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Posters Good > Better > Best

Monica Jarrett, PhD, RN

2014 SNRC Workshop And Conference

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Posters . . .

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. . . main function is to capture a moving audience with a message.

Visual Impact Academic/Clinical Statements

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Visual ImpactDESIGN

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Consider using an institution’s template.

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Or a tailored template developed for a study/project.

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Look for examples on the internet.

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Consider professional templates such as the Microsoft example below.

http://office.microsoft.com/en‐us/templates/

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Posters

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Have a simple and clear layout so your reader knows where to find the information.

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Set up the format so that is ease to follow.

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Software . . .

MS PowerPoint

Adobe Illustrator 

Corel Draw X6

Easy, but colors change with printer

Harder but what you see if what you get

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Next set the postersize . . .

What do the directions say?  

Commonsize:  3 x 6 ft

Commonsize:  3 in X 4.7 ft (56 in PP limit)

Beware! 4 x 8 ft

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Use 3 to 4 colors

Background and text 

Dark blue background with the white text 

White background Black and red text

Headings

Methods

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Decide on background and text colors.

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Use 3 to 4 colors

Background and text 

Dark blue background with the white text 

White background Black and red text

Headings

Methods

Consistent

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Contrasting

Standardized

Increases readability 

• font size, line spacing, alignment of graphics and text, and size of graphics 

•all elements with at least one other element

• light background with dark text (vice versa)

• formatting lets viewers know when they are looking at similar things (tables, headings, etc.)

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Consider using • “Ruler and” "Grid and Guides" tool under the "View" menu

• Blank space – increases readability

• Tables – set them off with shading

• Uniform spacing before and after headings

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Title

Introduction

Methods 

Results 

Conclusion 

References

Acknowledgement

Contact

Layout Tips• Simplicity prevents viewers from getting distracted. 

• Simplicity reminds the presenter what is essential about the subject. 

• Use variations of shades and tones for one or two colors to set off sections. 

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• Limit any horizontal line to about 10 words; otherwise, it is hard to read.

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HEALTHCARE IN ADULTS WITH IRRITABLE BOWEL SYNDROMEName(s) and Affiliation(s)

Purpose The purpose of this study is to characterize the healthcare utilization and the usage of complementary and alternative medicine (CAM) in adults with irritable bowel syndrome (IBS). IBS patients are reported to spend more on medical care and use higher amounts of herbal/dietary supplements than people without IBS.

Methods • Design: Secondary analysis of baseline data from a RCT.

• Sample: 39 men and 216 women with IBS recruited from the community.

• Healthcare utilization:

• Initial interview: Visits to healthcare and CAM providers over the prior 6 months.

• 4-week Diary: Use of prescription and over-the-counter medications including herbal and dietary supplements.

AcknowledgementThis study was supported by the National Institute of Nursing Research (NINR) through grant R01 NR004142 and CWHGR P30 NR04001.

Specialists % of people who visited

Specialists % of people who visited

Gastroenterologist 27.0 Nutritionist 5.1Gynecologist 20.0 Allergist 4.3Counselor/Therapist 18.4 Psychologist 4.3Ophthalmologist 13.7 Rheumatologist 3.9Physical Therapist 12.1 Cardiologist 3.1Dermatologist 11.3 Podiatrist 3.1Psychiatrist 7.4 Audiologist 2.7Neurologist 6.3 Urologist 2.3Surgeon 5.2 Pulmonologist 0.8

Table 1. Visits to Specialists During Prior 6 Months.

Figure 2. Percentage of subjects who visited a CAM practitioner during a 6 month period.

Figure 3. Percentage of subjects who used at least one supplement during a 4-week period.

Figure 4. Percentage of days over 4 weeks that subject’s used dietary supplements.

Results• Sample characteristics: The majority of the participants were female

(84.7%), Caucasian (90.6%), and well educated (89.9% > college degree).

• Conventional healthcare providers in the prior 6 months:

81.8% reported at least one visit.

18.3% reported seeing more than one conventional primary healthcare providers (Figure 1 & Table 1).

• CAM practitioner in the prior 6 months:

46.6% had at least one visit. 18.8% reported seeing more than one CAM practitioner (Figure 2).

