The impact of traditional mind-body exercises on pulmonary function, exercise capacity, and quality of life in patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis of randomized controlled trials.

Background: Chronic Obstructive Pulmonary Disease (COPD) is a chronic condition characterized primarily by airflow obstruction, significantly impacting patients' quality of life. Traditional mind-body exercises, as a non-pharmacological intervention for COPD, have become a new research focus. Objective: To assess the impact of traditional mind-body exercises (Tai Chi, Qigong, Yoga) on pulmonary function, exercise capacity, and quality of life in COPD patients. Additionally, to identify the most suitable form of traditional mind-body exercise for different indicators. Methods: Searches were conducted in databases such as Web of Science, PubMed, EBSCOhost, CNKI, etc., to collect randomized controlled trials (RCTs) evaluating the intervention of traditional mind-body exercises (Tai Chi, Yoga, Qigong) in COPD. The Cochrane evaluation tool was applied for methodological quality assessment of the included literature. Statistical analysis and sensitivity analysis were performed using Revman 5.4 software, while publication bias was assessed using R software. Results: This study included 23 studies with a total of 1862 participants. Traditional mind-body exercises improved patients' FEV1% index (WMD = 4.61, 95%CI [2.99, 6.23]), 6-min walk distance (SMD = 0.83, 95%CI [0.55, 1.11]), and reduced patients' SGRQ score (SMD = -0.79, 95%CI [-1.20, -0.38]) and CAT score (SMD = -0.79, 95%CI [-1.20, -0.38]). Qigong showed the most significant improvement in FEV1% and 6MWT, while Tai Chi primarily improved 6MWT, and the effect of Yoga was not significant. Sensitivity analysis indicated stable and reliable research conclusions. Conclusion: Traditional mind-body exercises are effective rehabilitation methods for COPD patients, significantly improving pulmonary function, exercise capacity, and quality of life. They are suitable as complementary interventions for standard COPD treatment. Systematic review registration: [https://www.crd.york.ac.uk/prospero/display-record.php?ID=CRD42023495104], identifier [CRD42023495104].

Plant fire-adaptive traits mediate long-term fire recurrence impact on the potential supply capacity of ecosystem services and their resilience.

Fire-induced changes in vegetation composition due to fire-regime intensification are leading to alterations in ecosystem services that might threaten their future sustainability. Fire recurrence, in particular, could be a key driver shaping ecosystem service resilience in fire-prone ecosystems. This study evaluates the impact of fire recurrence, over twenty-four years, on the potential supply capacity of ten regulating, provisioning, and cultural services selected as critical services by stakeholders and experts. We assessed fire effects in four fire-prone landscapes dominated by species with different functional-traits response to fire (i.e., obligate seeder vs resprouter species). Trends in the potential supply capacity linked to fire recurrence were estimated by applying a supervised classification of Land Use and Land Cover (LULC) classes performed using Landsat imagery, associated to an ecosystem service capacity matrix adapted to the local socio-ecological context. In landscapes dominated by seeders, fire recurrence broke off the potential supply capacity of services traditionally associated to mature forest cover (i.e., the predicted probability of a decrease in the potential supply capacity of climate regulation, timber, wood fuel, mushroom production, tourism, landscape aesthetic, and cultural heritage occurred with high fire recurrence). In landscapes dominated by resprouter species, the effect of fire recurrence was partially buffered in the short-term after fire and no substantial differences in trends of change were found (i.e., equal predicted probability in the potential supply capacity of ecosystem services regardless of fire recurrence). We detected two new opportunities for ecosystems service supply associated to fire recurrence: livestock and honey production, especially in sites dominated by seeders. These findings provide valuable information aiming at recovering post-fire ecosystem service potential supply to partially counterbalance the loss in the socio-ecological system. When the main post-fire restoration goal is preserving ecosystem service resilience in fire-prone ecosystems, establishing management strategies focused on promoting resprouter species could aid mitigating the fire-driven loss of their supply capacity.

Independent and joint associations of multiple metals exposure with vital capacity index: a cross-sectional study in Chinese children and adolescents.

