title: Effects of cyclical deep pressure applied by the FLOWpresso on sleep and anxiety

authors: Parkes, Alison Luise

subjects: Mental health

abstract: Sleep is a fundamental primitive state of human beings and a daily basic need as we spend nearly one third of our lives asleep. Neuroimaging tracing the electrical circuitry of the brain shows sleep is not passive, or a mere state of rest and disconnection for the brain, but rather a complex and heterogenous state of neuronal activity, potentially aiding in brain functions such as neuroplasticity, immunity, memory consolidation and emotional processing. The decimation of sleep throughout most nations due to today’s 24-hour society is an endemic in modern society. Large fractions of the global population are under slept, with one third of adults having sleep durations substantially below the recommended 7 to 9 hours sleep each night. Sleep disturbances may be initiated by the demands of life stressors originating within an individual or in the context of the environment in which they live. Regardless of origin, poor sleep can become a potent life stressor, it is a major stress on the neuro-hormonal system of the body. The role of sleep is a vital process for affective brain regulation and recalibrating limbic cortical regions, with its potential palliative influence on anxiety and other emotional disorders. Insufficient sleep is pervasive and holds ecological relevance, with under-slept  individuals having higher observations of over anxious and mental distress presentations. Though there is limited literature evaluating deep pressure therapy, recent studies show its benefits in reducing agitation and calming the body. This study reports on the use of a novel pneumatic compression device called the FLOWpresso that applies cyclical deep pressure squeezes to small regions of the body, from distal to proximal, in a rhythmic sequence, like a hug. The experimental chapter presents the effects of the FLOWpresso on sleep and S anxiety in two studies (Study A and B), with a large sample of adult first responders who are under daily psychological and sleep stress. Sleep and anxiety were investigated through validated self-reported questionnaires: the Patient Reported Outcomes Measurement Information System (PROMIS) sleep disturbance short form, and the Metagenics mood and stress form. All participants received three forty-minute FLOWpresso sessions over a 3-week period, with one session a week. Data was collected at two time-points: prior to first FLOWpresso session (Day 1), and 1 week after the third FLOWpresso session (Day 21). Pre and post scores were analysed using a two-paired samples t-test and the magnitude of difference of means was evaluated with Cohen’s d effect sizes. Results demonstrated that the FLOWpresso is an effective treatment for decreasing perceived sleep disturbance and reducing anxiety symptomology. In Study A, the p-values for the changes in sleep, anxiety, and stress scores were all considered significant (all p < 0.002). These changes were associated with a large effect size for sleep (d = 1.15 ± 0.32), and moderate effect sizes for stress (d = 0.57 ± 0.30) and anxiety (d = 0.53 ± 0.30). In Study B, the p-values for sleep, anxiety, and stress scores considered significant (all p < 0.001). The size of the positive benefit attained over the three-week intervention were categorised as large (d = 1.05 ± 0.31) for sleep and moderate for stress (d = 0.71 ± 0.30) and anxiety (d = 0.56 ± 0.30). The positive effects observed in this cohort of first responders, demonstrates that one 40- minute FLOWpresso treatment per week for three weeks was capable of improving self-reported measures of sleep, anxiety, and stress. While it is acknowledged that there was no control group, the magnitude of the effects warrants further investigation in this cohort that is exposed to high levels of vocational stress. The results are noteworthy given the short duration (3-weeks) of the intervention and the frequency of the treatment exposure (one session per week). The health burden of poor sleep contributes to global concerns regarding stress and, anxiety. The FLOWpresso device may represent an important countermeasure with the potential to have a positive impact on health and mental well-being.