• Herbal and dietary supplements:

58.9% of our IBS patients took at least one kind of herbal/dietary supplement, and 40.9% reported taking more than one kind (Figure 3).

Half of our patients reported to have taken herbal/dietary supplements for longer than three weeks within 28 days (Figure 4).

ImplicationsOur statistics reflect a national trend for people with functional digestive problems to augment their conventional medicine by taking herbal/dietary supplements (Bardia et al., 2007; Yu et al, 2000). Consulting CAM therapists (46.6%) was higher compared to a report in 2003 (9% in the past 12-month, 20.3% in lifetime) among people with IBS and Functional Dyspepsia (Koloski et al). This implies that the health care providers need to be aware of such high CAM usage. About 50~60% of the people were consistent users of supplements (75% of the days during a 4-week period). Casual users and consistent users should be differentiated when patients report taking herbal/dietary supplements.

ReferencesBardia, A. et al. (2007). Use of herbs among adults based on evidence-based indications. Mayo Clinic Proceedings,82(5), 561-566.

Koloski, N. A. et al. (2003). Predictors of conventional and alternative health care seeking for irritable bowel syndrome and functional dyspepsia. Alimentary Pharmacology & Therapeutics, 17(6), 841-851.

Yu, S. M. et al. (2004). Herbal supplements use among US women, 2000. American Medical Women’s Association, 59(1), 17-24.

Figure 1. Percent of subjects with visits to primary healthcare providers over 6 months.

Results

SimplicitySimplicity

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Academic/Clinical Statements

IMRAD

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Title characteristics • Essential number of words• Title case• Large font (100 pt)• Centered • Name and affiliation

Examples of titles - shorten

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1. Activity Log Tool Use to Determine Staffing & Role Redesign as Part of Patient Centered Medical Home Implementation

Staffing and Role Redesign Using an Activity Log in a Medical Home Setting

Staffing and Role Redesign Based on Activity Levels in a Medical Home Setting

Your turn to edit ‐ see handout

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Headings40‐44 font size, contrasting color, upper or title case.

Text36 font size, primary color, bullets and short statements 

Larger font for Objective and Conclusion 

Objectives• We hypothesized . ..• To test this hypothesis we compared . . .  

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Methods • Who are the participants?• How was the data collected?

• How was the data analyzed (e.g., compared)?

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Methods • Who are the participants?• How was the data collected?

• How was the data analyzed (e.g., compared)?

Results • What are the participant characteristics (e.g., age, race, education?

• Why is the spacing off?

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Tables!

• Use color to highlight ease significant differences

• Make the table in MS Word then copy in and adjust colors and size.

• Use lines (light color or white) and spacing 

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Acknowledgement 

• Funding source

• Participants

• Advisors

Figures 

• Create figure outside of table then copy and paste

• Legend explains the figure (The people below the bottom dashed line are those whose sleep is a lot worse . . .) 

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Graphs  

Visual – easier to understand than table of numbers – add color

Photo/images

Resolution 150 to 300 dpi

Save as jpg or png

Poor resolution in web images (test) – add color

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Conclusions

• Summary of key points• Bullets

References

• Be selective – supportive study/ review or method

Contact information

•Work site, address, phone, email 

http://seattlenursingresearch.org/

QR (quick response)

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Posters . . .

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Most common error in formatting posters is to include too much information.

IntroductionWe hypothesize that women with IBS, who experience chronic long-term stress, will also have physiological hyperarousal (increased cortisol) in response to physical and psychological stressors. To test this hypothesis, we compared the pattern of night-time ACTH and cortisol levels as indicators of hypothalamic pituitary-adrenal (HPA) axis regulation in response to the threat of public speaking in healthy women and women with IBS.

Methods

Menstruating women with IBS (n=43, Rome III criteria) and 24 healthy comparison (HC) women

Studied for 3 nights in a sleep laboratory with polysomnography.

On the third night we obtained serial blood samples throughout the night.

Immediately prior to bedtime, women were reminded that the next morning they would give a brief talk on their experiences to an audience.

Plasma ACTH and serum cortisol levels were determined every 20 minutes during the night.

For analysis purposes the night was divided into hourly periods relative to lights out and mean ACTH and cortisol levels computed within each time period.

