USA > Massachusetts > Plymouth County > Plymouth > Town annual report of the officers of the town of Plymouth, Massachusetts for the year ending 1927 > Part 18
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That all schools need artificial illumination has been fully demonstrated in a previous report and does not need to be gone into here.
NUTRITION
Much attention is paid to the nutrition of pupils. Weighing and measuring, done by the nurse and her as- sistant, is correlated with the health teaching in the school room as an incentive to the establishment of healthful habits of living.
All pupils ten percent or more underweight are weighed each month, their progress noted on a chart
School Report 7
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posted in the weighing room. Pupils are advised by the nurse as to their needs and many seem grateful for the service. Parents are consulted where pupils are con- sistently losing weight and in cases where it seems advis- able expert examination of the chest including the X-ray which is now deemed essential to diagnosis particularly in the juvenile type of pulmonary tuberculosis is ob- tained. In all cases parents are advised to consult the family physician and follow his advice.
The local Chapter of the American Red Cross which has always been actively interested in the nutrition prob- lems of the public school has made a notable contribution toward the solution of this problem by providing scales for all schools which have been without. Five of the modern Continental Scales were installed last June and in November four more added, making the equipment complete. This benefaction means a great saving of time for the nurse and is very much appreciated by the teach- ers who are eager to do all they can for the physical wel- fare of their charges.
The percentage of pupils found to be 10% or more below the average for their age and height as a result of the general weighing and measuring is indicated in the following table :
March
*Oct.
Dec.
Mt. Pleasant,
5.0%
7.0%
2.0%
Knapp,
3.2%
2.8%
2.8%
Hedge,
1.7%
10.0%
1.0%
Cornish & Burton,
5.7%
17.3%
6.0%
Three small schools,
5.6%
10.4%
5.7%
Average,
4.2%
13.5%
3.5%
* Much of the weighing reported in October was done in September as it takes several weeks to weigh and measure the school population.
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It will be seen from the above figures that there was a very marked increase in malnutrition when the pupils were weighed and measured in the fall after the summer vacation. The average in the spring having been 4.2% for all schools except the Junior High and increasing to 13.5% in September and October.
The increase in malnutrition is shared by the Mt. Pleasant School only to a limited extent and by the Knapp School not at all, while in the case of the Cornish and Burton Schools it is very marked indeed. No ex- planation of this striking increase has been forthcoming but the figures were checked up at the monthly re-weigh- ing of underweights and were confirmed. Whatever the cause it is gratifying to note the equally striking decrease in the percentage of underweights found in the general weighing made just before the close of school for the Christmas recess. The school nurse finds that there are seventy-seven of those who at the opening of school in the fall were ten percent below the average who are in December less than seven percent. below the average.
In the Cornish and Burton group the number dropped from sixty-five to twenty-four giving six percent of un- derweight pupils only and in the Hedge School a reduc- tion from forty-five underweights to only five in a group of 458 which establishes a new record of only one percent of underweights.
The Junior High School which always has a high per- centage of underweights had 16.2% in March. In Octo- ber there were 17% which was reduced before the Christmas recess to 12.7%.
Exclusive of the Junior High School, and few small schools for which the record was not available for this report, the percentage of underweight pupils for all the schools stood at the close of the last term at 3.5% which is a very satisfactory showing.
All milk served in the schools is pasteurized, the dairy is frequently inspected and the milk tested by the milk inspector of the Board of Health.
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Money raised from the sale of Christmas Seals with additions sent five underweight and undernourished chil- dren were able to spend eight weeks at the Summer Camp operated by the Plymouth County Health Association at South Hanson. They all returned much improved by their stay there. It is to be regretted that there was not money enough available to send Plymouth's full quota of six to the camp.
Among the agencies operating for the improvement of nutrition of the school children may be mentioned occa- sional talks to the teachers on subjects relating to nutri- tion by the school physician.
SCHOOL NURSE
The program of the school nurse is a constantly ex- panding one involving much detail which is expensive of time. Such things as the conduct of the Modern Health Crusade, the checking of the "Good Health" cards used in the early grades and the frequent weighing and measuring, not only of the regular routine but for special occasions like the State Clinic, would make it impossible for her to find time to do the home visiting and "fo up" which is so important, if it were not for her assist- ant, who takes a large part of this detail work off her hands. Miss Hazel Bruce, who was formerly in the of- fice of the High School principal, became the nurse's as- sistant soon after the opening of school in September and has made herself very useful in that capacity.
