E.A.

Vagner Perm State Medical University

Department of foreign studies

WORK EXPERIENCE JOURNAL

for foreign students

«Assistant of junior medical staff»

1st year student, Department of General Medicine

Department of propaedeutics of internal diseases №1

Name, Surname and Patronymic Swati Agarwal

Group 42

Hospital or/and Clinics

Practical training from from 12/07/2022 till 2/08/ 2022

Head of Practical training Education practice

Assessment / Evaluation
Perm 2022
 Chapter I General information about practical training.
The student works in a hospital as an assistant to junior medical staff.

Students who are practicing on clinical bases are required to appear on the first

day of internship at the starting meeting. At the end of internship, the student

provides this journal completed according to the requirements and passes a test

with the final score based on a five-point assessment system. The test results are

fixed in the record book.

The report form during Student’s practical training is this journal.

The list of required skills is shown in the table below.

You must fill in the table every day.

You cannot put + or –

You must specify how many times you have completed each task.

The place of internship and its terms can be changed only with the permission of the

Dean of the Department or the Deputy Dean for Practical Training.

Students who have not completed their practical training or who did not report for it

within the mentioned period are a subject to expulsion from the University as they

have not completed the curriculum.

Chapter II Record for starting instructions on labour protection, fire

safety, security measures and internal work regulations.

Signatures

Date of The person who gives The person

instruction Department instructions who gives

Student
s ( Full name, position) instructions
01.07.2022 GENERAL

MEDICINE
 Chapter III Combined plan schedule of internships

Student _Swati Agarwal ,1 year of studies

Group 42
Type of Internship: Work Placement
Mode: Clinical Internship
Dates of Internship From 12/7/2022 till 02/08/2022
Place of Internship: Mandsaur____________________________________

Stages of Dates of Type of Student’s activity Status

internship completing
Organisational State the date of Familiarization with the
stage beginning internship work programme;
Study of guidelines for
internship. Coordination of
student’s individual task;
Instructions for students on the
requirements of labour
protection, safety, fire safety, as Completed
well as the internal rules of the
organization on internal
schedule of work.

Main stage State the period Completing the individual task

of internship previewed in the internship
programme;
Everyday work in hospital;
Collection, processing and
systematization of information
on internship; Completed
Filling in the work placement
journal
Final stage State the last day Summarizing and reporting on
of internship and internship;
the date of credit Preparation and approval of
exam the internship reporting set of
documents certified by the
profile organisation;
Providing the department with
the internship reporting set of Completed
documents;
Submission of intermediate
internship results (defense of the
internship report at the
department).

Content of the internship and planned results are agreed with the Head of Internship in the profile
organisation.

Head of the Department of E.A. Vagner Perm State Medical Base for Internship
Universityf __________________________________________________________

_________________________________ Head of Internship in the profile

 Name, surname, patronymic___________________________

seal Signature ____________________________

seal
 Chapter IV Individual work schedule
Dear students, in the table below, you need to fix the working hours in the hospital

department, for example, you write from 8am to 4pm in the column “Working hours”. In the column

“Department”, you need to write the name of the departments where you work. Remember that

during all work placement time, you must work in the departments of therapy and surgery.

