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Tuesday
May222012

First Lady Launches Lunch Contest For Kids’ ‘State Dinner’

Official White House Photo by Lawrence Jackson(WASHINGTON) -- Calling all kids who enjoy making healthy lunches with their families. The first lady is giving you a chance to show the country what you can do in the kitchen.

Michelle Obama and Epicurious, in conjunction with the departments of Education and Agriculture, are launching a nationwide recipe challenge to promote healthy lunches. The winners will get an invitation to the White House for the first-ever kids’ “State Dinner.”

“We all want to ensure that our kids are eating nutritious, delicious food at every meal, and as a mom I know that parents are always looking for new ideas to make that happen,” the first lady said in a statement announcing the contest. “With parents and kids all across the country getting creative in the kitchen, I know we’ll find healthy meals that every family will enjoy.  And I can’t wait to try the kids’ creations myself.”

The “Healthy Lunchtime Challenge” invites parents and their children, ages 8-12, to create an original lunchtime recipe that is “healthy, affordable, and tasty.” The recipe contest is open for entries now until June 17.

Participants are encouraged to reference the USDA’s “MyPlate” nutritional guidelines when developing their recipes. “Entries should represent each of the food groups, either in one dish or as parts of a lunch meal, including fruit, veggies, whole grains, protein and low-fat dairy foods,” the contest announcement stated.

Fifty-six adult-child teams — one winner from each of the 50 states, plus the U.S. Territories, D.C., and Puerto Rico — will be flown to the nation’s capital and have the chance to attend the Kids’ “State Dinner” at the White House in August, where a selection of the winning recipes will be served.  Winners will be notified on July 16.

The winning recipes will be published online in an e-cookbook that features nutritional analysis, photos and drawings of the recipes.

The contest is part of the first lady’s “Let’s Move!” initiative to fight childhood obesity.

Copyright 2012 ABC News Radio

Tuesday
May222012

Estrogen Therapy Works Best in Younger Women

Jupiterimages/Thinkstock(NEW YORK) -- A reappraisal of the National Institutes of Health's Women's Health Initiative (WHI) study has found that "the age when women start hormone replacement therapy makes a huge difference," in risk of cancer and heart disease, according to Dr. Robert Langer, lead author of the reassessment, which was published in the journal Climacteric.

Researchers said "mass fear" left millions of women to needlessly suffer from menopause symptoms without the benefits of hormone replacement therapy when researchers of the WHI study found that women who took estrogen were at higher risk of certain cancers and heart disease.

New data showed that the risks only apply to older menopausal women who begin taking the medication late into menopause.

"The balance is towards benefit for women with hot flashes and other reasons to use it who start within 10 years of menopause," said Langer.  "But it's not beneficial for most women who start about 10 years or more into menopause."

Prior to the 2002 study, some research found that the menopausal hormone therapy actually helped to decrease the risk of heart disease, but the 2002 preliminary data found the treatment did not decrease risk and put women at increased risk of some invasive breast cancers and stroke.  Prior to the study results, hormones were one of the most-prescribed drugs in the country.

But the use of estrogen dropped by 71 percent from 2001 to 2009, according to the North American Menopause Society.

Researchers halted the clinical trial altogether three years early in 2002 because of the noted increased risk.

For some women, menopause symptoms are much more than the occasional hot flash.  Depression, low libido, night sweats, panic attacks and vaginal dryness are only a few of the many indications that storm through the body of a menopausal woman.

Symptoms like vaginal dryness and pain on intercourse are more difficult to bring up with a gynecologist than risks of heart disease and breast cancer, said Langer.

"Fears like the risk of breast cancer, or sometimes heart attacks or strokes, surface quickly in those discussions," continued Langer.  "The reporting of the WHI fed those fears to a degree not warranted by the small increase in breast cancer rates that probably only reflected earlier discovery of existing cancers, or by the fact that the heart attack risk and stroke was only seen in women who started more than 10 years after menopause."

