Lorenzo Baggiani - Academia.edu (original) (raw)
Uploads
Papers by Lorenzo Baggiani
Aging Clinical and Experimental Research
Background Widespread vaccination and emergence of less aggressive SARS-CoV2 variants may have bl... more Background Widespread vaccination and emergence of less aggressive SARS-CoV2 variants may have blunted the unfavourable outcomes of COVID-19 in nursing home (NH) residents. We analysed the course of COVID-19 epidemic in NHs of Florence, Italy, during the "Omicron era" and investigated the independent effect of SARS-CoV2 infection on death and hospitalization risk. Methods Weekly SARS-CoV2 infection rates between November 2021 and March 2022 were calculated. Detailed clinical data were collected in a sample of NHs. Results Among 2044 residents, 667 SARS-CoV2 cases were confirmed. SARS-CoV2 incidence sharply increased during the Omicron era. Mortality rates did not differ between SARS-CoV2-positive (6.9%) and SARS-CoV2-negative residents (7.3%, p = 0.71). Chronic obstructive pulmonary disease and poor functional status, but not SARS-CoV2 infection independently predicted death and hospitalization. Conclusions Despite that SARS-CoV2 incidence increased during the Omicron era, SARS-CoV2 infection was not a significant predictor of hospitalization and death in the NH setting.
Summary Objective The aim of this paper is to describe the results obtained from the application ... more Summary Objective The aim of this paper is to describe the results obtained from the application of a specific local deprivation index, to general and cause-specific mortality and influenza vaccination coverage among elderly people in the municipality of Florence. Methods General and cause-specific mortality data (2009-2013) and influenza vaccination coverage data (2015/16 and 2016/17) were collected for subjects aged ≥ 65 years residing in the municipality of Florence (Tuscany), at the 2011 Census section level. A Socio-Economic and Health Deprivation Index (SEHDI) was constructed and validated by means of socio-economic indicators and mortality ratios. Results Half of the population of Florence belonged to the medium deprivation group; about 25% fell into the two most deprived groups, and the remaining 25% were deemed to be wealthy. Elderly people mostly belonged to the high deprivation group. All-cause mortality and cause-specific mortality (cancer and respiratory diseases) reach...
International Journal of Environmental Research and Public Health, 2019
Many older adults who live at home depend on a caregiver. When familial support cannot provide th... more Many older adults who live at home depend on a caregiver. When familial support cannot provide the necessary care, paid caregivers are frequently hired. Health literacy (HL) is the knowledge and competence required of people to meet the complex demands of health in modern society. The aim of this study is to assess the HL level of paid non-familial caregivers who were enrolled through two different sources: from the homes of assisted people in two Tuscan health districts (first sample) and during job interviews in a home care agency operating in Florence (second sample). The two different recruitment contexts allow us to provide a broader view of the phenomenon, presenting a picture of the HL level of those who are already working and those who are looking for a new job in this field. One-on-one face-to-face interviews, which include the administration of the Newest Vital Sign (NVS) to measure HL, were conducted. Recruitment resulted in 84 caregivers in the first sample and 68 in th...
International Journal of Environmental Research and Public Health, 2019
The oral health state plays an important role in the concept of ‘elderly frailty’, since institut... more The oral health state plays an important role in the concept of ‘elderly frailty’, since institutionalized older people are prone to suffering from bad oral conditions. The aim of this study is to assess the state of oral health in the older residents of nursing homes and to measure its potential association with the cognitive state, the degree of functional autonomy, and the malnutrition risk. Methods: We enrolled 176 subjects from 292 residents in five nursing homes in Florence. For each subject, we performed the Malnutrition Universal Screening Tool, the Pfeiffer test, the Minimum Data Set—Long Form, a dental examination, and the Geriatric Oral Health Assessment Index questionnaire. The results show that the oral condition was poor in 43.8% of cases, medium in 38.1%, and good in 18.2%. A worse oral health state was significantly associated (p < 0.05) with a worse cognitive state and with a higher dependency in daily living activities. The malnutrition score among the older peo...
