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MedBridge partners with healthcare integration platform Redox that will allow MedBridge users to quickly create and assign Home Exercise Programs, and more easily document within their EMR, without interrupting their workflow.

MedBridge EMR integrated clients have already achieved savings of over $4,500 per clinician per year, by reducing five minutes of documentation time per patient.

MedBridge, the industry-leading continuing education and patient engagement solution that enables healthcare organizations to improve outcomes and optimize care delivery announced today its partnership with Redox, a healthcare integration platform that allows software vendors to seamlessly integrate with healthcare organizations to securely exchange healthcare data.

As part of the partnership, MedBridge will expand itscurrent network of integrations to include leading EMRs, enabling healthcareprofessionals to quickly collect and record accurate patient information,saving time, and standardizing care coordination.

For healthcare professionals, interoperability between their EMR and patient engagement solution will be essential to improving outcomes through a holistic, patient-centered approach, said Justin Kowalchuk, MedBridge founder, and CEO. We are excited to partner with Redox to significantly expand our EMR integration capabilities and further support our clients across all healthcare settings.

Partnership Benefits for MedBridge

This increased interoperability allows MedBridge users toquickly create and assign Home Exercise Programs, and more easily documentwithin their EMR, without interrupting their workflow. MedBridge EMR integratedclients have already achieved savings of over $4,500 per clinician per year, byreducing five minutes of documentation time per patient.

This partnership with MedBridge opens up new possibilities for thousands of healthcare organizations to enjoy both an increase in workflow efficiency and optimized transfer of secure patient information, said Niko Skievaski, co-founder and president of Redox. Their platform is a perfect example of how technology alleviates pain points felt by clinicians, health systems and patients. MedBridge has found clear benefits of the EMR as a source of truth, and as a member of the Redox interoperable network, well turn that data into actionable information using any EMR for better patient outcomes.

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MedBridge Partners with Redox to Expand Its Network of EMR Integrations - - HIT Consultant

Blue Cross Blue Shield of Arizona (BCBSAZ) announced the winners of the second annual Get Fit. Dont Quit! Spotlight Awards, recognizing organizations across Arizona that are inspiring health and wellness in their local communities. BCBSAZ awarded a total of $150,000 including five $10,000 prizes to organizations across the state, and an all-new $100,000 Get Fit. Dont Quit! Fitness Center to Kiser Elementary School in Gila Bend, Ariz.

BCBSAZ and fitness icon Jake Body by Jake Steinfeld launched the Get Fit. Dont Quit! program in 2018 to inspire Arizonans to live a healthier lifestyle through fun and engaging videos and tips on being active, eating better and staying motivated. Pam Kehaly, president and CEO of BCBSAZ, and Steinfeld announced the winners of the 2020 Spotlight Awards at a ceremony in downtown Phoenix on Monday, March 2.

Honorees were selected in six categories, with five winners receiving $10,000 from BCBSAZ to help further their health initiatives. Kiser Elementary School was presented with the $100,000 fitness center that will provide students, faculty and community members with a state-of-the-art exercise facility.

When we first introduced the Get Fit. Dont Quit! program, our hope was to inspire Arizonans to live a healthier lifestyle, said Kehaly. The Spotlight Award winners represent the type of dedication and commitment to health that inspires us to continue supporting innovative community programs that impact everyone in our state.

Kiser Elementary School was selected for providing safe recreational spaces for its students, as well as members of the community. The K-8 school is surrounded by rural farmland in Gila Bend and public recreation spaces are limited for residents of the area. Kiser has opted to keep the schools soccer fields and playgrounds open for residents to use on evenings and weekends.

We have an incredible student body and our teachers are passionate about ensuring we lead by example when promoting healthy habits, said Kristin Turner, principal of Kiser Elementary School and superintendent of Paloma Elementary School District. The fitness center will not only introduce physical education to our students but also offer our staff and our entire community a space where they can improve their health through exercise.

Kiser hosts free recreation programs for students and opens its pool to the public every summer to keep youth engaged and active. During the school year, sixth, seventh and eighth-grade students participate in daily 15-minute jogging breaks. The school also implemented a morning recess before breakfast last year to help increase physical activity and reduce tardy counts.

Additional winners recognized during Mondays ceremony included:

Business of the Year, Dancing in the Streets AZ: The studio provided dance lessons to more than 200 low-income and at-risk students in 2019. It was recognized for its dedication to breaking down cultural barriers through performing arts and focusing on providing the Tucsons youth with an outlet to improve physical and mental health.

City of the Year, City of Yuma: The city was honored for establishing its Yumas Wellness Ambassadors volunteer program that helped connect city employees with wellness initiatives that are available to them. Yuma invests in preventive care for its employees and incentivizes annual visits to a primary care physician. Most recently, the city transformed an unused space into a wellness room for employees that features physical fitness equipment and designated areas for relaxation.

County of the Year, Yavapai County: The county was commended for developing a coalition program that brought more than 20 health service providers in the county together and introduced a comprehensive website for school officials to access when seeking health resources for students. The county also launched an annual Yavapai Healthy Schools award program that recognizes schools for their efforts to improve health and wellness for students.

School District of the Year, Humboldt Unified School District: Last year, the districts wellness coordinator increased recess time throughout the school day and administered nutrition education courses in more than 70 classrooms.

Tribal Nation of the Year, White Mountain Apache Tribe: The tribe has engaged in a public health partnership with Johns Hopkins University for more than 40 years, and designed solutions for health disparities that are common among tribal nations. Programs have evolved over the years to focus on the most immediate health concerns of the community. Most recently, theyve focused on developing a youth sports program that promotes fitness, nutrition and reproductive health among Native youth.

Construction of the new fitness center at Kiser Elementary School will break ground this summer and is expected to be completed by the start of the 2020-2021 school year. For more information on Get Fit. Dont Quit!, visit getfitdontquit.com

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BCBSAZ awards $150K to help improve health of Arizonans - AZ Big Media

A type 2 diabetes prevention program from a UBC Okanagan and YMCA team-up will expand to more communities later this year.

The Small Steps for Big Changes program, which helps individuals make long-lasting positive lifestyle changes, was successfully piloted in the Okanagan in 2019 and will extend locally this year and to new communities over the next two years.

The inspiration for the Small Steps for Big Changes initiative was to support those living with prediabetes, and more importantly, to help empower them to maintain their diet and exercise behaviours, said Mary Jung, associate professor at UBC Okanagan.

The goal of our partnership is to help prevent the development of type 2 diabetes in those at risk by providing a program that is accessible.

READ MORE: UBCO researchers create technology to help protect grapes from wildfire smoke

The expansion of the Small Steps for Big Changes program will help steer behaviour change research directly, a goal that is aligned with the mission of the YMCA.

As a charity dedicated to creating a healthy community for all, the YMCA ensures that every member has equal access to YMCA programs, said Sharon Peterson, YMCA Okanagan CEO.

Our partnership with UBC is a natural alignment between two organizations who care about and are committed to improving the health of all community members.

