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This report describes Ohio's school restructuring efforts under the No Child Left Behind Act, including findings from interviews with state officials and case studies of nine schools in four school districts: Cincinnati Public Schools, Cleveland Metropolitan School District, Mansfield City Schools, and Mount Vernon City Schools. Key findings from the report include: (1) despite holding steady for the previous three years, the number of Ohio schools in restructuring rose from 56 schools in 2006-07 to 130 schools in 2007-08; (2) only 7 of the 177 Ohio schools ever in restructuring have successfully exited; (3) districts in Ohio that receive federal improvement funds must share data and permit state officials to visit their schools; and (4) while some Ohio schools have received attention for choosing to replace their entire staffs, most report doing so reluctantly and advise other schools to do so only as a last resort.