INTRODUÇÃO: Os pacientes com distúrbios do desenvolvimento sexual (DDS) constituem um desafio para os profissionais que se empenham no seu tratamento e acompanhamento. São raros os estudos na área psicológica com acompanhamento destes pacientes a longo prazo. Este estudo tem por objetivo avaliar os aspectos psicossociais e sexuais em relação ao diagnóstico etiológico, avaliar a influência de diversas variáveis na manutenção ou mudança da identidade de gênero nos pacientes que atingiram a idade adulta e a qualidade de vida numa grande coorte de pacientes com DDS 46,XY e 46,XX acompanhados em um mesmo serviço a longo prazo. MÉTODOS: O estudo teve caráter principalmente retrospectivo e foi realizado em pacientes com DDS de ambos os sexos acompanhados até o período pós-puberal ou idade adulta, num total de 151 pacientes maiores de 15 anos; destes, 55 pacientes apresentavam cariótipo 46,XX e 96 cariótipo 46,XY, tendo sido incluído neste ultimo grupo 6 pacientes que apresentavam cariótipo 46,XY em mosaicismo com a linhagem 45,X. O diagnóstico etiológico do DDS foi estabelecido pela avaliação clínica, citogenética, hormonal e por imagem em todos os casos e na maioria deles complementada pelo diagnóstico molecular. Todos os pacientes foram submetidos a tratamento clinico, psicológico e cirúrgico. Os instrumentos utilizados para a avaliação psicológica foram: a entrevista semi-estruturada com aplicação de um questionário específico com 192 questões, desenvolvido para avaliar os aspectos sociais, profissionais e sexuais, o teste projetivo do HTP para auxiliar na identificação da identidade de gênero e o questionário Whoqol-Bref para avaliar a qualidade de vida. RESULTADOS: A atribuição do sexo social feminino foi predominante em ambos os grupos com DDS. Houve mudança do sexo social em 20% dos pacientes com DDS 46,XY e em 14% dos pacientes com DDS 46,XX. Houve associação significativa da mudança para o gênero masculino nos pacientes do grupo DDS 46,XY por deficiência de 5-redutase 2 quando comparados ao grupo de pacientes com DDS 46,XY por deficiência da produção ou ação da testosterona. Foi encontrada uma maior frequencia de pacientes com orientação homo ou bissexual nas pacientes com sexo social feminino com maior prevalência em pacientes com hiperplasia adrenal virilizante. Nas pacientes com DDS 46,XX por deficiência da 21 hidroxilase não houve influência do número de repetições CAG nos estádios de Prader e na mudança da identidade de gênero. Observamos disforia de gênero em 8 pacientes com DDS 46,XX por deficiência da 21 hidroxilase, sendo que 5 deles mudaram para o sexo social masculino. Todos haviam sido tratados de maneira irregular, apresentaram virilização importante e provinham de famílias de baixa renda, indicando o papel da exposição dos andrógenos e do meio ambiente sobre a identidade de gênero. Três variáveis na análise univariada foram significativamente associadas com a mudança de sexo social para o masculino nos pacientes com DDS 46,XY e DDS 46,XX: brincadeiras masculinas ou neutras na infância, tarefas domiciliares tipicamente masculinas e auto-percepção da aparência física como masculina ou ambígua na infância. Houve associação significativa entre os aspectos da identidade de gênero inicial e o sexo social final no teste do HTP, mostrando ser este um instrumento útil para avaliação dos pacientes com DDS. A qualidade de vida, avaliada pelo teste Whoqol Bref, das pacientes com sexo social feminino foi melhor nas pacientes com DDS 46,XX em comparação com as pacientes com DDS 46,XY. A qualidade de vida dos pacientes com DDS 46,XY registrados no sexo social feminino que mudaram para o sexo social masculino, foi semelhante a daqueles registrados no sexo social masculino. Por outro lado, os pacientes com sexo social final masculino tiveram melhor qualidade de vida quando comparados aos pacientes com sexo social final feminino. O diagnóstico etiológico não teve influência sobre o grau de satisfação pessoal, atribuição do sexo e relacionamento amoroso. CONCLUSÃO: A atribuição do sexo social feminino foi predominante em ambos os grupos. A variável brincadeiras masculinas ou neutras na infância teve valor preditivo para a mudança de sexo social para o masculino nos pacientes com DDS 46,XY e 46,XX educados no sexo social feminino. O teste HTP foi útil na avaliação dos pacientes com DDS. A qualidade de vida dos pacientes 46,XY com sexo social final masculino foi melhor do que a dos pacientes com sexo social final feminino. A maioria dos pacientes referiu elevado índice de satisfação com o tratamento, mostrando a importância de uma equipe multidisciplinar no tratamento dos distúrbios do desenvolvimento sexual. / INTRODUCTION: Patients with disorders of sex development (DSD) constitute a challenge for professionals working in their treatment