READ MORE: Fresh Outlook Foundation to host community health summit in Kelowna

Building on a two-year collaboration as a university laboratory in the Kelowna YMCAs downtown branch, Jung and the UBCO-YMCA team hope to show that a personalized, one-on-one, training and counselling program will be successful in helping participants make lasting dietary and exercise changes.

More information can be found here.

To report a typo, email:newstips@kelownacapnews.com.

@KelownaCapNewsnewstips@kelownacapnews.comLike us on Facebook and follow us on Twitter.

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Previous story UBC Okanagan, YMCA team up to tackle prediabetes with prevention program - Salmon Arm Observer

Imagine you've tested positive for coronavirus. Once you've been isolated from the public and treated, a health official comes to your bedside and asks for an interview: Who have you infected?

Who have you come into close contact with face-to-face and less than a metre for a period of at least 10-15 minutes in the last 14 days?

You think back: There's your family and friends and perhaps workmates too, but also less obvious candidates, like whoever you've sat next to on the bus, or shared a table with at a cafe, and maybe also your hairdresser or beautician or a taxi driver.

You may eventually come up with a list that numbers a dozen people, many of them strangers.

The work of figuring out who these people are and then contacting them before they infect anyone else is known as contact tracing.

With coronavirus spreading in Australia, teams of public health workers are engaged in a high-stakes race that's taking place mostly behind-the-scenes, but which will determine how many people are infected with Covid-19 in the coming months.

Professor Dominic Dwyer, a medical virologist and NSW Health's Director of Public Health Pathology based at Westmead Hospital in Western Sydney, is at the centre of this effort.

He described contact tracing as urgent and arduous detective work that begins from the moment a lab test comes back positive.

"It's quite complicated and quite time-intensive and money-intensive," he said.

"It's a real sleuthing exercise a lot of shoe leather gets used in trying to contact everybody.

"Something like this coronavirus one you've got thousands of people working around the world, following up cases left, right and center.

We have a team of people going, 24/7 doing the laboratory testing and [NSW Health] have a team going, essentially, 24/7 doing contact tracing.

Passengers arrive in Sydney.

In late January, two people tested positive for coronavirus after travelling from Melbourne to the Gold Coast on a 180-seat passenger flight.

In response, hundreds of passengers from 13 different flights were contacted.

"They followed up all the cases and sure enough they found a couple more cases in Queensland," Professor Dwyer said.

Tracking down plane passengers is relatively easy since passengers have to buy a ticket once an infected person gets on a bus or train, it gets exponentially harder.

A few days ago, a Gold Coast beautician based at a busy shopping centre was identified as Queensland's sixth Covid-19 confirmed case.

From the contact tracing interview, it emerged she had seen between 30 and 40 clients for treatments including facials and waxing before she went home sick. These customers turned out to be much harder to track down than passengers listed on a flight manifest. Authorities have asked anyone who visited the salon on that day to come forward.

"People are hard to find," Professor Dwyer said.

"In a country like Australia where there's free movement of people, it can actually be quite hard to find people, particularly when you want to do it very quickly."

The network map below, created at the epidemiology unit of the US Center for Disease Control (CDC) shows the spread of an airborne infectious disease.

Black nodes are persons with clinical disease (and are potentially infectious), pink nodes represent exposed persons who are not yet infectious, and green represent exposed persons who have not been infected. Grey nodes are people that are still to be tested.

The black node in the centre is a 'super-spreader'.

Earlier this month, a 61-year-old woman in South Korea gave at least 37 people at her church Covid-19 over the course of four services. She was a super-spreader.

By comparison, current estimates suggest that a single person with coronavirus spreads the infection to about 2.2 additional people, on average.

The more easily a disease spreads, the higher its basic 'reproductive number'. Any reproductive number higher than one means the disease will keep spreading.

Another important variable for contact tracing is the duration between the onset of symptoms in one person and the onset of symptoms in the person they infect.

The faster a virus multiplies in the body, the smaller this 'serial interval'.

Serial intervals have an outsized effect on the speed with which a virus spreads.

To see just how much, this interactive tool instantly updates projections based on different values for the reproductive number and serial interval. Reducing the serial interval by just one day can increase the number of projected cases within the following week by five times.

The serial interval for Covid-19 is estimated to be about 4.4 days - relatively low for a respiratory infectious disease (therefore it spreads quickly).

By comparison, the serial interval for SARS is seven days and for measles about 11.7 days.

What this adds up to is that coronavirus spreads relatively quickly, meaning contact tracers have less time to identify potential cases.

Each person on average has about nine close contacts, says Dr Raina MacIntyre, Professor of Infectious Diseases Epidemiology at UNSW.

"It varies from case to case, but on average we know that from contact tracing other infectious diseases each person on average has about nine close contacts," she told Hack.

Contact tracers attempt to "ring fence" an infected person by first identifying and testing their direct contacts, and then the contacts of these contacts.

These counter-measures effectively reduce the reproductive number of the virus.

However, in this instance, contact tracing is made doubly hard by the fact that some people with coronavirus can spread it even though they have no symptoms.

Some public health experts fear 'stealth' or 'cryptic' transmissions may already be occurring in communities in the United States.

"People who are asymptomatic can have just as much virus in their nose and throat as people who have symptoms," Dr MacIntyre said.

In China, authorities are using mobile phone data as well as facial recognition software to monitor individual patients and suspected cases in real time.

In one case, officials tracked an infected person across the city of Nanjing minute by minute and published the details of the patient's travels on social media to warn residents that they may have been infected if they crossed paths. This doesn't happen in Australia.

Basically, contact tracing is much easier in a surveillance state.

"You do run into, at some stage, an ethical dilemma over this," Professor Dwyer told Hack.

"Facial recognition, population movements, all of that sort of stuff are much easier to control in China than they are in Australia.

"Populations accept different levels of control."

Professor Dwyer worked with the World Health Organisation during the SARS epidemic in Beijing in 2002 and 2003. He says that authorities knew exactly where anybody was at any given time in a city of almost 20 million people.

"You basically could go down to the street level and say, 'So and so's home' or 'No they're not home' or 'They're at work' or whatever," he said.

Chinese authorities are actually able to get hold of people surprisingly given the population much more easily than in Australia.

A Chinese health worker checks the temperature of a woman entering a subway station.

Australian police are already sharing phone-tracking systems they use in criminal investigations to help public health officials with contact tracing.

Asked whether the spread of a deadly disease might give reason for increasing surveillance, Professor Dwyer said, "There's a discussion to have around the ethics of all of that and what's enough control and what's too much control."

"If we have someone who comes to the ED and they happen to have coronavirus and then they go home, you have no idea where they are.

"They might go to a pub or a music thing, and people don't know where they are at any given time. Whereas in China it's more controlled."

Professor Dwyer says contact tracing is a priority during the 'containment' phase of an outbreak, when the number of cases remains relatively low.

But given how hard it is to track people down, the contact tracing system is easily overwhelmed.

"Now, if it gets out of hand, and you suddenly have thousands of cases, well, then clearly you're not going to be able to follow them all up," he said.

However, that doesn't mean the end of all contact tracing.