The journal of nutrition, health & aging, 2010
Annali di igiene : medicina preventiva e di comunità
Aim of this study is the evaluation of body composition (proxy of nutritional status) and its cor... more Aim of this study is the evaluation of body composition (proxy of nutritional status) and its correlation with functional abilities in a sample of 8-year-old children living in a florentine municipality. We have collected, for each subject, anthropometric variables (weight, height) and carried out bioelectrical impedance test and a group of physical tests to measure strength and physical ability. The results of vectorial interpretation of BIA, together with the analysis of the so called fitness tests, show a comprehensive good body composition and a very low prevalence of obesity for both genders. This fact is confirmed also by data about living and nutrition habits: scarce use of PC and TV (less than two hours a day) and, on the other hand, enough time spent to play in open spaces and to make sport.
Annali di igiene : medicina preventiva e di comunità
Journal of the American Geriatrics Society
Nutrition, 2009
Objective: We assessed the body composition of 8-y-old children living in Livorno through the int... more Objective: We assessed the body composition of 8-y-old children living in Livorno through the integration of bioelectrical and anthropometric evaluations. Methods: The study, conducted during December 2005, involved 8-y-old third graders of Livorno, Italy. We collected for each subject (449 children, 210 female and 239 male) anthropometric parameters and carried out bioelectrical impedance test with a STA/BIA Soft Tissue Analyzer. Data were processed with SPSS 14.0. Results: According to anthropometric parameters, a statistically significant difference between genders was found only for height. Percentages of overweight and obese children by gender were 13.9 and 2.4 for girls and 21.3 and 2.1 for boys (P < 0.05). No significant differences were observed for weight, height, and body mass index percentiles from national reference values, whereras significant differences were found in mid-upper arm circumference between our sample and-lacking national data-the reference (U.S.) population for age and gender. With regard to bioelectrical impedance analysis, a common trend of distribution was observed in both genders toward the left and the area above the spatial ellipses and a statistically significant difference between genders for all parameters with the exception of phase angle. A gradual mean impedance shortening vector was observed with an increase of body mass index or mid-upper arm circumference. The comparison of the two techniques showed a good relation between anthropometric and bioelectrical parameters. Conclusion: An integrated interpretation of bioelectrical impedance analysis and anthropometry, demonstrated by the correlation of many parameters between the two techniques, seems to emerge as a good indication of nutritional status for most children of both genders.
Igiene e sanita pubblica, 2008
The aim of this study was to describe changes in body composition and determine the prevalence of... more The aim of this study was to describe changes in body composition and determine the prevalence of malnutrition or of risk of malnutrition in long institutionalized elderly patients. Four hundred five patients aged over 64 years were included in the study. Nutritional status was evaluated by means of questionnaire, height and weight measurements and bioelectrical Impedance Vector Analysis (BIVA). Height, weight and phase angle significantly diminished with increasing age. Significant gender differences were also found, with phase angle being lower in females with respect to males. BIVA confidence analysis showed significant differences in body composition between subjects of different ages and levels of physical self-sufficiency.Overall, a large proportion of subjects in this study had evidence of malnutrition or were shown to be at risk for malnutrition. This indicates the importance of performing nutritional risk screening in all institutionalized subjects upon admission and during...
Aging Clinical and Experimental Research
Background Nursing home (NH) residents have been dramatically affected by COVID-19, with extremel... more Background Nursing home (NH) residents have been dramatically affected by COVID-19, with extremely high rates of hospitalization and mortality. Aims To describe the features and impact of an assistance model involving an intermediate care mobile medical specialist team (GIROT, Gruppo Intervento Rapido Ospedale Territorio) aimed at delivering “hospital-at-nursing home” care to NH residents with COVID-19 in Florence, Italy. Methods The GIROT activity was set-up during the first wave of the pandemic (W1, March–April 2020) and became a structured healthcare model during the second (W2, October 2020–January 2021). The activity involved (1) infection transmission control among NHs residents and staff, (2) comprehensive geriatric assessment including prognostication and geriatric syndromes management, (3) on-site diagnostic assessment and protocol-based treatment of COVID-19, (4) supply of nursing personnel to understaffed NHs. To estimate the impact of the GIROT intervention, we reported ...