and follow-up. Studies of patients with DSD have been focused on dissatisfaction in adulthood with sex assigned at birth. However, other parameters, such as psychosocial adjustment, sexual function, psychological health, social integration and the quality of life are rarely described. This study aims to evaluate the professional and psychosocial aspects, in order to identify the variables involved in gender identity and sexual orientation of a large cohort of patients with DSD 46 XY and, 46, XX and also assess the quality of life of patients in adulthood. METHODS: The study was mainly retrospective and was conducted in patients with DSD of both sexes followed until puberty or adulthood, a total of 151 patients older than 15 years; of these, 55 patients had 46, XX karyotype and 96 of them 46,XY karyotype, having been included in the latter group 6 patients who had 46, XY karyotype in mosaicism with the 45, X lineage. Etiological diagnosis of DSD was established by clinical evaluation, cytogenetics, hormonal and image studies in all cases and most of them complemented by molecular diagnosis. All patients underwent surgical and psychological treatment. Instruments used for psychological evaluation were: a semi-structured interview with application of a specific questionnaire with 192 questions developed to assess the social, professional and sexual aspects. The projective HTP test was used to assess gender identity and the Whoqol-Bref questionnaire to evaluate the quality of life. RESULTS: The female social sex assignment was prevalent in both groups with DSD. A change of assigned sex was found in 20% of the 46, XY DSD patients and in 14% of the 46,XX DSD patients. There was a significant association between the change to male social sex with DSD 46, XY due to 5 alpha-RD2 deficiency when compared with DSD 46,XY group due to defects in testosterone secretion or action. A greater frequency of homo or bisexual orientation was found in the patients with female social sex with higher prevalence in patients with virilizing congenital adrenal hyperplasia. In these patients the number of CAG repeats and Prader stage did not influence sexual orientation. We observe gender dysphoria in 8 patients with 46, XX DSD due to 21- hydroxylase deficiency, and 5 of them have changed to the male social sex. All of these patients had been treated irregularly, showed significant virilization and derived from low-income families indicating the role of exposure of androgens and environment on gender identity. Three variables in univariate analysis were significantly associated with change to male social sex in patients with 46, XY DSD and 46, XX DSD educated on female social sex: male or neutral plays in childhood, typically masculine household tasks and self perception of physical appearance as male or ambiguous in childhood but the male or neutral toys in childhood presented the best predictive value of male gender identity in adulthood. There was significant association between aspects of initial gender identity and final gender social sex in HTP test, showing that this is a useful tool for evaluation of patients with DSD. The quality of life of patients with 46,XX DSD was similar to patients with 46, XY DSD however patients with male social sex showed better quality of life than those with female social sex. Similarly, the quality of life of patients with 46, XY DSD the female register social sex who had switched to the male sex social was similar to those assigned in sex male indicating a good social adaptation of patients to new social sex. However, among the patients with female social sex, those with 46,XY DDS showed lower quality of life than 46, XX DSD patients. Male patients with 46,XY DDS had better quality of life than the 46,XY DSD patients with female gender. DDS patients who underwent masculinizing surgery showed better quality of life than the group which underwent feminizing surgery and both groups with DDS showed lower quality of life of patients than patients who undergone to kidney transplantation. The etiological diagnosis had no influence on the assignment of sex and the degree of personal satisfaction. CONCLUSION: Patients with 46,XY and 46, XX DDS showed good social, professional and sexual integration at adulthood. The variable male or neutral plays in childhood had better predictive value of male gender identity in adulthood in patients with 46,X and 46,XX DDS reared in the female social sex. The HTP projective test was useful in the overall assessment of patients with DSD. The quality of life of the patients with male social was better than those with female social sex. Most DSD patients expressed high satisfaction with treatment, showing the importance of a multidisciplinary team in the treatment of the disorders of sex development.