Copyright 2012 ABC News Radio

Tuesday
May222012

Reduce Dumb Decisions by Thinking in a Foreign Language

iStockphoto/Thinkstock(CHICAGO) -- People who think problems through in a foreign language -- and it doesn’t matter which one -- make more rational decisions and are more apt to take smart risks, especially in the financial realm, according to a recent study in the journal Psychological Science.

Left to follow their gut instincts, people are naturally loss-averse, sometimes myopically so, and often pass up favorable opportunities as a result, says Boaz Keysar, a psychologist at the University of Chicago and lead author of the study.

“Imagine I offer you $100, or we flip a coin and if it’s heads, you get $200, and if it’s tails, you get nothing,” Keysar says.  “Most people would say, ‘I’ll take the $100 and not risk getting nothing.  Ninety-nine percent of people would do that, even if I offer $2,200 or nothing.  We have an emotional reaction to a definite, immediate gain.”

But consider the proposal in Korean, French, Spanish, Japanese -- any non-native tongue -- and the aversion to losses diminishes, and our willingness to take risks changes, Keysar and his research team found.

“A foreign language is less emotionally connected than our native tongue, and distances you,” says Keysar, who, even after 25 years in the United States, says he still “operates differently” in English than in his native Hebrew.

“A non-native language takes you away cognitively and slows you down, especially if you’re not that skilled in it,” he says.

As counterintuitive as that seems, it’s a nice boost for the language slackers.

“The less proficient you are in a second language, the more you’ll deliberate over decisions,” Keysar says, “and your choices benefit from such deliberation.  It’s like you become somewhat of a different person.”

In one of six experiments to gauge just how different, Keysar and colleagues enlisted 54 University of Chicago students who were native English speakers but had been studying Spanish.  They gave each student $15 in $1 bills to make 15 separate bets in a coin toss.  In each toss, they could either pass up the bet and keep the dollar, or risk losing it for the possibility of getting an extra $1.50 if they won the toss, or nothing if they lost. 

These were advantageous bets, Keysar explains, as statistically, the students stood to come out ahead if they took all 15 bets.

While the students who considered the wager in Spanish took the bet 71 percent of the time, those who thought it through in English were willing to wager only 54 percent of the time.

“Bear in mind that we gave them the $15.  It’s not as if it was even their own money,” Keysar says.  “But in the foreign language, they were not as motivated by fear.”

Copyright 2012 ABC News Radio

Tuesday
May222012

New York, California Lead States in Injury Prevention

Comstock/Thinkstock(NEW YORK) -- When it comes to injury prevention -- with tougher policies on such things as seatbelt use, bike helmets and drunk driving -- New York and California lead the way, according to a new report released on Tuesday by the Trust for America's Health and the Robert Wood Johnson Foundation.

The report ranks states on steps taken to reduce the risk of accidental injury, the country's fifth-leading cause of death, according to the U.S. Centers for Disease Control and Prevention.

"There are proven, evidence-based strategies that can spare millions of Americans from injuries each year," Trust executive director Jeff Levi said in a statement.  "This report focuses on specific, scientifically supported steps we can take to make it easier for Americans to keep themselves and their families safer."

New York and California scored nine out of 10 on a list of injury prevention policies.  Eighteen states lack primary seat belt laws; 29 states do not require bicycle helmets for children; 31 states do not require helmets for all motorcycle riders; and 34 states and Washington, D.C. do not require mandatory ignition interlocks for convicted drunk drivers, according to the report.

"Seat belts, helmets, drunk driving laws and a range of other strong prevention policies and initiatives are reducing injury rates around the country," Amber Williams, executive director of the Safe States Alliance, said in a statement.  "However, we could dramatically bring down rates of injuries from motor vehicles, assaults, falls, fires and a range of other risks even more if more states adopted, enforced and implemented proven policies."

The rankings also reflect anti-violence and sport safety laws, as well as prescription drug monitoring programs.

While New York and California earned top scores, Maryland, North Carolina, Oregon, Rhode Island and Washington tied for second place with scores of eight out of 10.  Montana and Ohio ranked last with scores of two out of 10.