Vaccines
Evidence on the effectiveness of SARS-CoV2 vaccines in nursing home (NHs) residents is limited. W... more Evidence on the effectiveness of SARS-CoV2 vaccines in nursing home (NHs) residents is limited. We examined the impact of the BNT162b2 mRNA SARS-CoV2 vaccine on the course of the epidemic in NHs in the Florence Health District, Italy, before and after vaccination. Moreover, we assessed survival and hospitalization by vaccination status in SARS-CoV2-positive cases occurring during the post-vaccination period. We calculated the weekly infection rates during the pre-vaccination (1 October–26 December 2020) and post-vaccination period (27 December 2020–31 March 2021). Cox analysis was used to analyze survival by vaccination status. The study involved 3730 residents (mean age 84, 69% female). Weekly infection rates fluctuated during the pre-vaccination period (1.8%–6.5%) and dropped to zero during the post-vaccination period. Nine unvaccinated (UN), 56 partially vaccinated (PV) and 35 fully vaccinated (FV) residents tested SARS-CoV2+ during the post-vaccination period. FV showed signific...
International Journal of Infectious Diseases
Nutrition, 2009
Objective: We assessed the body composition of 8-y-old children living in Livorno through the int... more Objective: We assessed the body composition of 8-y-old children living in Livorno through the integration of bioelectrical and anthropometric evaluations. Methods: The study, conducted during December 2005, involved 8-y-old third graders of Livorno, Italy. We collected for each subject (449 children, 210 female and 239 male) anthropometric parameters and carried out bioelectrical impedance test with a STA/BIA Soft Tissue Analyzer. Data were processed with SPSS 14.0. Results: According to anthropometric parameters, a statistically significant difference between genders was found only for height. Percentages of overweight and obese children by gender were 13.9 and 2.4 for girls and 21.3 and 2.1 for boys (P < 0.05). No significant differences were observed for weight, height, and body mass index percentiles from national reference values, whereras significant differences were found in mid-upper arm circumference between our sample and-lacking national data-the reference (U.S.) population for age and gender. With regard to bioelectrical impedance analysis, a common trend of distribution was observed in both genders toward the left and the area above the spatial ellipses and a statistically significant difference between genders for all parameters with the exception of phase angle. A gradual mean impedance shortening vector was observed with an increase of body mass index or mid-upper arm circumference. The comparison of the two techniques showed a good relation between anthropometric and bioelectrical parameters. Conclusion: An integrated interpretation of bioelectrical impedance analysis and anthropometry, demonstrated by the correlation of many parameters between the two techniques, seems to emerge as a good indication of nutritional status for most children of both genders. Ó
Aging Clinical and Experimental Research
Background Widespread vaccination and emergence of less aggressive SARS-CoV2 variants may have bl... more Background Widespread vaccination and emergence of less aggressive SARS-CoV2 variants may have blunted the unfavourable outcomes of COVID-19 in nursing home (NH) residents. We analysed the course of COVID-19 epidemic in NHs of Florence, Italy, during the "Omicron era" and investigated the independent effect of SARS-CoV2 infection on death and hospitalization risk. Methods Weekly SARS-CoV2 infection rates between November 2021 and March 2022 were calculated. Detailed clinical data were collected in a sample of NHs. Results Among 2044 residents, 667 SARS-CoV2 cases were confirmed. SARS-CoV2 incidence sharply increased during the Omicron era. Mortality rates did not differ between SARS-CoV2-positive (6.9%) and SARS-CoV2-negative residents (7.3%, p = 0.71). Chronic obstructive pulmonary disease and poor functional status, but not SARS-CoV2 infection independently predicted death and hospitalization. Conclusions Despite that SARS-CoV2 incidence increased during the Omicron era, SARS-CoV2 infection was not a significant predictor of hospitalization and death in the NH setting.
Summary Objective The aim of this paper is to describe the results obtained from the application ... more Summary Objective The aim of this paper is to describe the results obtained from the application of a specific local deprivation index, to general and cause-specific mortality and influenza vaccination coverage among elderly people in the municipality of Florence. Methods General and cause-specific mortality data (2009-2013) and influenza vaccination coverage data (2015/16 and 2016/17) were collected for subjects aged ≥ 65 years residing in the municipality of Florence (Tuscany), at the 2011 Census section level. A Socio-Economic and Health Deprivation Index (SEHDI) was constructed and validated by means of socio-economic indicators and mortality ratios. Results Half of the population of Florence belonged to the medium deprivation group; about 25% fell into the two most deprived groups, and the remaining 25% were deemed to be wealthy. Elderly people mostly belonged to the high deprivation group. All-cause mortality and cause-specific mortality (cancer and respiratory diseases) reach...
