus A Emergence In Diagnostic Samples From 2010-2021 In Thailand, Parin Watcharavongtip, Patumporn Jermsutjarit, Angkana Tantituvanont, Dachrit Nilubol

The Thai Journal of Veterinary Medicine

This study investigates Senecavirus A (SVA) in Thai swine using 932 clinical samples, comprising 185 serum samples and 747 vesicular fluid and lesion tissue samples. These samples were collected from suspected cases between 2010 to 2021 at pig farms in the northern, western, and central regions of Thailand by the Swine Viral Evolution and Vaccine Development Research Unit (SVEVR) at Chulalongkorn University, Bangkok, Thailand. SVA was first detected in Thailand in 2016 and has been widespread since then, with PCR-based molecular detection showing an average prevalence of 16.3% for SVA, 30.7% for foot and mouth disease virus (FMDV), and 7.5% …

The Relationship Between Food Quality And Level Of Satisfaction With The Nutritional Status Of Students, Sakhwa Agustin, Milliyantri Elvandari, Eka Andriani

Bulletin of Culinary Art and Hospitality

Adolescence is the transition from childhood to adulthood. Nutritional status can be affected by nutrient intake. Nutritional problems that are not resolved properly can bring risks to health and can affect the ability to learn Islamic boarding schools in urban and rural areas; there are still many who do not pay attention to the quality of food and food service. This study aims to determine the relationship between food quality and satisfaction level with the nutritional status of students of Islamic boarding school X Serang regency. This study used a cross sectional design. The sample amounted to 197 students selected …

High Peripheral T Cell Diversity Is Associated With Lower Risk Of Toxicity And Superior Response To Dual Immune Checkpoint Inhibitor Therapy In Patients With Metastatic Nsclc, Mehmet Altan, Ruoxing Li, Ziyi Li, Runzhe Chen, Ajay Sheshadri, Hai T Tran, Latasha Little, Joshua Baguley, Jefferson Sinson, Natalie Vokes, Saumil Gandhi, Mara B Antonoff, Stephen G Swisher, Greg Lizee, Alexandre Reuben, John V Heymach, Jianjun Zhang

Faculty, Staff and Student Publications

INTRODUCTION: Despite significant successes, immune checkpoint blockade fails to achieve clinical responses in a significant proportion of patients, predictive markers for responses are imperfect and immune-related adverse events (irAEs) are unpredictable. We used T-cell receptor (TCR) sequencing to systematically analyze prospectively collected patient blood samples from a randomized clinical trial of dual immune checkpoint inhibitor therapy to evaluate changes in the T-cell repertoire and their association with response and irAEs.

METHODS: Patients with immunotherapy-naïve metastatic non-small cell lung cancer (NSCLC) were treated with ipilimumab and nivolumab according to trial protocol (LONESTAR, NCT03391869). Blood samples were systematically obtained at baseline (n=107), …

Diagnosis And Treatment Of Crop Inflammation Of Rough-Legged Buzzard (Buteo Lagopus) In Daqing Wildlife Nature Reserve, Heilongjiang Province, China, Wang Zheng, Ding Ruxin, Ge Yansong, Xu Enshuang, Zheng Jiasan

The Thai Journal of Veterinary Medicine

This article describes a Rough-legged Buzzard (Buteo lagopus) from the Wildlife Nature Reserve in Daqing, China. According to the staff of Daqing Wildlife Nature Reserve, the Rough-legged Buzzard was found to have impaired flight ability, depression, and loss of aggression, but its feathers were full and there were no obvious external injuries, so it was sent to the Wildlife Rehabilitation Center of the Teaching Animal Hospital of Heilongjiang Bayi Agricultural University for treatment. After the vet conducted X-ray and blood tests, he diagnosed the bird with a foreign body in the crop and crop inflammation. He finally treated …

Health Literacy On Physical Therapy Among Senior Citizens With Physical Disability And Community Health Workers, Kriza G. Ganotisi, Faye Angelene J. Barangay, Andrew A. Galang, Wina Frances Q. Lazaro, Christopher U. Rivera, Ryan Dean T. Sucgang

Philippine Journal of Physical Therapy

Introduction. This study was conducted to determine the health literacy on physical therapy (PT) among senior citizens with physical disability and community health workers (CHWs). Specifically, it identified the sociodemographic profile of the CHWs and senior citizens with physical disability, their extent of health literacy on PT as to prose, document and numeracy and how health policies, availability of PT programs, and available equipment and facilities for the rendition of PT services affect their health literacy.