Workin
Date Department
g hours

From

01.07 8am to
Management
. 22 3pm – 7

hours

From

4 .07. 8am to
Management
22 4pm – 8

hours

From

5 .07. 8am to
Nursing
22 3pm – 7

hours

From

6 .07. 8am to
Nursing
22 4pm – 8

hours

From
7
8am to
.07. Nursing
4pm – 8
22
hours

8.07. From
Nursing
22 8am to
 3pm – 7

hours

From
11
8am to
.07. Medicine
4pm – 8
22
hours

From
12
8am to
.07. Medicine
4pm – 8
22
hours

From
13
8am to
.07. Medicine
3pm – 7
22
hours

14 From

.07. 8am to Management

22 3pm – 7

15 From

.07. 8am to Ortho

22 3pm – 7

18 From

.07. 8am to ortho

22 3pm – 7

19 From

.07. 8am to Ortho

22 3pm – 7

20
From
.07. Nursing
8am to
22
 3pm – 7

hours

From
21
8am to
.07. Management
3pm – 7
22
hours

From
22
8am to
.07. Management
3pm – 7
22
hours

From
25
8am to
.07. Nursing
3pm – 7
22
hours

From

27.07 8am to
Lab
. 22 3pm – 7

hours

From

29.07 8am to
Lab
. 22 3pm – 7

hours

From
30
8am to
.07. Lab
3pm – 7
22
hours

Head Nurse’s Signature _____________________________________

Date _____________________________________
 Round seal of the PTF

Chapter V Individual Tasks

Day № R
1 2 3 4 5 6 7 8 9 10
e
c
o
m
m
e
n
d
e
d
a
m
o
Date u 01.0 05.0 08.0 12.0 17.0 20.0 22.0 24.0 28.0 29
n
Task t 7 7 7 7 7 7 7 7 26.07 7 7
Medical documentation
management 3 5 2 2 2 2 2 3 1 2 2
Desinfection solutions
preparation 2 3 2 2 2 2 2 3 3 3 3
Current and conclusive
disinfection of living
places 5 5 5 5 5 5 5 5 5 5 5
Anthropometry :
measuring weight and
height 2 2 2 5 5 5 5 5 5 5 5
Skin and hair
examination for
pediculosis 1 1 1 1 2 2 2 2 2 3 3
Hair sanitation in
pediculosis 5 5 5 5 5 5 2 2 2 2 5
Accompanying the
patient in the
department and to the
other hospital facilities 1 1 1 1 1 1 1 1 1 1 1
Organization of patient's
transportation 2 2 2 2 2 2 2 2 2 2 2
Skin sanitation
4 4 4 4 4 2 2 2 4 4 4
Prevention of decubital
sores, skin sanitation in
intertrigos and decubital
sores 1 1 1 1 1 1 1 1 1 1 1
Eyes and ears sanitation
5 5 5 5 5 5 5 5 5 5 5
Instilling of medical
treatments into nose ,
ears and conjunctival
sac. 2 2 2 2 2 2 2 2 2 2 2
Change of patients'
clothes and bed linen 2 2 2 2 2 2 2 2 2 2 2
Acquaintance with nurse
observation list 3 3 3 3 3 3 3 3 3 3 3
Blood pressure
measurement, pulse rate
calculation 5 5 5 5 5 5 5 5 5 5 5
Thermometry,
temperature records
sheet 4 4 4 4 4 4 4 4 4 4 4
Diuresis and drunk liquid
chart management 2 2 2 2 2 2 2 2 2 2 2
Compilation of cooked
to order lists 2 2 2 2 2 2 2 2 2 2 2
Feeding seriously ill
patients 2 2 2 2 2 2 2 2 2 2 2
Making applications
3 3 3 3 3 3 3 3 3 3 3
Carrying out inhalations
3 3 3 3 3 3 3 3 3 3 3
Use of a hot water bottle,
an ice pack applications 2 2 2 2 2 2 2 2 2 2 2
Participation in enema
applications

2 2 2 2 2 2 2 2 2 2 2
 In the table “Individual tasks”, you need to fix the dates and the number of
manipulations (you cannot write only + (done), or – (undone)

Head of the internship in the organization

(signature, full name)
_____________________________________

Date _____________________________________
Round seal of the PTF

Chapter VI Topics for educational and research student’s paper

Dear students, you need to prepare a research student’s paper on any topic
(examples are below) on 10-15 pages of A4 format. It will be necessary to
print it and bring it with you. You must know to answer the teacher’s questions
on topic you have chosen.

1. Physical activity and prevention of cardiovascular disease.

2. Overweight. Ways to normalize body weight.
3. Nutrition rules for patients with cardiovascular disease.
4. Nutrition rules for patients with the gastrointestinal tract pathology.
5. Smoking as a risk factor for reducing life expectancy.
6. Depression as a risk factor for cardiovascular disease.
7. HIV, AIDS. What do you need to know about the twentieth century plague?
8. Features of stroke care for a patient.
9. Tuberculosis. What do you need to know in order to prevent the disease?
 10. ARVI. Flu. What do you need to know in order to stay healthy during an
epidemy?
11. Another topic

Overweight. Ways to normalize body weight.

