USA > Massachusetts > Plymouth County > Plymouth > Town annual report of Plymouth, MA 1926-1927 > Part 17
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LIGHTING
In the report for 1925 it was shown that the light in the school rooms at the Cornish and Burton buildings was insufficient on dark days or on any day in November, December and January after three o'clock in the after- noon, and artificial lighting of an approved type recom- mended.
Through the courtesy of the Edison Electric Illumi- nating Company of Boston, a lighting engineer, Mr. R. B. Brown, Jr., came to Plymouth examined the buildings and made a detailed report with recommendations which would provide adequate illumination at all times.
The School Committee acted on the recommendations and the buildings were equipped with modern electrical illumination as specified by the engineer.
Tests made on November 30th, last, a cloudy day with rain, showed that at half past three in the afternoon the intensity of illumination had dropped to from 0.2 to 0.4 of one light unit (in one instance 0.01) eight units being the standard. With the new lighting system in operation: all rooms were found to be getting an adequate and even- ly distributed illumination which tested from 8. to 11. units at the pupil's desks.
Tests have been made at the Cold Spring school, which is not equipped with artificial light except at the teacher's desk, with the following result:
TESTS AT COLD SPRING SCHOOL MADE ON CLOUDY DAYS IN DECEMBER
North room at 10.53 a. m .= 8. F. C. North room at 3.43 p. m .== 0.2 F. C. South room at 11.07 a. m .= 6. F. C. South room at 3.46 p. m .= 0.1 F. C.
These tests were made on two cloudy days in December but the clouds on the day upon which the afternoon tests
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were made were light, and there was also snow upon the ground which increases the intensity of the illumina- tion. It was not a particularly dark day, though cloudy, when the morning test was made, but the intensity of illumination barely reaches an adequate amount (8. F. C.) about eleven o'clock when the light outside is at its best.
In the afternoon on a lighter day about the time of dismissal the illumination is anly 1/80 of what it should be in the South room, and 1/40 in the North.
The following data were secured at a test made at the Knapp building on a fair day in December :
Room .
Time
Intensity With Natural Light Only
Intensity With Artificial Light
Type of Equipment
First Floor
South East
3:50
0.1 F. C.
2.
F. C.
Exposed filament
North East
3:53
0.8 F. C.
2.
F. C.
Exposed filament
South West
3:56
0.9 F. C.
4.
F. C.
Modern
North West
4:00
0.4 F. C.
None
Second Floor
South West
4.02
0.8 F. C.
2.5 F. C.
Exposed filament
North West
4:06
0.5 F. C.
3.
F. C.
Frosted bulbs
North East
4:08
0.3 F. C.
One exposed filament lamp
South East
4:12
0.4 F. C.
2.
F. C.
Exposed filament None
West
4:11
0.6 F. C.
Remembering that the numerals denoting intensity represent foot candles or units of intensity and that 8 foot candles is the standard for the school room, it will be seen that even with the natural light augmented by such lighting equipment as the school possesses the intensity of illumination never approaches this standard.
The best lighted room is the South West one on the first floor which is equipped with four lamps enclosed in modern opal glass shades. The light in this room could probably be brought up to standard by simply putting in lamps of a higher wattage.
The next best room is the North West room on the second floor which has frosted bulbs and open glass
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shades but these give less than half the required illumina- tion. The other rooms have no artificial light or lamps with exposed filaments which are not now used as they do not diffuse the light and cause a troublesome glare. The installation of approved modern lamps and shades properly distributed and of sufficient candle power in all rooms would make the school independent of outside conditions and give as uniformly satisfactory results as are now enjoyed by the Cornish and Burton schools.
NUTRITION
A general weighing and measuring of pupils occurred in May which showed that exclusive of the Junior High school 5.4% of the school population were 10% or more below the average weight for their height and age. In- cluding the Junior High 1,773 pupils were weighed and measured of whom 122 were 10% or more underweight which is 7% of the whole number weighed. Thirty-nine of the 122 were from the Junior High which is 16% of the number weighed and measured from that school.