Methods. This study employed a descriptive research design. The respondents of the study involved 18 CHWs and 29 senior citizens. It was conducted in …

Epithelial Barrier Hypothesis: A Systematic Review, Krishna Patel, Peter Lio

Student Publications

Background

The epithelial barriers, which include the skin, the gut, and the respiratory lining, play a crucial role in protecting the body from pathogens and environmental threats. Many harmful toxins are increasingly part of modern life. The increase in usage of these damaging agents in conjunction with the increase in allergic inflammatory conditions suggests that the “epithelial barrier hypothesis”—the concept that damage to the epithelia by external agents can result in dysbiosis, inflammation, and allergy—may explain the rise in these conditions seen in the developed world.

Objective

We sought to assess the evidence for the epithelial barrier hypothesis, with particular …

Dental Clinic Deserts In The Us: Spatial Accessibility Analysis, Md Shahinoor Rahman, Jeffrey C. Blossom, Ichiro Kawachi, Renuka Tipirneni, Hawazin W. Elani

School of Public Health Faculty Publications

IMPORTANCE: Little is known about the spatial accessibility to dental clinics across the US. OBJECTIVE: To map the spatial accessibility of dental clinics nationally and to examine the characteristics of counties and US Census block groups with dental care shortage areas. DESIGN, SETTING, AND PARTICIPANTS: Cross-sectional study of US dental clinics in 2023 using data from the IQVIA national practitioners' database, which includes 205 762 active dentists. Data were analyzed from November 2023 to April 2024. EXPOSURES: Socioeconomic characteristics of block groups and counties including rurality, area deprivation, racial and ethnic segregation, and uninsured population. MAIN OUTCOMES AND MEASURES: Enhanced …

The Role Of The Triglyceride-Glucose Index As A Biomarker Of Cardio-Metabolic Syndromes, Verena Gounden, Sridevi Devaraj, Ishwarlal Jialal

Faculty, Staff and Students Publications

BACKGROUND: The Triglyceride-glucose (TyG) index represents a simple, cost-effective, and valid proxy for insulin resistance. This surrogate marker has also been proposed as a predictor of metabolic and cardiovascular disease (CVD). In this descriptive review, we aimed to assess the utility of the TyG index as a predictive biomarker of cardiometabolic diseases.

METHODS: A search was conducted in PubMed, and Web of Science to identify cross-sectional and more importantly prospective studies examining the use of the TyG index as a predictive biomarker. The following terms were utilized in addition to the TyG index: "insulin resistance", "metabolic syndrome", "diabetes"; "cardiovascular diseases". …

‘Prevention Is Better Than Cure’: Smallpox Vaccination In Postcolonial Tanzania, 1961–1980, Musa Sadock

Zamani: A Journal of African Historical Studies

This article examines the smallpox vaccination programme in postcolonial Tanzania from the 1960s to the early 1980s as part of the postcolonial future making in preventive medicine. The article departs from extant scholarship on smallpox vaccination in postcolonial Tanzania, which depicts the intervention as a success, while relegating to the background challenges associated with the intervention. The article argues that the smallpox vaccination programme registered challenges and successes that offer lessons for combating of future epidemics. The achievements of the programme were due to the adoption of specific public health policies, namely mass vaccination and public health education as well …

Childhood Maltreatment And The Conserved Transcriptional Response To Adversity (Ctra): The Protective Roles Of Social Support From Romantic Partners, Family, And Friends In Adulthood, Sumaiyah U. Syed

Psychology Theses and Dissertations

Childhood maltreatment is associated with an increased risk of chronic disease and mortality in adulthood, with chronic inflammation emerging as a key pathway. However, findings in the literature are mixed: while some studies associate childhood maltreatment with heightened inflammation, others report no such link. Given the prevalence of childhood maltreatment, identifying protective factors in adulthood is crucial. Social support during childhood has been shown to buffer the effects of early life stress on immune function, yet the role of social support from various sources in adulthood remains unclear. The current study examined the association between childhood maltreatment and the expression …

Repurposing The Land Of An East Los Angeles Church: The Discovery Of How Small And Medium Sized Churches Through Affordable Housing Can Combat Homelessness While Revitalizing Its Nonprofit Status, Donald Cook, Donald Ray Cook Ii

Doctor of Ministry Projects and Theses

In order to live, humans need to sleep; therefore, sleep is mandatory, but unfortunately, everyone does not have the option of sleeping inside. Subsequently, many homeless encampments have developed in many countries. The perspective that people have often determines their response to homelessness. One person might view a homeless encampment as a problem that needs to be removed while someone else can view it as an opportunity to serve the least of these. Not only did Adam and Eve experience homelessness when removed from the Garden of Eden, but Mary, Joseph, and Jesus experienced first-hand the rollercoaster of inadequate housing. …