OBJECTIVE: The current study aimed to explore the relationships between urinary metals and vital capacity index (VCI) in 380 children and adolescents in Northeast China using a variety of statistical methods. METHODS: A cross-sectional survey was conducted among 380 children and adolescents in Liaoning Province, China. To assess the relationships between urinary metals and VCI, Elastic-net (ENET) regression, multivariate linear regression, weighted quantile sum (WQS), bayesian kernel machine regression (BKMR) and quantile-based g computation (qgcomp) were adopted. RESULTS: The ENET model selected magnesium (Mg), vanadium (V), manganese (Mn), arsenic (As), tin (Sn) and lead (Pb) as crucial elements. In multiple linear regression, we observed urinary Pb, Mn was negatively correlated with VCI individually in both total study population and adolescents (all p values < 0.05) in the adjustment model. The WQS indices were negatively related with VCI in total study population (ß=-3.19, 95%CI: -6.07, -0.30) and adolescents (ß=-3.46, 95%CI: -6.58, -0.35). The highest weight in total study population was Pb (38.80%), in adolescents was Mn (35.10%). In the qgcomp, Pb (31.90%), Mn (27.20%) were the major negative contributors to the association in the total population (ß=-3.51, 95%CI: -6.29, -0.74). As (42.50%), Mn (39.90%) were the main negative contributors (ß=-3.95, 95% CI: -6.68, -1.22) among adolescents. The results of BKMR were basically consistent with WQS and qgcomp analyses. CONCLUSIONS: Our results indicated that Pb and Mn were priority toxic materials on VCI. The cumulative effect of metals was negatively related to VCI, and this relationship was more pronounced in adolescents.

Zno nanoparticles: improving photosynthesis, shoot development, and phyllosphere microbiome composition in tea plants.

BACKGROUND: Nanotechnology holds revolutionary potential in the field of agriculture, with zinc oxide nanoparticles (ZnO NPs) demonstrating advantages in promoting crop growth. Enhanced photosynthetic efficiency is closely linked to improved vigor and superior quality in tea plants, complemented by the beneficial role of phyllosphere microorganisms in maintaining plant health. However, the effects of ZnO NPs on the photosynthesis of tea plants, the sprouting of new shoots, and the community of phyllosphere microorganisms have not been fully investigated. RESULTS: This study investigated the photosynthetic physiological parameters of tea plants under the influence of ZnO NPs, the content of key photosynthetic enzymes such as RubisCO, chlorophyll content, chlorophyll fluorescence parameters, transcriptomic and extensive targeted metabolomic profiles of leaves and new shoots, mineral element composition in these tissues, and the epiphytic and endophytic microbial communities within the phyllosphere. The results indicated that ZnO NPs could enhance the photosynthesis of tea plants, upregulate the expression of some genes related to photosynthesis, increase the accumulation of photosynthetic products, promote the development of new shoots, and alter the content of various mineral elements in the leaves and new shoots of tea plants. Furthermore, the application of ZnO NPs was observed to favorably influence the microbial community structure within the phyllosphere of tea plants. This shift in microbial community dynamics suggests a potential for ZnO NPs to contribute to plant health and productivity by modulating the phyllosphere microbiome. CONCLUSION: This study demonstrates that ZnO NPs have a positive impact on the photosynthesis of tea plants, the sprouting of new shoots, and the community of phyllosphere microorganisms, which can improve the growth condition of tea plants. These findings provide new scientific evidence for the application of ZnO NPs in sustainable agricultural development and contribute to advancing research in nanobiotechnology aimed at enhancing crop yield and quality.

Predicting functional movement capacity in adults: the effect of range of motion and isometric strength.

The aim of the study was to determine the role of isometric strength and range of motion in predicting Functional Movement Screen (FMS) scores of adults. A total of 120 participants (age = 34.62 ± 11.82 years; height = 170.56 ± 9.63 cm; weight = 73.62 ± 15.39 kg) volunteered to participate in the study. Anthropometric measurements were performed, including height, body weight, muscle mass, and body fat. Following this, the ranges of motion of the shoulder, hip, knee, and ankle joints were measured sequentially. Isometric strength and FMS tests were then performed. Hip extension isometric strength explained 23% of the variation in FMStotal. The common effect of knee flexion, shoulder flexion, and dorsiflexion joint range of motion explained 34% of the change in FMStotal (F (3-116) = 20.375, p < 0.001). A significant relationship (R = 0.658, R2 = 0.413) was found between hip extension isometric strength, knee flexion, shoulder flexion, and dorsiflexion range of motion and FMStotal (F (4-115) = 21.952, p < 0.001). The common effect of all these variables explains 43% of the change in FMStotal. The results indicate that the FMS test scores, which are utilized to evaluate the risk of injury in sedentary adults, can be significantly predicted by the effect of hip extension isometric strength and parameters related to knee flexion, shoulder flexion, and dorsiflexion joint range of motion. At this time, it is advised that range of motion and isometric strength be taken into account when determining a person's functional movement capacity.