The nurse among other things makes all the arrange- ments for the numerous clinics that are held during the year so that they may go off smoothly without interfer- ing with the regular work of the schools.
A report on the re-examination clinic held here by the State Department of Health in April shows that twenty- two pupils were examined of whom sixteen had been pre- viously examined. The physical condition of all but two of these re-examined was found to have improved. Dr.
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Millett, who conducted the clinic here, commended our cooperation with the State Department of Health and said a good word for the excellent work of our nurse in following up and looking after these cases.
A recent additional task which was assumed by the school nurse was the examination of the high school girls last June as sort of screening process for the purpose of finding any who might need more careful attention.
The report of the school nurse follows:
Dear Doctor :
I hereby submit the report of the school nurse for the year 1927.
Number of school visits 601
Number of home visits
466
Contagious diseases found in homes 17
Contagious diseases found in school 49
Number of pupils excluded 76
Number of pupils referred to physicians 19
Number of pupils taken to clinic and hospitals 86
Number of pupils operated upon for T & A 45
(Jordan Hospital Clinic)
Number of pupils treated in school 568
Number of pupils inspected 4,115
Number of pupils inspected at home 98
The fifth year of the Health Crusade in the Plymouth schools was closed with various exercises in each school, in most instances as a part of the "Health Day" program. At the Hedge and Cornish Schools there was out-door marching, the children wearing the Crusader's costume of helmet and cape, with a "Knight" on horseback and a bugler leading the march.
The Accolade was held at the Manomet and Cliff Street Schools for the first time. At Manomet the part of Cru- sade Master was taken by Miss Johnson of the Massa-
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chusetts Tuberculosis League, and at Cliff Street by Miss Sampson, principal of the Hedge School. Pins or badges were awarded to all pupils who had done satisfactory work. The Crusade work for 1927-8 was not begun as early as usual, as it was felt that with more preparation even better results will be attained.
All pupils have been weighed and measured twice dur- ing the year. The nutrition classes for all pupils who are ten percent underweight have been continued. Charts are kept for all these pupils and the weight recorded every month.
The largest number of underweight pupils is found in the Junior High School. As it is necessary for many of these children to leave home early in the morning, break- fast is often a hurried or insufficient meal. It would be a great help to this group if the time now given to physical exercise could be used for a rest period with opportunity for a lunch of milk or cocoa.
A "Health Book" contest was conducted in the third, fourth, fifth and sixth grades. So many of these books were excellent that the task of the judges was somewhat difficult. In making the awards the following points were kept in mind.
(1) Originality, (2) Neatness, (3) Penmanship, (4) Arrangement of material, (5) Appreciation of the health idea.
The prize winners were:
Grade VI-Milo Cavicchi, Knapp School, seven other pupils receiving honorable mention.
Grade V-Lois Cunningham, Mt. Pleasant School, six other pupils receiving honorable mention.
Grade IV-Alma Guidetti, Hedge School, four others receiving honorable mention.
Grade III-Francis Poirier, Oak Street School, two others receiving honorable mention.
Respectfully submitted,
(Signed) SUSIE MacDONALD, R. N.,
School Nurse.
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THE FRESH-AIR-SCHOOL
The percentage of attendance for the school for the calendar year has been 92.36 which considering the physical condition of the pupils who are selected for the school is a remarkably good one.
The windows which are provided with cloth screens like inverted awnings to prevent direct drafts on the pupils are kept open all the time. The room is on the south side of the Cornish building, getting the sun all day and although a minimum temperature of 46 degrees has been recorded in January and March the warm "Eskimo" suits of wool provided with hoods and the socks which go on over the shoes and cover the legs, keep children warm and comfortable. In fact after a short stay in the school. they do not seem to feel the cold and the trouble has always been not to keep them warm but to get them to don' the suits when the temperature drops. The rule is suits for everybody at 55 degrees and above that temperature at any time for those who want them or for anyone the teacher thinks should put one on.
In January F. S. was transferred to the Hedge School, well.