Cette étude cherche à analyser la gestion sociomédicale et quotidienne de l’intersexualité, ainsi que les représentations et pratiques sociales en jeu dans les décisions concernant l’assignation sexuelle des enfants intersex. D’une part, il s’agit de comprendre les perspectives, les pratiques et les discours des professionnels de santé; d’autre part, ceux des jeunes intersex et de leurs familles. A partir d’une ethnographie réalisée à la fois dans un hôpital brésilien et un hôpital français, j’examine comment différents arguments (hormonaux, génétiques, sociaux, morphologiques, psychologiques, entre autres) contribuent à la prise de décision, comment s’organise le travail collectif, et comment fonctionnent les relations entre les différentes spécialités médicales. En ce qui concerne les familles des enfants/jeunes intersex et les jeunes personnes intersex elles-mêmes, j’analyse la manière dont elles sont insérées dans ces négociations, leur relation à la logique biomédicale, la façon dont elles perçoivent le corps intersex et dont elles gèrent l’intersexualité dans leur vie quotidienne. a recherche révèle que le sexe, dans le contexte de la prise de décision, émerge en tant qu’une «catégorie médico-diagnostique» construite à partir d’une combinaison d’éléments. Au Brésil autant qu’en France, la question est traitée de manière plus ou moins homogène: bien que l’accent soit mis de manière différente vis-à-vis d’aspects spécifiques impliqués dans les décisions, dans les deux pays la génétique et la biologie moléculaire sont devenues de plus en plus importantes dans le processus. Il existe également des conflits à l’égard de l’utilisation de la nomenclature «intersex», qui mettent en lumière des «ambiguités» et des tensions autour de la thématique. Enfin, l’étude démontre que les personnes intersex et leurs familles ne partagent pas toujours les mêmes perspectives que les médecins ou bien qu’elles n’utilisent pas les mêmes critères de classification sexuelle que ces derniers. Entre autres questions, tout au long de trajectoires de «corrections» et «régulations» corporelles, se révèle l’insuffisance d’un modèle basé sur des catégories sexuelles dichotomiques. En interrogeant ces dichotomies, les débats autour de l’intersexualité soulignent les limites éthico-théoriques qui circonscrivent le champs de la bioéthique et des droits sexuels en tant que droits humains. Plus loin, ces débats participent à la redéfinition d’autres catégories binaires telles que sexe versus genre, nature versus culture, réel versus artificiel et humain versus non-humain. / Este estudo busca analisar o gerenciamento sociomédico e cotidiano da intersexualidade, bem como as representações e as práticas sociais acionadas nas decisões envolvendo a designação do sexo em crianças intersex. De um lado, tratase de compreender as perspectivas, práticas e discursos de profissionais de saúde e, de outro, aqueles das famílias e jovens intersex. A partir da etnografia realizada em dois hospitais (um hospital brasileiro e outro francês), examino de que modo diferentes argumentos (hormonais, genéticos, sociais, morfológicos, psicológicos, entre outros) concorrem para as tomadas de decisão, de que forma acontece a organização do trabalho coletivo e as relações entre as diferentes especialidades médicas. No que se refere às famílias de crianças/jovens intersex e aos próprios jovens, analiso a maneira como estão inseridos nessas negociações, a forma de se relacionarem com a lógica biomédica, como percebem o corpo intersex e lidam cotidianamente com a intersexualidade. A pesquisa revela que, no contexto das decisões, o sexo surge enquanto uma “categoria médico-diagnóstica”, construída a partir de uma combinação de diferentes elementos. Há um tratamento mais ou menos homogêneo da questão no Brasil e na França e, embora se possa identificar ênfases diferenciadas em relação a determinados aspectos envolvidos nas decisões, nos dois contextos a genética e a biologia molecular vêm ganhando cada vez mais importância no processo. Identificam-se, ainda, embates em torno da nomenclatura “intersex”, os quais, entre outros aspectos, apontam para as “ambigüidades” e tensões que rondam a temática. Finalmente, o estudo demonstra que nem sempre as famílias e as pessoas intersex compartilham com os médicos a mesma perspectiva ou os mesmos critérios de classificação do sexo. Entre outras questões, no decorrer das trajetórias de “correções” e “regulações” corporais denuncia-se a insuficiência de um modelo que prevê categorias sexuais dicotômicas. Ao interpelar essas dicotomias, os debates em torno da intersexualidade escrutinam os limites ético-teóricos que circunscrevem o campo da bioética e dos direitos sexuais enquanto direitos humanos. Além disso, concorrem para a revisão de outras categorias binárias como sexo versus gênero, natureza versus cultura, verdadeiro versus artificial e humano versus não humano. / This study seeks to analyze the sociomedical and day-to-day management of intersexuality, as well as the representations and social practices brought into action in decisions involving sex assignment with intersex children. On the one hand, it aims to understand the perspectives, practices and discourses of health professionals and on the other, those of intersex youth and their families. Starting from an