A second general weighing and measuring was held in November which showed that exclusive of the Junior High school 5.1% of the school population were 10% or more below the average weight for their height and age. Including the Junior High 2034 pupils were weighed and measured of whom 129 were 10% or more underweight, which is 6.3% of the whole number weighed. Forty-five of the 129 were from the Junior High which is 11.2% of the number weighed and measured from that school.
There is always a much higher percentage of under- weight among the Junior High pupils than in the lower grades. Some of the reasons for it may be that it is a critical time in the life of the growing child, that the school curriculum is a full one, and that there is likely to be a full program for the pupil outside of the school, including music and dancing lessons and an increasing number of social functions. These activities make exces-
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sive demands upon the growing organism and malnutri- tion is one result. The remedy is to be found in ridding the daily program of the child of non-essentials, allowing sufficient time for sleep and taking enough wholesome food at the proper time. All pupils 10% or more under- weight are under the instruction of the school nurse and are weighed monthly. ,
A comparison of the results of weighings this year with the last one in 1925 may be interesting.
The figures indicate what percent. of the whole num- ber of pupils in the school are 10% or more underweight for their age and height.
Nov. 1925
May 1926 5.6%
Nov. 1926
Mt. Pleasant,
4.8%
7.5%
Knapp,
4.2%
4. %
4. %
Hedge,
4.6%
6.7%
4. %
Cornish and Burton,
7.3%
3.9%
3.3%
Nine, one and two room schools,
6.3%
5.4%
The figures show that the Cornish and Burton schools have been most successful in combating malnutrition, and this is the more gratifying as in November, 1924, 12.1% of the group were 10% or more underweight. At that time milk was not available at the school. It is now to be had at all the large schools and a large number of chil- dren are taking it.
Teachers are showing an interest in weighing and measuring as a means of teaching health, but in the smaller schools find themselves handicapped by the lack of scales. If scales could be placed in these schools it would place a valuable instrument for health instruction in the hands of the teachers and also save much time for the nurse who must set up the portable scales which she carries with her, which, in the aggregate, consumes much valuable time.
Five undernourished children had the benefit of eight weeks at the Camp of the Plymouth County Health Asso-
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ciation last summer. The expense of sending these chil- dren to the Camp is met by the sale of Christmas seals.
FRESH AIR SCHOOL
The Fresh-Air-School continues to be a haven for those pupils who for one reason or another are physically unable to meet the demands of the ordinary school pro- gram.
With the beginning of the year a very serious handicap for the teacher was removed by securing the services of a competent person to prepare the mid-day meal. An- other marked improvement has been made by equipping the school with the Moulthrop type of furniture which is as near the ideal as anything which has so far been available.
In June, nine pupils from the Fresh-Air-School were recommended for transfer to the regular grades. Six of these had been examined in the clinics held by the State Department of Health and found to be "suspicious" i. e. to show indications of the juvenile type of tubercu- losis. Three of these "suspicious" cases remained in the school at the request of parents. All are doing well with the possible exception of a boy who had been operated for empyaema. He did well in the Fresh-Air- School, and was allowed to go into the regular grades, but has not done as well since. He is being carefully watched and is to be taken by the nurse for an X-ray of his chest.
There are at present thirteen children in the school. Two of these have recently entered (in December). Another, a boy, has gained eight pounds since school opened in September which is 266% of his expected gain. He will be transferred to the regular grades. All have gained in weight since September, the amount varying from one pound to eight. Of the two who gained but one pound, one was ill with intestinal trouble and lost stead- ily up to the first of November, gaining three pounds
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after that time. The other one has an organic disease of the heart.
It is not to be inferred from what has been said about gains in weight that this constitutes the only benefit conferred by the school.
There is an almost universal impression that pupils entering the Fresh-Air School will necessarily fall behind in their studies. This is an erroneous impression. With the preparation of the food taken out of the teacher's hands she has more time to devote to lessons, and the number of pupils is never more than half what the ordi- nary room teacher has. A study of a group of pupils who have passed through the school under less favorable conditions shows that they have made the progress which might be expected from any unselected group, some doing better than the average as shown by the relation of their chronological age to their school grade, some are average and a few whose school work was inferior before entering the Fresh-Air-School, are below the average. Under present improved conditions it will not be surprising if we find in the future that the school actually improves the scholarship of those passing through it. However that may be it is evident that these pupils are not marking time in school work while they are building better bodies and acquiring health habits which are essential to their future welfare. The Fresh-Air-School is turning out hardier children, more alert and more resistant to dis- ease.