International Journal of Environmental Research and Public Health, 2019
Many older adults who live at home depend on a caregiver. When familial support cannot provide th... more Many older adults who live at home depend on a caregiver. When familial support cannot provide the necessary care, paid caregivers are frequently hired. Health literacy (HL) is the knowledge and competence required of people to meet the complex demands of health in modern society. The aim of this study is to assess the HL level of paid non-familial caregivers who were enrolled through two different sources: from the homes of assisted people in two Tuscan health districts (first sample) and during job interviews in a home care agency operating in Florence (second sample). The two different recruitment contexts allow us to provide a broader view of the phenomenon, presenting a picture of the HL level of those who are already working and those who are looking for a new job in this field. One-on-one face-to-face interviews, which include the administration of the Newest Vital Sign (NVS) to measure HL, were conducted. Recruitment resulted in 84 caregivers in the first sample and 68 in th...
International Journal of Environmental Research and Public Health, 2019
The oral health state plays an important role in the concept of ‘elderly frailty’, since institut... more The oral health state plays an important role in the concept of ‘elderly frailty’, since institutionalized older people are prone to suffering from bad oral conditions. The aim of this study is to assess the state of oral health in the older residents of nursing homes and to measure its potential association with the cognitive state, the degree of functional autonomy, and the malnutrition risk. Methods: We enrolled 176 subjects from 292 residents in five nursing homes in Florence. For each subject, we performed the Malnutrition Universal Screening Tool, the Pfeiffer test, the Minimum Data Set—Long Form, a dental examination, and the Geriatric Oral Health Assessment Index questionnaire. The results show that the oral condition was poor in 43.8% of cases, medium in 38.1%, and good in 18.2%. A worse oral health state was significantly associated (p < 0.05) with a worse cognitive state and with a higher dependency in daily living activities. The malnutrition score among the older peo...
The journal of nutrition, health & aging, 2010
Annali di igiene : medicina preventiva e di comunità
Aim of this study is the evaluation of body composition (proxy of nutritional status) and its cor... more Aim of this study is the evaluation of body composition (proxy of nutritional status) and its correlation with functional abilities in a sample of 8-year-old children living in a florentine municipality. We have collected, for each subject, anthropometric variables (weight, height) and carried out bioelectrical impedance test and a group of physical tests to measure strength and physical ability. The results of vectorial interpretation of BIA, together with the analysis of the so called fitness tests, show a comprehensive good body composition and a very low prevalence of obesity for both genders. This fact is confirmed also by data about living and nutrition habits: scarce use of PC and TV (less than two hours a day) and, on the other hand, enough time spent to play in open spaces and to make sport.
Annali di igiene : medicina preventiva e di comunità
Journal of the American Geriatrics Society
Nutrition, 2009
Objective: We assessed the body composition of 8-y-old children living in Livorno through the int... more Objective: We assessed the body composition of 8-y-old children living in Livorno through the integration of bioelectrical and anthropometric evaluations. Methods: The study, conducted during December 2005, involved 8-y-old third graders of Livorno, Italy. We collected for each subject (449 children, 210 female and 239 male) anthropometric parameters and carried out bioelectrical impedance test with a STA/BIA Soft Tissue Analyzer. Data were processed with SPSS 14.0. Results: According to anthropometric parameters, a statistically significant difference between genders was found only for height. Percentages of overweight and obese children by gender were 13.9 and 2.4 for girls and 21.3 and 2.1 for boys (P < 0.05). No significant differences were observed for weight, height, and body mass index percentiles from national reference values, whereras significant differences were found in mid-upper arm circumference between our sample and-lacking national data-the reference (U.S.) population for age and gender. With regard to bioelectrical impedance analysis, a common trend of distribution was observed in both genders toward the left and the area above the spatial ellipses and a statistically significant difference between genders for all parameters with the exception of phase angle. A gradual mean impedance shortening vector was observed with an increase of body mass index or mid-upper arm circumference. The comparison of the two techniques showed a good relation between anthropometric and bioelectrical parameters. Conclusion: An integrated interpretation of bioelectrical impedance analysis and anthropometry, demonstrated by the correlation of many parameters between the two techniques, seems to emerge as a good indication of nutritional status for most children of both genders.