Results

HCN = 24

IBSN = 43

Age , mean (SD) 28 (6) 30 (7) NS

Race, Caucasian 79% 93% NS

Education, college 79% 73% NS

Job, professional-manager

17% 29% NS

Table 2: Sleep Indices of Healthy Controls (HC), Patients with IBS and separate IBS-constipation (IBS-C) and IBS-diarrhea (IBS-D) from Polysomnography

HC IBS P1 IBS-C IBS-D P2

Mean (SD) Mean (SD) Mean (SD) Mean (SD)

Total time in bed (min) 482 (33) 476 (37) NS 476 (29) 476 (44) NS

Total time asleep (min) 393 (44) 361 (58) .008 351(63) 372 (52) NS

Sleep efficiency index % 82 (8) 76 (13) .009 74 (14) 78 (13) NS

Sleep latency lights out to S2

23.1 (23.8) 26.0 (27.7) NS 28.8 (32.5) 23.1 (22) NS

Sleep latency S1 to REM 80.2 (50) 101.0 (65) .165 92.7 (61) 109.7 (70) NS

Sleep latency S1 to SWS 15.4 (13.7) 15.9 (10.1) NS 18.3 (11.0) 13.4 (8.6) NS

Sleep fragmentation index 7.6 (2.8) 7.7 (3.0) NS 8.2 (3.7) 7.2 (2.1) NS

Percent time awake 14.1 (7.6) 18.5 (10.2) .007 19.8 (10.6) 17.2 (9.8) NS

Percent time in S2 37.2 (9.4) 36.9 (9.4) .024 37.9 (10.1) 35.8 (7.3) NS

Percent time in SWS 21.3 (9.3) 20.6 (7.9) NS 16.5 (5.9) 18.6 (5.2) NS

Percent time in REM 21.2 (5.2) 17.5 (5.6) .004 16.5 (5.9) 18.6 (5.2) NS

Table 1. Demographics

P1 = p-value for testing IBS versus HC controlling for age, BMI, and Night 2 value of the measure.P2 = p-value for testing IBS-D versus IBS-C, controlling for age, BMI, and Night 2.NS = p>.20

Conclusions

• There is evidence of HPA axis dysregulation in response to an anticipation of public speaking stressor in a subset of women with IBS.

• These data support our hypothesis that women with IBS experience HPA dysregulation in response to an acute psychological stressor.

Figure 1. The people below the bottom dashed line are those whose sleep is a lot worse on night-3 than on night-2, i.e. they are very responsive to stress. They are all IBS, all but 1 are IBS-C.

Figure 2. Serial measurement of serum cortisol obtained every 20 minutes but averaged for one hour time periods starting 2 hours prior to lights out. ….

Figure 3. Serial measurement of serum ACTH drawn every 20 minutes but averaged for one hour time periods starting 2 hours prior to lights out. .

Supported by National Institute of Nursing Research, NIH, NR01NR001094

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Edit 

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Your turn to suggest edits to this poster.

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Occult Hypoperfusion in Seriously Injured Combat Casualties (Pre‐Post MEDEVAC)Name and Affiliation 

PURPOSEDescribe the perfusion  state of seriously injured combat casualties pre/post MEDEVAC transport  from point of injury (POI) or after initial resuscitation when the casualty is being evacuated  from Role II (field hospital) to a higher level of care based on standard indicators  (blood pressure, heart rate, base deficit, lactate) and NIRS skeletal tissue oxygenation  (StO2)

METHODS• Field (point of injury)

• HR, BP, RR, GCS, SaO2, StO2

• Role II (Forward Operating Base)/Role III Trauma Hospital

• HR, BP, RR, GCS, SaO2, StO2

• Lactate, base deficit, blood gas

• Interventions  (surgery, blood products)

• Enroute (POI‐Role II/Role II‐III)

• Transport time

• Resuscitation enroute  (fluids, blood products)

• Characterization of hypoperfusion 

• SBP < 90 mm Hg and/or HR > 120 bpm

• Lactate (mmol/L)

• Mild‐Moderate 2.5‐5/Severe > 5

• Base deficit  (BD)  

• Mild (‐2 to ‐6) /Severe (< ‐6)

• StO2 < 75% or > 90%

• Equipment: Portable, rechargeable StO2 monitor (Hutchinson Technology)