[CLICK HERE TO SEE THE FULL LIST OF STATE RANKINGS]

The report says state policies aimed at curbing accidents and violence pay off in the number of lives saved.  New York has an annual accidental injury rate of 37.1 per 100,000 people compared to Montana's 86.5, according to the U.S. Centers for Disease Control and Prevention.  The national average is 57.9 deaths due to injury per 100,000 people.

Copyright 2012 ABC News Radio

Tuesday
May222012

Taking a Dip? Think Again: One in Five Admit to Peeing in Pools

iStockphoto/Thinkstock(NEW YORK) -- You may want to think twice before taking a dive into a backyard or community pool.  A new survey finds 20 percent of respondents admitting to peeing in a pool.

Dr. Chris Wiant, the chairman of the Water Quality & Health Council, says, “No matter how easy it is to pee anonymously in the pool, swimmers should avoid doing so.”

Dr. Wiant also advises parents to take their children on frequent bathroom breaks.

But urine isn’t the only contaminant affecting the water quality of a pool.  The WQHC survey finds that while virtually all Americans, 93 percent, say they would never re-use someone else’s bath water, 68 percent admit they do not shower before going in a pool.

“Swimming is not a substitute for bathing.  Too many people unknowingly treat the pool as a communal bathtub,” says Dr. Wiant. 

Health experts say a pre-swim shower removes sweat and cosmetics that can mix with chlorine to create irritants in the water that lead to problems for swimmers.

The Water Quality & Health Council survey involved 1,000 U.S. adults.

Copyright 2012 ABC News Radio

Monday
May212012

Govt. Panel Scuttles Prostate Cancer Testing Recommendations

iStockphoto/Thinkstock(WASHINGTON) -- The governmental advisory panel tasked with issuing cancer screening guidelines made a final recommendation on the most common form of prostate cancer screening, suggesting it's not needed, regardless of age.

On Monday, the United States Preventive Services Task Force, or USPSTF, put forth this guideline on prostate-specific antigen (PSA) blood tests, which more than 20 million American men get each year. The formal recommendation follows draft guidance the task force issued in October 2011. These guidelines drive the screening decisions of doctors throughout the country.

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The PSA blood test is the traditional way to detect evidence of prostate cancer, which is the most common cancer diagnosed in American men. The National Cancer Institute estimates that in 2012, almost 250,000 new cases and more than 28,000 prostate cancer-related deaths will occur.

The task force maintains that PSA tests do more harm than good. Dr. Michael LeFevre, co-vice chairman of the task force, said the medical procedures arising from the tests could have serious downsides, including blood clots, heart attacks, strokes and possibly death. Other complications include impotence and urinary incontinence.

"Of 1,000 men who are screened, at most one man will avoid a prostate cancer death," LeFevre said. "Two to three will have blood clot, heart attack, stroke or even death from treatment of the prostate cancer. One in 3,000 men screened will die of surgical complications from the treatment."

However, the medical community is split on Monday's recommendation. And most urologists -- the doctors who arguably treat the most cases of prostate disease -- do not agree with the task force's guidelines.

"PSA screening is the only test we have," says Dr. William Catalona, a professor of urology at Northwestern University. "The great majority of doctors who deal with prostate cancer patients believe that the task force underestimated the benefits and overestimated the harm. Perhaps it is because none of the Task Force members were urologists."

"There is no mention of the dramatic decline in the number of men with advanced prostate cancer," says Dr. Patrick Walsh, professor of urology at Johns Hopkins University. "In 1990, 21 percent of men at diagnosis had metastatic prostate cancer to bone. Today it is 4 percent. This is clearly a dramatic effect of PSA testing."

"[The new recommendations] fail to recognize that in the absence of PSA testing, a man will not know that he has the disease until he has symptoms, at which time the cancer is too far advanced to cure," Walsh said.

And Dr. Gerald Andriole, chief of urology at Washington University School of Medicine, called the task force's recommendations "too draconian on categorically dismissing PSA."