text: Effects of cyclical deep pressure applied by the FLOWpresso on sleep and anxiety Sleep is a fundamental primitive state of human beings and a daily basic need as we spend nearly one third of our lives asleep. Neuroimaging tracing the electrical circuitry of the brain shows sleep is not passive, or a mere state of rest and disconnection for the brain, but rather a complex and heterogenous state of neuronal activity, potentially aiding in brain functions such as neuroplasticity, immunity, memory consolidation and emotional processing. The decimation of sleep throughout most nations due to today’s 24-hour society is an endemic in modern society. Large fractions of the global population are under slept, with one third of adults having sleep durations substantially below the recommended 7 to 9 hours sleep each night. Sleep disturbances may be initiated by the demands of life stressors originating within an individual or in the context of the environment in which they live. Regardless of origin, poor sleep can become a potent life stressor, it is a major stress on the neuro-hormonal system of the body. The role of sleep is a vital process for affective brain regulation and recalibrating limbic cortical regions, with its potential palliative influence on anxiety and other emotional disorders. Insufficient sleep is pervasive and holds ecological relevance, with under-slept  individuals having higher observations of over anxious and mental distress presentations. Though there is limited literature evaluating deep pressure therapy, recent studies show its benefits in reducing agitation and calming the body. This study reports on the use of a novel pneumatic compression device called the FLOWpresso that applies cyclical deep pressure squeezes to small regions of the body, from distal to proximal, in a rhythmic sequence, like a hug. The experimental chapter presents the effects of the FLOWpresso on sleep and S anxiety in two studies (Study A and B), with a large sample of adult first responders who are under daily psychological and sleep stress. Sleep and anxiety were investigated through validated self-reported questionnaires: the Patient Reported Outcomes Measurement Information System (PROMIS) sleep disturbance short form, and the Metagenics mood and stress form. All participants received three forty-minute FLOWpresso sessions over a 3-week period, with one session a week. Data was collected at two time-points: prior to first FLOWpresso session (Day 1), and 1 week after the third FLOWpresso session (Day 21). Pre and post scores were analysed using a two-paired samples t-test and the magnitude of difference of means was evaluated with Cohen’s d effect sizes. Results demonstrated that the FLOWpresso is an effective treatment for decreasing perceived sleep disturbance and reducing anxiety symptomology. In Study A, the p-values for the changes in sleep, anxiety, and stress scores were all considered significant (all p < 0.002). These changes were associated with a large effect size for sleep (d = 1.15 ± 0.32), and moderate effect sizes for stress (d = 0.57 ± 0.30) and anxiety (d = 0.53 ± 0.30). In Study B, the p-values for sleep, anxiety, and stress scores considered significant (all p < 0.001). The size of the positive benefit attained over the three-week intervention were categorised as large (d = 1.05 ± 0.31) for sleep and moderate for stress (d = 0.71 ± 0.30) and anxiety (d = 0.56 ± 0.30). The positive effects observed in this cohort of first responders, demonstrates that one 40- minute FLOWpresso treatment per week for three weeks was capable of improving self-reported measures of sleep, anxiety, and stress. While it is acknowledged that there was no control group, the magnitude of the effects warrants further investigation in this cohort that is exposed to high levels of vocational stress. The results are noteworthy given the short duration (3-weeks) of the intervention and the frequency of the treatment exposure (one session per week). The health burden of poor sleep contributes to global concerns regarding stress and, anxiety. The FLOWpresso device may represent an important countermeasure with the potential to have a positive impact on health and mental well-being.

year: 2021

title: The impacts of tourism at a UNESCO heritage site in China – a need for a meta-narrative? The case of the Kaiping Diaolou

authors: Ryan, Chris

subjects: China

abstract: In China, sites categorised as UNESCO World Heritage Sites are commonly used as a means of economic regeneration through tourism development. This study is of a recent addition to the list, the diaolou (fortified tower houses) of Kaiping, Guangdong, in South China. This rural zone, characterised by past emigration and farming, is in the early stages of tourism development. The study, based on interviews and a survey, permits findings to be compared with other rural areas in China such as Hungcun and the Tangyue Arches of Bao Village in Anhui, and thus while similarities in attitudes are found, in Kaiping differences exist whereby tourism has been found to permit entrepreneurial activities while retaining an agricultural base as the “new tourism rich” employ others to continue farming. The work is contextualised within a model of evolving literature related to tourism impacts on communities. The paper explores a range of issues in sustainable tourism, including the use of tourism as a tool for social, economic and cultural development, holistic approaches to heritage tourism, and the development of glocalisation as a response to globalisation. It discusses differences in approach to heritage tourism, cultural change and commodification between western and Chinese scholars and society.