Igiene e sanita pubblica, 2008
The aim of this study was to describe changes in body composition and determine the prevalence of... more The aim of this study was to describe changes in body composition and determine the prevalence of malnutrition or of risk of malnutrition in long institutionalized elderly patients. Four hundred five patients aged over 64 years were included in the study. Nutritional status was evaluated by means of questionnaire, height and weight measurements and bioelectrical Impedance Vector Analysis (BIVA). Height, weight and phase angle significantly diminished with increasing age. Significant gender differences were also found, with phase angle being lower in females with respect to males. BIVA confidence analysis showed significant differences in body composition between subjects of different ages and levels of physical self-sufficiency.Overall, a large proportion of subjects in this study had evidence of malnutrition or were shown to be at risk for malnutrition. This indicates the importance of performing nutritional risk screening in all institutionalized subjects upon admission and during...
Aging Clinical and Experimental Research
Background Nursing home (NH) residents have been dramatically affected by COVID-19, with extremel... more Background Nursing home (NH) residents have been dramatically affected by COVID-19, with extremely high rates of hospitalization and mortality. Aims To describe the features and impact of an assistance model involving an intermediate care mobile medical specialist team (GIROT, Gruppo Intervento Rapido Ospedale Territorio) aimed at delivering “hospital-at-nursing home” care to NH residents with COVID-19 in Florence, Italy. Methods The GIROT activity was set-up during the first wave of the pandemic (W1, March–April 2020) and became a structured healthcare model during the second (W2, October 2020–January 2021). The activity involved (1) infection transmission control among NHs residents and staff, (2) comprehensive geriatric assessment including prognostication and geriatric syndromes management, (3) on-site diagnostic assessment and protocol-based treatment of COVID-19, (4) supply of nursing personnel to understaffed NHs. To estimate the impact of the GIROT intervention, we reported ...
Vaccines
Evidence on the effectiveness of SARS-CoV2 vaccines in nursing home (NHs) residents is limited. W... more Evidence on the effectiveness of SARS-CoV2 vaccines in nursing home (NHs) residents is limited. We examined the impact of the BNT162b2 mRNA SARS-CoV2 vaccine on the course of the epidemic in NHs in the Florence Health District, Italy, before and after vaccination. Moreover, we assessed survival and hospitalization by vaccination status in SARS-CoV2-positive cases occurring during the post-vaccination period. We calculated the weekly infection rates during the pre-vaccination (1 October–26 December 2020) and post-vaccination period (27 December 2020–31 March 2021). Cox analysis was used to analyze survival by vaccination status. The study involved 3730 residents (mean age 84, 69% female). Weekly infection rates fluctuated during the pre-vaccination period (1.8%–6.5%) and dropped to zero during the post-vaccination period. Nine unvaccinated (UN), 56 partially vaccinated (PV) and 35 fully vaccinated (FV) residents tested SARS-CoV2+ during the post-vaccination period. FV showed signific...
International Journal of Infectious Diseases
Nutrition, 2009
Objective: We assessed the body composition of 8-y-old children living in Livorno through the int... more Objective: We assessed the body composition of 8-y-old children living in Livorno through the integration of bioelectrical and anthropometric evaluations. Methods: The study, conducted during December 2005, involved 8-y-old third graders of Livorno, Italy. We collected for each subject (449 children, 210 female and 239 male) anthropometric parameters and carried out bioelectrical impedance test with a STA/BIA Soft Tissue Analyzer. Data were processed with SPSS 14.0. Results: According to anthropometric parameters, a statistically significant difference between genders was found only for height. Percentages of overweight and obese children by gender were 13.9 and 2.4 for girls and 21.3 and 2.1 for boys (P < 0.05). No significant differences were observed for weight, height, and body mass index percentiles from national reference values, whereras significant differences were found in mid-upper arm circumference between our sample and-lacking national data-the reference (U.S.) population for age and gender. With regard to bioelectrical impedance analysis, a common trend of distribution was observed in both genders toward the left and the area above the spatial ellipses and a statistically significant difference between genders for all parameters with the exception of phase angle. A gradual mean impedance shortening vector was observed with an increase of body mass index or mid-upper arm circumference. The comparison of the two techniques showed a good relation between anthropometric and bioelectrical parameters. Conclusion: An integrated interpretation of bioelectrical impedance analysis and anthropometry, demonstrated by the correlation of many parameters between the two techniques, seems to emerge as a good indication of nutritional status for most children of both genders. Ó