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Coachingissotimeintensivetheonlywayacoachcanbe assured of having time with his or her own family is to erectile dysfunction wikihow buy generic levitra with dapoxetine 40/60 mg line make time erectile dysfunction medication patents purchase levitra with dapoxetine 40/60mg on-line. Take a cue from football and basketball and give track and field a chance to erectile dysfunction for young males generic 40/60 mg levitra with dapoxetine with amex be a spectator sport by presenting your home meets as entertainment erectile dysfunction gnc discount 40/60 mg levitra with dapoxetine overnight delivery. Putyourpersonalstamponeachofyourathletes,assistantcoaches and on every phase of your program. An assistant coach, no matter how knowledgeable in a specific track or field event area, with a bad attitude can sabotage an entire program. Anyoneinaleadershiproleissubjecttothepositive 16 ChapTer 1 A Philosophy for Coaching High School Athletes or negative influence of others. Identify those who can positively influence your coaching career and seek their advice and council. High School Sports as an Extended Classroom Schools have interscholastic sports programs because they provide students with unique learning experiences that are not obtainable in other segments of the school curriculum. Through participation in interscholastic sports, athletes improve strength, speed, endurance and acquire the complex skills and poise needed to perform at their best in athletic competition. Few educators have the opportunity to affect the lives of their students more than a coach. The best coaches use their practices and competitions as extended classrooms and strive to inspire athletes to reach for their best both athletically and academically. High school students are young adults who look to their coaches for leadership, knowledge, instruction and direction. Many lessons can be taught and learned through participation in competitive interscholastic sports such as how to set goals, how to compete, how to take risks, how to deal with success and failure and how to maintain emotional self-control. Important values and attitudes such as sacrifice, dedication, accountability and self-confidence can be learned along with such virtues as good sportsmanship, teamwork, camaraderie, respect for opponents, mental toughness and persistence in the face of adversity. Those experiences and character traits will lead young athletes toward successful, fulfilling lives long after their high school athletic careers are over. The benefits that can be derived from participating in sports, however, do not result from participation alone. Research indicates it is the quality of adult leadership that determines whether youngsters have a good or bad experience in competitive sports. An effective high school coach will be an inspirational leader, a knowledgeable teacher and an appropriate role model. More than just a teacher of skills and strategies, the high school coach is a significant adult force in the life of a student-athlete. Coaches can have a great impact on the psychological growth and personal development of athletes. High school coaches often believe their first responsibility is to produce winning teams; however, winning should not be the single measure of success for the coach or the athletes. An overemphasis on winning can produce such negative responses in young athletes as anxiety, fear of failure, reduced self-esteem and a loss of motivation. Coaching success should be measured in a variety of ways other than a state ranking, win/loss record, or a high place in the league meet. Winning the majority of the meets during the season does not necessarily make any coach a good leader or positive role model for young athletes. Coaches must teach respect for the rules, the opponents and the judgment and integrity of officials by example through their behavior. It affects how a coach wants to motivate and discipline, and what role, if any, athletes are permitted to have in making decisions that affect them. Experienced coaches should also periodically re-examine their coaching styles to ensure they are still following the path onto which they originally embarked. Here are some suggestions that can help determine a sound coaching philosophy: · Remembertheathletes should be the center of attention. Theremustbeaforum for open communication or the coach will never be in touch with the athletes.