Instead, the containment zone would shrink. Professor Dwyer gave the scenario of a "mega-outbreak in Sydney or Melbourne". Others parts of Australia may then trace the contacts people who have come from there, in the way they did for people from Wuhan in January.

You might have special groups in the community that you want to be very careful about containment. For example, our Indigenous communities - you want to stop these diseases getting into remote areas of Australia.

Asked for his thoughts on what's in store in the coming months, Professor Dwyer said he thinks there will be more cases in Australia, and they might spread.

"But I think it's unlikely we'll get the really nasty outbreaks we've seen in other countries.

"We've got pretty pretty good public health systems, we've got pretty good health facilities, we've got very good laboratories."

NSW Health told Hack Covid-19 is demanding a "whole of health response".

"Resources are applied as required in response to the evolving situation," a spokesperson said.

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'A real sleuthing exercise': Every coronavirus case starts a race to track contacts - ABC News

Newswise Good exercise habits formed in adolescence correlate positively with exercise habits in adults, and adults with good exercise habits have better physical performance and appropriate body-mass index scores for their age, according to a new study presented this week at the Association of Academic Physiatrists Annual Meeting in Orlando.

Regular exercise habits can lead to better physical fitness and mental health in people of all ages. However, research shows that people in the United States and Canada tend to exercise less as their age increases, and the most significant drop-offs in exercise habits take place during the teenage and early adult years. For this retrospective study, researchers in Taiwan wanted to know if exercise habits formed in adolescence could affect physical fitness in later adulthood, and to assess the relationship between adolescent and adult exercise habits and its influence on later physical fitness.

Professor Will Chou, Vice Chairman of Taiwan Academy of Physical Medicine and Rehabilitation, trained a group of coaches and exercise teachers who later discussed whether exercise habits set early in life might correlate to fitness later in adulthood, said Po-Wei Blake Chen, MD, a PM&R resident physician at Chi Mei Medical Center in southern Taiwan and the studys co-author.

The conclusions of our study may persuade physicians to give their patients an exercise prescription, and to encourage teenagers to form exercise habits as young as possible, said Dr. Chen. Most aspects of physical fitness, such as cardiopulmonary function, muscle strength and endurance, and body-mass index show significant differences between adults who exercise and those who do not. However, flexibility and the percentage of chronic diseases between these two groups do not. The researchers felt that one reason for this discrepancy was that the study subjects mostly engaged in aerobic and resistance exercises. Flexibility exercises, such as yoga or Pilates, were done less often. Also, we do not have exact laboratory data or regular chronic disease medical records for our subjects. These are some aspects that we have to improve for future studies.

The researchers collected exercise habits data from 413 individuals aged 25 to 65. The questionnaires were conducted by trained and qualified representatives of the sports administration department of the Ministry of Education in Taiwan. Participants shared details of their adolescent and adult exercise habits, demographic information and chronic diseases. Using the American College of Sports Medicines guidelines, the researchers analyzed the participants exercise habits by frequency, intensity, session time duration, type of exercise, total exercise amount and reasons why they did not exercise. They also tested participants cardiopulmonary function with a six-minute walk test, their muscle strength by 30-second sit-ups, muscle endurance by 60-second sit-ups, and flexibility by the distance between their fingertips to the ground when they performed a standing forward bend.

They found that adults exercise habits showed positive correlation with exercise habits in adolescence. The frequency, intensity, time and type (FITT) of exercise habits in adolescence showed significant differences compared to adults. Adults who had good exercise habits had better cardiopulmonary function, muscle strength, muscle endurance and body-mass index (BMI). However, there were no differences in flexibility and percentage of chronic diseases between adults and teens.

In Taiwan, sarcopenia and frailty are important issues for patients treated by physiatrists, said Dr. Chen. Decreased muscle mass and strength with further functional decline were also noted in our study, and studies in Taiwan reveal that sarcopenia and frailty will increase significant medical costs.

###

The Association of Academic Physiatrists (AAP) is a professional society with a mission to create the future of academic physiatry through mentorship, leadership, and discovery. Its members are leading physicians, researchers, educators and in-training physiatrists from 35 countries. The AAP holds an Annual Meeting, produces a leading medical journal in rehabilitation:AJPM&R, and leads a variety of programs and activities that support and enhance academic physiatry. On March 4-9, 2020, the AAP is hosting the ISPRM World Congress in Orlando, Florida. To learn more about the association, the specialty of physiatry and the World Congress, visitphysiatry.organd follow us on Twitter at @AAPhysiatrists.

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Exercise Habits Set Early in Life May Lead to Better Physical Fitness, BMI & Performance in Adulthood - Newswise

Could the key to a healthier brain and body be a brisk walk?

Researchers from the University of Mnster, Germany have found that faster walkers have better-performing, healthier brains. Analyzing the brain scans of 1,200 volunteers, the team of psychiatrists and statisticians found that walking speed is associated with enhanced brain health and cognitive function.

For the study, the researchers used open data from the Human Connectome Project, a centralized database of volunteers brain scans, based at the University of Washington in St. Louis, Missouri. Ethically reviewed by the university, the data bank allows scientists from around the world to conduct their own research on its findings.

The Mnster team studied volunteers who had their brains scanned using Magnetic Resonance Imaging (MRI). Among other tasks, the volunteers, at the time of the scans, had been asked to walk as quickly as they could, for two minutes. How far they walked was recorded, and the volunteers also took a number of tests to measure mental performance. The cognitive tests measured memory, sharpness, judgement, and reasoning.

Screening

Using rigorous statistical analysis, the team at Mnster screened out other variables, such as obesity and age, and determined that physical fitness was associated with better performance on the cognitive tests. Whats more, they found that volunteers who walked further in two minutes had greater microstructural integrity of white matter in their brains. In other words: better walking performance was associated with a healthier brain.

White matter acts as an insulator for nerve fibres in the brain, ensuring nerve signals pass quickly and smoothly from one part of the brain to the other. White matter is mostly made up of lipids (fat cells), giving it its whitish colour. It acts like electrical wiring insulation, explained Dr. Jonathan Repple, coordinator of the research team at the University of Mnster. By looking at the MRI scans of the volunteers brains, he told the National Post, the team was able to measure the structural integrity, or health, of white matter.

Once the research team had collected data on volunteers walking speed, brain function, and cognition performance, they rolled up their sleeves for the next challenge: rigorous statistical analysis. The team included an economist and statistician, Stella Martin, who helped run complex statistical procedures called linear regressions, to see how the data was related. She repeated analyses to see if other variables besides physical fitness, such as Body Mass Index (BMI), were affecting the results.

What they found astounded them: volunteers who walked further in the two-minute test had greater concentrations of white matter and had higher test scores on the cognitive tests. Whats more, white matter was correlated with better cognitive performance. Fitter people had better insulation on their brain wiring, reported Dr. Repple.

It seems like the wire is better insulated in people who are physically active and fit, he told the Post. These seem to be better-working people who are actively fit.

Why would this be?

Fit people have better blood circulation and a better regulated immune system, leading to less inflammation in the brain. The nerve fibres arent being attacked, he said.

It sounds stupid, Martin said, but the two-minute walking test is highly externally validated and highly correlated with other measures of physical fitness. Its a great measure of peoples fitness level.

