230 likes | 244 Views
Uppsala, Sweden. 1st EUROPEAN CONFERENCE ON KMC. Our hosts Pr Uwe Ewald Dr Kertsin Hedberg Nyqvist. October 6Th. The beautiful Inaugural song. …. October 6Th. …. October 7th. …. October 7th. October 7th. October 7th. October 7th. October 7th. October 7th. October 7th.
E N D
Uppsala, Sweden 1st EUROPEAN CONFERENCE ON KMC Our hosts Pr Uwe Ewald Dr Kertsin Hedberg Nyqvist
October 6Th The beautiful Inaugural song …
Poster presentations • P 1. BFHI AND BREASTFEEDING PROMOTION IN EGYPT Azza Abul-Fadl, MD, MPH, IBCLC, Professor and Head of Pediatric Department Benha Faculty of Medicine, Benha University, Egypt, 26B, ElGezira AlWosta • Summary • P 2. MATERNAL RELAXATION DURING SKIN-TO-SKIN CONTACT (KMC) Sheau-Huey Chiu 1, Gene Cranston Anderson1 College of Nursing, University of Florida, Gainesville 1 • Summary • P 3. HOW TO MOTIVATE FAMILY TO CONTINUE KANGAROO MOTHER CARE (KMC) AT HOME IN MADAGASCAR D. Andrianarimanana1, S. Nagai1,2, N. Rabesandratana1, R. Mori2,3, N. Yonemoto3, A. Ramarijaona1, M. E. Raza-fanomezanjanahary1, T.Nakayama2 University hospital of Mahajanga, Madagascar 1, Kyoto University, School of Public Health, Japan 2, Osaka Medical Center and Research Institute for Maternal and Child Health, Japan 3. Summary • P 4. . EARLIER IS BETTER? RANDOMIZED CONTROLLED TRIAL (RCT) OF KANGAROO MOTHER CARE (KMC) IN MADAGASCAR S. Nagai1,2, D. Andrianarimanana2, N. Rabesabdratana2, R. Mori1,3, N. Yonemoto3, A. Ramarijaona2, M. E. Raza-fanomezanjanahary2,T.Nakayama1 Kyoto University, School of Public Health, Department of Health Informatics, Japan 1, University hospital of Mahajanga, Madagascar 2, Osaka Medical Center and Research Institute for Maternal and Child Health, Japan 3. Summary • 5. THE OBSTACLES TO IMPLEMENT CONTINUOUS KANGAROO MOTHER CARE (KMC) AT HOSPITAL IN MADAGASCAR N. Rabesandratana1 , S. Nagai1,2, D. Andrianarimanana1, R. Mori2,3, N. Yonemoto3, A. Ramarijaona1, M. E. Raza-fanomezanjanahary1, T.Nakayama2 University hospital of Mahajanga, Madagascar 1, Kyoto University, School of Public Health, Japan 2, Osaka Medical Center and Research Institute for Maternal and Child Health, Japan 3. Summary • 6. AMBULATORY MANAGEMENT AND OUTCOMES AT ONE YEAR OF 2092 PRETERM/LBW INFANTS DISCHARGED HOME WHILE RECEIVING OXYGEN. THE EXPERIENCE OF THE KANGAROO FOUNDATION IN BOGOTA, 2003-2008 Maria Isabel Angel, RN1, Nathalie Charpak, MD1,2 on behalf of the KMCP research group 1. Kangaroo Foundation, Bogota, Colombia. 2. Integral Kangaroo Mother Care Program, San Ignacio teaching hospital, Javeriana University, Bogota, ColombiaSummary
Poster presentations • P 7. ESTABLISHING A CENTER OF EXCELLENCE FOR KMC IN RWANDA: MUHIMA DISTRICT HOSPITAL Baribwira C1, Aissatou Lo A. 2, de Graft – Johnson J 2 , Mwebesa W2 , Mac Dowell J 2 Kigali Teaching Hospital/Belgium Technical Cooperation, Rwanda1, ACCESS2 Summary • P 8. The Morbidity and Mortality of Low Birth Weight Infants in Mongolia Bayasgalantai Bavuusuren, Z.Gerelmaa NICU, Maternal and Child Health Research Center of Mongolia Summary • P 9. SKIN TO SKIN CONTACT REDUCES POSTPARTUM DEPRESSION AND INCREASES