text: The impacts of tourism at a UNESCO heritage site in China – a need for a meta-narrative? The case of the Kaiping Diaolou In China, sites categorised as UNESCO World Heritage Sites are commonly used as a means of economic regeneration through tourism development. This study is of a recent addition to the list, the diaolou (fortified tower houses) of Kaiping, Guangdong, in South China. This rural zone, characterised by past emigration and farming, is in the early stages of tourism development. The study, based on interviews and a survey, permits findings to be compared with other rural areas in China such as Hungcun and the Tangyue Arches of Bao Village in Anhui, and thus while similarities in attitudes are found, in Kaiping differences exist whereby tourism has been found to permit entrepreneurial activities while retaining an agricultural base as the “new tourism rich” employ others to continue farming. The work is contextualised within a model of evolving literature related to tourism impacts on communities. The paper explores a range of issues in sustainable tourism, including the use of tourism as a tool for social, economic and cultural development, holistic approaches to heritage tourism, and the development of glocalisation as a response to globalisation. It discusses differences in approach to heritage tourism, cultural change and commodification between western and Chinese scholars and society.

year: 2011

title: Mai i te kore, ki te pō, ki te ao mārama: He kohinga pūrākau hauora o ngā kaumātua Māori, Māori Elders health and wellbeing stories in life transitions

authors: Shelford, Pita

subjects: pūrākau

abstract: Introduction
New Zealand’s general population is ageing. Kaumātua (Māori elders) only make up approximately 3.1 percent of the total population and yet, they are disproportionately overrepresented in poor health, wellbeing and ageing statistics. However, this is a one-sided story and the focus of a deficit approach. There is a strong need for a strength-based approach where kaumātua voices of problem-solving and resilience related to ageing and the changes it presents, are heard. The purpose of this study is to identify and share those voices and to respond to the call from Māori academics to apply pūrākau as an alternative to Western narrative approaches. Through a pūrākau approach, this thesis sought to answer three key research questions: 

1)What are the cultural and communication features of the kaumātua teina narratives?
2) What are the cultural and communication characteristics of the kaumātua tuakana conversational styles? and 
3) What is the nature of the kaumātua journeys in how the stories unfold, and relationships develop? 

Methods
This study analyses pūrākau from the Kaumātua Mana Motuhake (KMM) collaboration project between the University of Waikato and the Rauawaawa Kaumātua Charitable Trust in Hamilton, Aotearoa New Zealand. The KMM project sought to enhance kaumātua wellbeing during life changes such as losses of licence, independence or spouse, health changes and retirement through a peer-support tuakana-teina programme. The KMM team implemented a tuakana-teina peer support programme where kaumātua (n= 121) engaged in up to three conversations as kaumātua tuakana-teina pairs. The conversations involved exploring the life changes the teina chose with the tuakana guiding the conversations and sharing potential services to help with the changes.
This thesis analysed 30 kaumātua conversations in 10 tuakana-teina pairs to tell a strengths-based story of health and wellbeing. Taking a Kaupapa Māori approach, the research prioritised, privileged and foregrounded Māori and Indigenous epistemology, ontology, and axiology. A pūrākau-grounded analysis approach was developed and applied to the conversations.

Findings
Related to the first research question, the analysis revealed kaumātua narratives that spoke to stories about adversity, turning points, independence and resilience. Regarding the second research question, the study identified key cultural and communicational characteristics kaumātua tuakana used, speaking with words of kinship and reciprocation, words of ignition and guidance, and words of empathy and affirmation. Pertaining to the third research question, the analysis illustrated conversational and relational journey types kaumātua pairs travelled, consisting of conversations that went direct to topics, detours that became defining moments, small tiki tours that came back to the topic, stories that were revisited, and hospitality becoming defining moments. 