In March a girl lost her membership on account of an attack of whooping-cough but entered again in Sep- tember.
In April two pupils left the school to enter the County Hospital, one a serious case of organic heart disease and the other a girl who had been in the County Hospital on account of her poor condition in 1925 and left against advice.
In June five pupils were recommended for transfer to regular grades in September as their physical condition seemed to warrant it as follows :
H. S., seventh grade, still somewhat underweight but gained nine pounds in weight and two and a half inches in height during the school year. In excellent physical condition.
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R. G., sixth grade, gained ten pounds in weight and one and one-half inches in height, reducing his percentage below the average weight from fifteen to ten. In good physical condition.
M. R., fifth grade, gained seven pounds in weight and two inches and three-quarters in height and would be rated one hundred percent except that her posture was not perfect.
M. D., fifth grade, entered Dec. 13th and gained two pounds in weight and one and three-quarters inches in height since then. Her general condition was good and she was transferred but kept under observation.
M. S., fourth grade, gained nine and three-quarters pounds in weight and two inches in height. In excellent physical condition.
During the year there has been a gross gain in weight of the pupils in the school of 95.75 pounds.
Of the thirteen pupils now members of the school two have only recently entered. One was overweight when he was admitted for nervousness. He was later trans- ferred back to his home school greatly improved.
A record of the gains made by the remaining ten pupils of the school since the opening of the school year and per- centage of the actual gain with relation to the expected gain follows :
Gains In Fresh-Air-School Since September A. J., 10 years. 44 to 4634 lbs. = 234 lbs. = 44 oz. Expected gain 28 oz. = 160%
M. C., 8 years. 431/2 to 46344 lbs. = 31/4 lbs. = 52 oz. Expected gain 21 oz. = 247%
J. G., 12 years. 59 to 621/2 lbs. = 31/2 lbs. = 56 oz. Expected gain 30 oz. = 186%
I. M., 12 years. 621/2 to 681/2 lbs. = 6 lbs. = 96 oz. Expected gain 39 oz. = 246%
C. R., 13 years. 86 to 941/4 lbs. = 81/4 = 132 oz. Expected gain 40 oz. = 330%
.
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F. K., 12 years. 56 to 59 lbs. = 3 lbs. = 48 oz. Expected gain 33 oz. = 145%
F. G., 12 years.
69 to 733/4 lbs. = 43/4 lbs. = 76 oz.
Expected gain 36 oz. = 211%
F. V., 12 years. 46 to 493/4 lbs. = 60 oz. Expected gain 42 oz. = 142%
M. G., 9 years. 571/4 to 58 lbs = 12 oz. Expected gain 22 oz. = 54%
A. B., 8 years. 441/4 to 471/4 lbs. = 48 oz.
Expected gain 24 oz. = 200%
It will be seen that all but one of the pupils have made better than the expected gain for their age and height the improvement in some instances being very marked.
Recent investigation has shown that cod liver oil, which has long been known to have remarkable nutritive value, contains something which for want of a better name is called vitamine D which seems to be identical with the ultra violta rays of the sunlight which is so es- sential to the welfare of the living and especially the growing organism. As the children, in common with the rest of us enjoy a very limited supply of sunlight through- out the winter, it seems reasonable to make up the defici- ency at least measurably, by the ingestion of the oil. All pupils of the Fresh-Air-School have therefore, been asked to provide themselves with a bottle of cod liver oil to be taken at the school.
This "liquid sunshine" as it has been aptly called, and an extra half hour of rest on their cots before leaving the school for the day, are recent additions to the program.
There is a popular feeling that the school helps the children physically, but that they fall behind in their work. As a matter of fact a pupil will do as well, at least, in the Fresh-Air-School as he will in the ordinary school. If he is slow or dull outside he will be inside, except as improved health helps him to do better work. As Baldwin of the University of Iowa has shown, poor
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physical development and inferior accomplishment in school work go hand in hand. As pupils in poor physical condition are the ones chosen for the school, we should not look for or expect too much, but any given child will do as well or better in the school than he will out of it.