MATERAL SENSITIVITY DURING FEEDING Ann E. Bigelow1, Michelle Power1, Marion Alex1, Janis MacLellan- • Peters1, Judith Cormier1, Penny Fuller2, Terry Penny2, Magdy Fouad3, Ann Marie Murdock3, Doris Gillis1, Claudette McDonald4, Kim MacLean1, Clare Fawcett1, Sherry Bowman1 St. Francis Xavier University, Antigonish, Nova Scotia, Canada 1, St. Martha’s Regional Hospital, Antigonish, Nova Scotia, Canada 2, Aberdeen Regional Hospital, New Glasgow, Nova Scotia, Canada 3, Colchester East Hants Health Authority, Truro, Nova Scotia, Canada 4. Summary • P 10. A COMPARISON OF NURSE AND MOTHER ATTITUDES REGARDING MATERNAL SKIN-TO-SKIN CARE AS A PAIN RELIEVING STRATEGY DURING HEEL LANCE FOR PRETERM NEONATES Campbell-Yeo, Marsha1, Johnston, Celeste 2, Filion, Francoise2, McNaughton, Kate2 IWK Health Centre Halifax, Nova Scotia1, McGill University Montreal, Quebec2 CANADA Summary • P 11. OXYGEN DEPENDENT INFANTS: SAVED AT THE NEONATAL UNIT, FORGOTTEN AFTER DISCHARGE. THE PARADOX OF ACCESS TO TECHNOLOGY IN RESOURCE CONSTRAINED SETTINGS Nathalie Charpak, MD1 and Juan G Ruiz, MD MMedSci1,2 1Research group, Kangaroo Foundation, Bogota, DC, Colombia 2Clinical Epidemiology, Universidad Javeriana, Bogota, DC, Colombia Summary • P 12 CLINICAL COURSE AND PROGNOSIS AT ONE YEAR OF 827 COLOMBIAN INFANTS BORN BEFORE 31 WEEKS AND DISCHARGED HOME IN KANGAROO POSITION. Nathalie Charpak, MD 1,2, Maria Isabel Angel RN1 on behalf of the KMCP research group 1Kangaroo Foundation, Bogota, Colombia 2Integral Kangaroo Mother Care Program, San Ignacio teaching hospital, Javeriana University, Bogota, Colombia Summary
Poster presentations • P 13. MASSAGE THERAPY DURING THE NICU PERIOD: A PILOT STUDY Vo Thi Thanh Tra1, Laurie Dubois2, Luong Kim Chi3, Réjean Tessier4 1 -Tu Du Hospital, Ho Chi Minh City, Vietnam; 2- School of psychology ,Université Laval, Québec, Canada, ; 3- Tu Du Hospital, Ho Chi Minh City, Vietnam; 4- School of psychology, Université Laval, Québec, Canada • Summary • P 14. MOTHERS’ RESPONSE ON KANGAROO MOTHER CARE (KMC): AN ASSESSMENT IN ESTABLISHING KMC PROGRAM IN INDONESIA Bernie Endyarni, Rosalina Roeslani, Soedjatmiko, Rinawati Rohsiswatmo Department of Child Health, Faculty of Medicine, University of Indonesia – Cipto Mangunkusumo Hospital, Jakarta, Indonesia Summary • P 15. PROMOTING KANGAROO CARE –INTERVENTION USED AT LEVEL 3 NICU Aino Ezeonodo RN, CEN (Certified Emergency Nurse), CPN (Certified Pediatric Nurse), CNICN (Certified Neonatal Intensive Care Nurse), MHC (Master of Health Care), Päivi Luukkainen MD, PhD, Pediatrician, Neonatologist Helsinki University Central Hospital (HUCH), Children’s Hospital, Dept for Neonatology, Neonatal Intensive Care Unit, K7 Summary • P 16. SKIN-TO-SKIN CONTACT FOR PAINFUL PROCEDURES: THE EXPERIENCE OF MOTHERS OF PRETERM INFANTS Ananda Fernandes1, Elvira Santos1, Céleste Johnston2 1Coimbra College of Nursing Coimbra College of Nursing, Coimbra, Portugal 2McGill University Summary • P 17. PHYSICAL, NEUROLOGICAL AND COGNITIVE DEVELOPMENT OF PRETERM INFANTS AT 5 YEARS OLD Martha Cristo, MSc , Psychologist, 1,2 & Zita Figueroa MD, Pediatrician1,2 1 Kangaroo Mother Care Program, Hospital San Ignacio, Bogotá, Colombia. 2Kangaroo Foundation, Bogotá Summary