If you are overweight and your doctor recommends that you lose weight, dieting

may not be the way to go. That's because many diet plans wantyou to cut way

back on calories or give up certain foods. This approach may work in the short run,

but most dieters gain back the weight they lost when they go back to their old

eating habits.

So what's the best way to drop excess weight? Create a new normal and focus on

healthy behavior! Replace old, unhealthy habits with new, healthier ones. Here are

5 ways to make that happen:

Skip the sugary drinks. Sugary drinks, such as soda, juice, sweet tea, and sports

drinks, add extra calories with little or no nutritional value. People who

regularly drink sugary beverages are more likely to be overweight. Choose

water or low-fat milk most of the time.

Exercise. Regular physical activity burns calories and builds muscle — both of

which help you look and feel good and can help keep weight off. Walking

the family dog, cycling to school, and doing other things that increase your

daily level of activity can make a difference. If you want to burn more

calories, increase the intensity of your workout and add some strength

exercises to build muscle.

Reduce screen time. People who spend a lot of time in front of screens are

more likely to be overweight. Set reasonable limits on the amount of time you

spend watching TV, playing video games, and using computers, phones, and
 tablets not related to school work. Turn off all screens at least an hour before

bedtime so you can get enough sleep.

Watch portion sizes. Big portions pile on extra calories that can cause weight

gain. Choose smaller portions, especially when eating high-calorie snacks.

When eating away from home, try sharing an entree or save half your meal to

take home.

Eat 5 servings of fruits and veggies a day. Fruits and veggies are about more

than just vitamins and minerals. They're also packed with fiber, which means

they fill you up. And when you fill up on fruits and veggies, you're less likely to

overeat.

Objective

This study aimed to investigate trends and sociodemographic factors underlying

weight misperception in adults with overweight and obesity in England.

Methods

This study used descriptive and logistic regression analyses based on a pooled

nationally representative cross‐sectional survey, Health Survey for England, for the

years 1997, 1998, 2002, 2014, and 2015 of individuals with BMI ≥ 25 (n = 23,459). The

main outcomes were (1) weight misperception and (2) weight‐loss attempts as well

as the associations with demographic and socioeconomic characteristics and

health status.

Results

The proportion of individuals with overweight and obesity misperceiving their weight

status increased over time between 1997 and 2015 (37% to 40% in men; 17% to 19%

in women). There were socioeconomic disparities in the misperception of weight

status, with lower‐educated individuals from poorer‐income households and

members of minority ethnic groups being more likely to underestimate their weight.

Those underestimating their overweight and obesity status were 85% less likely to try

to lose weight compared with people who accurately identified their weight status.

Conclusions

The upward trend in underassessment of overweight and obesity status in England is

possibly a result of the normalization of overweight and obesity. Obesity prevention

programs need to consider differential sociodemographic characteristics

associated with underassessment of weight status.

Introduction

The year 2018 started with a fresh launch of new plus‐size women's wear from Marks

& Spencer, one of the leading fashion retailers in the United Kingdom 1. The new

fashion range is elegantly called “Curve,” a more flattering term than “plus,” aiming

to minimize the negative image of plus‐size fashion. By introducing a new design

and styling tailored for plus‐size customers and using carefully selected fabrics

complementing fuller figures, Curve primarily contributes to promoting body

positivity. While this type of body‐positive movement helps reduce stigmatization of

larger‐sized bodies, it can potentially undermine the recognition of being

overweight and its health consequences.

Seeing the huge potential of the fuller‐sized fashion market, plus‐size retailers may

have indeed contributed to the normalization of stigma associated with overweight

and obesity. Not only have clothes for larger‐sized bodies been repackaged to

flatter curvy women 2, changing the labeling of clothes sizes can distort consumers'

perceptions of size 3. In the United Kingdom and United States, “vanity sizing,” or size

inflation whereby clothing manufacturers label the clothes with sizes smaller than

the actual cut, is widely practiced. Although purchasing clothes with smaller size
labels helps promote a positive self‐related mental imagery and self‐esteem 4,

vanity sizing can potentially lead to the misperception of weight status and

consequently undermine action to reduce weight 5.

