Post on 07-Sep-2014
description
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Pedro Cantista
El termalismo del siglo XXI, medicina y entornos saludables. Capital salud
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COMO PLANIFICAR UM POLO TERMAL NOS DIAS
DE HOJE?
El termalismo del siglo XXI, medicina y entornos
saludables. Capital salud2
Pontos fundamentais
• Construir o futuro mantendo a tradição (não descaracterizar a identidadade local)• A Água Mineral Natural como elemento diferenciador (conservação dos aquíferos, perímetros de protecção)• Estância e Balneário: locais de saúde! (supervisão médica; ligação aos sistemas de saúde- publicos ou privados;
termalismo social) Implementar e divulgar a Medicina Termal (formação, especialização e investigação) Não “matar” o termalismo clássico (prevenção, tratamento e reabilitação) Incluir o termalismo de bem estar numa óptica de saúde (promoção de saúde, comportamentos de saúde) Introduzir o Modelo ICF no termalismo (Organização Mundial de Saúde; factores circunstanciais são também
terapêuticos) Conservar / melhorar o contexto Termal (arquitectura, qualidade hoteleira, ambiente circundante, instalações,
equipamentos, recursos humanos, modelo operativo, certificação ISO) Defender o termalismo no campo jurídico (aquífero, ambiente, boas práticas, modelo operativo
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ICF MODEL
UM EXEMPLO DE BOA INTGRAÇÃO DOS FACTORES
CIRUNSTANCIAIS
Unhais da Serra5
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Tradição / Investigação
A tradição termal dá-nos uma base empírica sobre a qual devemos desenvolver uma aprofundada investigação em ordem ao atingimento do conhecimento científico
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Tradição histórica14
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CALDAS DA RAINHA CALDAS DA RAINHA PORTUGAL XV centuryPORTUGAL XV century
Evolução científica16
17Francisco da Fonseca Henriques, 1726
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Realidade Termal Europeia na actualidade
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European SurveyBender Tamás; Cantista, Pedro
European Survey: Results
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According to this survey performed among the delegates of the UEMS-PRM section, in which 27 countries took part
Balneology and/or Medical Hydrology is officially recognized in 68% of the countries.
In 19% of the countries it is a medical “speciality” In 44% is considered a medical “competence” In 56% it is included in another medical specialities (e.g.
PRM, Rheumatology, Dermatology). Medical units using thermal water for therapeutic
purposes exist in 76% andReimbursement of costs by health insurances is possible in
72% of the countries.
Pedro Cantista
Balneology in Europe
Some countries don’t recognize Hydrology as a medical discipline
They don’t accept its scientific character
Ex: England, Scandinavian Countries
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Medical Education on Balneology24
In 56% of the European countries undergraduate medical education includes Balneology
Post-graduate courses also exist.
Research units exist in 48% of the countries.
Pedro Cantista
Research
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Evidences on CrenotherapyMethodology in Medical Hydrology Research
Pedro Cantista
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Portugal, 25-28 June 2008Portugal, 25-28 June 2008
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www.ismh08.org
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Opening Ceremony
Water, science and culture
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Research and Evidence
Thermal research suffered a decline in the second half of the 20th century.
But these last years very acceptable investigations have been performed
They concern the biological properties, the specificity, the security of thermo-mineral
products and components as well as the clinical efficiency of spa therapy;
in the international literature in these last ten years 60 controlled clinical trials can be found out of about 300 papers
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• Wider recognition• Scientific evidence• Publication of relevant papers• Standardization• Definitions • Glossary• Methodology• Consensus
Pedro Cantista
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Teaching Balneology in Europe
Which contents should we include?35
Definitions and concepts within Hydrology, Climatology, Health Resort Medicine, Health behaviour (diet, exercise, relaxation, social interaction)
Therapeutic principles of Medical Hydrology and Climatology (physical, chemical, biological, psychological, sociological, environmental).
The physiologic effects of water immersion The physiologic effects of mineral products (water, steam, gas, pelloids) Characteristics and Classification of different mineral waters The main Hydrotherapy and Crenotherapy techniques The main complementary techniques The indications, non indications and contra indications of thermal
treatments Knowing how to orientate a patient to a specific thermal station or
program
Pedro Cantista
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UNIVERSITY
FACULTIES
PREGRADUATE
POST GRADUATE
INDEPENDENT DISCIPLIN
PORTO 2
1 1 1
LISBOA 2
- 1 -
COIMBRA 1 1 1
-
BRAGA 1 - - -
COVILHÃ 1 1 1* -
TOTAL 7 3 3 1
* TERMALISM
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What about the Future ?
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What do we already achived?
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Consensus 40
GUTENBRUNNER C, BENDER T, CANTISTA P, KARAGÜLLE Z
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A proposal for a worldwide definition of health resort medicine, balneology, medical hydrology and climatology.
Int J Biometeorol. 2010 Jun 9
Thermal Certification42
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ISO
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INTERNATIONAL ORGANIZATION FOR STANDARDS
ORGANISATION INTERNATIONALE DE NORMALISATION
Como poderemos então idealizar um balneário para o
futuro?45
O exemplo de Vidago46
Vidago Hotel (1910) 47
Remodelação actual48
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Vidago Conference Centre (antigo balneário)
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CÂMARA MUNICIPAL DE CHAVES
Projecto novo balneário termal
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FUNÇÕES E VALÊNCIAS
Clinica (diagnóstica, assistencial)CrenoterapicaPedagógica (formativa, educativa)Científica CooperativaCulturalSocialTurística
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Outros pontos de intervenção
Protecção do recursoSistemas de adução e armazenamentoIntegração da população no projectoHotelaria e Restauração (dietas, exercício)Renovação urbanaÊnfase na Hidropinia e Pista Medicalizada
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Termas de Monte Real 10 e 11 de Junho, 2011
PEDRO CANTISTA
Thermal Treatments and Methodologies
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Hydropinia(oral intake / drinking)
Variable doses Different posologies
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Ears, nose, throat
Irrigation Inhalation Nebulizatio
n Pulverizatio
n
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EntericGynecological
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Douches
Jet doucheCircle douche PulverizationDouche massageSub aquatic douche
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Imersion modalities98
Imersion modalities99
Steam100
Flebology 101
Many others…
PeloidsPsamitotherapy (sand)RadonCavetherapy MophetasSaunaTurkish BathsMassage
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Glossaries
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Christoph Kirschner(German-English)
Maria Ángeles Ceballos Hernansanz(Several Languages)
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