"In some respects we have not been using PSA as well as we could," Andriole said. "However, to post a headline that says 'No More PSA Testing' is throwing the baby out with the bathwater."

Primary care physicians differed on whether the recommendations are a good idea. Some, like Dr. Jacques Carter, assistant professor of medicine at Harvard Medical School, insisted that "screening for prostate cancer saves lives." Others, like Dr. Jim Jirjis, director of adult primary care at Vanderbilt University, said they had already begun to recommend against the tests. Still, others said that the decision needed to be made on a case-by-case basis.

"I agree that screening for prostate cancer in men in general is a bad idea," said Dr. John Messmer, associate professor of family and community medicine at Penn State Hershey College of Medicine. "That being said, the possibility of obtaining a PSA on a man with particular circumstances should still be an option."

As for the millions of middle-aged and older men who find themselves in the middle of this debate, the consensus among the physicians is for them to communicate openly with their doctors.

"This does not preclude a patient from asking for the test and the physician offering the test," says LeFevre. "There should be an open and honest discussion with significant known harms."

And while the USPSTF's recommendations may drastically reduce the number of men who undergo a PSA blood test, those considered to have a strong family history of prostate cancer -- in other words, more than one first degree relative with prostate cancer before the age of 69 -- may still want to consider getting it.

Copyright 2012 ABC News Radio

Monday
May212012

'Gummy Bear' Breast Implants: The Future of Breast Augmentation Surgery?

Dr. Grant Stevens, a plastic surgeon in Marina Del Rey, Calif., coined the term, "gummy bear breast implant" for a type of silicone implant. (ABC News)(LOS ANGELES) -- Like kids in a candy store, more women are seeking out a type of silicone breast implant that one doctor calls the "gummy bear."

Dr. Grant Stevens, a prominent plastic surgeon in Marina Del Rey, Calif., coined the term "gummy bear breast implant." He said he gave the implants their catchy nickname because when cut in half, the implant is stable and retains its shape, much like the chewy, gummy bear candies.

Stevens is an advocate of the "gummy bears" because he said he believes they look and feel more like natural breasts. He insisted that "gummy bears" are also safer than other types of implants because they have a lower rupture rate.

These new "high-strength silicone gel implants" made by a company called Sientra were approved in March by the U.S. Food and Drug Administration. But neither the agency nor the company call them "gummy bears."

"We do not condone the use of such terms," Sientra CEO Hani Zeini told Nightline via email.

Zeini said equating a medical device to a piece of candy trivializes it, and FDA officials are inclined to agree.

Breasts are big business in the United States, with about $1 billion spent on cosmetic breast surgery a year. According to the American Society of Plastic Surgeons, more than 300,000 American women undergo cosmetic breast augmentation every year -- up 45 percent since 2000.

Improvements in breast implant technology have had a huge impact on the market in the past. Over the past 15 years, since silicone implants became widely available in the U.S., the number of cosmetic procedures has tripled.

For years, this type of high-strength silicone gel breast implant was only available to patients in the U.S. who were willing to take part in clinical trials through surgeons like Stevens.

For some patients, it's their second breast augmentation surgery. Aubrie Chacon said she wanted to get her breast implants redone because her current ones felt like "weird water" under her skin.

"I would like something that felt more natural," she said. "Not so fake, not so foreign."

Christy Carlton, another one of Stevens's patients, said she got her Sientra breast implants through a clinical trial six years ago, and hasn't had any problems since. She added that her partner didn't know that she had breast augmentation surgery until she told him because she said her breasts looked and felt so natural.

But breast surgery is a sensitive subject. In most cases, it's totally elective and, of course, it is closely tied to the patient's self image. Plus, when any new product is introduced, there is a real issue of safety and there have been problems in the past.

Europe is in the midst of a full scale recall of breast implants manufactured by the French company Poly Implant Prothese. Some of PIP's silicone implants, which were never sold in the U.S., were found to contain industrial-grade silicone gel of the type used in mattresses. While the risk remains unclear, thousands of women around the world had to have their implants removed over concerns that PIP's implants tended to rupture and leak. The company's CEO is now in jail.