Bat Cutaneous Microbial Assemblage Functional Redundancy Across A Host-Mediated Disturbance, Matthew Grisnik, Donald M. Walker

Biology

Understanding the processes and factors that influence the structure of host-associated microbial assemblages has been a major area of research as these assemblages play a role in host defense against pathogens. Previous work has found that bacterial taxa within bat cutaneous microbial assemblages have antifungal capabilities against the emerging fungal pathogen, Pseudogymnoascus destructans. However, our understanding of natural fluctuations in these cutaneous microbial assemblages over time due to shifts in host habitat is lacking. The objective of this work was to understand how the taxonomic and functional bat cutaneous microbial assemblage responds to seasonal shifts in host habitat. We hypothesized …

Making Conflicts Of Interest Matter To Federally Funded Academic Research, Kimberly M. Papadantonakis

Journal of the National Association of Administrative Law Judiciary

This article first provides background on the academic science and technology enterprise and the concerns of counterintelligence agencies that prompted the White House, DOJ, and Congress to act. Section III discusses specific criminal and civil cases, focusing on where prosecutions succeeded or faltered. Section IV covers the new rules and how the agencies are implementing them. Finally, Section V analyzes themes from the cases and examines how the new rules may impact future enforcement and compliance efforts.

Rethinking Safe Nurse Staffing In The Post-Covid Icu: A Comparative Analysis Of The Nurse-To-Patient Ratio And Mixed Model Approach For State Policies, Emilie A. Maxie

Dissertations

The coronavirus pandemic (COVID-19) led to an unprecedented surge in ICU admission, increasing the nurse-to-patient ratios and intensifying stress on ICU nurses. This prompted many nurses to leave bedside care, exacerbating the ongoing nursing shortage and creating unsafe working conditions. Fourteen states have enacted safe nurse staffing policies. California implemented a mandated nurse-to-patient ratio, while Massachusetts adopted a mixed model for ICUs that involves a ratio, nurse committees, and workload tools. In post-COVID, this raises the question of which state policy approach is more effective in retaining ICU nursing staff. Literature suggests a mixed policy may be more effective.

Minimizing Infant Injury Risk By Utilizing Parental Education In A Primary Care Setting, Courtney Munroe, Erin Kuehl, Rachel Mahlberg

Doctor of Nursing Practice Projects: College of Nursing

Introduction

Accidental injury and death to infants has been correlated to lack of proper education to parents of infants in the primary pediatric care setting. Sudden infant death syndrome (SIDS) and unintentional injuries were the second and third leading causes of post neonatal death during this period of time (Centers for Disease Control and Prevention [CDC], 2016). Studies have found that motor vehicle accidents are a leading cause of child injury and death for infants under 12 months of age. The CDC found that drowning, suffocation, and poisoning were other leading causes that contributed to child injury and death rates …

Interactions Of The Sars-Cov-2 Viral Genome 3’-Untranslated Region With Viral And Host Rnas, Caleb Frye, Mihaela Rita Mihailescu

Electronic Theses and Dissertations

This dissertation focuses on the characterization of RNA-RNA interactions within the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) genome and with host microRNAs. As the causative agent of coronavirus disease 2019 (COVID-19), SARS-CoV-2 has evolved rapidly since its appearance. This has warranted prompt characterization of the virus particularly of its single stranded RNA (ssRNA) genome. By using a combination of bioinformatics, biophysics, and/or biological assays, we analyzed the SARS-CoV-2 viral genomic RNA and uncovered interactions of genomic RNA with host RNAs, highlighting an underutilized method of targeting RNA viruses. We showed here that the conserved elements in the viral genomic …

Evaluating The Implementation Of Community Schools’ Strategies To Address Post-Pandemic Student Mental Health, Dawn Gordon

Electronic Theses and Dissertations

This research explores the systemic and structural barriers affecting the effectiveness of community schools, particularly in providing mental health services and support, with a specific focus on how principals have responded to these needs in the post-COVID-19 era. Employing qualitative methods, including focus groups with principals from schools implementing the community schools’ model, the study identifies three major themes: difficulties with lead agency collaboration and coordination with host schools, systemic and structural barriers to effective functioning, and holistic approaches to enhancing student support and well-being with mental health.

Difficulties with lead agency collaboration and coordination reveal how inadequate communication and …