Adaptive capacity to reduce disaster risks in informal settlements.

The eMalahleni Local Municipality (eLM) in Mpumalanga province, South Africa, has a number of informal settlements because of the influx of people seeking employment in the municipal area. These informal settlements are exposed to a number of hazards, including underground fires, air and water pollution, sinkholes, abandoned mining areas and acid mining drainage. South Africa's National Development Plan (NDP) incorporates the United Nation's Sustainable Development Goals, which are intended to upgrade informal settlements on suitable land. The Department of Human Settlement recognised the gap in the policy because upgrading only included physical structures and did not include adaptive capacity for communities to create resilience to withstand disasters. The researcher used a case study research design for the inquiry intended to recommend adaptive capacity and reduce disaster risks in informal settlements in the eLM. Purposive sampling was used to select 25 participants from eLM, provincial government departments and informal settlements. The data were analysed using thematic analysis based on the study's conceptual framework. The research findings revealed that the government has not done much to involve vulnerable communities during the development of policies to reduce disaster risks within informal settlements. In particular, the failure of the government to promote and reinforce public participation in disaster risk reduction programmes leaves the vulnerable communities defenceless. Contribution: This study strengthens the intergovernmental structures and public participation to reduce disaster risks in communities. This study discourages a silos mentality and encourages coordination between government departments to identify root causes by applying the pressure and release model for effective disaster risk reduction.

The Effect of Targeted Temperature Therapy on Antioxidant Levels in Patients With Spontaneous Circulation After Cardiac Arrest.

Introduction In this study, we aimed to measure the change in total antioxidant status (TAS), total oxidant stress (TOS), oxidative stress index (OSI), and nuclear factor erythroid 2 (Nrf-2) levels during the treatment period in patients who restored spontaneous circulation return after cardiac arrest with targeted temperature management (TTM) therapy in our hospital. Methods The study included 36 patients who were hospitalized in the anesthesia intensive care unit and coronary intensive care unit of our hospital and were treated with TTM therapy after cardiac arrest. TAS, TOS, OSI, and Nrf-2 levels were measured at 0 (beginning), 12, 24, and 48 (end) hours of TTM therapy. Results The mean age of the patients participating in the study was 54.25±17.10. TAS and TOS levels decreased gradually during TTM therapy, but statistically significant decrease was observed at the end of the hour. When Nrf-2 and OSI levels were evaluated, it was found that no statistically significant difference was observed during the TTM therapy. Conclusion In our study, the oxidant-antioxidant balance was preserved in patients who received TTM therapy after cardiac arrest. We predict TTM therapy is effective on oxidative stress after cardiac arrest and should be applied for at least 48 hours.

Effect of Cardiovascular Endurance Training on the Exercise Capacity and Endurance in Children With Cerebral Palsy.

BACKGROUND: Cerebral palsy (CP) is non-progressive brain damage that occurs before, during, or shortly after birth. CP is associated with poor physical fitness, which is linked to health problems and the development of secondary illnesses like obesity, cardiovascular disease, and diabetes. Compared to healthy peers without CP, children with CP have considerably lower VO2 peaks, which reduces their performance and aerobic capacity. OBJECTIVE: This study aimed to evaluate changes in exercise capacity and endurance among children with CP, as well as fatigue levels among their parents and caregivers, after participation in cardiovascular endurance training. METHODOLOGY: This study included 16 children aged 7-12 years with CP (Gross Motor Function Classification System levels I, II, or III). Participants completed a 12-week cardiovascular endurance program consisting of 60-minute sessions three times weekly designed to achieve 64-95% of their heart rate maximum,based on the American College of Sports Medicine guidelines. Pre- and post-intervention measurements were recorded for the following: distance covered in a six-minute walk, maximal oxygen consumption (VO2 max) level, Early Activity Scale for Endurance rating, and Patient-Reported Outcomes Measurement Information System (PROMIS) Pediatric Fatigue Scale score and PROMIS Parent Proxy Scale and Fatigue Scale scores.  Result: Upon completing the cardiovascular endurance training, the distance covered during a six-minute walk improved by 20.95 points, resting heart rate by 5.19 points, VO2 max by 0.06 points, Early Activity Scale for Endurance by 4.06 points, PROMIS Pediatric Fatigue Scale by 7.29 points, PROMIS Parent Proxy Scale by 6.81 points, and PROMIS Fatigue Scale by 5.07 points. The maximum heart rate also showed a slight improvement of 0.33 points (p<0.01). CONCLUSION: A structured exercise protocol aimed at improving cardiovascular endurance can benefit children with CP by improving their exercise capacity and endurance, which in turn can help decrease fatigue levels among their parents and caregivers.