The FDA said it had no opinion on whether these Sientra implants are better or worse than the ones already on the market, and the agency said it did not conduct tests to compare different kinds of implants. But FDA officials told Nightline that Sientra's eight-year clinical trial with the Sientra implants, which tested the product on nearly 1,800 women, showed that the implants were safe and effective. Although Stevens swears by what he calls the "gummy bear" implants, other plastic surgeons don't. Dr. Garth Fischer is one of the top plastic surgeons in Beverly Hills and a consultant on the ABC TV show Extreme Makeovers. His clientele includes several celebrities -- he's the plastic surgeon Bruce Jenner turned to correct several bad face-lifts done by other surgeons. Fischer also fixed Lisa Rinna's lips.

Fischer said while he sees the benefits of the "gummy bears," he prefers the conventional round implants, and suggested that surgeons who don't have his skills may use the "gummy bears" as a crutch.

"'Gummy bears' have been around a long time," he said. "[But] I think some doctors need that shape maybe because they can't create it on their own."

Dr. Robin Yuan is another prominent Beverly Hills plastic surgeon and the author of Behind the Mask, Beneath the Glitter, a guide for patients considering a surgeon. He acknowledged that it can be confusing for patients, especially when doctors sell one technique over another, and patients have little basis to judge which approach is best for them.

"You can't say a Rolls Royce is better than a Ferrari," he said. "They're both cars that get you from A to B but they have different characteristics."

"I think there are very few patients who go to a neurosurgeon and ask what drill they're going to use to open their skull," Yuan said. "But they ask that of plastic surgeons. Most of the time, in other professions, they just trust the doctor to do what's appropriate in certain conditions."

Whether patients are considering the "gummy bears" or something else, the bottom line is to find a doctor you trust.

Copyright 2012 ABC News Radio

Monday
May212012

Moderate Weight Loss Can Decrease Breast Cancer Risk

iStockphoto/Thinkstock(SEATTLE) -- Could moderate weight loss lower your chance of developing breast cancer? Researchers from the Fred Hutchinson Cancer Research Center think it's possible.

The connection between obesity and breast cancer risk in women after menopause has long been suspected. Specifically, weight gain from early adulthood into the 60s has been consistently associated with risk of breast cancer after menopause. Cancer researchers believe the reason for this is that fat tissue becomes a major source of estrogen in postmenopausal women, and this estrogen causes certain types of tumors in the breast to grow. Because obese women have more fat tissue, they make more estrogen when compared with women who are thin.

Now, this new study shows for the first time that weight loss directly lowers hormones linked to breast cancer.

Dr. Anne McTiernan, director of the Prevention Center at Fred Hutchinson in Seattle, Wash., and author of the study, said that postmenopausal women who reduce their weight moderately through diet and exercise can lower the amount of these hormones circulating through their bodies, which can in turn decrease their risk of developing breast cancer.

Up to 75 percent of postmenopausal women with breast cancer have the estrogen receptor positive variety, meaning that these cancer cells will grow when estrogen is present. McTiernan estimated that reducing these estrogen levels through weight loss can lower a woman's chance of estrogen sensitive breast cancer by as much as 50 percent.

"Twenty-five to 50 percent breast cancer reduction is estimated based on how much we know estrogen can affect breast cancer risk," she said. "There were nine studies who had been done that showed women with the highest estrogen/testosterone levels had at least a two times increased risk of breast cancer. We estimated that we could see that reduction based on these studies."

Importantly, the study found that even modest weight loss can lower breast cancer risk.

"One main point is that women don't have to be like the 'Biggest Loser,'" McTiernan said. "A lot of people are thinking for general health benefits that they have to lose 50 pounds if they are 200 pounds. That's not what we are seeing.

"Having a first goal of 10 percent of weight lost can have major health effects; it's not as difficult as people are thinking it is."