Miss Belonger who taught the school for a year gave herself unsparingly to the task which at that time was indeed a hard one. Miss Harvey, who took the school last September, is new to the work, but finds it to her liking.
SCHOOL NURSE
We have increased the efficiency of our school nurse during the past year by giving her an assistant which relieves her of much routine work and gives her more
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time for instruction and valuable "follow up" work. It is now possible to secure data from our records which we have not heretofore been able to get.
For instance last spring we wished to know what the facts were with regard to posture in our schools. The examinations had been made and the results recorded on the physical record cards but no one knew what they were. The assistant was put to work and secured the information which led to an earnest effort to obtain better posture.
This winter the car which the nurse has driven for nine years, though it still ran, had reached the point where it was a source of constant annoyance and often caused serious delays and gave very inadequate protec- tion in bad weather. The new closed car is greatly appre- ciated, enabling the nurse to render better service and giving her the protection in bad weather which will pro- long her usefulness.
REPORT OF SCHOOL NURSE
The fourth year of the Health Crusade was completed . in May. Accolades were held at the Cornish, Knapp and Hedge schools, Miss Johnson of the Massachusetts Tuberculosis League, officiating. More than 900 pupils received pins for satisfactory work, 160 gold pins being awarded to pupils who had earned the highest honors. While the results of the Crusade have been very good on the whole, the need is felt of more cooperation with the home. At present the score-cards are kept and marked in school only. In the coming year, it is planned to have each child keep a score-card at home as well as at school that the parents may keep more in touch with what is being done. Also there will be a period of preparation during which the pupils will be instructed in all matters
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pertaining to the Crusade and particularly in the import- ance of keeping the scores accurately.
It is a pleasure to report the fine cooperation of all the teachers in health work, the time given, and interest taken is much appreciated.
The interest of the pupils is maintained by health clubs, the making of health posters, health rhymes, build- ing "health houses", etc. A set of "Health Dolls" loaned by the Massachusetts Tuberculosis Association have been exhibited in most of the schools, were greatly admired by the children and were helpful in impressing the dif- ferent health chores on their memory.
The pupils in a sixth grade at the Hedge school under the direction of the teacher, Miss Corey, issue a very in- teresting "Health Newspaper" the "Standish" every month which contains a report of all the health work being done in the building also original health stories, etc.
In this school, ten pupils from the 5th and 6th grades make an inspection of all the rooms in the building twice a month. Points are given for temperature, light, desks, floors, partly eaten food covered, cleanliness and neatness of pupils, cloak-rooms, appearance of sand tables, and blackboards. The room which receives 100 points is given a Health Banner, which is greatly prized and much effort is put forth to hold it. The inspections are made at unexpected times, thus keeping the pupils on the alert.
The Henryson Measuring Chart used this year when weighing and measuring, has proved more satisfactory than the previous method, as the average weight can be given at the time of weighing. Pupils are encouraged to remember their present weight, and what they should weigh and record it on their classroom chart. In grades from one to six, of 1635 pupils about 5% were 10% un- derweight. While in the Junior High School more than 10% were 10% or more underweight. In this group are many pupils for whom breakfast, if eaten at all, is often a very hurried meal. Children often report they "did not have time" to eat.
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If parents would see that their children have the pro- per amount of sleep, at least ten hours, that breakfast be served promptly, and that sufficient time is taken to eat a substantial meal, improvement both in the health and school work would undoubtedly follow.
In the Junior High School a Health Club for girls has been formed which meets every week. Each girl keeps her individual record, also the class record of the percents she receives in obeying the ten rules which will aid in the improvement in her health. Every week this is tested out to see whether or not there is any improvement in the individual record and in the class room record of the preceding week, the aim to be, every week a higher per- cent of accomplishment. Much stress is placed upon the various health habits, and a careful study made of each one by all the pupils in the school.