How "global" is research in early intervention for psychosis? A bibliometric analysis.

INTRODUCTION: Unlike high-income countries (HICs), there are few early intervention services for psychosis in low-and middle-income countries (LAMICs). In HICs, research spurred the growth of such services. Little is known about the state of EIP research in LAMICs, which we address by examining their research output and collaborations vis-à-vis that of HICs. METHODS: We conducted a search in Scopus database for early psychosis publications in scientific journals since 1980. Data from each record, including title, author affiliation, and date, were downloaded. For HIC-LAMIC collaborations, data on first, corresponding and last authors' affiliations, and funding were manually extracted. Descriptive statistics and social network analysis were conducted. RESULTS: Globally, early psychosis publications increased from 24 in 1980 to 1297 in 2022. Of 16,942 included publications, 16.1 % had LAMIC authors. 71.3 % involved authors from a single country (regardless of income level). 21.9 % were collaborations between HICs, 6.6 % between HICs and LAMICs, and 0.2 % among LAMICs. For research conducted in LAMICs and involving HIC-LAMIC collaborations, the first, last, and corresponding authors were LAMIC-based in 71.8 %, 60.7 %, and 63.0 %, respectively. These positions were dominated (80 %) by authors from four LAMICs. 29.4 % of the HIC-LAMIC subset was funded solely by LAMIC funders, predominantly two LAMICs. CONCLUSIONS: LAMICs are starkly underrepresented in the otherwise flourishing body of early psychosis research. They have far fewer collaborations and less funding than HICs. Closing these gaps in LAMICs where most of the world's youth live is imperative to generate the local knowledge needed to strengthen early psychosis services that are known to improve outcomes.

Evaluation of Watershed Non-Point Source Pollution Risks Using Water Environment Capacity Analysis.

A thorough understanding of the geographical and spatial attributes of nonpoint source pollution risk in watersheds is crucial for conducting nonpoint source pollutant studies and implementing effective scientific administration strategies. The inclusion of a water-related functioning zone was considered during the nonpoint source's pollution risks assessment procedure. Nevertheless, there has not been a thorough investigation into the potential risk of nonpoint sources of pollution to adequately safeguard the quality of water in watersheds having varying capacities to handle contaminants in the water. This research presents an innovative approach for assessing the risk of nonpoint sources contamination. This allows for a quantitative evaluation of the effect of discharges of pollution from a sub-catchment on the quality of water bodies nearby. The nonpoint source losses of nutrients process, as modeled by the Water and Soil Assessment Tool, had been used to assess the hazard of nonpoint source contamination in Le 'a River Watersheds. This assessment happened on both yearly and monthly scales. The findings indicated that the risk of nonpoint source contamination exhibits both seasonal and regional variations and is significantly impacted by the ability of the fluid ecosystem. Elevated nonpoint sources pollutants do not always equate to elevated pollutant dangers. On the other hand, a small amount of nutrients in the nonpoint sources does not indicate an insignificant degree of susceptibility to region risk. Furthermore, by utilizing a risk assessment method that considers the capacity of the water's environment, it is possible to identify variations in risk levels that may be overlooked when solely considering nonpoint sources contaminant losses, and fluid functioning zone. This approach allows for precise regulation of nonpoint sources of pollution administration.

Unlocking time-quantile impact of energy vulnerability, financial development, and political globalization on environmental sustainability in Turkey: Evidence from different pollution indicators.