A. Hutchinson  Technology – Rechargeable portable StO2 monitor prototype  (Equipment  loaned from Hutchinson  Technology – Phase I). B. InSpectra StO2

Spot Check (Phase II –Supported by grant from Clinical Investigations Facility – Travis AFB, CA)

A B

The opinions or assertions  contained  herein  are  the private  views of the authors  and are not to be construed  as official or as reflecting  the views of the Department  of the Air Force or the Army or the Department  of Defense.   This study was conducted  under  a protocol  reviewed  and approved  by the US Army Medical Research  and Materiel Command  Institutional  Review  Board,  and in accordance with  the approved  protocol.

Phase I: Point of Injury – Role II Hospital (6 severely injured adult combat casualties)

Phase II: Pre/post Role II – Role III transport (37 severely injured adult combat casualties)

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Average Times (Phase I)

• Injury to initial StO2: 22 ± 7 min

• Initial StO2 to Role II StO2: 17 ± 20 min

• Injury to arrival at Role II: 39 ± 24 min

• All casualties normothermic 

• All casualties received fluids in the field or during transport to Role II

• 500 to 1000 ml crystalloid  (n = 5)

• 500 ml of colloid (n = 1; subject #6)

Injury Information Pre‐Hospital (POI) Role II (Upon Arrival)

MOI Injury Notes Tourniquet HR SBP SaO2 StO2 HR SBP SaO2 StO2 Lac BD

IED RLE puncture wound, open fx tib/fib, right hip puncture wound 2nd lac to occiput

2LLE/1 RLE 99 84 95 91 99 146 96 95 1.24 ‐2

GSW LLE (ankle, tib/fib fx) LLE 94 110 90 93 60 126 ‐‐ 88 3.36 ‐4

GSW Right knee RLE 80 120 92 86 87 139 98 88 ‐‐ ‐2

Rocket Open right tib/fib fx with crush injury to left foot and facial lacerations

R upper leg 114 138 78 68 110 126 100 59 2.58 ‐6

GSW GSW to left calf L Upper leg 118 114 99 84 114 134 98 71 2.84 ‐7

Rocket Bowel evisceration LLQ d/t rocket attack ‐‐ 140 90 ‐‐ 34 130 111 ‐‐ 25 8.89 ‐14

Most Common Mechanism of Injury

• IED/Rocket/Bomb (17)

• GSW (11)/MVC (2)

Time (median/IQR)

• Injury  to Transport: 423 min (328‐633)

• ECCN Transport: 43 min (30‐72)

Care Before Transport

• Surgery (n = 28)

• Blood products

• PRBCs (n = 26, median 7 units; IQR 4‐12)

• FFP ( n = 22, median 6 units, IQR 4‐22)

• Whole blood (n = 6, median 7.5 units;IQR 6‐8)

Care During Transport

• Ventilator (26)

• Crystalloids (24)

• 75%  < 250 ml

• Vasopressor (4)

• Blood products (3)

• Fentanyl (23)

• Propofol (10)

• Versed (15)

• NMB (16)

Acknowledgements: To MAJ Scott Baumgartner and the Enroute Critical Care Nurses (ECCNs) and the Joint Combat Casualty Research Team for their invaluable assistance collecting data in Afghanistan.  We also wish to acknowledge the important contribution to the future of trauma care made by the wounded warriors included in this study. 

Pre‐Transport Phase

Perfusion Status n

Hypoperfusion Severity

StO2Mean (SD)

THIMean (SD)

StO2

< 75 75‐90 > 90

NormalAbnormal VS with normal BD or lactateOvert Hypoperfusion (Abnormal VS & BD/lactate)Occult (Normal VS with abnormal BD/lactate)No pre‐transport labs

8310138

Normal 11 83 (10) 10.6 (4) 2 5 1

Mild‐Moderate 18 78 (14)

11.3 (3) 6 11 3

Severe 5 83 (11) 14 (3) 3 1 1

CONCLUSIONS (PHASE II)• 23/29 patients with pre‐transport  labs had indications 

of hypoperfusion  (13 occult)• 9/17 patients with post‐transport  labs had indications 

of hypoperfusion  (5 occult)• A decrease in StO2 was found  in all patients who had a  

deterioration  in perfusion  status (Pre‐post  transport)