Furthermore, according to the visual normalization theory, as larger body weights

have become more common, overweight and obesity have become normalized,

leading to underestimation of weight status 6. Indeed, both epidemiological data

and experimental studies have shown that exposure to obesity not only increases

the acceptability of heavier body weights but also influences body shape

preferences 7, 8. While it remains debatable whether the correct perception of

one's own weight has a beneficial effect on health 9, awareness of overweight

status is a prerequisite for weight‐loss attempts 10. With more than one in four adults

aged 15 and older classified as having clinical obesity in the United Kingdom 11,

underassessment of overweight can pose a serious global burden to health and

health expenditure 12, 13.

To this end, this study aims to explore the trends in perceived weight status among

the English adult population with overweight or obesity. The study also investigates

demographic and socioeconomic factors associated with self‐perception of

weight status, particularly weight underassessment and attempts to lose weight.

Methods

Data and participants

Using a multistage stratified sampling design, the Health Survey for England is a

nationally representative annual survey designed to provide regular information on

the health of people in England. Data collection involves both face‐to‐face

interviews and a self‐completion questionnaire. Apart from information on health

and health‐related behaviors, information on socioeconomic factors, physical

measurements, and biological samples is also collected. This allows for an

estimation of the prevalence of risk factors and behaviors associated with specified

health conditions.

BMI is calculated based on weight and height information recorded by trained

nurses (kilograms divided by meters squared). These BMI data are considered to be

the major source of health statistics to inform policies on obesity in the United

Kingdom 14. The weight status categories associated with BMI ranges are defined

based on the following World Health Organization guidelines: (1) BMI < 18.5 is

classified as underweight, (2) BMI of 18.5 to 24.9 is normal weight, (3) BMI of 25.0 to

29.9 is overweight, and (4) BMI ≥ 30.0 is obesity.

In order to assess trends in self‐perception of weight status, the analysis was based

on pooled data from 5 years (1997, 1998, 2002, 2014, 2015) of the Health Survey for

England, which contained a question on weight perception. The pooled data had

a sample size of 77,424. Participants were excluded from the analysis if they were

younger than 16 years of age (n = 26,493) or were missing BMI measures (n = 5,043),

information on their weight perception (n = 3,859), information on whether they

were trying to change weight (n = 128), or information on ethnicity (n = 9). This study

focuses on participants with BMI ≥ 25, thus bringing the final analytic sample size to

23,459.

Measures

The primary outcome of interest was underassessment of overweight and obesity

status. This variable was constructed based on BMI measures and the question on

self‐perception of one's own weight. Respondents were asked, “Given your age

and height, would you say that you are…” and were provided with the following

four options: (1) about the right weight, (2) too heavy, (3) too light, and (4) not sure.

Underassessment of overweight and obesity status was a binary variable coded 1

when individuals with BMI > 25 described themselves as too light or about the right

weight, and they were coded 0 otherwise.

The secondary outcome was whether the participants were trying to lose weight.

This variable was based on the survey question that asks whether the respondent is

currently trying to lose weight, trying to gain weight, or not trying to change weight.

Those who answered that they were currently trying to lose weight were coded 1,

and they were coded 0 otherwise.

Statistical analyses

Stata software version 13.0 (StataCorp LLC, College Station, Texas) was used for

statistical analysis. Multivariate logistic regression analyses were conducted to

evaluate the relationship between years of survey, BMI status, and the outcome

variables. All models were adjusted for age, sex, ethnicity, education, household

income, and self‐rated health.

Results

A normalization of overweight and obesity has become widespread in England.

Among individuals with overweight or obesity, a substantial proportion, 38.5% of

men and 17.2% of women, perceived their weight as about the right weight. Figure

​Figure11 suggests that the number of individuals with overweight underassessing

their weight increased over time, from 48.4% to 57.9% in men and 24.5% to 30.6% in

women between 1997 and 2015. Similarly, among individuals classified as having

obesity, the proportion of men misperceiving their weight as about the right weight

in 2015 doubled that of 1997 (6.6% vs. 12.0%).

Get more sleep

You're not just grumpy when you don't get enough sleep. Research has found that

a lack of sleep can lead to weight gain, too. Getting enough shut-eye helps

prevent weight gain that results from late-night snacking and lets the body actively

burn more calories. Aim for eight to nine hours of sleep every night to maintain a

healthy weight and improve your well-being. Get tips on how to get a better night's

sleep.

