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Pediatrics International (2014) 56, 759–762
doi: 10.1111/ped.12350
Original Article
Is attitude toward epilepsy and driving affected by media coverage? Akihisa Okumura, Shinpei Abe, Mika Nakazawa and Toshiaki Shimizu Department of Pediatrics, Juntendo University Faculty of Medicine, Tokyo, Japan Abstract
Background: The media have recently reported on car accidents related to persons with epilepsy in Japan. We were concerned that sensational media coverage may worsen the attitude toward epilepsy among non-medical persons. We carried out a questionnaire survey among non-medical students in order to evaluate the effects of media on the attitude toward epilepsy and the holding of a driving license in persons with epilepsy. Methods: The survey was performed using a structured questionnaire. The students were divided into two groups according to knowledge on the recent serious car accidents related to persons with epilepsy. In order to clarify the effects of media coverage, we compared the attitude toward epilepsy and driving in persons with epilepsy between those who knew about the accidents and those who did not. Results: The proportion of students who were familiar with epilepsy was higher in those who knew about the accidents, whereas no significant difference was observed in attitude toward epilepsy. The proportion of students who opposed the idea of persons with epilepsy holding a driving license was not different according to knowledge of the car accidents, whereas that of students who opposed severe punishment of epilepsy patients in the case of a car accident was lower in those who knew about the accidents. Conclusions: Media coverage did not affect the attitude of the participants toward restriction of driving license in persons with epilepsy, whereas the proportion of participants who object to severe punishment for car accidents in persons with epilepsy was decreased.
Key words attitude, car accident, driving license, epilepsy, media coverage.
The misunderstanding of epilepsy can be a greater handicap to persons with epilepsy than the seizures themselves or the adverse effects of anti-epileptic medication.1,2 There have been several studies on public awareness, attitudes, and understanding of epilepsy in many countries,3–7 whereas public understanding of epilepsy has not been investigated sufficiently in Japan. Several severe car accidents caused by persons with epilepsy have recently occurred in Japan. The mass media have reported some of them sensationally and many remarks have been made on the Internet. Although the majority of them are rational and correct, some of them are incorrect and discriminatory, leading to prejudice against persons with epilepsy. We were concerned that sensational media coverage may worsen the attitude toward epilepsy among non-medical persons. We conducted a preliminary questionnaire survey in non-medical university students in order to evaluate the effects of media coverage on attitude toward epilepsy and driving in persons with epilepsy.
Methods Reports on the following three serious car accidents caused by persons with epilepsy have been broadcast widely in Japan: (i) at Correspondence: Akihisa Okumura, MD PhD, Department of Pediatrics, Juntendo University School of Medicine, 2-1-1 Hongou, Bunkyoku, Tokyo 113-8421, Japan. Email: [email protected] Received 15 July 2013; revised 14 November 2013; accepted 24 March 2014.
© 2014 Japan Pediatric Society
Yokkaichi city in December 2010, a car driven by a patient with epilepsy pushed several persons into a train crossing, and two persons were hit by a train and died; (ii) at Kanuma city in April 2011, a mobile crane driven by a patient with epilepsy ran over a row of elementary school children, and six children died; and (iii) at Kyoto city in April 2012, a car driven by a patient with epilepsy sped into a crowded crossing, and seven persons and the driver died and another 11 persons were injured. Among these accidents, the latter two have been reported sensationally and led to hot debates on social aspects of epilepsy. We conducted a questionnaire survey on familiarity with epilepsy, and attitude towards epilepsy and the holding of a driving license by persons with epilepsy among students attending Juntendo University School of Health and Sports Science. The survey was performed in October 2012 using a short structured questionnaire, before one (AS) of the authors gave a lecture on basic knowledge of neurological diseases among children. Participants were informed that the results of the survey might be presented in academic meetings or journals. The age and sex were included in the questionnaire, whereas additional personal information that could be used to identify the participants was not included. This study was approved by the ethics committee of Juntendo University Faculty of Medicine. The questionnaire consisted of 10 questions (Table 1). Questions 1–7 were adopted from a previous report.8 The first four questions were on familiarity with epilepsy and the latter three were on attitude toward epilepsy. These questions were answered
760
A Okumura et al.
Table 1 The questionnaire Q1. Q2. Q3. Q4. Q5.
