A prime diffi culty facing all people with epilepsy is dealing with the stigma which is associated with it in almost all societies. Stigma arises from the perception of difference from the norm, particularly powerful when that difference is not understood. This arises from the uniquely human need for predictability, resulting from the ability to think abstractly, and thus to surmise the future. A failure of expectation, or the uncertainty caused by an inability to predict, causes insecurity, or a “fear of the unknown”, which we try to reduce by rejecting its perceived cause. Stigma can be attached to themselves or their epilepsy by the person with epilepsy, as well as by others about them. Such discomfort is accentuated by perceived inconsistency between the familiar and unfamiliar. Discrimination occurs as a result of stigma, causing people with epilepsy to be preoccupied with epilepsy and expending much psychological energy on disclosure anxiety, vigilance and a consequent uncertainty of identity. This can result in lower self-esteem, self-fulfi lling prophecies, self-blame and self-rejection, and ultimately dehumanisation. The most effective means of overcoming stigma is by contact between people with epilepsy and those holding the stigma against them. Such contact must be on an equal status footing, repeated and consistent, require interdependence, be socially approved and enjoyable, contradict the stereotypes held, and be with individuals seen as representative of the out-group as a whole. Hence familiarity, rather than breeding contempt, produces the predictability and consequent comfort and acceptability of the normal.

Epilepsy has many non-medical effects on the people with epilepsy, their family and community. To ensure that epilepsy is fully controlled requires a specialist neurologist or paediatrician with up-todate detailed knowledge to diagnose and prescribe treatment, a general practitioner to supervise dayto-day medical management and an epilepsy specialist community worker to provide psychosocial support, information and education to help maintain quality of life. By working together as a team, the specialist, the general practitioner and the epilepsy specialist community worker can ensure that the psychological and social impact of epilepsy is reduced to a minimum.

The Epilepsy New Zealand Field Officer scheme is a model for the provision of community care for people with epilepsy. Epilepsy New Zealand is a voluntary organization. It runs the community care service by employing 27 Field Officers throughout the country. The Officers provide support and information to people with epilepsy, their family and the general public. It is estimated that the service covers about 10% of epilepsy patients in New Zealand. All Field Officers are required to study for nationally recognized Certificate and Diploma in Epilepsy Care qualifications. The funding for this service is by a grant from the Government, charitable trusts and other fund-raising activities.

Introduction: None of the quantitative scale for public attitudes toward epilepsy was translated to Chinese language. This study aimed to translate and test the validity and reliability of a Chinese version of the Public Attitudes Toward Epilepsy (PATE) scale. Methods: The translation was performed according to standard principles and tested in 140 Chinese-speaking adults aged more than 18 years for psychometric validation. Results: The items in each domain had similar standard deviations (equal item variance), ranged from 0.85-0.95 in personal domain and 0.75-1.04 in general domain. The correlation between an item and its domain was 0.4 and above for all, and higher than the correlation with the other domain. Multitrait analysis showed the Chinese PATE had a similar variance, floor and ceiling effects, and relative relationship between the domains, as the original PATE. The Chinese PATE scale showed a similar correlation with almost all demographic variable except age. Item means were generally clustered in the factor analysis as hypothesized. The Cronbach’s α values was within acceptable range (0.773) in the personal domain and satisfactory range (0.693) in the general domain. Conclusion: The Chinese PATE scale is a validated and reliable translated version in measuring the public attitudes toward epilepsy.

Purpose: Seminal oxidative stress (OS) is a recognized factor potentially associated with male infertility, but the efficacy of antioxidant (AOX) therapy is controversial and there is no consensus on its utility. Primary outcomes of this study were to investigate the effect of AOX on spontaneous clinical pregnancy, live birth and miscarriage rates in male infertile patients. Secondary outcomes were conventional semen parameters, sperm DNA fragmentation (SDF) and seminal OS. Materials and Methods: Literature search was performed using Scopus, PubMed, Ovid, Embase, and Cochrane databases.Only randomized controlled trials (RCTs) were included and the meta-analysis was conducted according to PRISMA guidelines. Results: We assessed for eligibility 1,307 abstracts, and 45 RCTs were finally included, for a total of 4,332 infertile patients.We found a significantly higher pregnancy rate in patients treated with AOX compared to placebo-treated or untreated controls, without significant inter-study heterogeneity. No effects on live-birth or miscarriage rates were observed in four studies.A significantly higher sperm concentration, sperm progressive motility, sperm total motility, and normal sperm morphology was found in patients compared to controls. We found no effect on SDF in analysis of three eligible studies. Seminal levels of total antioxidant capacity were significantly higher, while seminal malondialdehyde acid was significantly lower in patients than controls. These results did not change after exclusion of studies performed following varicocele repair. Conclusions The present analysis upgrades the level of evidence favoring a recommendation for using AOX in male infertility to improve the spontaneous pregnancy rate and the conventional sperm parameters. The failure to demonstrate an increase in live-birth rate, despite an increase in pregnancy rates, is due to the very few RCTs specifically assessing the impact of AOX on live-birth rate. Therefore, further RCTs assessing the impact of AOX on live-birth rate and miscarriage rate, and SDF will be helpful.