ethnography carried out in one Brazilian and one French hospital, I examine how different arguments (hormonal, genetic, social, morphological, psychological, among others) compete during decision making, in what ways collective work organization takes place and the relationships between the different medical specialties. Regarding the families of intersex children/youth and the young people themselves, I analyze the manner in which they are inserted into these negotiations, the way they are related to the biomedical logic, how they perceive the intersex body and how they deal with intersexuality in their day-to-day lives. The research reveals that sex arises as a “medical-diagnostic category” in the decision making context and that it is constructed from a combination of elements. In both Brazil and France, the question is given a more or less homogeneous treatment; although it is possible to identify some differences in emphases regarding specific aspects involved in the decisions, in both countries genetics and molecular biology have become increasingly important in the process. There are conflicts around the use of "intersex" nomenclature as well, which point to the "ambiguities" and tension surrounding the theme. Finally, the study demonstrates that intersex people and their families do not always hold the same perspectives or use the same sex classification criteria as doctors do. Among other questions, over the course of the various bodily “corrections” and “regulations”, the insufficiency of a model in which the categories are based on a sexual dichotomy is revealed. By questioning these dichotomies, the debates around intersexuality scrutinize the ethical-theoretical limits which circumscribe the field of bioethics and of sexual rights as human rights. Moreover, they compete for a revision of other binary categories, such as sex versus gender, nature versus culture, real versus artificial and human versus non-human.

[pt] O que acontece quando nasce uma criança intersex no Brasil? Para responder a este e a outros questionamentos, o presente trabalho objetiva apresentar um estudo teórico sobre a intersexualidade. Inicialmente será realizada uma análise sobre as divergências envolvendo o tema e em seguida, uma reflexão sobre os corpos para observar, através das transformações interpretativas que sofreram historicamente, se as marcas do sexo e do gênero formam um padrão binário que teria o poder de invisibilizá-los se não for atendido. Através de histórias coletadas, procura-se compreender os critérios utilizados para rotular os corpos como intersex e as experiências vividas por seus protagonistas. Uma análise das intervenções externas a que estes indivíduos foram e são submetidos ao nascer também será realizada, para entender a situação contemporânea. Neste sentido, a teoria winnicottiana será importante ferramenta para não apenas questionar o protocolo atual, mas também trazer a visão da constituição da subjetividade na infância e pensar em uma alternativa de cuidado que respeite esta construção. Os papéis exercidos pelo Direito brasileiro finalizam o estudo para investigar se o mesmo tem funcionado como obstaculizador ou garantidor dos direitos dos menores intersex. Analisa-se se há papéis sendo exercidos em consonância com as alterações internacionais, verificando em diplomas legais vigentes os empecilhos existentes e as possibilidades de pensar sobre o tema. Por fim, um caminho sob a perspectiva do Direito Civil-constitucional será projetado, buscando a admissão de existências plurais, isto é, novas acepções para a consciência do eu, capazes de permitir o pleno desenvolvimento de identidades e respeitar a dignidade da pessoa humana. / [en] What happens when an intersex child is born in Brazil? To answer this and other questions, this study aims to present a theoretical study of intersexuality. Initially, there will be performed an analysis of the divergences involving the theme and then, a reflection on bodies to observe, through the interpretive transformations that they have suffered historically, if the sex and gender marks form a binary standard that would have the power to turn them invisible if not attended. Through collected stories, we seek to understand the criteria used to label bodies as intersex and the experiences of its protagonists. An analysis of the external interventions that these individuals were and are subject to birth, will also be conducted to understand the contemporary situation. In this sense, Winnicott s theory will be an important tool to not only question the current protocol, but also bring the vision of the constitution of subjectivity in childhood and think of an alternative of care that respects this construction. The roles played by the Brazilian Law finalize the study to investigate whether it has functioned as an obstacle or as a guarantor of the rights of intersex infants. We examine whether there are rolls being held in line with international changes, checking in current legislation the existing obstacles and the possibilities to think about the matter. Finally, a path from the perspective of the Civil-constitutional Law will be designed, seeking the admission of plural existences, i.e., new meanings to the consciousness of self, able to allow the full development of identities and respect the human dignity.

