The document discusses planning a new spa center in the 21st century based on tradition and modern medical practices. It emphasizes using the natural mineral water resource, integrating medical supervision, and promoting health and wellness through prevention, treatment, rehabilitation and health behaviors. New spa centers should conserve local identity and context while improving infrastructure and certifying quality standards. Research on balneotherapy is increasing and its medical education needs wider recognition.

1. Pedro Cantista El termalismo del siglo XXI, medicina y entornos saludables. Capital salud

2. COMO PLANIFICAR UM POLO TERMAL NOS DIAS DE HOJE? El termalismo del siglo XXI, medicina y entornos saludables. Capital salud

3. 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

4. ICF MODEL

5. UM EXEMPLO DE BOA INTGRAÇÃO DOS FACTORES CIRUNSTANCIAIS Unhais da Serra

13. 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

14. Tradição histórica

15. CALDAS DA RAINHA PORTUGAL XV century

16. Evolução científica

17. Francisco da Fonseca Henriques, 1726

19. Realidade Termal Europeia na actualidade

21. European Survey Bender Tamás; Cantista, Pedro

22. European Survey: Results 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% and Reimbursement of costs by health insurances is possible in 72% of the countries. Pedro Cantista

23. Balneology in Europe Some countries don’t recognize Hydrology as a medical discipline They don’t accept its scientific character Ex: England, Scandinavian Countries

24. Medical Education on Balneology 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

25. Research Evidences on Crenotherapy Methodology in Medical Hydrology Research Pedro Cantista

28. Portugal, 25-28 June 2008 www.ismh08.org

29. Opening Ceremony Water, science and culture

31. 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

33. Teaching Balneology in Europe Pedro Cantista

34. Wider recognition Scientific evidence Publication of relevant papers Standardization Definitions Glossary Methodology Consensus Pedro Cantista Teaching Balneology in Europe

35. Which contents should we include ? 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

36. * TERMALISM UNIVERSITY FACULTIES PRE GRADUATE 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

38. What about the Future ?

39. What do we already achived?

40. Consensus

41. GUTENBRUNNER C , BENDER T , CANTISTA P , KARAGÜLLE Z A proposal for a worldwide definition of health resort medicine, balneology, medical hydrology and climatology . Int J Biometeorol. 2010 Jun 9

42. Thermal Certification

43. © EOQ. Developed by MVEurope

44. ISO INTERNATIONAL ORGANIZATION FOR STANDARDS ORGANISATION INTERNATIONALE DE NORMALISATION

45. Como poderemos então idealizar um balneário para o futuro?

46. O exemplo de Vidago

47. Vidago Hotel (1910)

48. Remodelação actual

70. Vidago Conference Centre (antigo balneário)

76. CÂMARA MUNICIPAL DE CHAVES Projecto novo balneário termal

82. FUNÇÕES E VALÊNCIAS Clinica (diagnóstica, assistencial) Crenoterapica Pedagógica (formativa, educativa) Científica Cooperativa Cultural Social Turística

86. Outros pontos de intervenção Protecção do recurso Sistemas de adução e armazenamento Integração da população no projecto Hotelaria e Restauração (dietas, exercício) Renovação urbana Ênfase na Hidropinia e Pista Medicalizada

92. Termas de Monte Real 10 e 11 de Junho, 2011

93. PEDRO CANTISTA Thermal Treatments and Methodologies

94. Hydropinia (oral intake / drinking) Variable doses Different posologies

95. Ears, nose, throat Irrigation Inhalation Nebulization Pulverization

96. Enteric Gynecological

97. Douches Jet douche Circle douche Pulverization Douche massage Sub aquatic douche

98. Imersion modalities

99. Imersion modalities

100. Steam

101. Flebology

102. Many others… Peloids Psamitotherapy (sand) Radon Cavetherapy Mophetas Sauna Turkish Baths Massage

103. Glossaries Christoph Kirschner (German-English) Maria Ángeles Ceballos Hernansanz (Several Languages)