Poster presentations • P 18. STAKES OF A PILOT CENTER FOR THE DIFFUSION OF THE KANGAROO MOTHER CARE METHOD IN AFRICA: THE CASE OF THE LAQUINTINIE HOSPITAL IN DOUALA (CAMEROON) Odette N. Guifo, MD1 ; Beatrice Moudze-Kaptué, MD2 ; Kevine - Laure Nkaghere, MD3 1: Paediatrician, Chief of Paediatric Department, Kangaroo Mother Care Unit, HLD, 2: Pediatrician, kangaroo mother care Unit HLD, Email,; 3: General practitioner, Kangaroo Mother Care Unit, Laquintinie Hospital of Douala Summary • P 19. KANGAROO MOTHER CARE (KMC) IN LBW INFANTS: A WESTERN RAJASTHAN EXPERIENCE Mukesh Gupta (1), Rakesh Jora (2), Chandra K Singhal (3) 1. Prof. Pediatrics 2. Ass. Prof. Pediatrics 3. Prof. & Head Obs. & Gyn. Medical College, Jodhpur (Rajasthan). India Summary • P 20. BFI ASSESSMENT TOOL: A QUEBEC METHODOLOGY TO ASSESS COMPLIANCE WITH BREASTFEEDING-RELATED POLICIES AND PRACTICES IN HEALTH CARE FACILITIES Laura N. Haiek1, Lydia Rochealeau2 1,2 Direction de santé publique de la Montérégie, 1Institut national de santé publique du Québec, 1Department of Family Medicine, McGill University, Québec, Canada Summary • P 21. ACADEMIC DETAILING TO ENHANCE BREASTFEEDING COUNSELLING AND BABYFRIENDLY COMPLIANCE IN A LOCAL SERVICES NETWORK IN QUEBEC Stéphane Groulx, Laura N. Haiek, Céline Lafrenière, Christian Viens 1,2 Direction de santé publique de la Montérégie, 1Institut national de santé publique du Québec, 1Department of Family Medicine, McGill University, Québec, Canada Summary • P 22. THE EFFECT OF KANGAROO MOTHER CARE (KMC) ON BREASTFEEDING AT THE TIME OF NICU DISCHARGE. M. Heidarzadeh1, MB. Hosseini2, M Ershadmanesh3, M Gholamitabar4 Neonatal health office, ministry of health, Iran 1, Department of Pediatrics, Tabriz Medical Science University, Tabriz, Iran 2, Neonatal research center, Tabriz Medical Science University, Iran 3, Department of midwifery, Tabriz midwifery center, Tabriz, Iran 4 Summary
Poster presentations • P 23. BREASTFEEDING PRETERM INFANTS IN NINE STEPS Yvonne Kasim Ragab-olders, lactation consultant IBCLC Leiden University Medical Center, Obstetrics, Leiden, The Netherlands Summary • P 24. KANGAROO FEEDING AND NUTRITION Roshanak, Vakilian-Health adviser, Midwife, Master science, Bibi Malihe Nazarie, Public health expert, Dr. Soheila Khazaei, MD, Professor, Super specialist of pediatric infectious diseases, Medical assistant professor, Health adviser Iran Ministry of health, Teheran, Iran Summary • P 25. DESCRIPTIVE ANALYSIS OF THE PROGRAM KANGAROO IN THE MATERNITY CONCEPTION PALACES (2002-2007) CARACAS, VENEZUELA Eunice Lample, MD*, Maria E* Torres, Freddy Bello ** * Department Neonatology, **Department Obstetrics, Maternity Conception Palaces, Caracas, Venezuela Summary • P 26. EXTREMELY PREMATURE INFANTS’ REACTIONS TO SKIN-TO-SKIN CONTACT Ragnhild Maastrup, RN Knowledge Centre for Breastfeeding Infants with Special Needs, Rigshospitale, Copenhagen, Denmark Summary • P 27. INFORMATION TO PARENTS ABOUT SKIN-TO-SKIN CONTACT IN THE NICU Ragnhild Maastrup, RN Knowledge Centre for Breastfeeding Infants with Special Needs, Rigshospitalet, Copenhagen, Denmark Summary • P 28. KNOWLEDGE CENTRE FOR BRESTFEEDING INFANTS WITH SPECIAL NEEDS, RIGSHOSPITALET, DENMARK Ragnhild Maastrup, RN Knowledge Centre for Breastfeeding Infants with Special Needs, Rigshospitalet, Copenhagen, Denmark • Summary
