Background and Objectives: Opioid addiction is a major contributor to the global burden of disease and carries a significant risk of morbidity and mortality. Individuals with opioid addiction are subject to numerous adverse consequences including infectious diseases, medical complications, psychiatric disorders, and social disintegration. Women especially experience a heightened vulnerability to the adverse medical and social consequences of opioid addiction as a result of biological sex characteristics and socially-defined gender roles, which increases their risk for poor treatment outcomes. The general objective of this thesis if to investigate sex and gender differences in the management and treatment of opioid addiction with a focus on hormonal influences, genetic variation, and sociobehavioral characteristics including substance use behavior, health status, and social functioning. Methods: Using various methodologies, we compared the biological and social characteristics of men and women with opioid addiction in the context of methadone treatment. We assessed sex and gender differences in methadone treatment outcomes using a systematic review of the literature and a meta-analysis, which was developed based on published protocol. Next, we used data from the multi-centre GENOA cross-sectional study including 250 patients with opioid addiction recruited from Ontario methadone clinics to measure testosterone levels among men and women compared to non-opioid using controls; total serum testosterone was assayed using ELISA and RIA techniques. Following this study, we conducted a systematic review and meta-analysis to test the effect of opioid use on testosterone levels, performing subgroup analyses by sex and type of opioid used. Using the previous GENOA sample, we then completed genotype analysis on variants of BDNF and DRD2 genes to test the genetic effect on continued opioid use, measured through urine drug screening. Finally, we recruited an additional 503 participants meeting criteria for opioid use disorder who were receiving treatment with methadone, from which we obtained information on drug use patterns and addiction severity using the Maudsley Addiction Profile (MAP) tool to evaluate sex and gender differences. Results: In our initial systematic review, we found 20 studies collectively showing that women were less likely than men to report alcohol use, employment, or legal involvement, but were more likely to misuse amphetamines. Using the GENOA dataset of methadone patients, we found a significant reduction in testosterone level among men but not women, which was associated with methadone dose. We also determined that testosterone did not fluctuate significantly between menstrual cycle phases. In line with these findings, our systematic review showed a significant suppression in mean testosterone level among men that use opioids compared to controls, but not in women. Our results also showed that methadone did not affect testosterone differently than other opioids. Among GENOA participants, BDNF rs6265 and DRD2 rs1799978 genetic variants were not significantly associated with continued opioid use while in methadone maintenance treatment. Our final study identified sex and gender differences in substance use, health status, and social functioning. Women were younger, had children, were current smokers, had higher rates of benzodiazepine use, more frequent physical and psychological health problems, family history of psychiatric disorders, more partner conflict, and began regular use of opioids through a physician prescription. In comparison, men were more likely to be employed and to report cannabis and amphetamine use. Conclusions: This thesis has demonstrated that men and women are differentially affected by opioid addiction and experience sex- and gender-specific challenges throughout the course of methadone treatment that are likely to impact treatment outcomes. The identification of clinically-relevant sex and gender differences is important to our understanding of the addiction profile, and can therefore be used to promote strategies for effective treatment and management of opioid addiction among men and women incorporating both biological and social perspectives. / Thesis / Doctor of Philosophy (PhD)

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"May 2002." Bibliography: leaves 123-144. Aspects of the control of ventilation and an upper airway dilator muscle (genioglossus) are compared between healthy men and women, in an attempt to identify a gender difference that may contribute to the high male prevalence of sleep apnea.

The purpose of this study is to analyze the sources of occupational segregation between men and women. Specifically, three hypotheses are tested. First, do stiff specific training requirements for an occupation increase the likelihood that it is male-dominated, as would be expected from human capital theory? Second, do differences in perceived natural ability between the sexes heavily influence the possibility of an occupation being male- or female-dominated? Finally, do differences in preferences for job attributes between men and women influence the chance of whether an occupation will be male- or female-dominated? The data used in this study cover 495 occupations from 1979 in which on-the-job worker requirements are provided describing workers' level and type of education, natural ability, on-the-job environmental conditions, and physical demands. Occupations are divided into three categories: female-dominated, male-dominated, or neutral. The empirical model uses a multinomial approach to estimate the log of the odds that an occupation is male-dominated relative to being neutral and the log of the odds that an occupation is female-dominated relative to being neutral. The results of this study imply that sizable specific training requirements for an occupation increase the likelihood that it is male-dominated and higher levels of general education requirements increase the possibility that an occupation is female-dominated. There is evidence to support the hypothesis that differences between the sexes' perceived abilities contribute to occupational segregation. Most on-the-job environmental conditions and physical demands do not affect the likelihood that an occupation is male- or female-dominated in contrast to the traditional claim that women prefer more desirable working conditions than men. / Graduation date: 1994

Thesis (M.A.)--University of North Carolina at Wilmington, 2004. / Includes bibliographical references (leaves : [109]-111).

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Research shows that the initial honeymoon phase of a marriage dissolves after some time and differences between the couple begin to hamper the harmony in the relationship. One of these differences is that attributed to gender. This study attempts to study these phases of the relationship. It approaches this issue from an inductive standpoint to counterbalance the deductive quality that pervades most literature in this field. A mixed qualitative and quantitative design was selected in a multiple case study format. An open style interview preceded and followed a Q-sorting exercise. Ten individuals (five couples) who have been married between five and ten years were studied. For several reasons, including the need to widen the cultural base of the research field, the study was conducted in Malta, a Mediterranean culture. The information provided by each participant (called coresearcher here to indicate the empowerment accorded to them in the research), was organized by re-casting it into a narrative form. The accuracy of the narrative was additionally validated by the respective co-researcher and an independent reviewer. The purpose was to construct individual and common stories of the marriage f r om the perspective of difference and harmony. Comparisons between individuals and gender revealed common factors, indicating the generic path of these relationships, and individual factors based on previous history, personality, gender and culture Individual life thanes, the dialectic pattern of relating, and phases i n the relationships were identified. Finally, the results were compared to previous research on love, relational development, gender differences, and attachment. The model of the dialectic was found to be a useful tool for understanding relationships and integrating research. Finally, the implications of this study on counselling, and possibilities for further research were discussed.