Many interesting projects are devised by teachers in all the schools, by which "health" is made attractive to the pupils, and many have shown a decided improvement as a result of the health teaching.
Number of school visits 620
Number of home visits 572
Number of pupils inspected in school 5,451
Number of pupils treated in school 1,124
Number of contagious diseases found in school .
74
Number of contagious diseases found in homes . 39
Number of pupils excluded 127
Number of pupils referred to physicians 40
Number of pupils taken to hospitals or clinics .
57
Number of pupils operated on at Jordan Hospital Clinic for T. and A. 37
Number of pupils weighed and measured 4,930
Respectfully submitted,
(Signed) SUSIE MACDONALD, R. N.
School Nurse.
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RE-EXAMINATION CLINIC
On April 13th, a so-called "Re-examination Clinic" was held at the Cornish and Hedge Schools. This was in connection with the School Clinics which have been held here for several years by the examining unit of the State Department of Health as a part of their campaign against tuberculosis. The purpose of the "Re-examina- tion Clinic" as its name implies, is the re-examination of those who were found to be in danger of developing tuberculosis when examined at the last clinic. Twenty- nine children were re-examined. Of these ten were found to be "apparently well," twelve were found to be "im- proved" and seven "unimproved". We are provided with a "clinic school record sheet" for each child re-examined, to be kept for a period of twelve months, the weight to be recorded each school month and at the end of six months, the height. At the end of twelve months a sec- ond re-examination will probably be made. The report commends our nurse "for her good follow up work and cooperation in this program".
The present condition of the seven found "unimproved" last April is as follows :
P. B., who was 10% below the average weight for his age and height, is now but 7% below and in very good condition.
A. C. is now up to the average weight for his age and height.
B. C. is in the Fresh-Air-School and is improved in nutrition. Does much better when school is in session. Always loses during vacations.
D. G. is 15% below the average weight for age and height. Left Fresh-Air-School against advice. No im- provement.
M. T., who was more than 15% below the average weight for her age and height in May, is now 7% below and in very good general condition.
M. S. is in the Fresh-Air-School and was 7% below the average weight for her age and height last June. She
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returned to school in September 15% below. The ex- pected gain in weight for a girl of her age would be about 3,1/3 pounds for the four months since school opened but she has really gained 6 pounds.
H. B., who was 15% below the average weight for her . age and height, is now only 6% below the average and is in good condition.
ORAL HYGIENE AND DENTAL CLINIC
It has been the policy of this department to emphasize the educational and preventive side of the dental pro- gram.
A dental conference was held on September 9th with Mr. Handy the Superintendent, the school dentists, the dental hygienist and the school physician present. It was agreed that in view of present knowledge concern- ing the development of dental cavities that the examina- tion of pupils by the dentists should be limited to the first three grades and that the repair work of the clinic should be confined to the sixth year molar, all fissures to be filled and no root canal work done, beginning with the first grade children and working up as far as time allows. Those present concurred unanimously in the opinion that the present policy of the School Department in offering dental prophylaxis to all pupils as a part of the educa- tional program, was sound and should be continued.
Miss White, our dental hygienist, has been emphasiz- ing nutrition in her teaching and recently has been send- ig a circular letter home by each child who has his or her teeth "cleaned" inviting the parents to visit her office at certain hours or at least call her by telephone so that she may tell them something about the part good food plays in making sound teeth.
Dimouth Twenty ML.
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REPORT OF ORAL HYGIENE DEPARTMENT AND DENTAL CLINIC 1926
Dear Dr. Shaw:
I hereby submit my report of the work done in the Oral Hygiene Department and the Dental Clinic during the year 1926.
Number of Prophylactic treatments (cleanings) .. 1,100 Number of Oral Hygiene talks 400
During this year I planned and put into operation a course for teaching Oral Hygiene. Each month I taught a specific lesson to gain a certain result. The course seemed to work out very well and I shall continue to go on the same way the coming year with such occasional changes as seem to be necessary with progression.