Q1
Have you ever read or heard about a disease called epilepsy? Is there anyone with epilepsy among your acquaintance? Have you ever witnessed a person having an epilepsy seizure? Do you think that epilepsy is a mental disorder? Do you oppose your children playing or attending school with children with epilepsy? Q6. Do you think that people with epilepsy should be hired in the same way as other people? Q7. Do you oppose your children marrying a person with epilepsy? Q8. Do you know about the following car accidents caused by persons with epilepsy? A. Yokkaichi accident B. Kanuma accident C. Kyoto accident Q9. Do you think that persons with epilepsy should be prohibited from getting a driving license? Q10. Do you think that severe punishment should be given to persons with epilepsy when they cause a car accident?
100%
All questions but Q8 were answered in terms of “Yes”/“No”/ “Neither”. In Q8, the respondents were required to answer for each of the three accidents in terms of “I know it in detail”/“I know it roughly”/“I do not know it”.
80%
P 30 000 subjects in the USA reported a relative risk of 1.33 (95% confidence interval: 1.00–1.73), which was similar to that in people with diabetes or medical conditions that do not carry driving restrictions, such as cardiovascular disease.13 A case–control study of road traffic accidents did not show any overrepresentation of persons with epilepsy in the accident group,14 and the lifetime risk of road traffic accidents does not differ between those with and without epilepsy.15 These facts were infrequently referred to in the media coverage on car accidents in persons with epilepsy in Japan. In such a situation, emotional discussion tends to be predominant. The present results indicate insufficient promotion of correct information regarding epilepsy and driving. Although there have been no studies on the relationship between the severity of punishment and the occurrence of car accidents, severe punishment can result in non-compliance with legal standards, especially in those with insufficient seizure control, and can fail to reduce the risk of car accidents in persons with epilepsy. Drazkowski et al. showed that allowing people with epilepsy to drive following shorter seizurefree intervals would probably promote better compliance.16 Reducing the driver restriction from a 12 month seizure-free interval to a 3 month seizure-free interval did not significantly increase the incidence of car crashes and deaths from seizures in the 3 years following implementation. Calm debate based on objective data and promotion of correct information on epilepsy will be necessary to reach an appropriate consensus. We should be conscious of the effect of the media, especially that of the Internet, on the attitude toward epilepsy, although it is not clear in the present study. McNeil et al. investigated the potential of Twitter for information dissemination and concluded that although Twitter has the power to positively affect how epilepsy and seizures are perceived, the stigma surrounding epilepsy is still being perpetuated.17 Mott et al. reported that elementary school teachers frequently cited the Internet as their primary source of information on epilepsy.18 Some studies on YouTube showed that YouTube videos can be used as an excellent patient resource for infantile spasms19 and that video-sharing websites including YouTube may have the potential to correct the misinformation and the stigma surrounding epilepsy.20 These studies clearly indicated that the Internet has the ability to shape people’s perceptions of epilepsy. © 2014 Japan Pediatric Society
762
A Okumura et al.
There are shortcomings in the present study. First, there has been no standard questionnaire on knowledge, attitudes, and perception of epilepsy. This makes it difficult to compare the present results with those of other studies. The present participants do not represent the general public in Japan. It is clear that the attitude toward epilepsy is affected by several factors including age, education, and socioeconomic status.21–23 The explanatory power of the present investigation was limited by the small number of questions. A more detailed questionnaire or interview will improve the explanatory power of this kind of study. Conclusion
The present questionnaire survey, although preliminary, provides information on the attitude of non-medical persons toward epilepsy and driving in persons with epilepsy. The media coverage did not affect the attitude of the participants toward restriction of driving license in persons with epilepsy, whereas the proportion of participants who objected to severe punishment for car accidents in persons with epilepsy was decreased. Future studies should focus on the effects of media on knowledge, attitudes, and perception of epilepsy in the general public. These data are needed to improve the public understanding of, and attitude toward, epilepsy.
Acknowledgment All authors have no conflict of interest in relation to this manuscript.
