Skull osteology and osteological phylogeny of the Western whip snake Hierophis viridiflavus (Squamata, Colubridae).

The skull osteology of Hierophis viridiflavus is here described and figured in detail on the basis of 18 specimens. The sample includes specimens from the ranges of both H. viridiflavus viridiflavus and H. viridiflavus carbonarius as well as specimens not identified at sub-specific level. The main characters that define H. viridiflavus in comparison to the parapatric congeneric species Hierophis gemonensis are wide maxillary diastema, basioccipital crest well distinct in three lobes and basioccipital process well marked. The foramina of the otoccipital and prootic, and the basioccipital process of the basioccipital are among the most ontogenetically variable characters, as indicated by two juvenile specimens included in the sample. A specimen-level phylogenetic analysis including H. gemonensis and other outgroups (overall 6 species, 26 specimens, 64 skull characters) recovered all H. viridiflavus specimens in one clade, indicating the presence of a clear phylogenetic signal in the applied characters. However, the resolution within the H. viridiflavus clade is poor the monophyly of H. viridiflavus carbonarius was retrieved, but not that of Hierophis v. viridiflavus. Probably due to the relatively high variability, the skull morphology does not support the recently proposed specific status of the two subspecies.

Hearing loss and depressive symptoms in elderly patients.

AIMS: Hearing loss is a common disability that has a profound impact on communication and daily functioning in the elderly. The present study assesses the effects of hearing aids on mood, quality of life and caregiver burden when hearing loss, comorbidity and depressive symptoms coexist in the elderly. METHODS: A total of 15 patients aged older than 70 years suffering from hearing loss and depressive mood were recruited. Comorbidity was evaluated by the Cumulative Illness Rating Scale, functional ability by the Activities of Daily Living scale and the Lawton Instrumental Activities of Daily Living scale, cognitive capacity by the Mini-mental State Examination and the Clock Drawing Test, psychological status by the Center for Epidemiological Studies-Depression scale, and quality of life by the Short Form (36) Health Survey. Caregiver burden was appraised by the Caregiver Burden Inventory. Testing was carried out at baseline and at 1-, 3- and 6-month intervals, assessing the use of binaural digital and programmable hearing aids. RESULTS: Reduction in depressive symptoms and improved quality of life at statistically significant levels were observed early on with the use of hearing aids. In particular, general health (P < 0.02), vitality (P < 0.03), social functioning (P < 0.05), emotional stability (P < 0.05) and mental health (P < 0.03) all changed for the better, and were maintained for the study duration. The degree of caregiver burden also declined, remaining low throughout the study. CONCLUSIONS: The benefits of digital hearing aids in relation to depressive symptoms, general health and social interactivity, but also in the caregiver - patient relationship, were clearly shown in the study. The elderly without cognitive decline and no substantial functional deficits should be encouraged to use hearing aids to improve their quality of life.