OBJECTIVE: Personalized genomic medicine (PGM) has been lauded as the future of medicine, as new human genomic research findings are applied towards the development of screenings, diagnostic tools and treatments that are tailored to the genomic profiles of individuals. However, the development of PGM is still in its nascent stages, therefore, some have supported the development of clinical tools and treatments based on population-level characteristics, such as race or ethnicity. Race-based medicine (RBM), has been, and continues to be, promoted as an interim form of PGM, and although an academic debate has flourished over medical, social and ethical concerns related to RBM, to date, there have only been a few small studies that have examined lay beliefs and attitudes regarding RBM. The extent to which the greater American public would believe in the effectiveness of RBM and indicate an intention to use RBM is unclear. Furthermore, it is possible that racial and ethnic groups would differ in their beliefs and attitudes regarding RBM, considering RBM implies the controversial and contested conceptualization of race as having some genetic basis. Therefore, the purpose of this dissertation study was to use, for the first time, a nationally representative sample of adult Americans and examine the importance of race with respect to the following: beliefs and attitudes regarding RBM; the extent to which these beliefs and attitudes can be influenced by mass media messages about the relationship between race and genetics; and how beliefs and attitudes regarding RBM compare with those regarding PGM. METHODS: In order to answer these questions, this dissertation study used a nationally representative sample of self-identified non-Hispanic white, non-Hispanic black and Hispanic U.S. residents who participated in an online survey examining beliefs and attitudes regarding RBM and PGM, and the effect of a vignette experiment using mock news articles that varied in their messages about the relationship between race and genes on these beliefs and attitudes. The survey assessed the following constructs using new measures designed for this dissertation study: RBM's effectiveness at the individual, clinical level; PGM's effectiveness at the individual, clinical level; preferences for using RBM; preferences for using PGM; and RBM's ability to address health inequalities in the U.S. Means, frequencies, mean-difference tests and multiple regression were used to examine the effect of race and/or the vignette experiment on beliefs and attitudes regarding RBM and PGM. RESULTS: The results of this dissertation study show that the majority of white, black and Hispanic Americans equally agreed that RBM would not be clinically effective at the individual level, but the majority of all groups also equally agreed that they would prefer to use RBM if it was available. More than forty percent of all respondents who did not believe RBM would be effective at the individual level, still preferred to use a race-specific treatment if it was available. The three racial/ethnic groups examined in this study did diverge in belief in RBM's ability to reduce health inequalities. Greater portions of the black and Hispanic respondents believed RBM would be effective at reducing health inequalities than white respondents. Racial differences were also seen in the effect of the vignette experiment on RBM beliefs and attitudes. While the vignette experiment had no effect on whites' beliefs and attitudes regarding RBM, vignettes that stated or implied a genetic basis to racial difference were associated with lower endorsement of RBM beliefs and attitudes among the black respondents. Finally, the results indicated that both white and black Americans endorsed PGM's effectiveness at the individual level at greater levels than RBM's effectiveness, and both groups indicated greater preferences for using PGM than RBM. However, while most white respondents indicated that they believed PGM would be effective at the individual level and that they would prefer to use PGM if it was available, nearly half of the black respondents did not believe PGM would be clinically effective, and 1 out of 4 black respondents did not prefer to use PGM. CONCLUSIONS: The results suggest that white, black and Hispanic Americans do not significantly differ in their beliefs and attitudes regarding the effectiveness of or preferences for using RBM. This finding diverges from prior studies that showed racial differences in beliefs and attitudes regarding RBM. The lack of racial difference may be due to a lack of familiarity with this concept, for the results also suggested that once respondents were exposed to varying mock news article messages about the relationship between race and genes, racial differences began to emerge. The results also showed discordance between belief in RBM's effectiveness and preferences for using RBM. This finding suggests that there is still an incentive for the pharmaceutical and diagnostic testing industries to develop and market RBM even if there is generally low public opinion regarding RBM's effectiveness. PGM has been promoted by the biomedical industry as a potential solution to racial and ethnic health disparities both in the U.S. and globally, and RBM has been promoted as an interim form of PGM until it is further developed. Despite noted clinical, social and ethical concerns regarding RBM specifically, proponents of RBM have focused on promoting the message of its potential to mitigate racial and ethnic health disparities. The results from this study indicate that on the surface at least, this argument may in fact resonate with black and Hispanic Americans. In addition to being the first nationally representative study to examine potential racial differences in RBM beliefs and attitudes, this dissertation was also the first nationally representative study to examine potential racial differences in beliefs and attitudes regarding PGM. Although the results clearly showed that all Americans endorsed the effectiveness of and preferences for using PGM at greater levels than RBM, whites were significantly more likely than blacks to believe PGM would be clinically effective and to indicate a preference for using PGM. Thus, while the merits of PGM may seem apparent to the clinical and academic communities, the results of this study indicate that there is not universal support for PGM among the public. Cautious support for PGM from black respondents may reflect more general mistrust towards the medical community and new forms of health technologies. Even though racial and ethnic minority populations seem open to RBM and PGM as potential strategies to address health inequalities, support for both could change as the public becomes more familiar with both concepts, whether through exposure to mass media messages, mass marketing of treatments and genetic testing, or through their clinical providers. The findings from this dissertation study significantly advance our knowledge of the American public's beliefs and attitudes regarding RBM and PGM, particularly with respect to racial differences, and should be considered by stakeholders in current and future debates surrounding efforts to develop and promote both.