Poster presentations • P 29. THE “SOFT” EXPERIENCE: FROM ACONYM TO ACCOMPLSHMENTS Carol Lopez Melcher, RNC, CLE, MPH, Clinical Director Perinatal Services Network of Loma Linda University Children’s Hospital, Loma Linda, California, USA Summary • P 30. BEST PRACTICE GUIDELINES FOR MOTHERINFANT ATTACHMENT IN THE HOSPITAL Carol Lopez Melcher, RNC, CLE, MPH, Clinical Director Perinatal Services Network of Loma Linda University Children’s Hospital, Loma Linda, California, USA Summary • P 31. IMPLEMENTING BIRTH KANGAROO CARE FOR FULL-TERM INFANTS: A TRANSLATIONAL RESEARCH PROJECT IN THE U.S. Barbara Morrison, PhD, CNM, FNP; Susan Ludington-Hoe, PhD, CNM, FAAN Case Western Reserve University, Cleveland, Ohio, Frances Payne Bolton School of Nursing, Cleveland, Ohio, USA Summary • P 32. IMPLEMENTING BIRTH KANGAROO CARE FOR FULL-TERM INFANTS: A TRANSLATIONAL RESEARCH PROJECT IN THE U.S. Barbara Morrison, PhD, CNM, FNP; Susan Ludington-Hoe, PhD, CNM, FAAN Case Western Reserve University, Cleveland, Ohio, Frances Payne Bolton School of Nursing, Cleveland, Ohio, USA Summary • P 33. A CRITICAL ASSESSMENT OF THE KANGAROO MOTHER CARE UNIT’S ACTIVITY IN THE LAQUINTINIE HOSPITAL (HLD) IN DOUALA (CAMEROON) Beatrice Moudze-Kaptué, MD1; Odette N. Guifo, MD2 ; Edwige Ndap, MD3 ; Mireille Happi Fossi, MD4 ; Olive Etogo, NP5 ; Angelique Tchagou, NP6 ; Bertine Wakia, NP7 1: Paediatrician, kangaroo mother care Unit HLD, 2: Paediatrician, Chief of the Paediatric Department, Kangaroo Mother Care Unit, HLD, 3, 4, 5, 6, 7: (Kangaroo Mother Care Unit, Laquintinie Hospital of Douala) • Summary
Poster presentations • P 34. CLINICAL PRACTICE GUIDELINE DEVELOPMENT FOR KANGAROO CARE IN JAPAN –JAPANESE CONSENSUS UPON AVAILABLE EVIDENCE– Kangaroo Care Guideline Working Group Yoriko Nishizawa1, Shuko Nagai1, Shigeru Ohki2, Rintaro Mori1, Kenji Shirai2, Shinichi Watabe3 Osaka Medical Center and Research Institute for Maternal and Child Health, Japan 1, Seirei Hamamatsu General Hospital 2, Kurashiki Central Hospital 3. Summary • P 35. PSYCHOAFFECTIVE EXPERIENCE OF PREMATURITY AND KANGAROO MOTHER CARE: A CONTEXTUAL STUDY IN THE LAQUINTINIE HOSPITAL OF DOUALA (CAMEROON). Erero F. Njiengwé PhD1; Odette N. Guifo MD2 ; Hilaire Ngoumela3; Medical and Paramedical staff of the Premature Unit 1: Psychopathologist, Clinical Psychologist, Laboratory of Behavioural Sciences and Applied Psychology (LAPSA) The University of Douala / Kangaroo Mother Care Unit HLD; 2: Paediatrician, Chief of the Paediatric Department, Kangaroo Mother Care Unit, HLD; 3: Clinical Psychology Student (Residency), Kangaroo Mother Care Unit, HLD Summary • P 36. EVALUATION OF THE KANGAROO MOTHER CARE (KMC) STUDY TOUR FOR INDONESIAN HEALTH PROFESSIONALS TO SOUTH AFRICA Hadi Pratomo1, Ella N. Hadi2, and Berni Endyarti3 1Professor