Le genre Rumina Risso, 1926 (Subulinidae) est constitué de gastéropodes terrestres, hermaphrodites et capables de réaliser de l’autofécondation ainsi que de la fécondation croisée. Plusieurs espèces ont été décrites sur base de subtiles différences morphologiques telles que la forme et la taille de la coquille et la coloration du corps. Trois espèces sont actuellement toujours reconnue dans la littérature: Rumina decollata (Linnaeus, 1758), R. saharica Pallary, 1901 et R. paivae (Lowe 1861). Cependant, uniquement le statut spécifique de R. decollata et R. saharica a été confirmé par la morphologie de la coquille et l'anatomie génitale. L’objectif de la thèse est de clarifier la taxonomie du genre Rumina par une approche de taxonomie intégrative en associant des caractères moléculaires, morphologiques et anatomiques ainsi que les méthodes issues de la génétique des populations. Quatre gènes mitochondriaux et deux gènes nucléaires ont été séquencés pour reconstruire la phylogénie de Rumina. Les résultats confirment le statut d’espèce de R. saharica, excluent R. paivae en tant qu’espèce et proposent une nouvelle classification pour R. decollata en 6 espèces phylogénétiques. R. saharica est aussi confirmé en tant qu’espèce morphologique suite à une étude morphomètrique, cependant les nouvelles espèces de R. decollata n’ont pas pu être différenciées ni par les variables morphologiques testées, ni par des particularités dans l’anatomie génitale. Néanmoins, deux des espèces de R. decollata correspondent à deux morphotypes (clair et foncé) auparavant décrits et étudiés dans la région de Montpellier. L’étude de ces deux espèces phylogénétiques avec des microsatellites et allozymes permettent de confirmer le statut spécifique des deux morphotypes et révèlent que R. decollata pratique l’autofécondation croisée à un taux supérieur à celui rapporté dans la littérature, défiant ainsi la règle selon laquelle les hermaphrodites pratiqueraient exclusivement l’autofécondation ou exclusivement la fécondation croisée. L’espèce correspondante au morphotype foncé a été introduite en plusieurs endroits du monde et semble être l’espèce possédant la plus grande capacité invasive parmi les Rumina. Ainsi, nos résultats suggèrent que le genre Rumina, auparavant décrit comme étant composé de trois espèces, est en fait un complexe de sept espèces, qui doivent être davantage étudiées de façon à confirmer leur statut d’espèce par d’autres concepts d’espèce. / Rumina spp. Risso, 1826 (family Subulinidae) is a hermaphroditic terrestrial snail, performing both selfing and outcrossing. Several nominal species have been described based on subtle differences in the shape and size of the shell, and body coloration. Currently, three taxa are still recognized, viz. R. decollata (Linnaeus, 1758), R. saharica Pallary, 1901 and R. paivae (Lowe, 1860). Yet, species-specific differentiation has only been confirmed for R. decollata and R. saharica, based on shell and genital morphology. This work aims at resolving the taxonomy of the genus Rumina through an integrative taxonomic approach by combining molecular, morphological and anatomical characters, as well as population genetic methods. Four mitochondrial and two nuclear genes were used to infer Rumina’s phylogeny. Results suggest that R. saharica is a phylogentic species, R. paivae is not a phylogenetic species and R. decollata is composed by 6 phylogenetic species. The specific status of R. saharica was confirmed by a morphometric analysis, however the remaining phylogenetic species of R. decollata could not be differentiated neither by the shell characters analyzed nor by the genital anatomy. Nevertheless, two phylogenetic species of Rumina representing the dark and light colored strains previously described in the Montpellier region. The study of both these strains with microsatellites and allozymes confirmed their specific status and revealed that outcrossing might be more prevalent than was previously suggested in the literature, therefore defying the alleged rule that hermaphroditic species should be either strict self-fertilizers or strict outcrosser. The dark strain was introduced in several places through the world and seems to be the one with highest invasive character within the genus Rumina. Therefore, our results suggest that the genus Rumina, previously described as having three species, is in fact a complex of seven species that need to be further explored in order to confirm their species status under other species concepts. / Doctorat en Sciences / info:eu-repo/semantics/nonPublished