Increasing energy vulnerability can cause environmental pollution by increasing fossil fuel consumption. If it leads to cost-cutting-oriented industry growth, financial development can lead to environmental regulations being ignored, compromising environmental quality. Political globalization and economic growth can increase short-term environmental pressures, straining long-term ecological balance and causing habitat loss and pollution. This study investigates the impact of energy vulnerability, financial development, and political globalization on environmental sustainability in Turkey for the 2000-2019 period using with wavelet quantile-based techniques. According to results, while the negative effect of energy vulnerability on environmental quality is lower in the short term, the size of the effect increases in the medium and long term. In addition, at low quantiles of environmental quality, the negative effect of financial development is low in the short and long term, while the effect becomes evident in the long term. Moreover, the effects of political globalization on environmental quality are positive in all quantiles. Additionally, the harmful effects of economic growth are more evident at lower quantiles of environmental quality. Turkey should increase its clean energy investments by using its geographically advantageous location. Policymakers should also prioritize environmental regulations and promote sustainable practices in industries. Incentives for cleaner production technologies and environmentally friendly initiatives can help steer the financial sector towards more responsible and environmentally friendly practices. Additionally, the study suggests that increasing institutional capacity and aligning national policies with international agreements can accelerate the positive effects of political globalization.

Does the Repeated-Bout Effect Influence Post-Activation Performance Enhancement in Recreational Runners?

Purpose: This study examined how a low dose of an eccentric-oriented lunge exercise could induce the repeated-bout effect (RBE) and affect the subsequent post-activation performance enhancement (PAPE) in recreational runners. Methods: Twenty male recreational runners (32.1 ± 2.8 years; 173.4 ± 6.1 cm; 73.3 ± 11.5 kg; 57.8 ± 7.2 mL·kg-1·min-1) were divided into control (N = 10) and experimental (N = 10) groups. In the first and fourth weeks, the groups were assessed for jump capacity, dynamic balance, and submaximal running kinematics before and after an incremental shuttle-run test until exhaustion. The experimental group was also submitted to two sessions of the eccentric-oriented lunge exercise (3 sets of 10 repetitions with 2 min of passive recovery) in the second and third weeks. Results: We observed that the first session promoted muscle damage, which was significantly (p < .05) reduced after the second training session, thus indicating an RBE. Meanwhile, there was no effect of the RBE on dynamic balance and submaximal running kinematics in the post-intervention. However, there was a significant increase in countermovement jump height (p = .008) for the experimental group when compared to the control group, although no PAPE was observed. Conclusions: The current results demonstrate that a simple, low-dose eccentric-oriented exercise may induce an RBE, leading to reduced muscle damage and a possibly improved lower limbs' muscle power in recreational runners. However, the absence of PAPE effects suggests that the RBE may not directly influence the potentiation/fatigue balance after fatiguing running exercises.

Responsible inclusion: A systematic review of consent to social-behavioral research with adults with intellectual disability in the US.

BACKGROUND: In recognition of their status as a health disparities population, there is growing emphasis on conducting research inclusive of adults with intellectual disability to generate new knowledge and opportunities to improve health and equity. Yet they are often excluded from research, and human research participant protection experts and researchers lack agreement on effective consent protocols for their inclusion. OBJECTIVE: We sought to identify approaches to consent in US-based social-behavioral research with adults with intellectual disability. METHODS: We conducted a systematic review on approaches to self-consent with adults with intellectual disability published between 2009 and 2023, identified via searching eight databases and reference list hand searches. We identified 13 manuscripts and conducted a thematic analysis. RESULTS: Our analysis identified themes related to guiding principles, strategies to enhance informed and voluntary consent, approaches to consent capacity, involving individuals subject to guardianship, and strategies for expressing decisions and enhancing ongoing decisions. CONCLUSIONS: Manuscripts largely reflected an emphasis on identifying approaches to consent that reflect disability rights principles to promote the right to be included and make one's own decisions based on assessment of relevant information, risks and benefits, and to employ reasonable modifications to achieve inclusion. To avoid the risks of exclusion and advance the responsible inclusion of adults with intellectual disability, we make recommendations to align consent approaches anchored in contemporary thinking about human research participant protections, including through integration with disability rights.

Laboratory capacity expansion: lessons from establishing molecular testing in regional referral laboratories in Ethiopia.