Miss Boyd, principal of the Cornish district in which the school is located, confirms this statement basing her opinion on the results of a series of tests made in December, 1926, which included: (1) The National In- telligence Test, (2) The Monroe Standardized Silent Reading Test, (3) The Wilson Arithmetic Test and (4) The Wilson Language Error Test. Later tests showed satisfactory improvement in all pupils of the Fresh-Air- School, a result which is to be attributed in part to im- proved physical condition, and in part to the individual attention which these pupils received.
ORAL HYGIENE AND DENTAL CLINIC
On September ninth a dental conference was held in the clinic room in the Governor Bradford building. The superintendent of schools, Miss White, the dental hygien- ist, Drs. Donovan and Dyer, and the school physician, were present as usual, and in addition to these the Board of Health was represented for the first time by Mr. Max- well. The desirability of examining the mouths of all pupils of the first six grades was discussed and approved. At the suggestion of Mr. Maxwell, a formal request was later sent to the Board of Health asking for the services of the dentists five mornings a week, instead of two, until the work should be completed.
This request was granted and the work done. It was decided at the conference that the clinic should, as hereto- fore, confine its repair work to the sixth year molar alone with no treatments nor root canal work, start- ing in with the first grade and carrying on up through the third as far as time would allow. It was agreed that hereafter in the prosecution of the dental
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work being carried on by the Board of Health and the School Department, fissures should be regarded as cavi- ties. It was agreed that children of any grade referred to the clinic by the Poor Department of the town should be cared for without charge.
The policy of offering dental prophylaxis to all pupils who do not employ their own dentist for it was again en- dorsed as a valuable factor in the educational program being carried on by the hygienist.
The examination of all pupils of the first six grades made by the dentists included a total of fifteen hundred and sixty-three pupils of whom fifty-five showed no cavi- ties. The Hedge school had three pupils free from cavi- ties or 0.679%, the Cornish and Burton twenty-five or 7.%, the Knapp eleven or 4.5%, the Mt. Pleasant thirteen or 5.9%, and ten small schools showed only three or .97% of the total number of pupils in their schools.
Charts of the teeth with cavities clearly indicated were given to all children examined to take home for the in- formation of parents, the cards to be returned to the school.
The graph on the following page is a result of a study of the charts except that the dotted line was plotted from information obtained from the pupils directly.
100
90
80
70
PERCENTAGE
60
50
40
30
20
10
O
1
2
3
4
5
ES
GRADES
PERCENTAGE WHO HAVE EVER HAD WORK DONE BY THEIR OWN DENTIST. PERCENTAGE WITH CAVITIES OF FIRST SET. PERCENTAGE WITH CAVITIES OF SECOND SET.
PERCENTAGE WITH CAVITIES OF FIRST AND SECOND SETS.
-
E.R. Harlow Jr.
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It is evident from the above graph as shown by the continuous line that 74% of the pupils of the first grade have cavities of the first or deciduous teeth, and that the number increases up to the third grade and then rapidly declines as the teeth loosen and fall out until in the sixth grade 27% still have a few of the first set present and decaying.
The most striking feature of the graph is the high per- centage of pupils with cavities of the second or permam- ent set as shown by the interrupted line, but it should be borne in mind that in the examination from which the figures used here are taken, slight faults in the enamel called fissures, are included. The pictures would be quite different if open cavities alone had been recorded.
It appears that 44% of the pupils in the first grade have permanent teeth (sixth year molars) which are de- cayed or threatened with decay. The number of pupils so affeected then rapidly increases until in the third grade 83% of the whole number have defective perman- ent teeth. In the fourth grade for some reason which is not evident there is a slight improvement but in the fifth grade 90% of the pupils are affected, a condition which hardly improves in the sixth grade. In the face of such a showing the little that we can do to stay the tide of dental caries seems insignificant but it is evident that we shall accomplish most by doing repair work only in the early grades when it will be most effective in checking the disease. Our best chance of accomplish- ment however will be to implant a desire for a sound set of teeth in the mind of the child by every possible means of which we can avail ourselves. Working with this idea Miss White has planned and carried out a course of in- struction in dental hygiene which has attracted much favorable attention.
The dot and dash line in the graph showing the per- centage of pupils with cavities of both first and second teeth approaches the continuous line of those with cav-
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ities of the first teeth, as the second teeth become more numerous in the second grade, and follows that line very consistently throughout.