Conclusions
The findings compiled weave a collective tapestry of kaumātua teina pūrākau, kaumātua tuakana communication styles, and kaumātua conversational and relational journeys. Kaumātua teina have voiced a pūrākau for us to understand inter-generational trauma and how cultural connection liberated their wellbeing. Kaumātua tuakana have composed a script of communication protocols emphasising connection and relationship development essential to upholding tikanga (practices, principles, communications). The paired kaumātua journeys have drawn a signposted road map that highlighted journey types, emphasising reciprocity in conversing, learning, guiding, connecting, developing, strengthening and enhancing communications, relationships, and wellbeing

Implications
Via kaumātua conversations, invaluable understandings into Māori and Indigenous wellbeing, ageing and development scholarship are offered, strengthening transformation, leadership and resilience theories. Pūrākau and whanaungatanga (relationships) methodologies are advocated for and culturally responsive research is promoted. Health, wellbeing and ageing programme development, policy and service delivery can be practically informed, accentuating mentorship, intergenerational initiatives, and culturally appropriate kaumātua support. Together, the findings can cultivate community wellbeing and nurture cultural continuity.

text: Mai i te kore, ki te pō, ki te ao mārama: He kohinga pūrākau hauora o ngā kaumātua Māori, Māori Elders health and wellbeing stories in life transitions Introduction
New Zealand’s general population is ageing. Kaumātua (Māori elders) only make up approximately 3.1 percent of the total population and yet, they are disproportionately overrepresented in poor health, wellbeing and ageing statistics. However, this is a one-sided story and the focus of a deficit approach. There is a strong need for a strength-based approach where kaumātua voices of problem-solving and resilience related to ageing and the changes it presents, are heard. The purpose of this study is to identify and share those voices and to respond to the call from Māori academics to apply pūrākau as an alternative to Western narrative approaches. Through a pūrākau approach, this thesis sought to answer three key research questions: 

1)What are the cultural and communication features of the kaumātua teina narratives?
2) What are the cultural and communication characteristics of the kaumātua tuakana conversational styles? and 
3) What is the nature of the kaumātua journeys in how the stories unfold, and relationships develop? 

Methods
This study analyses pūrākau from the Kaumātua Mana Motuhake (KMM) collaboration project between the University of Waikato and the Rauawaawa Kaumātua Charitable Trust in Hamilton, Aotearoa New Zealand. The KMM project sought to enhance kaumātua wellbeing during life changes such as losses of licence, independence or spouse, health changes and retirement through a peer-support tuakana-teina programme. The KMM team implemented a tuakana-teina peer support programme where kaumātua (n= 121) engaged in up to three conversations as kaumātua tuakana-teina pairs. The conversations involved exploring the life changes the teina chose with the tuakana guiding the conversations and sharing potential services to help with the changes.
This thesis analysed 30 kaumātua conversations in 10 tuakana-teina pairs to tell a strengths-based story of health and wellbeing. Taking a Kaupapa Māori approach, the research prioritised, privileged and foregrounded Māori and Indigenous epistemology, ontology, and axiology. A pūrākau-grounded analysis approach was developed and applied to the conversations.

Findings
Related to the first research question, the analysis revealed kaumātua narratives that spoke to stories about adversity, turning points, independence and resilience. Regarding the second research question, the study identified key cultural and communicational characteristics kaumātua tuakana used, speaking with words of kinship and reciprocation, words of ignition and guidance, and words of empathy and affirmation. Pertaining to the third research question, the analysis illustrated conversational and relational journey types kaumātua pairs travelled, consisting of conversations that went direct to topics, detours that became defining moments, small tiki tours that came back to the topic, stories that were revisited, and hospitality becoming defining moments. 

Conclusions
The findings compiled weave a collective tapestry of kaumātua teina pūrākau, kaumātua tuakana communication styles, and kaumātua conversational and relational journeys. Kaumātua teina have voiced a pūrākau for us to understand inter-generational trauma and how cultural connection liberated their wellbeing. Kaumātua tuakana have composed a script of communication protocols emphasising connection and relationship development essential to upholding tikanga (practices, principles, communications). The paired kaumātua journeys have drawn a signposted road map that highlighted journey types, emphasising reciprocity in conversing, learning, guiding, connecting, developing, strengthening and enhancing communications, relationships, and wellbeing

Implications
Via kaumātua conversations, invaluable understandings into Māori and Indigenous wellbeing, ageing and development scholarship are offered, strengthening transformation, leadership and resilience theories. Pūrākau and whanaungatanga (relationships) methodologies are advocated for and culturally responsive research is promoted. Health, wellbeing and ageing programme development, policy and service delivery can be practically informed, accentuating mentorship, intergenerational initiatives, and culturally appropriate kaumātua support. Together, the findings can cultivate community wellbeing and nurture cultural continuity.

year: 2025-11-04