Respiratory viruses contribute to high morbidity and mortality in Africa. In 2020, the Ohio State University's Global One Health Initiative, in collaboration with the Ethiopian Public Health Institute and the US Centers for Disease Control and Prevention, took action to strengthen Ethiopia's existing respiratory virus surveillance system through decentralization of laboratory testing and scale-up of national and regional capacity for detecting respiratory viruses. In August 2022, four regional laboratories were established, thereby raising the number of reference laboratories conducting respiratory virus surveillance to five. This article highlights lessons learned during implementation and outlines processes undertaken for laboratory scale-up and decentralization.

Neurocognitive Disorders: Medical Illness or Mental Disorder: Examining the Mental Health and Wellbeing Act 2022 (Vic) Using Neurocognitive Disorders.

Victoria has new legislation, the Mental Health and Wellbeing Act 2022 (Vic) (MHWA) to govern the care and treatment of people with mental illness that came into effect on 1 September 2023. It takes a human rights approach with a focus on person-centred care. The definition of mental illness encompasses conditions such as dementia even though it is rarely used to manage such conditions. How would the management of dementia and associated conditions change if these conditions were managed under the MHWA? This article uses dementia to examine the differences between the new MHWA, the Medical Treatment Planning and Decisions Act 2016 (Vic) and the Guardianship and Administration Act 2019 (Vic) and how the human rights approach taken by the MHWA might inform future directions in managing dementia.

Insight and the Capacity to Refuse Treatment with Electroconvulsive Therapy.

All Australian jurisdictions have statutory provisions governing the use of electroconvulsive therapy. Cases in which the patient lacks insight into their psychotic illness and need for treatment and refuses to have ECT are particularly poignant. In Re ICO [2023] QMHC 1, the Queensland Mental Health Court considered whether a patient with a treatment-resistant psychotic illness had decision-making capacity to refuse ECT. The Court also considered whether the patient had been provided with an adequate explanation of the proposed treatment including the expected benefits, risks and adverse effects of ECT. As well as deciding whether ECT was appropriate in the circumstances, the Court considered whether there were alternative treatments including another trial of the oral antipsychotic clozapine. This article reviews issues relating to lack of insight in persons with psychotic illness and relevant considerations for determining capacity to decline ECT.

Important legal principles of consent and mental capacity.

Consent is an essential part of healthcare practice, allowing patients to make autonomous decisions. However, this changes when a patient has mental incapacity or is unable to make decisions for themselves for a duration of time. This month's Policy column looks at some of the key principles of the Mental Capacity Act 2005, and how this can be applied in community nursing practice.

How does the data element-driven industry affect corporate cash holdings? Evidence from Chinese listed companies.

The data element-driven industry (DEDI) generates large amounts of data, thereby mitigating information asymmetry. Does this affect corporate cash holdings? On the basis of theoretical analysis, this study empirically analyzes the impact of DEDI on enterprises' cash holdings and its transmission path using data of Chinese cities and A-share listed enterprises from 2008 to 2020. First, the results indicate that the DEDI reduces corporate cash holdings. As the development level of the DEDI improves, the corporate cash holdings gradually decrease. Second, the DEDI indirectly affects corporate cash holdings by influencing debt-financing and external credit supply capacities. Specifically, the DEDI increases the upstream corporate debt-financing and downstream corporate external credit supply capacities. Improvements in debt-financing and the external credit supply capacities can reduce corporate cash holdings. Third, the DEDI has a heterogeneous impact. For enterprise with CEO duality, small and medium-sized, and information technology enterprises, the impact of DEDI in reducing cash holdings is greater.

Associations between capacity of cognitive control and sleep quality: a two-wave longitudinal study.

This longitudinal study explored the impact of the upper limit of cognitive control on the sleep quality of high school students. We collected data in two waves to examine four main variables: capacity of cognitive control (CCC), trait mindfulness, emotional distress and sleep quality. At the first time point (T1), trait mindfulness and emotional distress were measured by rating scales, and the CCC was evaluated by revised backward masking majority function task. Sleep quality was rated 5 months later (T2). The results indicated that: (1) the CCC was negatively correlated with trait mindfulness, and trait mindfulness was negatively correlated with emotional stress; (2) there was no simple mediation of either trait mindfulness or emotional distress in the relationship between CCC and sleep quality; (3) instead, the CCC was associated with poor sleep quality in a sequential mediation through trait mindfulness and then emotional stress. The research highlights the importance of trait mindfulness and emotional distress for addressing sleep problems in adolescents.