References 1 Williams J. Learning and behavior in children with epilepsy. Epilepsy Behav. 2003; 4: 107–11. 2 Williams J, Phillips T, Griebel M et al. Factors associated with academic achievement in children with controlled epilepsy. Epilepsy Behav. 2001; 2: 217–23. 3 Mecarelli O, Capovilla G, Romeo A, Rubboli G, Tinuper P, Beghi E. Past and present public knowledge and attitudes toward epilepsy in Italy. Epilepsy Behav. 2010; 18: 110–15. 4 Mecarelli O, Capovilla G, Romeo A, Rubboli G, Tinuper P, Beghi E. Knowledge and attitudes toward epilepsy among primary and secondary schoolteachers in Italy. Epilepsy Behav. 2011; 22: 285– 92. 5 McEwan L, Taylor J, Casswell M et al. Knowledge of and attitudes expressed toward epilepsy by carers of people with epilepsy: A UK perspective. Epilepsy Behav. 2007; 11: 13–19. 6 Rafael F, Dubreuil CM, Burbaud F et al. Knowledge of epilepsy in the general population based on two French cities: Implications for stigma. Epilepsy Behav. 2010; 17: 82–6.
© 2014 Japan Pediatric Society
7 Aragon CE, Hess T, Burneo JG. Knowledge and attitudes about epilepsy: A survey of dentists in London, Ontario. J. Can. Dent. Assoc. 2009; 75: 450. 8 Hills MD, Mackenzie HC. New Zealand community attitudes toward people with epilepsy. Epilepsia 2002; 43: 1583–9. 9 Okumura A, Watanabe K. Questionnaire survey on the understanding of epilepsy among non-medical persons. Pediatr. Int. 2008; 50: 319–21. 10 Gastaut H, Zifkin BG. The risk of automobile accidents with seizures occurring while driving: Relation to seizure type. Neurology 1987; 37: 1613–16. 11 Gilliam F, Kuzniecky R, Faught E, Black L, Carpenter G, Schrodt R. Patient-validated content of epilepsy-specific quality-of-life measurement. Epilepsia 1997; 38: 233–6. 12 Classen S, Crizzle AM, Winter SM, Silver W, Eisenschenk S. Evidence-based review on epilepsy and driving. Epilepsy Behav. 2012; 23: 103–12. 13 Hansotia P, Broste SK. The effect of epilepsy or diabetes mellitus on the risk of automobile accidents. N. Engl. J. Med. 1991; 324: 22–6. 14 Gislason T, Tomasson K, Reynisdottir H, Bjornsson JK, Kristbjarnarson H. Medical risk factors amongst drivers in singlecar accidents. J. Intern. Med. 1997; 241: 213–19. 15 McLachlan RS, Starreveld E, Lee MA. Impact of mandatory physician reporting on accident risk in epilepsy. Epilepsia 2007; 48: 1500–5. 16 Drazkowski JF, Fisher RS, Sirven JI et al. Seizure-related motor vehicle crashes in Arizona before and after reducing the driving restriction from 12 to 3 months. Mayo Clin. Proc. 2003; 78: 819– 25. 17 McNeil K, Brna PM, Gordon KE. Epilepsy in the Twitter era: A need to re-tweet the way we think about seizures. Epilepsy Behav. 2012; 23: 127–30. 18 Mott J, Shellhaas RA, Joshi SM. Knowledge of epilepsy and preferred sources of information among elementary school teachers. J. Child Neurol. 2013; 28: 740–44. 19 Fat MJ, Doja A, Barrowman N, Sell E. YouTube videos as a teaching tool and patient resource for infantile spasms. J. Child Neurol. 2011; 26: 804–9. 20 Lo A, Esser MJ, Gordon K. YouTube: A gauge of public perception and awareness surrounding epilepsy. Epilepsy Behav. 2010; 17: 541–5. 21 Bozkaya IO, Arhan E, Serdaroglu A, Soysal AS, Ozkan S, Gucuyener K. Knowledge of, perception of, and attitudes toward epilepsy of schoolchildren in Ankara and the effect of an educational program. Epilepsy Behav. 2010; 17: 56–63. 22 Spatt J, Bauer G, Baumgartner C et al. Predictors for negative attitudes toward subjects with epilepsy: A representative survey in the general public in Austria. Epilepsia 2005; 46: 736– 42. 23 Chung K, Ivey SL, Guo W et al. Knowledge, attitudes, and practice toward epilepsy (KAPE): A survey of Chinese and Vietnamese adults in the United States. Epilepsy Behav. 2010; 17: 221–7.
