NorTex 2013 Spring Newsletter

March 22, 2013 • NorTex

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The North Texas Primary Care Research Network Newsletter


The Primary Care Research Center is pleased to announce the launch of a new newsletter to keep our members informed of NorTex-related news and events to be published in March and September each
year. NorTex is housed in the Primary Care Research Center at the University of North Texas Health Science Center (UNTHSC), and currently includes over 130 clinics in the North Texas region. NorTex has also recently begun to expand its membership into rural Texas. NorTex is a practice-based research network (PBRN) which functions in a collaborative effort to conduct primary care research among North Texas primary care clinics, including family medicine, general internal medicine, pediatrics, geriatrics, and obstetrics/gynecology. The newsletter seeks to inform members of current projects and research results, connect members to recent news, and highlight clinic members and their practices. If you or someone you know would like to be included in our mailing list, please send us an email at with your name, mailing address, and e-mail.


The North Texas Primary Care Registry Project (NRP) was established to develop and maintainSpring 2013 2 a database of individuals who may be contacted
for future NorTex studies. The program is simple to implement. Front desk personnel hand out 4-inch x 6-inch cards to patients checking in for their appointments. This card explains the project on one side and collects demographic and medical histories on the other side. The cards are returned to the Primary Care Research Center where they
are entered in a confidential database. This information provides NorTex researchers with the ability to contact potentially eligible participants for future projects. Currently, 15 NorTex clinics are involved, and 1,239 patients have returned cards. We hope to grow this database to 10,000 potential research participants. If you are interested in signing up your clinic for the NRP, please email us at


We are updating the demographic information for all NorTex clinics. NorTex clinics should have received an invitation to participate in the Clinical Demographic Survey Program to provide these updates. If you would like more details or would like to make sure we have your most recent clinic information, please email us at



The Relationship between Perceived Sense of Control and Visceral Adipose Tissue – the North Texas Healthy Heart Study

The purpose of this study was to elucidate the association between one’s perceived sense of control and visceral adipose tissue (VAT), regardless of chronic disease status, smoking behavior, and socioeconomic status. Data from the North Texas Healthy Heart Study (NTHH) were analyzed. The NTHH – led by Roberto Cardarelli, DO, MPH – included 571 non-Hispanic Caucasian, non-Hispanic African American, and Hispanic participants ages 45 and older. Participants had no self-reported history of cardiovascular disease, renal failure, or liver failure. They completed a questionnaire, body measurements, a multi-slice computed tomography scan to assess for visceral adipose tissue centered at the L4L5 spinal interspace, and serum chemistries. A total of 506 participants were used in the final analysis.

An increase in sense of control was associated with a decrease in VAT before and after controlling for other potential confounders. Other factors significantly associated with VAT in the adjusted model included age, BMI, male gender, non-Hispanic African American race, and diet. For more information on this project, please see the full length research article for the following citation.
Cardarelli R, Asari-Hogan S, Fulda KG, Carroll J. (2011). The relationship between perceived sense of control and visceral adipose tissue – the North Texas Healthy Heart Study. BioPsychosocial Medicine, 2011, 5:12. 2013 3


Improving COPD Diagnosis in Family Medicine

NorTex investigators are collaborating with the Office of Professional and Continuing Education (PACE) at the UNT Health Science Center to assess provider performance, knowledge, and attitudes about using spirometry for patients meeting the risk profile for chronic obstructive pulmonary disease (COPD) in family medicine clinics. The study includes three phases. In Phase I, physicians, physician assistants, and residents were surveyed about their knowledge, beliefs, and practices about using spirometers in their practice. During Phase II, participants received an in-person training on when to use and how to interpret the results of spirometry as well as personalized continuing medical education. Phase III will include resurveying the physicians to determine differences pre/post to education intervention. Physicians will receive a total of 20 hours of CME credit for participating in the entire process. (PI: K Fulda; Funded by: UNTHSC PACE Office and Glaxo-Smith Kline).



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From left to right, Keith Sims, Kaley Halliday, Dr. Kimberly Fulda, Dr. Anna Espinoza, Dr. Roberto Cardarelli, Daniel Freedman

The NorTex 3rd Annual Convocation of Practices: Translating Research into Practice featured short presentations on current and completed NorTex projects by NorTex staff, clinicians, and a medical student on Oct. 23 at the Fort Worth Club. Topics included results from the Mental Health Screening and Treatment Initiative and the North Texas Healthy Heart studies, unmet needs for children with special health care needs, vitamin D deficiency in Asian Indians, and benefits of participating in research. The convocation of practices provides an excellent opportunity for NorTex members to meet, exchange ideas, and provide input on NorTex’s future research. Keep a look out for the 4th Annual Convocation of Practices to be held in winter 2013!




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Robert A. Strzinek, DO (’78), PhD, in addition to practicing medicine, works with his son, Wade, in Protenium Clinical Research, a clinical research facility Dr. Strzinek founded in 2000 that specializes in Phase 1-4 research trials. He has also founded to advance patient awareness and participation in clinical research.
Since 1999, Dr. Strzinek has served as principal investigator in more than 100 Phase 1-4 clinical trials related to the development of medications for the treatment of diabetes, hypertension, hyperlipidemia, GI disorders, and men’s and women’s health issues, an area in which he has recently published.
He has been active in research most of his professional life, and participated in a post-doctorate fellowship at the NASA Manned Spacecraft Center in Houston from 1970 to 1973. While there, he researched the effects of zero gravity on cell metabolism during the Apollo 14-Skylab 1 space exploration programs as a recipient of a National Research Council Post-doctoral Fellowship.
Dr. Strzinek has also served as the Director of Immunology for Helena Laboratories in Beaumont, Texas, where he was involved in the development of immunological assay procedures for serum proteins and immunoglobulins.
A Dallas native, he received PhD in biology/chemistry from the University of North Texas and his DO degree from the Texas College of Osteopathic Medicine in 1978. He earned a BS in chemistry from Abilene Christian University. He is board certifed in family medicine and has practiced in the mid-cities area since 1979.

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