While previous studies have shown connections between exercise and brain health, they have relied on small samples, making the results less generalizable. This study, which used some 1,200 volunteers, allowed the research team to control for interfering variables.

If fitter volunteers have better brains, could physical fitness help with mental decline in old age?

Perhaps, says, Repple. A basic level of fitness seems to be a preventable risk factor for brain health.

Past steps

The University of Mnsters study confirms other reports connecting the benefits of walking on physical and mental health. According to Harvard Health, walking can reduce the risk of cardiovascular problems by 31 per cent, and cut the risk of dying by 32 per cent. Walking and other moderate exercise programs also help protect against dementia, peripheral artery disease, obesity, diabetes, depression, colon cancer and even erectile dysfunction, Harvard Health says in its online materials.

In fact, walking is so important that the U.S. Surgeon General has called on Americans take up the activity. Walking is a powerful public health strategy, the Surgeon Generals office noted. It can reduce illness from chronic diseases and premature death, and lower levels of anxiety and depression among students.

Walking is accessible, low-cost, and presents a lower risk of injury than other activities, note fitness experts Lee Scott and Michele Stanten in their new volume, The Walking Solution. Stepping out for a walk of just 30 minutes per day can lower the risks of heart disease, stroke, diabetes and breast cancer, they say.

Next steps

Having shown an association between walking performance and mental health, Repple says he would next like to explore the association as it relates to patients with mental and psychiatric illnesses. Individuals with bipolar disorder and depression have different amounts of white matter in their brains, affecting the transmission of brain signals.

Could exercise treat such illnesses? Repple cant say for certain, but he would like to pursue exercise physical training studies to (explore) brain connectivity and psychiatric outcomes.

What about the researcher themselves? Do they walk the walk?

Our team didnt go for walks, Martin laughed, when asked if the research team at the University of Mnster were clocking up big step counts. The Town of Mnster is known for cycling. When we go to work we go there by bike.

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A brisk walk could be the pathway to a healthier brain, says a new study - National Post

LONG, WINDY, BUMPY ROAD: Though hailed as a historic breakthrough, the Agreement for Bringing Peace to Afghanistan signed by the U.S. and Taliban leaders in Doha Saturday is a basically an agreement to try to reach a peace deal in the future and gives both sides plenty of room to wriggle out of it.

This is going to be a long, windy, bumpy road. There will be ups and downs and we'll stop and start, Defense Secretary Mark Esper told reporters yesterday That's going to be the nature of this over the next days, weeks and months.

Here are five things to keep in mind about the plan.

FOR NOW, THE US GAVE UP NOTHING: While on the surface it appears the Taliban achieved its primary goal the complete withdrawal of all foreign forces within 14 months the U.S. has agreed only to do what it planned to do anyway, with or without an agreement. We are going to show good faith and begin withdrawing our troops, and we can stop that at any moment, said Esper. What we'll do is we'll go to 8,600 and we're going to stop, and we'll assess the situation.

Thats the number of American troops U.S. commanders have said are needed to carry out the current advise and assist and counterterrorism missions. The U.S. has retained the option to keep those troops in Afghanistan if theres no progress toward peace. We can pause it based on, again, changing circumstances, Esper said.

FOR NOW, THE TALIBAN GAVE UP NOTHING: While the seven-day reduction of violence agreement was a precondition for signing the withdrawal agreement, the Taliban have made it clear they do not believe it applies to its war against Afghan government forces, and at any rate it has expired.

The reduction in violence... has ended now and our operations will continue as normal," Taliban spokesman Zabihullah Mujahid told the French news agency AFP. That the Taliban plans to continue its strategy of fighting while negotiating came as a motorcycle bomb attack that killed three people is eastern Afghanistan. Whether the Taliban or some other group was responsible for the attack was unclear.

THE LEVEL OF VIOLENCE IS IN THE EYE OF THE BEHOLDER: The peace agreement not only contains no provisions for a peace, beyond intra-Afghan negotiations to begin next week in Oslo, it also does not include a truce or ceasefire.

I would caution everybody, to think that there's going to be an absolute cessation of violence in Afghanistan, that is probably not going to happen, admitted Joint Chiefs Chairman Gen. Mark Milley at yesterday's Pentagon briefing. It's probably not going to go to zero.

Regarding yesterdays attack, Milley underscored the subjective nature of determining if violence is Taliban-related. We don't know exactly who did that yet.

ALL WE ARE SAYING IS GIVE PEACE A CHANCE: Our expectation is that the reduction in violence will continue, it would taper off until we got intra-Afghan negotiations, where it would ultimately consummate in a cease-fire, if you will, Esper said.

A negotiated political settlement is the only responsible way to end the war in Afghanistan, and this was an important step, said Milley. This agreement provides the best hope for a peaceful future for the people of Afghanistan.

Just watch what really happens. Pay less attention to statements, pay less attention to things people say. Watch what happens on the ground, said Secretary of State Mike Pompeo on Fox news. Theres been a lot of work done at detailed levels about how this will proceed. So far, so good. Were just hours into this.

WHATEVER HAPPENS, TRUMP IS OVER AFGHANISTAN: Asked at the White House what would happen if the peace talks failed to take place and violence flared anew, President Trump said, Well, we're going to find out.

But we're getting out. We want to get out, he said. We had good meetings with the Taliban. And we are going to be leaving, and we're going to be bringing our soldiers back home. We've been there for almost 20 years. It's a long time. We've done a great job in terms of getting rid of terrorists. Now it's up to other countries to get rid of those terrorists.

Good Tuesday morning and welcome to Jamie McIntyres Daily on Defense, written and compiled by Washington Examiner National Security Senior Writer Jamie McIntyre (@jamiejmcintyre) and edited by Susan Katz Keating (@SKatzKeating). Email here with tips, suggestions, calendar items, and anything else. Sign up or read current and back issues at DailyonDefense.com. If signing up doesnt work, shoot us an email and well add you to our list. And be sure to follow us on Twitter: @dailyondefense.

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HAPPENING TODAY THE BEGINNING OF BUDGETPALOOZA: As you know, we have a busy week here at the Pentagon, said Defense Secretary Mark Esper DoD leadership will be testifying in 20 hearings before Congress in the coming days as we continue to brief the Hill on the department's F.Y. '21 budget request.

See our calendar below for the schedule of hearings this week.

ALSO TODAY: Esper welcomes Estonian Defense Minister Juri Luik to the Pentagon at 1 p.m. on the steps of the River Entrance. Esper and Luik will brief reporters in the Pentagon briefing room a approximately 2 p.m. Steamed live at https://www.defense.gov/Watch/Live-Events

NEW AF CHIEF: Air Force Gen. Charles Q. Brown Jr. has been nominated to be the next chief of staff of the Air Force, when current chief David Goldfein retires this year. Brown is currently commander of Pacific Air Forces; air component commander for U.S. Indo-Pacific Command; and executive director, Pacific Air Combat Operations Staff, Joint Base Pearl Harbor-Hickam, Hawaii.