StO2• Among patients with StO2 < 75%, 9/11 (pre‐transport) 

and (4/5) post‐transport were hypoperfused• Among patients with StO2 > 90% 3 of 5 (pre‐transport) 

and 0 of 1 (post‐transport) were hypoperfused

StO2 Interpretation• StO2 < 75% or > 90% indicates need for further 

examination of patient  for hypoperfusion• StO2 75%‐90% does not rule out hypoperfusion• A > 5% decrease  in StO2 was associated with a 

worsening of perfusion  status (pre‐post  transport)

Limitations• Pre‐transport phase limited by asynchronous  StO2 and 

lab measurements• Post‐transport analysis limited by small number of 

patients with labs (research ongoing)

FUTURE RESEARCH QUESTIONS/AIMS• Describe physiologic state during enroute phase of 

care• Is there an abnormally high StO2 that indicates altered 

O2 delivery or consumption  (? shunt)  in trauma patients?

• Evaluate enroute  interventions  to safely optimize perfusion  status in post‐damage  control phase of care using noninvasive hemodynamic/perfusion monitoring

CONCLUSIONS (PHASE I)• No difference  in SBP/HR in field for casualties who were  

hypoperfused  on arrival to the Role II compared to casualties with normal perfusion

• Upon arrival to the Role II, the StO2 threshold of 75%:• Confirmed severity of injury in the casualty with the 

most severe hypoperfusion  despite SBP correction • Correctly identified 2/3 casualties with mild to 

moderate occult hypoperfusion• Ruled out two casualties without hypoperfusion

StO2 Interpretation• StO2 < 75% ‐ hypoperfused  even if BP is normal• StO2 > 75% cannot rule out hypoperfusion

• D/t rapid time to first StO2 measurement and use of tourniquets  –unknown  if casualties developed hypoperfusion  enroute  : Would change in StO2 in addition to absolute values identify at risk casualty?

RESULTS

Pre‐Post Transport Change in Perfusions Status & StO2 

Pre‐Post Perfusion Status StO2 Percent StO2

Continued Perfused (4) 1.2 ± 3 1.5 ± 4

Hypoperfused to Normal  (4) 1.8 ± 4 3.0 ± 7

Normal to Hypoperfused (2) 6 ± 6 6.6 ± 6

Continued Hypoperfused (6) 5.6 ± 20 5.9 ± 22

• 17 patients with post‐transport  labs (9 hypoperfused)  – StO2 < 75 (n = 5)/StO2 > 90 (n = 1) ‐ StO2 < 75% in 4/5 with hypoperfusion 

• 20 patients without post‐transport  labs ‐ StO2: 84 ± 13; StO2 < 75 (n = 4)/StO2 > 90 (n = 9) 

p = .09

81 ± 13

76 ± 12

Post‐Transport StO2 by Perfusion State (n = 17)

Do your best . . .

Navajos thought evil spirits could escape only through an error in art.

The makers of Persian carpets made obvious errors in their rugs to show that no one was perfect except Allah. 

but know that mistakes happen.

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PresentingYOUR POSTER

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Making eye contact with people encourages engagement.Preparer a 1-min. and 3-5 min. summary of your findings.Handouts – for those interested in your work

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Sound bite Briefly capture key message(s) in case that is all that is read or remembered.

In 30 in 60 seconds (10 words):

• What you found.

• Why it makes a difference.

• What comes next.

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http://www.forbes.com/sites/danmunro/2012/12/23/top‐ten‐healthcare‐quotes‐for‐2012‐2/

EX:  Just because patients have pedometers; it doesn’t make them fit.”

Poster Printers• Order a small poster version to proof. 

• Recommend "glossy“ surface which makes the poster easier to view. 

• International printing companies [e.g., www.hubcast.com]

• e‐Posters 

• About one week between ordering a poster online and receiving it. 

• Use your poster at work or local conferences 

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Mock Presentation

Before the actual presentation, give a mock presentation to colleagues and invite questions and comments on the visual presentation.

Poster Presentations

"The poster medium is an excellent discipline for crystallizing your views on a topic. However unless you get a chance to discuss the poster with other delegates it can feel like you are having a discourse with yourself.“

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