The dusky grouper Epinephelus marginatus (Lowe 1834), is a protogynous sequential hermaphrodite and is considered to be one of the most important fish species in the Mediterranean Sea. It is a K-strategist, being slow growing and late maturing, and this, coupled with its reproductive biology and relatively sedentary behaviour, has made it extremely sensitive to overexploitation, leading it to be classified by the IUCN as an endangered fish species. Wild dusky grouper have suffered from disease outbreaks in the past decade, leading to mass mortalities across the Mediterranean Sea, including Libyan coastal waters. These mortalities have mostly been attributed to Nodavirus infections. In Europe and Brazil, efforts are in place to culture this fish for commercial grow-out and stock enhancement programmes. In Libya, the dusky grouper is consumed regularly and is considered a prime-eating fish. Its importance for the Libyan internal market, as well as its potential for export, makes it an ideal candidate for future Libyan aquaculture activities. Given the scarce literature regarding the dusky grouper in Libya, this study aimed first to assess dusky grouper fisheries, spawning seasons and to identify the main threats that the fishing sector poses for wild stocks. Second this study aimed to determine the health status of wild dusky grouper offered at a local fish market in the capital Tripoli, in order to identify pathogens, pathologies or other health issues that might pose a hazard to cultured populations but also to remaining wild dusky grouper stocks. To achieve these aims, twelve field surveys spanning the period of 2013-2015 were conducted. From these surveys, it was established that the dusky grouper is captured throughout the year, including the spawning season. Fish sizes offered for sale ranged between 20-92 cm total length (TL), with the fish being sold from local fishing grounds around Tripoli, but also from as far as Benghazi, 1300 km to the east of Tripoli. The dusky grouper is principally caught in artisanal fisheries and by spearfishing, with approximately 300 spear-fishermen serving one particular fish market in Tripoli that was a focus in this study, and with dusky grouper being one of their main targets. Over the period of the survey, 267 landed dusky grouper were inspected for visible lesions prior to sampling. A total of 50 dusky grouper with sizes ranging from 27- 66 cm TL including the gonads from a further five fish measuring 66-92 cm TL that were sampled separately and examined to assess the stage of sexual maturity and to look for the presence of parasitic infections mainly affecting the gills, skin and gonads. The spawning season was found to extend from May to early September, with females ranging between 39-68 cm TL, males measuring 57-92 cm TL, and transient fish measuring 58-68 cm TL. From otolith readings of 8 fish, the youngest fish was a 3 year old juvenile of 28 cm TL and the oldest was an 8-9 year old 56 cm TL female. Whilst the highest prevalence of parasitic infection was found to be monogenean infection of the gills, with 100% prevalence, followed by gnathiid isopods infecting the oral cavity with 92% prevalence, it was the nematode Philometra sp. infecting post-spawning ovaries at 52% prevalence, that gave the highest apparent pathological impact. Necrosis potentially attributed to Philometra sp. in one particular ovary, was at a level likely to have caused complete parasitic castration, while others showed varying levels of probable functional reduction. The pathologies described need further investigation, especially in relation to possible synergies between Philometra sp. and bacteria in causing the necrosis. From the 267 inspected dusky grouper, 55 fish ranging in size from 42-92 cm TL were observed to be affected by external skin lesions of unknown aetiology. Twenty-six of these fish were sampled, having lesions at various stages of severity, and 5 further unaffected fish were used for histological assessment of the skin as negative controls. Histopathologically, the lesions comprised a multifocal, unilateral or bilateral dermatitis, involving the epidermis, superficial dermis and scale pockets, and sometimes, in severe cases, the hypodermis. Severe lesions had marked epidermal spongiosis progressing to ulceration. Healing was observed in some fish. Bacteria and fungi could be isolated from severe lesions, although they were not seen histopathologically in early-stage lesions. By contrast, metazoan parasite eggs were observed in the dermis and epidermis of some fish with mild and moderate dermatitis. Unidentified gravid digenean trematodes, carrying similar eggs, were also seen within the blood vessels of the deep and superficial dermis. The newly described condition was termed dusky grouper dermatitis (DGD). DGD’s geographical distribution along the Libyan coastline was investigated using a novel application of the social media network Facebook. Using Facebook, it was possible to document skin lesions of dusky grouper in Libyan waters from images attached to the entries of spear-fishermen. Thirty two Facebook accounts and 8 Facebook groups posting from 23 Libyan coastal cities provided a retrospective observational dataset comprising a total of 382 images of dusky grouper caught by spearfishing