One of the world's leading epidemiologists, Dr. Walter Willett of Harvard University said the findings were supported by past research.

"From many studies, we know that lower levels [of sex hormones] reduce risk of breast cancer," Willett said. "We have seen that levels of estrogens are about three times higher in obese compared to lean women."

"Weight loss by postmenopausal women is one of the best ways to reduce risk of breast cancer."

Willett also mentions a study showing that women who lost a moderate amount of weight had a 60 percent lower risk of breast cancer.

"And best of all are the side effects: lower risk of diabetes, heart disease, stroke, and other forms of cancer," he said.

While other experts agree weight loss is important they note that there is limited evidence to support these findings.

There is "no direct evidence for this at present," said Dr. Clifford A. Hudis of Memorial Sloan-Kettering Cancer Center in New York.

But, he said, "There is no argument in favor of obesity. Protection from breast cancer is simply one more good reason to be thin, whether it actually prevents breast (or other) cancers needs to be confirmed."

Copyright 2012 ABC News Radio

Monday
May212012

Spider Phobics Hold Hairy Tarantula, Get Cured

Katherina Hauner(CHICAGO) -- B.D., a 34-year-old with a lifelong fear of spiders, found his phobia intensified after a trip to Australia where he encountered the Huntsman variety, a hairy tarantula that scuttles out from behind curtains and is notorious for entering cars and scurrying across the dashboard.

But today, after two hours of exposure therapy as part of a study at Northwestern University, B.D. finds spiders tame and amusing -- so much so that he allowed a hairy, Chilean rose tarantula named Florence to amble up his arm.

"It was like the ultimate extreme sport, a chance to face my fears in a very literal sense," B.D., an administrative assistant, wrote on a blog about his experience on his blog, "Room 101."

"It's been three years now, but I am still amazed whenever I react calmly and reasonably to their presence in my life," he wrote. "Just yesterday I helped a big green fellow off my desk, marveling that I didn't flee the room instead."

In 2009, B.D. was paid $100 to take part in a study at Northwestern University's Feinberg's School of Medicine, the first to document the immediate and long-term brain changes after exposure therapy. There, 12 terrified subjects were exposed to a variety of spiders -- first in photos, then in a terrarium and finally in the palm of their hands.

The study revealed that a single brief therapy session for adults with a lifelong fear of spiders -- or arachnophobia -- showed lasting changes to the brain's response to fear.

Arachnophobia is one of the most common specific phobias, and those who are afraid will go to great lengths to make sure they never see a spider. They may avoid hiking or camping or any situation where a spider might be present.

Specific phobias, which fall under anxiety disorders, affect about 7 percent of the population, according to the researchers. The most common include fear of blood, needles, snakes, flying and enclosed spaces.

But they say that their study may be applicable to all kinds of common phobias, as well as obsessive-compulsive disorder and post traumatic stress disorder.

"Before treatment, some of these participants wouldn't walk on grass for fear of spiders or would stay out of their home or dorm room for days if they thought a spider was present," said lead researcher Katherina Hauner, a post-doctoral fellow in neurology.

"But after a two or three-hour treatment, they were able to walk right up and touch or hold a tarantula. And they could still touch it after six months. They were thrilled by what they accomplished."

The study, which was published in the journal, Proceedings of the National Academy of Sciences, was the first to use functional MRIs to measure anxiety in the brain before and after exposure to the feared object.

Not only were patients less afraid after the two-hour therapy session, but they were phobia-free six months later.

The anxiety levels in their brain were measured at different intervals. When subjects experienced fear, certain parts of the brain, like the amygdala, insula, and cingulate cortex, lit up with activity on a functional MRI scan.

When the same study participants were asked to touch the tarantula six months later, "they walked right up to it and touched it," according to Hauner said.

Study participants had to meet the criteria for specific phobias as defined by the American Psychiatric Association's a Diagnostic and Statistical Manual of Mental Disorders.

"They had to be much more afraid of spiders than the average person," said Hauner. "And to meet the diagnostic criteria, it had to interfere with their life."