Bibliography: leaves 259-282. / iii, 282 leaves ; 30 cm. / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / Thesis (Ph.D.)--University of Adelaide, Dept. of Anthropology, 1996

Thesis (DPhil (Sociology and Social Anthropology))--Stellenbosch University, 2008. / The uncertainty and insecurity generated by social transformation within local and global contexts foregrounds concerns with identity. South African society has a legacy of an entrenched racial order which previously privileged those classified ‘white’. The assumed normality in past practices of such an institutionalised system of racial privileging was challenged by a changing social, economic and political context. This dissertation examines the discourse of white middle-class South Africans on this changing context. The study draws on the discourse of Afrikaansspeaking and English-speaking interviewees living in urban and rural communities. Their discourse reveals the extent to which these changes have affected the ways they talk about themselves and others. There is a literature suggesting the significance of race in shaping people’s identity has diminished within the post-apartheid context. This study considers the extent to which the evasion of race suggested in a literature on whiteness is apparent in the discourse on the transformation of the society. By considering this discourse a number of questions are raised on how interviewees conceive their communities and what implication this holds for future racial integration. What is meant by being South African is a related matter that receives attention. The study draws the conclusion that in spite of heightened racial sensitivity, race remains a key factor in the identities of interviewees.

This thesis is a study of the impact of militarisation, conflict and Small Arms and Light Weapons (SALW) proliferation on women and children amongst the pastoralist communities of North East Africa. It explores the way pastoralists communities' lives have changed over the decades with the introduction of SALW to make cattle rustling a lethal pastime that involves all members of society but with implications for the vulnerable population caught between warring groups. The study delves into the variety of options facing them, such as the fact that the dangers posed by introduction of SALW in turn militarises the vulnerable population caught between being helpless bystanders or taking up arms to defend their herds or else perish from hunger when the remaining stock are stolen at gunpoint. After an introductory chapter examining thematic issues involved in the complex web knitted by militarisation, conflict, SALW proliferation, cattle rustling and pastoralist communities, the thesis examines circumstances surrounding the need to wage war on neighbours in cattle raids pitting pastoralist communities' against governments interested in the pursuit of politics that disfavour their interests. The following chapters examine various aspects of this complex militarisation/SALW proliferation/cattle rustling web placing it in the context of the subsequent implications for both the pastoralist communities' vulnerable population and the security of the entire region. It delves into ways the vulnerable population is impacted upon with a view to show that the side effects have far-reaching implications for the pastoralists and citizens of the states they belong to. We analyse existing efforts to combat proliferation and instruments aimed at protecting the vulnerable population in armed conflict with a view to ascertain their strengths and challenges. We finally examine possible ways out of the quagmire resulting from the marriage between SALW proliferation and cattle rustling and conclude by offering policy recommendations.