of the Faculty of Public Health, the University of Indonesia and Health Service Program (HSP)/USAID Consultant; 2) Department of Health Promotion, Faculty of Public Health, the University of Indonesia; 3The Indonesian Pediatric Society (IDAI) and also Chairperson of the Participants of the Study Tour Summary • P 37. EVALUATION OF A 2 DAY KANGAROO MOTHER CARE (KMC) TRAINING BY THE INDONESIAN PERINATAL SOCIETY (PERINASIA) Hadi Pratomo1, Uud Uhudiah2, and Hesti Tobing3 1Professor of the Faculty of Public Health, the University of Indonesia, Chairman of the Board of Planning Program, Perinasia, 1) Vice-Chairperson for KMC Training Team, Perinasia; 3Research Staff of Perinasia • Summary
Poster presentations • P 38. THE OBSTACLES TO IMPLEMENT CONTINUOUS KANGAROO MOTHER CARE (KMC) AT HOSPITAL IN MADAGASCAR N. Rabesandratana 1 , S. Nagai 2, D. Andrianarimanana1, R. Mori 2,3, N. Yonemoto 3, A. Ramarijaona1, M. E. Raza-fanomezanjanahary1,T.Nakayama2 1University hospital of Mahajanga, Madagascar, 2Kyoto University, School of Public Health, Japan, 3Osaka Medical Center and Research Institute for Maternal and Child Health, Japan Summary • P 39. KANGAROO BABY IN TROTRO AN-KODITRA PROGRAM Yvonne Ranaivoson, G. Ramahandridona, A. Sambany CHU Befelatanana Maternity, Antananarivo, Madagascar Summary • P 40. KANGAROO MOTHER CARE FOR LOW BIRTH WEIGHT INFANTS: A ANDOMIZED-CONTROLLED TRIAL Suman Rao, MD, Associate Professor of Neonatology, Rekha Udani MD: Professor & HOD, Ruchi Nanavati MD, Associate Professor St. John’s Medical College & Hospital, Bangalore; Seth GS Medical College & KEM Hospital, Mumbai; D Y Patil Medical College & Hospital, Navi Mumbai, India Summary • P 41. THE IMPLEMENTATION OF CONTINUOUS KANGAROO MOTHER CARE (KMC) AT THE NATIONAL TOP REFERRAL HOSPITAL (RSCM) IN JAKARTA Yeni Rustina, BN, MAppSc., PhD¹, Rosalina D Roeslani2 , Nining aswini3, Mimin Mintarsih4 ¹Faculty of Nursing, the University of Indonesia/Perinatology Division, Depok Campus, West Java, and dr Cipto Mangunkusumo Hospital (RSCM), Jakarta; ²,3Perinatology Division, dr Cipto Mangunkusumo Hospital (RSCM), Jakarta; Department of Obstetric and Gynecology, dr Cipto Mangunkusumo Hospital (RSCM) Summary • P 42. EVIDENCE-BASED GUIDELINES FOR THE USE OF THE KANGAROO MOTHER CARE (KMC) METHOD IN STABLE LBW INFANTS IN COLOMBIA Juan G Ruiz, MD MMedSci, Professor1,2 and Nathalie Charpak, MD2. 1Clinical Epidemiology, Universidad Javeriana, Bogota, DC, Colombia and 2Research group, Kangaroo Foundation, Bogota, DC, Colombia • Summary
Poster presentations • P 43. COMMUNITY KANGAROO MOTHER CARE: THE WAY FORWARD Nancy L. Sloan,1 Salahuddin Ahmed2 1 Dept. oc Community Medicine, Mount Sinai School of Medicine, New York; 2 John Hopkins University, Dhaka; Summary • P 44. EVALUATION OF CONTINUOUS KMC IN A HIGH TECH NICU Ylv Thernström Blomqvist, RN, Doct. Cand., Kerstin Hedberg Nyqvist, RN, Associate Professor of Pediatric Nursing Neonatal unit 95 F, University Hospital, Uppsala, and Dept. of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden Summary • P 45. EVALUATION OF KANGAROO MOTHER CARE DURATION AND ITS OUTCOME Rekha