In my report of the work done at the Dental Clinic I note the amount does not seem to be as large as the year previous. This has been due to the fact that we have given our attention exclusively to the small children. One hundred and twenty-three six-year molars were saved this year. We hope to triple this number during the year 1927 and we deem it the most important work we can do in the small amount of time we have. No first teeth will be filled this year contrary to the practise of last year. It is also necessary to attend to the first teeth but because our time is so short we must limit ourselves to that which is most important and so we are making a drive to preserve the six-year molars which are the first permanent teeth to erupt, the last one on each side of the child's mouth when he is six or seven years old.
The tiniest cavities in these teeth called "fissures" are being filled which is a policy now being advocated by the State Department of Health.
Within a period of about three months up to the Christ- mas recess, THREE HUNDRED AND NINE PUPILS have been to their own dentists for dental work exclusive of the High School. This to my mind is a significant showing.
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REPORT OF DENTAL CLINIC
Number of examinations by dentist 537
Number of six-year molars found decayed 1,174
Number of temporary teeth extracted (first teeth) 125
Number of permanent teeth extracted (second
teeth)
39
Number of emergency treatments
29
Number of fillings (123 sixth year molars includ- ed) 175
Number of operations (total)
911
Number of patients (total) 806
Number of new patients for filling and extracting 54
Number of children who had all dental work fin- ished 45
Amount of money received for filling, extracting and tooth brushes $150.12
School Dentists, Dr. E. H. Donovan, Dr. W. O. Dyer.
Respectfully submitted,
(Signed) GLADYS WHITE,
Dental Hygienist.
CONFERENCES WITH TEACHERS
The monthly conferences with teachers have been con- tinued throughout the year while the schools were in session.
The first two conferences of the year continued a course in "First Aid", one taking up "Burns", including burns from electricity and the other "Poisons", which conclud- ed the course.
One month there was an explanation and discussion of the "Instruction Bulletin" issued to teachers giving the procedure to be followed in referring pupils to the school physician or nurse.
Several conferences were devoted to "School Hygiene"
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as treated in "A Health Survey of 86 Cities", a report made by the Research Bureau of the American Child Health Association.
Other subjects discussed were "Posture" with respect to our own needs and the methods to be employed to secure improvement in conditions with a demonstration of correct posture and how to get it on the living subject ; instruction in proper adjustment of school furniture; instruction in the proper proceedure in making and re- cording test of sight and hearing and a talk on "What we mean by 100% pupils, a plan to interest children in the physical examination."
RECORDS AND STATISTICS
Each teacher now has on her desk a filing case with guide cards in which are kept all the physical record cards, of her pupils, thus she has available in an instant all the data concerning the physical condition of any one of her pupils. This information is vitally important and the greater the use we make of it the more efficient our health service will be. After the physical examination of pupils in a room has been made the school physician whenever possible calls the attention of the teacher to the defects found.
A still better proceedure would be to have the teacher present at the examination and this has already been ar- ranged for in one large school at the suggestion of the principal. Parents are invited to the examination of chil- dren of the first grade and in one school room of 25 pu- pils recently, every child with two exceptions was accom- panied by the mother or a member of the family. While we have been trying to interest the teacher and the par- ent in the physical examination of the child, we have not so far, made any direct effort to interest the child him- self, except in the matter of weight. Hereafter an at- tempt will be made to do this by finding out which chil- dren in each room, are, as we say, "100%" physically
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sound. To be "100%" a child must be free from serious defects which influence his normal growth and develop- ment unfavorably.
Having a desire to be "100%" the child approaches his examination with interest, hoping to pass the require- ments but if not, he is glad to learn what defects stand in his way so that he may overcome them and reach the desired goal of "100%" at the next examination.
CONTAGIOUS DISEASES
An examination of the vital statistics of the town of Plymouth for the year 1925 shows that there were only six deaths from pulmonary tuberculosis which will be recognized by those who have followed the records, as a very low figure, perhaps the lowest yet reached. This is encouraging and is as it should be, but when we turn to the record of deaths from heart disease for 1925 we find that there were fifty-three. Heart disease is now believed to be largely due to local infection. Such sources of in- fection are diseased tonsils and teeth. An examination of the statistics at the end of this report will show that diseased tonsils and teeth are by far the most common defects found in our school children.
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