Watch your calories

To lower your BMI, you need to consume fewer calories than you burn. Don't get

overwhelmed. Start by lowering your calories by 500 each day, which can result in

about a pound of weight loss per week. One way to do that is to not eat in front of

the television. Research from the University of Massachusetts found that you'll eat up

to 288 calories more while watching TV. Instead, eat at the table and trade one

hour of TV for a casual walk. Combined, you'll burn 527 calories.

Brush those chompers

Have you ever brushed your teeth and then had a sip of orange juice? The

beverage probably tasted sour. That can work to your advantage when you're

trying to avoid post-dinner munching. Try brushing your teeth earlier in the evening

instead of right before bedtime. After you brush your teeth, you're less likely to snack

on empty calories later in the evening.

Keep a food diary

Record everything you drink and eat. Many apps and websites can help, or you

can use tried-and-true pen and paper. Note trouble spots that you'll need to

address, like that midafternoon snack. This process will make you feel more

accountable for what you eat every day. You may think you're eating healthy. But

writing down every bite makes you aware of those extra calories you consume

without even realizing it. Just an extra handful of nuts could cost you more than 100

calories.
Dream of candy

Say it ain't so. Feel free to daydream about the chocolate bar or gummy bears you

saw at the supermarket checkout line. Just don't buy them. Researchers from

Carnegie Mellon University in Pittsburgh found that by fantasizing about your

favorite treats, your consumption of that treat may be reduced because your brain

has already "experienced" them on some level.

Prep your meals

Meal prep prevents you from grabbing takeout on the way home from work. On

Saturday afternoon, scan cookbooks, magazines and websites to figure out what

healthy foods and recipes you'll eat in the coming week. On Sunday, grocery shop

armed with a list. Then spend the rest of the weekend doing food prep, like

cooking/freezing meals or chopping up vegetables. Read how one woman

stopped dieting and started cooking good food.

Watch little bites

Yes, it may just be a taste here and there. But the calories from those bites and licks

add up. A free sample of pizza at the grocery store. A nibble of the cookies your

colleague brought into work. A lick of your son's ice cream at the diner. Your best

bet is not to eat it if you're not hungry or the food isn't on your meal plan.

Make hydration fun

Drinking ice-cold water can help you burn more calories throughout the day,

according to a study published in the Journal of Clinical Endocrinology and

Metabolism—up to 490 calories a week! Other research shows that drinking water

before a meal can help you eat less. Just monitor how much you're guzzling down.

Consider buying a reusable water bottle that's at least 20 fluid ounces. That way you

know exactly how much water it holds, and you can refill it as many times as you

need to do so. Add fresh lemon, cucumber, mint or any other fruit or veggie. Not
only does it make the flavor more interesting, but you're more likely to drink it when

you take the time to do something special.

Become more active

Dieting will only take you so far. Exercise helps you build lean muscle tissue and lose

more fat, which helps change your body composition. Get more active. It doesn't

take much. Take the stairs instead of the elevator, walk to work if possible, ride a

bike, play outdoors with the kids or walk the dog.

Set realistic goals

When you’re planning for weight loss it’s important to have a realistic goal. The first

step is stopping the weight gain. Then focus on losing 5% of your weight. For a 200lb

person that’s 10lbs. If you’re at risk for diabetes, that will cut that risk by 50%! If you

have hypertension, your blood pressure will improve. You may even be able to

lower your medication (with a doctor’s assistance, of course). Know that if you’re

obese and eventually lose 15% of your weight and keep it off, that’s a true success

even if it doesn’t meet your goal of being a specific clothing size.As I tell my

patients, maintaining the weight loss takes hard work. It is a marathon over time,

with sprints and walks in between. At each 5% weight loss, slow down and take the

time to get established with your new routine so it becomes a habit. Celebrate

maintaining your weight loss! It’s important to break the cycle of yo-yo weight loss

and gain. When you’re comfortable and confident that you can maintain your new

routine, then take on the next 5% of weight loss.