from December 2011-December 2015. Skin lesions were observable on 57 / 362 fish, for which images were of sufficient quality for analysis, giving a minimal prevalence for lesions of 15.75%. Only dusky grouper exceeding an estimated 40 cm total length exhibited lesions. The ability to collect useful data about the occurrence and geographical distribution of pathological conditions affecting wild fish using social media networks, demonstrates their potential utility as a tool to support epidemiological studies and monitor the health of populations of aquatic animals. The gravid digenean trematode described from mild lesions of five fish was identified using reconstruction through histological sectioning as belonging to the Family Aporocotylidae Odhner, 1912. This is the first description of a blood fluke from the dusky grouper, as well as from dermal blood vessels. The parasite was relatively long; the longest section of the parasite that could be measured was 1500 µm and 20-80 µm in width, while the total length of the parasite was estimated at 1500-2000 µm. Minute tegumental spines, possibly covering only a few parts of the parasite, were seen from some cross-sections. The parasite had one post-testicular ovary, which might overlap the testis, a pre-ovarian ascending uterus, and a post-ovarian descending uterus. It also possessed an oesophagus surrounded by oesophageal glandular cells and a pre-ovarian and pre-testicular extension of the vitelline cells, mostly at the level of the ascending uterus. The parasite was observed to be intra-vascular, the uterine lumen varies in size to accommodate between 1-7 eggs. The uterine eggs were embryonated and observed to span several stages of maturation. Eggs were also found in the dermal blood vessels, in the dermis, and in the epidermis, with the latter appearing to provide a potential route of egress of eggs into the environment. The extra-uterine eggs were 23.5 to 37.52 µm long and contained a ciliated miracidium. The eggs seemed to elicit a mixed inflammatory reaction, with degranulation of eosinophilic granular cells attached to the external surface of some of the eggs within the blood vessels but also the dermis. From observations made in the current study, this parasite appears to be a new species, most closely allied to none of the currently described Aporocotylidae genera. / In summary, the present study has demonstrated that the dusky grouper is extensively fished in Libya without discrimination to sizes and season, by both artisanal and spearfishing, with the latter as one of the main fishing methods, posing treats to the spawning potential and conservation of dusky grouper in Libya. The philometrid infecting the ovaries has a potential to reduce fecundity or to result in parasitic castration of wild broodstock. Gill-infecting monogeneans might represent a hazard for all stages of dusky grouper production. Dusky grouper dermatitis is a skin lesion, although there are no indications that infections may result in mortalities. Under culture conditions, however, this might change due to increase bacterial loads, which might lead to secondary bacterial infection. The presence of skin lesions would undoubtedly reduce the market value of whole fish. These findings are important for existing wild stocks, and for future plans regarding the aquaculture of dusky grouper. Future studies need to focus on the pathology of DGD, describing the disease process and aetiology using laboratory techniques such as TEM and virology as well as using morphology and molecular-based tools to describe the blood fluke and to determine their potential role in the initiation the disease. The novel approach to disease surveillance using social media Facebook posts could be further expanded by attracting citizen scientists, for future research assessing disease in wild fish, for sightings of mortality events and/or the appearance of disease outbreaks, or, for mapping marine mammal stranding’s and/or turtle nesting activity.

LGBT+ and Public Libraries Hana Bouchalová English Abstract The purpose of this thesis is to define the relations of the Czech LGBT+ community (lesbian, gay, bisexual and trans* with respect to other gender identities and sexual orientations) and Czech public libraries. Focusing on LGBT+ literature and library and information services, the thesis offers both library and LGBT+ community perspective, using following research methods: questionnaires and interviews (executed with the help of LGBT+ groups and organisations), interviews with librarians, mystery shopping and analysis of selected Czech public library collections. Theoretical chapters discussing the existence of Czech queer libraries and the situation of LGBT+ community in the Czech Republic and elsewhere are also included. Final chapter contains suggestions for libraries how to better design and improve their services and offers related topics for further discussion.