If confirmed, Brown will be the first African American to serve as a service chief. In 1989, Army Gen. Colin Powell became the first African American chairman of the Joint Chiefs of Staff.

NO TEARS FOR DAVE: Goldfein, you may recall, was the pick of former Defense Secretary Jim Mattis to succeed Marine Gen. Joseph Dunford as the next chair of the Joint Chiefs of Staff, but President Trump preferred Army Gen. Mark Milley.

Still, Goldfein retires as the Air Forces top officer after a distinguished 37 year career, which included flying F-16s and F-117s in combat missions in operations Desert Shield, Desert Storm, Allied Force and Enduring Freedom.

Goldfein also has the distinction of being one of two U.S. pilots shot down over Serbia in 1999, when a surface-to-air missile hit his F-16.

DRIP, DRIP, DRIP: Every couple of days the U.S. Africa Command drops another press release that begins with the same boilerplate language, In coordination with the Federal Government of Somalia, U.S. Africa Command conducted airstrikes targeting al-Shabaab terrorists

The latest release announced that two airstrikes targeting al-Shabaab killed one and wounded two terrorists. In drone strikes that kill one or two enemy fighters at a time, the U.S. continues a low-intensity war against the group that is an offshoot of al Qaeda.

US Africa Command is focused on support to the Federal Government of Somalia and helping them end al-Shabaabs brutal ambitions and treatment of the Somali people, said U.S. Army Maj. Gen. Bill Gayler, director of operations, U.S. Africa Command.

According to a tally of AFRICOM releases from so far this year, the U.S. has killed 17 al-Shabaab fighters in 15 strikes, including a senior al-Shabaab leader and his wife who were said to have been behind the Jan. 15 attack on Manda Bay, that killed one U.S. soldier and two American contractors.

CORONAVIRUS CONCERNS: Defense Secretary Esper says the threat of infection from the corona virus has been the focus of a high-level daily working group that includes senior Pentagon officials, members of the Joint Staff, and combatant commanders around the world.

At the end of last week, I did a deep dive with DOD civilian and military leadership, including all the service secretaries, the COCOM commanders to ensure the entire department is equipped for all scenarios: short and long-term, domestic and international, Esper said. Commanders of individually affected geographic commands have all the authority they need and we'll provide specific guidance to their troops as the situation continues to evolve.

EXERCISES MOSTLY UNAFFECTED: Right now, the overall broad impact to the uniformed U.S. military is very, very minimal, said Joint Chiefs Chairman Milley. It's not to say it's zero, but it's very, very minimal. Very few cases have been diagnosed, et cetera.

Milley noted that while a command post exercise was postponed in Korea, other exercises in Asia and Europe are going on as planned.

We're taking a look at some other exercises to see if they need to be modified or changed, he said. We're looking at the exercises, but right now we don't see any significant negative impact on that.

US-ISRAELI EXERCISE: The U.S. European Command announced today that Juniper Cobra, a combined missile defense exercise with the Israel Defense Forces began today, and will run through March 13.

Approximately 2,500 U.S. personnel and 1,000 IDF personnel will participate in the long-planned exercise, which EUCOM says is driven by overall dynamics in the Middle East, but is not a response to any recent developments or specific real-world events.

IRAN TO IRAQ TRANSMISSION: The Washington-based Institute for the Study of War says Irans inability to contain the coronavirus has allowed the disease to spread to Iraq, whose health institutions are poorly equipped to manage the potential pandemic.

Iraq is vulnerable due to the hundreds of thousands of internally displaced persons, congested anti-government demonstrations, and routine pilgrimages by religious observers across the region, particularly from Iran, says the ISWs latest situation report. Failure to contain the virus could lead to greater anti-Iranian sentiment among Iraqis. Iraq imports billions of dollars in cross border trade from Iran per year. Restricted movement will lead to increased prices on basic necessities.

INDUSTRY WATCH: BAE Systems has been awarded a five-year $188.2 million contract to provide the Navys AEGIS Technical Representative office with critical large-scale system engineering, integration, and testing expertise for the AEGIS weapons and combat systems aboard U.S. Navy surface combatant ships, the company said on Monday.

BAE Systems personnel have worked side-by-side with Navy sailors and civilians for nearly 40 years to strengthen and modernize the fleet of AEGIS-equipped surface ships, said Mark Keeler, vice president and general manager of BAE Systems Integrated Defense Solutions business.

Washington Examiner: Peace with the Taliban will be a 'bumpy road,' defense chiefs say

Washington Examiner: A war would trigger devastating consequences: Turkey and Russia try to avoid clash as Erdogan hammers Assad

Wall Street Journal: White House Drops Nominee Who Questioned Ukraine Aid Suspension

AP: Kim Watches N Korea Military Drill Alongside Masked Officers

AP: North Korean swagger may conceal brewing virus disaster

Military Times: Communities Fighting Transfers Of Coronavirus Patients From Military Installations

Breaking Defense: Hypersonic Missiles: Plethora Of Boost-Glide & Cruise

Defense News: Pentagon Launches Hypersonic Industrial Base Study

USNI News: CNO Gilday Defends 36-Month Carrier Cycle, Says Navy Has Never Missed A Deployment

USNI News: U.S. Issues Formal Protest To China Over P-8A Lasing Incident In Philippine Sea

Military Times: U.S. Loses Drone Over Niger

Marine Corps News: Commander Of Texas-Based Marine Reserve Aerial Refueling Squadron Fired

Washington Examiner: Opinion: The Taliban shows Trump whos really boss

Washington Post: Michle Flournoy and Stephen J. Hadley: The U.S. deal with the Taliban is an important rst step

TUESDAY | MARCH 3

8 a.m. 900 South Orme St., Arl. Brig. Gen. Stephen Michael, deputy commander of the Army Combined Arms Center for Training, delivers keynote address at the National Defense Industrial Association Human Systems Conference. https://www.ndia.org/events

8 a.m. 1200 South Hayes St., Arl. The RAND Corporation hosts Defense Department State-of-the-Science meeting on blast injury research, with Raj Gupta, acting director of the Defense Department's Blast Injury Research Coordinating Office https://www.rand.org/events/2020/03/03.html

9:30 a.m. 1919 Connecticut Ave. N.W. President Trump; Rep. Stephanie Murphy, D-Fla.; Rep. John Katko, R-N.Y.; and former Secretary of State Colin Powell, former chairman of the Joint Chiefs of Staff, participate in a general session of the National Association of Counties 2020 Legislative Conference. https://www.naco.org

10:30 a.m. 2118 Rayburn House Armed Services Committee hearing: The Fiscal Year 2021 National Defense Authorization Budget Request for the Department of the Army, with testimony from Army Secretary Ryan McCarthy and Army Chief of Staff Gen. James McConville. https://armedservices.house.gov/hearings

12 p.m. Hudson Institute discussion on "Dialogues on American and Foreign Policy and World Affairs," focusing on "China, the broader American strategy in the Indo-Pacific region, and other challenges facing the U.S. across the globe, with former Assistant Secretary of State for East Asian and Pacific Affairs Kurt Campbell; Dan McKivergan, vice president of government relations at Hudson; and Walter Russell Mead, fellow in strategy and statesmanship at Hudson http://www.hudson.org