The dotted line showing the percentage of pupils who have had work done by their own dentist although prob- ably not very accurate in the early grades will give an idea of the proportion of pupils interested enough in preserv- ing their teeth to seek the services of a dentist. When we see that between fifty and sixty percent of the pupils of the fourth, fifth and sixth grades (and here we feel that our figures are dependable) have at some time had dental work done on their own initiative we are led to feel that the situation is not hopeless.
In the past year since the 100% plan has been in effect we know that many pupils who had never before done so have sought the services of a dentist.
To sum up, although the prevalence of dental caries among the pupils is rather appalling we feel that we are working out our problem in the right way in the light of recent knowledge and that having now an accurate record of the situation we shall in the future be in a posi- tion to demonstrate the results that we are getting.
The report of the dental hygienist follows :
REPORT OF ORAL HYGIENE DEPARTMENT & DENTAL CLINIC
My dear Dr. Shaw:
I hereby submit my report :
ORAL HYGIENE DEPARTMENT
Number of children having teeth cleaned ... 1,042 Number of Oral Hygiene lessons taught in schools . 315
During September and October I assisted the dentists in examining the teeth in the first six grades, thus mak-
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ing the total of my prophylactic treatments less than in previous years.
In my teaching this year I have including the following subjects: "Teeth In General," "Where They Are" and "What They Are For," "What Makes Teeth," How We Ourselves Can Help To Build Sound Teeth."
(In teaching diet I have used stories, mimiographed pictures, to color, songs and rhymes, and blackboard drawing, allowing the children themselves to lead.)
"Care of the Teeth and the Proper Way to Clean Them." (Toothbrush drills and dental floss drills in the class room are a part of this lesson. I have the children bring a small mirror, such as found in a lady's pocketbook and pass out a piece of gauze and a piece of dental floss, watching each one until he or she can use it. This drill is used in grades three and four. The toothbrush drill is taught in grades one and two. The children bring their brushes to school in a waxed envelope which I give them. They are then given water, salt and a paper towel and remain in their seats while I help each one. At the end of the drill each child comes with me to the sink and is shown how to rinse the mouth and the brush.)
"Decay." "Value of the Dentist." "How and When To Call Upon Him." "Respect For Him."
"The Growth of the New Teeth and the Loss of the First Teeth."
(I have the children draw the teeth with colored crayons which helps to impress the lesson upon their minds.)
"The Toothbrush." "Kind and How To Care For It."
The toothbrushes are examined in May and are tagged if they are in good condition. Every toothbrush which is not in good condition I destroy and replace it with a new
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one, having the children bring me five cents for it at an- other time.
At the end of the year rewards are given out to those who have taken good care of their teeth.
The children in the first six grades will have their teeth examined at the beginning of every year, and a chart sent home to the parents indicating the results found. It is our hope that the parents will take their children to the family dentist and have him attend to all necessary cavities. When the children go to their dentist they should take the white card given out in school, and have the dentist cross off the teeth as he corrects them, signing the card when finished when it should be returned to the school. This permits us to check up on the number of children who have had their teeth attended to. It is most important. that the tiniest crack in a tooth be filled as this often- times prevents the necessity of filling that tooth ever again, where if the tiny crack is neglected and not filled, in the course of six months or a year the entire inside of the tooth may be lost.
For our teaching in the schools and also in out dental clinic, which is maintained through the cooperation of the Board of Health we are following a policy advocated by the Division of Hygiene of the State Department of Health, and we believe that this policy enables us to give the little people who come to us the very best help that it. is possible to give them with the means at our disposal.
REPORT OF DENTAL CLINIC
Number of examinations 1604
Number of temporary teeth extracted 135
Number of permanent teeth extracted 26
Number of fillings 169
Note :- We are only filling second teeth because of the short amount of time we have, so that all the fillings are permanent ones, nearly every one a silver one, with the exception of an occasional por- celain.
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. Number of treatments (toothaches) 37 Total number of patients (not individuals) 303 Many of these patients returned several times, needing more than one treatment.
Number of patients finished at clinic 51
We still have the services of a dentist only two morn- ings each week, so have to limit our work to that which seems most important. Thus we do not fill any first teeth here at the clinic. First teeth should be filled to help pre- vent toothache and to keep the tooth in place until the new tooth is ready to take its place.
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