Copyright of Pediatrics International is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
Pediatrics International (2014) 56, 759–762
doi: 10.1111/ped.12350
Original Article
Is attitude toward epilepsy and driving affected by media coverage? Akihisa Okumura, Shinpei Abe, Mika Nakazawa and Toshiaki Shimizu Department of Pediatrics, Juntendo University Faculty of Medicine, Tokyo, Japan Abstract
Background: The media have recently reported on car accidents related to persons with epilepsy in Japan. We were concerned that sensational media coverage may worsen the attitude toward epilepsy among non-medical persons. We carried out a questionnaire survey among non-medical students in order to evaluate the effects of media on the attitude toward epilepsy and the holding of a driving license in persons with epilepsy. Methods: The survey was performed using a structured questionnaire. The students were divided into two groups according to knowledge on the recent serious car accidents related to persons with epilepsy. In order to clarify the effects of media coverage, we compared the attitude toward epilepsy and driving in persons with epilepsy between those who knew about the accidents and those who did not. Results: The proportion of students who were familiar with epilepsy was higher in those who knew about the accidents, whereas no significant difference was observed in attitude toward epilepsy. The proportion of students who opposed the idea of persons with epilepsy holding a driving license was not different according to knowledge of the car accidents, whereas that of students who opposed severe punishment of epilepsy patients in the case of a car accident was lower in those who knew about the accidents. Conclusions: Media coverage did not affect the attitude of the participants toward restriction of driving license in persons with epilepsy, whereas the proportion of participants who object to severe punishment for car accidents in persons with epilepsy was decreased.
Key words attitude, car accident, driving license, epilepsy, media coverage.
The misunderstanding of epilepsy can be a greater handicap to persons with epilepsy than the seizures themselves or the adverse effects of anti-epileptic medication.1,2 There have been several studies on public awareness, attitudes, and understanding of epilepsy in many countries,3–7 whereas public understanding of epilepsy has not been investigated sufficiently in Japan. Several severe car accidents caused by persons with epilepsy have recently occurred in Japan. The mass media have reported some of them sensationally and many remarks have been made on the Internet. Although the majority of them are rational and correct, some of them are incorrect and discriminatory, leading to prejudice against persons with epilepsy. We were concerned that sensational media coverage may worsen the attitude toward epilepsy among non-medical persons. We conducted a preliminary questionnaire survey in non-medical university students in order to evaluate the effects of media coverage on attitude toward epilepsy and driving in persons with epilepsy.
Methods Reports on the following three serious car accidents caused by persons with epilepsy have been broadcast widely in Japan: (i) at Correspondence: Akihisa Okumura, MD PhD, Department of Pediatrics, Juntendo University School of Medicine, 2-1-1 Hongou, Bunkyoku, Tokyo 113-8421, Japan. Email: [email protected] Received 15 July 2013; revised 14 November 2013; accepted 24 March 2014.
© 2014 Japan Pediatric Society
Yokkaichi city in December 2010, a car driven by a patient with epilepsy pushed several persons into a train crossing, and two persons were hit by a train and died; (ii) at Kanuma city in April 2011, a mobile crane driven by a patient with epilepsy ran over a row of elementary school children, and six children died; and (iii) at Kyoto city in April 2012, a car driven by a patient with epilepsy sped into a crowded crossing, and seven persons and the driver died and another 11 persons were injured. Among these accidents, the latter two have been reported sensationally and led to hot debates on social aspects of epilepsy. We conducted a questionnaire survey on familiarity with epilepsy, and attitude towards epilepsy and the holding of a driving license by persons with epilepsy among students attending Juntendo University School of Health and Sports Science. The survey was performed in October 2012 using a short structured questionnaire, before one (AS) of the authors gave a lecture on basic knowledge of neurological diseases among children. Participants were informed that the results of the survey might be presented in academic meetings or journals. The age and sex were included in the questionnaire, whereas additional personal information that could be used to identify the participants was not included. This study was approved by the ethics committee of Juntendo University Faculty of Medicine. The questionnaire consisted of 10 questions (Table 1). Questions 1–7 were adopted from a previous report.8 The first four questions were on familiarity with epilepsy and the latter three were on attitude toward epilepsy. These questions were answered
760
A Okumura et al.
Table 1 The questionnaire Q1. Q2. Q3. Q4. Q5.