1 p.m. Pentagon Briefing Room 2D972 Defense Secretary Mark Esper welcomes Estonian Defense Minister Juri Luik to the Pentagon on the steps of the River Entrance. The secretary and Minister Luik also brief the press at approximately 2 p.m. Streamed live at

2 p.m. 2118 Rayburn House Armed Services Subcommittee on Readiness hearing: The Fiscal Year 2021 Air Force and Space Force Readiness Posture, with testimony from Shon Manasco, acting undersecretary of the Air Force; Gen. Stephen Wilson, Air Force vice chief of staff; and Lt. Gen. David Thompson, vice commander, U.S. Space Force. https://armedservices.house.gov/hearings

2:30 p.m. 2212 Rayburn House Armed Services Subcommittee on Strategic Forces hearing: The Fiscal Year 2021 Budget Request for Nuclear Forces and Atomic Energy Defense Activities, with testimony from Lisa Gordon-Hagerty, administrator, National Nuclear Security Administration; Victorino Mercado, performing the duties of assistant secretary of defense for strategy, plans, and capabilities; Vice Adm. Johnny Wolfe, Navy director, Strategic Systems Programs; Air Force Lt. Gen. Richard Clark, deputy chief of staff for strategic deterrence and nuclear integration; and Allison Bawden, director, natural resources and environment team, Government Accountability Office. https://armedservices.house.gov/hearings

2:30 p.m. 1300 Pennsylvania Ave. N.W. Woodrow Wilson Center Africa Program discussion on "The Trump Administration and U.S. Africa Policy: What has been Accomplished and What Lies Ahead?" with Assistant Secretary of State for African Affairs Tibor Nagy; and Monde Muyangwa, director of the WWC Africa Program. https://www.wilsoncenter.org/event

3 p.m. H-140 Capitol House Appropriations Subcommittee on Defense hearing on National Guard and Reserve FY 2021 budget request, with Gen. Joseph Lengyel, Chief of the National Guard Bureau; Lt. Gen. David Bellon, commander, Marine Forces Reserve; Lt. Gen. Charles Luckey, chief of the Army Reserve; Vice Adm. Luke McCollum, chief of the Navy Reserve; and Lt. Gen. Richard Scobee, chief of the Air Force Reserve. https://appropriations.house.gov/events

WEDNESDAY | MARCH 4

8 a.m. 900 South Orme St., Arl. Army Col. Michael McGurk, director of research and analysis at the Center for Initial Military Training Directorate, delivers keynote address at the National Defense Industrial Association Human Systems Conference https://www.ndia.org/events

9 a.m. 1300 Pennsylvania Ave. N.W. McAleese Defense Programs Conference, with national security adviser Robert OBrien; Ellen Lord, undersecretary of defense for acquisition and sustainment; Michael Griffin, undersecretary of defense for research and engineering; Army Secretary Ryan McCarthy, and more than a dozen others. https://www.mcaleese.com/events

10 a.m. 2118 Rayburn House Armed Services Committee hearing: The Fiscal Year 2021 National Defense Authorization Budget Request for the Department of the Air Force, with testimony from Air Force Secretary Barbara Barrett; Air Force Chief of Staff Gen. David Goldfein; Gen. John Raymond, chief of space operations, U.S. Space Force. https://armedservices.house.gov/hearings

11 a.m. H-140 Capitol House Appropriations Subcommittee on Defense hearing on U.S. Navy/Marine Corps FY 2021 budget request, with Marine Corps Commandant Gen. David Berger; Chief of Naval Operations Adm. Michael Gilday; and Thomas Modly, acting secretary of the Navy. https://appropriations.house.gov/events

12 p.m. 1957 E St. N.W. George Washington University Elliott School of International Affairs holds a film screening and discussion on "The Barbed Wire Fence," focusing on the Korean Demilitarized Zone, with filmmaker Dai Sil Kim-Gibson; and Young-Key Kim-Renaud, senior adviser in the GWU Institute for Korean Studies https://elliott.gwu.edu/event-calendar

2:30 p.m. 2212 Rayburn House Armed Services Subcommittee on Intelligence and Emerging Threats and Capabilities hearing: The Fiscal Year 2021 Budget Request for U.S. Cyber Command and Operations in Cyberspace, with testimony from Kenneth Rapuano, assistant secretary of defense for homeland defense and global security; and U.S. Cyber Commander and National Security Agency Director Army Gen. Paul Nakasone. https://armedservices.house.gov/hearings

2:30 p.m. 1030 15th St. N.W. Center for the National Interest and the Eurasia Center debate: Why should the US care about Ukraine? with Will Ruger, vice president for research and policy at the Charles Koch Institute; and Alina Polyakova, president & CEO of the Center for European Policy Analysis. The moderators are Jacob Heilbrunn, editor of The National Interest; and Melinda Haring, deputy director of the Eurasia Center. Register at : https://www.atlanticcouncil.org/event

3 p.m. H-140 Capitol House Appropriations Subcommittee on Defense hearing on U.S. Space Force organizational plan, with Maj. Gen. Clinton Crosier, director, space force planning, Office of the Chief of Space Operations; and Lt. Gen. David Thompson, vice commander, U.S. Space Force. https://appropriations.house.gov/events/hearings

9:30 p.m. ET Hoover Institution, Stanford, Ca. Intelligence Squared U.S. debates "The Maximum Pressure Campaign Against Iran Is Working, with former national security adviser retired Lt. Gen. H. R. McMaster and Military Historian Victor Davis Hanson arguing for the proposition and Martha Crenshaw, terrorism studies expert and Abbas Milani of the Iran Democracy Project arguing against. Streamed live at https://www.intelligencesquaredus.org/debates

THURSDAY | MARCH 5

8 a.m. 2425 Wilson Blvd., Arl. Association of the U.S. Army Hot Topics Forum on "Army Space and AMD (Air and Missile Defense): Protection of the U.S. Homeland, Forces Abroad, Allies and Partners, with Army Lt. Gen. James Dickinson, deputy commander of the U.S. Space Command; and Navy Vice Adm. Jon Hill, director of the U.S. Missile Defense Agency. https://www.ausa.org/events/amd-hot-topic

9 a.m. 2359 Rayburn House Appropriations Subcommittee on Defense hearing on Defense Health Program, with Army Surgeon General Lt. Gen. R. Scott Dingle; Navy Surgeon General Rear Adm. Bruce Gillingham; Air Force Surgeon General Lt. Gen. Dorothy Hogg, Thomas McCaffery, assistant secretary of defense for health affairs; Lt. Gen. Ronald Place, director, Defense Health Agency; and Bill Tinston, program executive officer, Defense Healthcare Management Systems https://appropriations.house.gov/events/hearings

9:30 a.m. 2212 Rayburn House Armed Services Subcommittee on Tactical Air and Land Forces Hearing: The Fiscal Year 2021 Army and Marine Corps Ground Modernization Programs, with testimony from Bruce Jette, assistant secretary of the army for acquisition, logistics and technology; Gen. John Murray, commanding general, Army Futures Command; Lt. Gen. Eric Smith, commanding general, Marine Corps Combat Development Command; and James Geurts, assistant secretary of the navy for research, development, and acquisition https://armedservices.house.gov/hearings