H Udani, Aloke V.R., Ruchi N Nanavati Seth G S Medical College & KEM Hospital, Mumbai, India D Y Patil Medical college & Hospital, Navi Mumbai, India Summary • P 46. KANGAROO MOTHER CARE AND GROWTH IN HIGH RISK LOW BIRTH WEIGHT BABIES Rekha H Udani, Aloke V.R., Ruchi N Nanavati Seth G S Medical College & KEM Hospital, Mumbai ,India D Y Patil Medical college & Hospital, Navi Mumbai, India. Summary • P 47. AN INTRODUCTION TO TRAINING MANUAL ON KANGAROO MOTHER CARE Rekha H. Udani, Ruchi N. Nanavati, Suman Rao, Naveen Bajaj, Tushar Parikh, Dharmesh Shah, Shrinivas Chinta. Seth G S Medical College & KEM Hospital, Mumbai, India; D Y Patil Medical college & Hospital, Navi Mumbai, India Summary • P 48. ANALGESIC EFFECT OF SKIN - TO – SKIN CONTACT IN KANGAROO POSITION IN PRETERM NEWBORNS Kiran Kumar BV, Rekha H. Udani Seth G S Medical College & KEM Hospital, Mumbai, India D Y Patil Medical college & Hospital, Navi Mumbai, India • Summary
Poster presentations • P 49. EFFECT OF EXPRESSED BREAST MILK AND SKIN TO SKIN CONTACT IN KANGAROO POSITION ON PAIN RELATED BEHAVIOR IN PRETERM INFANTS DURING HEEL LANCING Kiran Kumar BV, RH Udani Seth G S Medical College & KEM Hospital, Mumbai, India D Y Patil Medical college & Hospital, Navi Mumbai, India Summary • P 50. KANGAROO MOTHER CARE INITIATIVE IN INDIA YEAR 2005, WHERE ARE WE? Rekha H Udani. Ruchi N Nanavali., Ashish Satpathy, Tushar Parikh, Suman Rao Department of Neonatology, KEM Hospital and Seth G. S. Medical College, Mumbai – 400012, INDIA Summary • P 51. INNOVATION – K.E.M. KANGAROO BAG FOR KANGAROO MOTHER CARE Rekha H. Udani , Ruchi N. Nanavati,A V Mauskar, Suman Rao,T Kulkarni Department of Neonatolog , Seth GS Medical College & KEM Hospital , Mumbai, India Summary • P 52. EVALUATION OF KANGAROO MOTHER CARE (KMC) TRAINING IN METROPOLITAN OF JAKARTA, INDONESIA Uut Uhudiah1, Hadi Pratomo2 and Ely Sawitri3 1) Vice- hairman for KMC Training Team, Perinasia (The Indonesian Society for Perinatology); 2Professor of the Faculty of Public Health, University of Indonesia, Chairman of the Board of Planning Program, Perinasia, 3Research Staff of Perinasia Jakarta, Indonesia Summary • P 53. THE UNDERSTANDING AND PERCEPTIONS OF MOTHERS PRACTICING KANGAROO MOTHER CARE AT KALAFONG HOSPITAL Elise van Rooyen1, Anne-Marie Bergh2, Rachel Mkhondo3 Kalafong hospital, Department of Paediatrics1, University of Pretoria, The Medical Research Council Unit for Maternal and Infant Health Care Strategies2 3, South Africa • Summary
Poster presentations • P 54. AN ONGOING AUDIT OF KANGAROO MOTHER CARE AT KALAFONG HOSPITAL Elise van Rooyen1, RC Pattinson2 Kalafong Hospital, Department of Paediatrics1, University of Pretoria, The MRC Unit for Maternal and Infant Health Care Strategies2, South Africa Summary • P 55. THE KANGAROO METHOD IS SAFE FOR PREMATURE INFANTS UNDER 30 WEEKS OF GESTATION DURING VENTILATORY SUPPORT Henriette A. van Zanten, RN Leiden University Medical Centre, Neonatology, Leiden, The Netherlands Summary • P 57. KANGAROO MOTHER CARE WITH TRIPLETS: PARENTS’ EXPERIENCE Mónica Virchez Figueroa, President of the Prematura Spain • Summary