Q1
Have you ever read or heard about a disease called epilepsy? Is there anyone with epilepsy among your acquaintance? Have you ever witnessed a person having an epilepsy seizure? Do you think that epilepsy is a mental disorder? Do you oppose your children playing or attending school with children with epilepsy? Q6. Do you think that people with epilepsy should be hired in the same way as other people? Q7. Do you oppose your children marrying a person with epilepsy? Q8. Do you know about the following car accidents caused by persons with epilepsy? A. Yokkaichi accident B. Kanuma accident C. Kyoto accident Q9. Do you think that persons with epilepsy should be prohibited from getting a driving license? Q10. Do you think that severe punishment should be given to persons with epilepsy when they cause a car accident?
100%
All questions but Q8 were answered in terms of “Yes”/“No”/ “Neither”. In Q8, the respondents were required to answer for each of the three accidents in terms of “I know it in detail”/“I know it roughly”/“I do not know it”.
80%
P 30 000 subjects in the USA reported a relative risk of 1.33 (95% confidence interval: 1.00–1.73), which was similar to that in people with diabetes or medical conditions that do not carry driving restrictions, such as cardiovascular disease.13 A case–control study of road traffic accidents did not show any overrepresentation of persons with epilepsy in the accident group,14 and the lifetime risk of road traffic accidents does not differ between those with and without epilepsy.15 These facts were infrequently referred to in the media coverage on car accidents in persons with epilepsy in Japan. In such a situation, emotional discussion tends to be predominant. The present results indicate insufficient promotion of correct information regarding epilepsy and driving. Although there have been no studies on the relationship between the severity of punishment and the occurrence of car accidents, severe punishment can result in non-compliance with legal standards, especially in those with insufficient seizure control, and can fail to reduce the risk of car accidents in persons with epilepsy. Drazkowski et al. showed that allowing people with epilepsy to drive following shorter seizurefree intervals would probably promote better compliance.16 Reducing the driver restriction from a 12 month seizure-free interval to a 3 month seizure-free interval did not significantly increase the incidence of car crashes and deaths from seizures in the 3 years following implementation. Calm debate based on objective data and promotion of correct information on epilepsy will be necessary to reach an appropriate consensus. We should be conscious of the effect of the media, especially that of the Internet, on the attitude toward epilepsy, although it is not clear in the present study. McNeil et al. investigated the potential of Twitter for information dissemination and concluded that although Twitter has the power to positively affect how epilepsy and seizures are perceived, the stigma surrounding epilepsy is still being perpetuated.17 Mott et al. reported that elementary school teachers frequently cited the Internet as their primary source of information on epilepsy.18 Some studies on YouTube showed that YouTube videos can be used as an excellent patient resource for infantile spasms19 and that video-sharing websites including YouTube may have the potential to correct the misinformation and the stigma surrounding epilepsy.20 These studies clearly indicated that the Internet has the ability to shape people’s perceptions of epilepsy. © 2014 Japan Pediatric Society
762
A Okumura et al.
There are shortcomings in the present study. First, there has been no standard questionnaire on knowledge, attitudes, and perception of epilepsy. This makes it difficult to compare the present results with those of other studies. The present participants do not represent the general public in Japan. It is clear that the attitude toward epilepsy is affected by several factors including age, education, and socioeconomic status.21–23 The explanatory power of the present investigation was limited by the small number of questions. A more detailed questionnaire or interview will improve the explanatory power of this kind of study. Conclusion
The present questionnaire survey, although preliminary, provides information on the attitude of non-medical persons toward epilepsy and driving in persons with epilepsy. The media coverage did not affect the attitude of the participants toward restriction of driving license in persons with epilepsy, whereas the proportion of participants who objected to severe punishment for car accidents in persons with epilepsy was decreased. Future studies should focus on the effects of media on knowledge, attitudes, and perception of epilepsy in the general public. These data are needed to improve the public understanding of, and attitude toward, epilepsy.
Acknowledgment All authors have no conflict of interest in relation to this manuscript.