3 p.m. 1030 15th St. N.W. Atlantic Council discussion with British Defense Secretary Ben Wallace on "The Next Era of UK Defense." https://www.atlanticcouncil.org/event

6 p.m. 600 New Jersey Ave. N.W. Georgetown University Law Center discussion: "America's Misadventure With Torture: New Revelations and Hard Lessons, with former UN Special Rapporteur on Torture Juan Mendez; Alka Pradhan, human rights counsel to Guantanamo Military Commissions; former Military Commissions Chief Investigator Mark Fallon; Susan Brandon, former research director of the High-Value Detainee Interrogation Group; Gregg Bloche, professor at Georgetown Law; David Luban, professor at Georgetown Law; and Steven Barela, senior fellow at the University of Geneva. https://www.law.georgetown.edu/news

This is going to be a long, windy, bumpy road. There will be ups and downs and we'll stop and start. That's going to be the nature of this over the next days, weeks and months. And so I'm not going to get too excited about what happens at the moment. We're just going to deal with each situation as it arises and make sure we stay focused on the mission.

Defense Secretary Mark Esper, speaking to reporters at the Pentagon

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Five things to know about Trump's get-out-of-Afghanistan plan - Washington Examiner

Mark Capapas

Patrons of CRCE use the workout machines located on the workout floor on Feb. 19. The University Extension aims to help students build healthy habits.

Throughout March, the University Extension will focus on a campaign that promotes a holistic, healthy lifestyle. They will be hosting free online programs and events open to all students on campus.

Cheri Burcham, University Extension educator in family life, describes the campaign as having a two-fold goal.

We want to make people aware that there are family consumer science educators in the University Extension, Burcham said. The second part of it is the actual programs.

The programs include education on meal planning, food budgeting, brain health programs, healthful foods, exercise and smart financing.

On Wednesday, an introductory program for nutrition and brain health will begin at the Lodgic Everyday Community Event Hall in Champaign, followed by five other sessions that each explore different aspects under this topic.

Other March programs in Champaign-Urbana include a financial well-being series, an event exploring physical activity interventions for older adults and the disABILITY Resource Expo, with the goal to promote a better quality of life for people with disabilities.

One of the highlights the Living Well Campaign is trying to educate the public on is smart financial decision-making and saving. According to PwCs 2019 Employee Financial Wellness Survey, 59% of full-time employed U.S. adults said that financial matters and challenges cause them the most stress, above their jobs, relationships, health concerns and miscellaneous stressors.

If we can help students start to build the habit now, to set aside some money so they have (it) as a security if they need it, then when they are at full-time jobs, it will be a habit that they can grow and start to save for different kinds of financial goals they have, said Kathryn Sweedler, consumer economics educator from the University Extension.

Sweedler added that financial worries can affect ones wellness at work and their physical state, such as added stomachaches and headaches. It can also cause conflict with significant people, such as family and friends.

There are programs the University Extension offers that run all year and are open for the general public to register. Most of the programs are free, unless certain materials are needed for an activity, according to Burcham. Accommodations for language barriers or disabilities are also a goal of the campaign.

According to the National Institutes of Health, researchers found that Americans who maintained five healthy lifestyle factors lived more than a decade longer than those who did not maintain any of the five. The five factors examined were maintaining a healthy eating pattern, not smoking, drinking moderately, exercising weekly and keeping a healthy body weight.

I think its really important for everybody, including students, to start thinking about how maintaining their wellness in different arenas adds to their overall wellness, Sweedler said.

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University Extension sponsors Living Well Campaign - Daily Illini

From assisted horseback riding and rock climbing to yoga for Parkinsons, here are 17 Philly-area athletic organizations offering adaptive fitness.

When it comes to adaptive fitness, the Philly area has a range of options. Weve rounded up 17 of them, including Michael Cavacinis DDP chair yoga for older adults. / Photograph by Stephanie Cavacini.

Muscle-building, mood-boosting, and overall feel-good exercise isnt just for able-bodied folks. In fact, the Philly area offers a number of adaptive and assisted fitness and sports programs, so that people living with disabilities can pursue health and wellness. From marathon-training and kayaking to a variety of yoga classes, these 17 athletic organizations and studios in and around Philly help disabled and differently-abled folks stay active, motivated, and strong.

Note: Many YMCA branches in and around the city offer therapeutic swimming and adapted aquatics. Contact your local YMCA for more details.

50th Street and Baltimore Avenue, West Philadelphia

Created by yoga instructor and occupational therapist, Rachel Dobkin, Adaptive Yoga Philly offers yoga instruction to meet a variety of needs. Their adaptive yoga is fully customizable for anyone in a wheelchair, has amputations, or experiences mobility difficulties. They also provide sensory-friendly yoga and yoga for caregivers, as well as prop-based sessions for older adults.

Ainsleys Angels is a national nonprofit that believes all individuals, especially those living with a disability, deserve to be included in running races. At all of their Roll with the Wind races, they pair able-bodied runners with individuals who wouldnt be able to complete an endurance race without assistance. (Fun fact: the southeast PA ambassador for Ainsleys Angels was our 2019 Health Hero!)

265 Mattson Road, Garnet Valley

Since 2009, All Riders Up has been providing horseback riding to individuals ages 4 through 74. Their equine-facilitated psychotherapy is meant to serve individuals living with all types of trauma, including veterans living with PTSD. Not only are they located on 12 acres of pasture in a fairly residential area making riders and their families feel comfortable, relaxed, and right at home but theyve got a sensory trail and a hydraulic lift that transfers students from wheelchair to horse.

608 Shearer Street, North Wales

This nonprofits mission is to promote a better quality of life for people with physical disabilities via sports. They host a bunch of athletic events throughout the year, including tennis clinics, wheelchair basketball, sitting volleyball, adaptive cycling, archery, and powerlifting. Many of their board members are trained in rehab sciences, and some are para-athletes themselves.

101 Bortons Mill Road, Cherry Hill, NJ

Founded by all-inclusive playground nonprofit Build Jakes Place, the Camden County NJ Miracle League is a baseball program for children and adults living with physical and cognitive disabilities. Their major and minor leagues play on Saturday mornings in both the spring (8 weeks) and fall (6 weeks). All games are played at Boundless Field, a cushioned baseball field that accommodates wheelchairs and walking-assistance devices and provides a level-playing field for all players.

4300 Avenue of the Republic, West Philadelphia

Sponsored by Philadelphia Parks and Recreation, Carousel House in West Fairmount Park is a year-round program offering recreational and educational services to Philadelphians living with disabilities. Their wide-range of fitness activities include swimming, dance, martial arts, nature walks, and weight lifting. Their weight room also houses wheelchair-accessible training equipment and their outdoor complex includes an accessible garden and fitness track.