Self-monitor

However you choose to cut calories or burn calories, research shows keeping a

record of how you’re doing will improve your likelihood of success. There’s a fine line

between motivation and frustration, so see what works for you. You may want to

check and record your weight daily or weekly. Definitely keep track of your exercise
and be proud of what you do. Focus on the positive changes you’re making.For

your diet, try recording everything you eat for a while so you can look for places to

improve your nutrition and cut your calories. Eventually you can keep a record of

specific interventions like cutting down on alcohol. Look for triggers that derail you.

It could be a place or a time of day. Maybe late night binge-watching shows is

linked with eating too much junk food.

Learn about nutrition & meal planning

There are many diets out there to choose from, so it can be confusing. Mainly

because there’s not one diet that will help everyone lose weight equally. There are

too many variables. So whether you go low-fat or low-carb, or some other diet,

choose a diet you can stick with for at least the beginning of your weight loss

program.

You have to restrict calories, but while you’re doing that you want to maximize

nutrition. The healthiest weight loss diets will be similar to the Mediterranean or DASH

diet. You’ll be increasing your fruit and vegetable intake and cutting out processed,

high calorie foods. These diets are also rich in nuts, seeds, beans, and complex

carbs. You’ll be encouraged to drink water and drop high-calorie drinks. If you’re

obese and at risk for medical conditions like high blood pressure and heart disease,

this type of diet is the way to go.

Get support

Making changes in your diet and exercise are tough. Don’t try to do it alone. Work

with your family and friends so that everyone is eating better and moving more. As

you learn about nutrition, serve up healthier foods. Meet friends for walks rather than

drinks. Consider joining a weight loss program, whether it’s in person or online. There

are community-based and commercial organizations that can help with nutrition
and exercise for weight loss. Look for programs where you can learn how to make

lifestyle changes to lose the weight and then keep it off.

Talk to your doctor

Even with diet and exercise changes, some people need more help with weight

loss. You may benefit from weight-loss medication if your lifestyle changes aren’t

enough and your BMI is 30 or higher, or if your BMI is 27 or higher with an

obesity-related medical problem like diabetes or heart disease. For those who are

severely obese or obese with multiple medical problems, surgery for weight loss may

be an option. Talk to your doctor about your options, or look for a doctor who

specializes in obesity medicine.

Stay positive!

Wherever you are today with your weight and your general health, stay positive!

Small changes do make a difference, and they add up. Make a plan to add a few

new habits to your routine, and know you’re already on your way to a healthier self!

Celebrate the progress, and not just the end goal of pounds or inches lost. That first

5% of weight loss will dramatically improve your health, even if you don’t see or feel

it quite yet.
 Results of the internship
Work placement results / Student’s opinion

(fill in by the student)

In this section you need to write what you learned while doing practical

training. Write also, please, what you liked / disliked; what you managed to do /

didn’t manage to do.

In this internship I learned about nursing and patient care, and management of

hospital. This internship helped me to learn about medicine and lab activities.

Management ant atmosphere of hospital was good and very supportive towards

staff and patients.​

​To sum up I got a lot of experience working as an assistant of general junior staff. I

want to emphasize the importance of undergoing this practice…..

thankyou

Student’s Signature _____________________________________

Date _____________________________________
 REVIEW – REFERENCE

Student (Full name) Agarwal Swati

of the Department of General Medicine, full time, 1st year , group 42 , training as «Assistant

of junior medical staff» in the period from12.07 2022 to02.08.2022 on the internship basis

Main review provisions:

1. Discipline
2. Attitude to work, patients, colleagues, PTF employees
3. Practical skills acquisition (interest, diligence, formalities etc.)
4. Not acquired practical skills, reasons
5. General impression on the student
(The review is written in the developed form with detailed description of basic provisions of the
review!)

1. Swati is well disciplined student and dedicated towards her work.

2. Her attitude towards work and other colleagues is very nice
3. Her practical skills are interesting but need to do some more practice
4. She is good in hospital management and towards paitents​

Head of the hospital (signature, full name) _____________________________________

Head of the internship in the organization _____________________________________

(signature, full name)

Date _____________________________________

Round seal of the PTF

Final grade at university

Credit for practical training of 1st year student group of the Department of General

Medicine

_______________________ ____________________________

Grade Full name of PSMU teacher

«_______»__________________20 _____ ____________________________

Signature of PSMU teacher

If the grade is below 5 (excellent), a brief explanation of the reasons is required