References 1 Williams J. Learning and behavior in children with epilepsy. Epilepsy Behav. 2003; 4: 107–11. 2 Williams J, Phillips T, Griebel M et al. Factors associated with academic achievement in children with controlled epilepsy. Epilepsy Behav. 2001; 2: 217–23. 3 Mecarelli O, Capovilla G, Romeo A, Rubboli G, Tinuper P, Beghi E. Past and present public knowledge and attitudes toward epilepsy in Italy. Epilepsy Behav. 2010; 18: 110–15. 4 Mecarelli O, Capovilla G, Romeo A, Rubboli G, Tinuper P, Beghi E. Knowledge and attitudes toward epilepsy among primary and secondary schoolteachers in Italy. Epilepsy Behav. 2011; 22: 285– 92. 5 McEwan L, Taylor J, Casswell M et al. Knowledge of and attitudes expressed toward epilepsy by carers of people with epilepsy: A UK perspective. Epilepsy Behav. 2007; 11: 13–19. 6 Rafael F, Dubreuil CM, Burbaud F et al. Knowledge of epilepsy in the general population based on two French cities: Implications for stigma. Epilepsy Behav. 2010; 17: 82–6.
© 2014 Japan Pediatric Society
7 Aragon CE, Hess T, Burneo JG. Knowledge and attitudes about epilepsy: A survey of dentists in London, Ontario. J. Can. Dent. Assoc. 2009; 75: 450. 8 Hills MD, Mackenzie HC. New Zealand community attitudes toward people with epilepsy. Epilepsia 2002; 43: 1583–9. 9 Okumura A, Watanabe K. Questionnaire survey on the understanding of epilepsy among non-medical persons. Pediatr. Int. 2008; 50: 319–21. 10 Gastaut H, Zifkin BG. The risk of automobile accidents with seizures occurring while driving: Relation to seizure type. Neurology 1987; 37: 1613–16. 11 Gilliam F, Kuzniecky R, Faught E, Black L, Carpenter G, Schrodt R. Patient-validated content of epilepsy-specific quality-of-life measurement. Epilepsia 1997; 38: 233–6. 12 Classen S, Crizzle AM, Winter SM, Silver W, Eisenschenk S. Evidence-based review on epilepsy and driving. Epilepsy Behav. 2012; 23: 103–12. 13 Hansotia P, Broste SK. The effect of epilepsy or diabetes mellitus on the risk of automobile accidents. N. Engl. J. Med. 1991; 324: 22–6. 14 Gislason T, Tomasson K, Reynisdottir H, Bjornsson JK, Kristbjarnarson H. Medical risk factors amongst drivers in singlecar accidents. J. Intern. Med. 1997; 241: 213–19. 15 McLachlan RS, Starreveld E, Lee MA. Impact of mandatory physician reporting on accident risk in epilepsy. Epilepsia 2007; 48: 1500–5. 16 Drazkowski JF, Fisher RS, Sirven JI et al. Seizure-related motor vehicle crashes in Arizona before and after reducing the driving restriction from 12 to 3 months. Mayo Clin. Proc. 2003; 78: 819– 25. 17 McNeil K, Brna PM, Gordon KE. Epilepsy in the Twitter era: A need to re-tweet the way we think about seizures. Epilepsy Behav. 2012; 23: 127–30. 18 Mott J, Shellhaas RA, Joshi SM. Knowledge of epilepsy and preferred sources of information among elementary school teachers. J. Child Neurol. 2013; 28: 740–44. 19 Fat MJ, Doja A, Barrowman N, Sell E. YouTube videos as a teaching tool and patient resource for infantile spasms. J. Child Neurol. 2011; 26: 804–9. 20 Lo A, Esser MJ, Gordon K. YouTube: A gauge of public perception and awareness surrounding epilepsy. Epilepsy Behav. 2010; 17: 541–5. 21 Bozkaya IO, Arhan E, Serdaroglu A, Soysal AS, Ozkan S, Gucuyener K. Knowledge of, perception of, and attitudes toward epilepsy of schoolchildren in Ankara and the effect of an educational program. Epilepsy Behav. 2010; 17: 56–63. 22 Spatt J, Bauer G, Baumgartner C et al. Predictors for negative attitudes toward subjects with epilepsy: A representative survey in the general public in Austria. Epilepsia 2005; 46: 736– 42. 23 Chung K, Ivey SL, Guo W et al. Knowledge, attitudes, and practice toward epilepsy (KAPE): A survey of Chinese and Vietnamese adults in the United States. Epilepsy Behav. 2010; 17: 221–7.
Copyright of Pediatrics International is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