3853 Old Easton Road, Doylestown

Doylestown Rock Gym provides multiple adaptive climbing options for anyone who needs it. Their Flying Squirrel allows climbers to be pulled into the air, resulting in a floating sensation, while their Mini-Zip lets the climber ride the zip on a seated apparatus to practice upright balance. They also own specialty adaptive climbing equipment for individuals with limited mobility in their extremities.

Multiple locations

The mission of Magee Rehab at Jefferson Health is to provide high-quality cognitive and physical rehabilitation services. In addition to serving patients with orthopedic and brain injuries, amputations, and Multiple Sclerosis, Magee offers wheelchair tennis, basketball, racing, and rugby to keep people moving and active.

1700 Sansom Street, 6th floor, Rittenhouse

Maha Yoga offers two specialized classes. Yoga for Parkinsons is an adaptive, donation-based yoga class for anyone living with the disease, as well as their caretakers. Additionally, their Connected Warriors is a free, trauma-conscious class for veterans, active service members, first responders, and their families/support groups.

1900 John F. Kennedy Boulevard, Center City

On Sunday mornings at Penn Center House, Michael Cavacini, Philadelphias first certified DDP yoga instructor, teaches DDP chair yoga program designed specifically for seniors and those with limited mobility. The series of stretches and body-weight movements aim to help participants decrease pain, improve circulation, build strength, and increase flexibility.

4 Boathouse Row, Fairmount

Operating out of Boathouse Row, the PA Center for Adapted Sports (PCAS) currently has 13 year-round sports and wellness programs aimed to help individuals build and maintain strength, boost emotional health, and engage with community members. Whether youre climbing, cycling, kayaking, skiing, or practicing yoga, PCAS provides all the equipment, training, and assistance needed to achieve your goals.

1601 Chestnut Street, Center City

Founded in 2012, Philly Achilles hosts free group runs every Saturday morning at 9 a.m. out of the Cigna fitness center in Center City. These all-paces-friendly weekly runs are good for athletes and volunteers to get in some exercise, or train for the next marathon.

2900 Southampton Road, Northeast Philadelphia

The local chapter of PAs Special Olympics, SOPA Philly provides year-round Olympic-like sports training and athletic competitions to children and adults living with intellectual disabilities. Their community-based programs feature swimming, gymnastics, bocce, bowling, soccer, and field hockey, among others. Every spring, SOPA Philly hosts a huge Olympic games competition for over 300 program athletes.

224 South Broad Street, 8th floor, Center City

Parkinsons Fit at The Sporting Club is a fitness training and support program for anyone living with the disease. PWR!4Life uses research-based integrated exercises to increase balance, flexibility, and posture, while Rock Steady offers boxing training builds muscular endurance and hand-eye coordination. All participants will be matched with for a class based on a personal assessment at the time of enrollment.

Multiple locations

Team River Runner (TRR) provides active duty service members, veterans, injured military, first responders, and area residents living with disabilities to pursue health and healing through kayaking. The nonprofit has experience working with individuals living with PTSD, brain injury, amputation, spinal cord injuries, and sight impairment. All new participants complete a two-hour pool session to learn the basics of kayaking, and are joined by volunteer experts on the river for training. You can check their calendar for upcoming events.

700 South High Street, West Chester

West Chesters kinesiology department runs three adaptive fitness opportunities. Their Adapted Lifetime Fitness Program helps adults with cognitive disabilities build strength, endurance, and flexibility once per week. Their 10-week APA Wednesday Night Program focuses on adapted sport, physical education, and swimming, and serves individuals ages five through 21. Finally, the department hosts a three-day para-sports camp over Memorial Day Weekend for school-age children living with visual impairments.

424 East Elm Street, Conshohocken

Yoga Homes adaptive yoga is owner Kerri Hanlons homage to her late son, Sean, who had cerebral palsy. In these classes, yogis whether seated, standing, or lying on the floor use blocks, blankets, chairs, and the wall to adapt postures to their liking. The studio also hosts gentle chair yoga, yoga for caregivers, and yoga for kids on the spectrum.

Want to hear more from us? Join Be Well Philly at:FACEBOOK|INSTAGRAM|NEWSLETTER|TWITTER

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17 Disability-Friendly Fitness Studios and Organizations in and around Philly - phillymag.com

Trying to eat right and exercise (especially in the yucky weather months) would be nearly impossible for me without these two important things. Maybe my humble advice will help you, too.

1. Patience and faith to let the process take as long as it needs to throughout life. Because many times in the past I expected to see major and unrealistic results immediately, and if I didn't, I'd get depressed and give up...and then comfort myself with junk food (on the couch, under a blanket, while binge watching a show.)

The other thing I would do was to have an 'all or nothing' mentality. Which meant that I could never have a cheat meal or skip a day of exercising. And that once I did (because we're all human) I would call myself a failure and give up right away.

I will also remind you that choosing to become (and remain) healthy is a long-term lifestyle change, and rushing through some silly 6-week program where you lose 20 pounds too quickly, usually results in long-term failure. Most people I know who have done this 'cult-like' type of group thing have gained back all the weight or weren't able to sustain the insane workouts. But learning the science behind how you should eat and slowly building in new and better habits and making better choices as you go...and, again, practicing patience instead of getting mad at yourself that you're not losing fast enough, is really the key to long-term success.

2. Be accountable to someone (and usually that is NOT your BFF.) I have tried going to the gym and eating right with friends. But usually after a while it becomes TOO comfortable -- comfy enough for you both to agree to bag the workout and clean eating in exchange for the bottle of wine and some chocolate that you both 'deserve' so much. It's too easy to understand when your friend says she has a migraine and you'd rather bring her coffee than tell her you're still going to stick to the plan and go to the gym.

I find that the best investment of your time and money is to join a program or sign up with a registered dietician (the real experts that have gone to school for this and are certified) and/or a personal trainer. And if your first thought is that you don't have that kind of money, there are affordable programs. PLUS: your health insurance might cover meeting with a dietician, and your doctor can refer you to a program that costs only a dollar a day!!! (More on that below.)

But also, it is super helpful if the person or people in your home who do the cooking (if it's not you) or who eat with you (aka your spouse, family, roommate) can respect that you are trying to take care of your health and join in to support you or, at the very least, keep their bad foods away from you.

When I know I have an appointment with my trainer (Karen Meggles) it gets me to the gym every time. Because I don't want to disrespect someone's time. (Whereas, ironically, without the trainer, I would disrespect myself and skip the gym with the slightest of last-minute excuses.) And getting there IS the battle, so if knowing you have a trainer waiting for you gets you in, that is worth it all!

*** There are several amazing programs at The Atlantic Club that are designed for your long-term success and providing the best support system to help you along the way, but the one I am taking is only $1 a day for 2 months. Yep. $60 for a lifetime of advice -- both nutritionally and in the form of an exercise program with a personal trainer. And it's through your doctor that you can get in.

All you have to do is see your primary physician or ob/gyn and get a referral to this program to be eligible. (You don't have to be a member of The Atlantic Club.)

CLICK HERE to find out about the P.R.E.P. (Physician Referred Exercise Program) where you get not only a personal trainer but seminars with an amazing registered dietician!

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Liz's Weekly Journal #6: Two Things I Have Learned - 943thepoint.com

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