"Some wouldn't go home or stay in a dorm room for days if they thought a spider was there," she said. "One person avoiding traveling -- but after the study, they went on a trip."

Researchers used hierarchical steps to introduce patients to the feared object, first in photos of different spiders and then approaching a live one.

Copyright 2012 ABC News Radio

Monday
May212012

Mental Health Worker Fatally Stabbed While Delivering Medication

ABC News(ST. HELENS, Ore.) -- The stabbing death of a mental health worker has put the spotlight on the safety of home visits.

Jennifer Warren, 38, was killed Sunday while delivering medication to a patient in St. Helens, Ore., ABC affiliate KATU reported. Warren worked for Columbia Community Mental Health, which provides in-home counseling and medication management for people with mental illness.

"She was a real good worker," Columbia Community Mental Health's director Roland Migchielsen told KATU. "We had her for 10 years, and this is a devastating loss."

The suspect, 30-year-old Brent Redd, was taken to a hospital and treated for injuries, KATU reported. Police would not say whether Redd's injuries were self-inflicted or the result of a struggle with Warren, but did say he called 911 to report what he'd done.

In 2007, Redd was found not guilty by reason of insanity for the attempted murder of his mother. He was sentenced to 20 years under the jurisdiction of the Oregon Psychiatric Security Review Board, a sentence he started serving in Oregon State Hospital. But in 2010, the board granted Redd conditional release into community care.

"Public safety is the first concern of the Psychiatric Security Review Board," Mary Claire Buckley, executive director of the board, said in a statement Sunday. "Today's tragic incident is the first time in 34 years when any client under the board's jurisdiction has been alleged to have committed a violent act of this nature."

Because of patient confidentiality laws, the nature of Redd's mental illness is not known. His family told KATU he had been taking antipsychotic and antidepressant medications, but that the doses had been scaled back for an upcoming surgery.

"Given his past history of violence, that could certainly have put him at an increased risk of becoming psychotic and violent again," said Dr. Ken Robbins, clinical professor of psychiatry at the University of Wisconsin-Madison.

Robbins, who is not involved in Redd's treatment, said courts are usually reluctant to release people who commit violent crimes into the community.

"Presumably, he had received treatment that made mental health professionals believe he was no longer at risk for violence," he said, adding that the continued treatment would have been one of the conditions for Redd's release. "If the antipsychotic and antidepressant medications that had treated his illness were being decreased, one would have to anticipate he might become more unstable, more dangerous."

Robbins said violence is a rare, but a real risk for mental health workers conducting home visits.

"If someone is going to visit someone with a history of psychiatric illness and a history of violence and it's unclear whether they've been compliant with their medications, one obviously has to be very vigilant," he said, describing how workers are trained to look for signs of anxiety. "But the signs can be very hard to read, and these unfortunate instances have nothing to do with a particular mental health worker's skills."

Jerome Fesler, whose wife delivered medication to Redd before quitting over fear for her safety, said workers should be sent on home visits in pairs.

"They should double them up," Fesler told KATU. "They should have someone else. They should be working in pairs, plain and simple. You know, two people is always better than one. You've got someone there that if something does happen. They can call for help."

Robbins believes there is safety in numbers, but that extra workers can also trigger anxiety in patients.

"If you have too many people show up, it can feel crowded and threatening, and you may actually precipitate violence," he said. "On the other hand, there are safety reasons you may want to have two or three people along. You have to think through the pluses and minuses."

More than 400 of the 615 people currently under Oregon's Psychiatric Security Review Board jurisdiction live in the community, according to the board. And since 1978, only 2 percent of the more than 1,400 people found guilty by reason of insanity supervised by the board have committed crimes again.

"You would think if someone committed a crime because they were psychotic, that once the psychosis is treated they shouldn't have to spend their life in a facility," said Collins. "At some point, it would make sense that conditional release be considered, assuming there's a way to make sure they stay on treatment that's working."

Copyright 2012 ABC News Radio