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We always find ourselves within a situation erectile dysfunction treatment pumps cheap 40/60 mg levitra with dapoxetine with visa, and throwing light on it is a task that is never entirely finished' (301) erectile dysfunction is caused by purchase 40/60mg levitra with dapoxetine. Thus impotence essential oils buy cheap levitra with dapoxetine 40/60 mg line, we can strive toward what he calls ``effective-historical consciousness' or a reflective awareness about the horizon of our situation impotence signs buy levitra with dapoxetine 40/60 mg with mastercard, recognizing it to be dynamic and not the only element determining our eventual understanding. Gadamer defines the horizon as ``the range of vision that includes everything that can be seen from a particular vantage point' (302). The horizon of our cultural tradition, then, is not a mere instrument of vision, but the condition in which vision occurs. Gadamer explains: ``Our usual relationship to the past is not characterized by distancing and freeing ourselves from tradition. Rather, we are always situated within traditions, and this is no objectifying process-i. The horizon is a substantive perspectival location from which the interpreter looks out at the world, a perspective that is always present but that is open and dynamic, with a temporal as well as physical dimension, moving into the future and into new spaces as the subject moves. The idea of a closed horizon, Gadamer says, is merely an ``abstraction': ``The historical movement of human life consists in the fact that it is never absolutely bound to any one standpoint, and hence can never have a truly closed horizon' (304). The concept of horizon helps to capture the background, framing assumptions we bring with us to perception and understanding, the congealed experiences that become premises by which we strive to make sense of the world, the range of concepts and categories of description that we have at our disposal. It is thus useful in elucidating cultural, or group-related, and personal differences that affect 96 Identities Real and Imagined interpretation. The horizon is just the individual or particular substantive perspective that each person has, that makes up who that person is, consisting of his or her background assumptions, form of life, and social location or position within the social structure and hierarchy. We are not left with a dysfunctional relativism by acknowledging such perspectival knowledges: we can note the limitations of each, the different ways in which each is positioned epistemically, and then argue that one or the other has the epistemic advantage depending on what our project is. This concept of horizon thus offers an account of knowledge that links experience and identity as constitutive features for understanding without making them all-determining, and thus provides a realistic approach to explaining the relevance of identity to understanding while allowing for the mediated nature of experience and the fluid character of identity. The mediations performed by individuals in processes of interpreting their experience and the world are produced through a foreknowledge or historical a priori that is cultural, collective, historical, and politically situated. Social location is the site of mediations and is itself indexed to a particular (rather than universal) ethical engagement or interest with the issue at hand as well as a particular foreknowledge operative for certain persons in certain contexts and not for others. Reflective rationality requires, perhaps above all, the capacity to doubt, a capacity which has been said to be the basis for all inquiry. Peirce argued, doubting requires prior content and context: true or real doubt comes only when we have reasons to doubt, reasons that are by necessity substantive beliefs (Peirce 1940). Doubting does not guide inquiry as an abstract operation that would be equally applied to any and every claim; such a universal doubt that made no distinctions between predictions about the weather and the idea that your partner might really be a robot would be irrational. The doubting that is the basis of rationality is prompted by a specific experience, a feeling of anxiety and uneasiness. This feeling is based on an incoherence between our actual beliefs and beliefs that we have had proposed to us. Thus, the background foreknowledges that one holds are what makes possible the operation of critical reason, providing the context within which a claim will appear either plausible or inspiring of doubt. We cannot, therefore, stand completely outside of all traditions, freely choosing what will be preserved and what will be relinquished. Our ability to negate, and even to reflect on and identify, aspects of the traditions within which we stand is always and necessarily partial. The main problem with this kind of account of reason, and why some prefer the modern, contextually transcendent account, is that it apparently opens the doors to a dysfunctional relativism. Horizons yield different conclusions, yet how can we claim that a horizon is ``wrong'? To admit the salience of horizon, some think, is to condemn us to a relativism without recourse. Another way to put this problem is that knowledges constituted by horizons will be unrelievedly ethnocentric. It is no overstatement to say that the specter of ethnocentrism haunts the Western academy in these times. I suspect this crisis has been brought on more by the critique of Eurocentrism-revealing the purported universals emanating from the West as no more than particulars all along, and thus shaking faith in the universal-than by clear reasoning, because it takes only a moment of reflection to see the absolute falsity of the claim that horizons of justification are truly incommensurable, with no shared content from which to begin the work of clarifying disagreements.

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The number of applied pulses per patient and therapy session was identical in both groups impotence treatment reviews levitra with dapoxetine 40/60 mg amex. The gluteal and femoral therapy regions selected before the treatment were treated with 800 pulses using the handpiece at an average energy level of 0 erectile dysfunction treatment in kuala lumpur generic levitra with dapoxetine 40/60mg overnight delivery. Each treated therapy region was approximately 10 Volume 28 · Number 5 · September/October 2008 · 539 20 cm erectile dysfunction treatment garlic order levitra with dapoxetine 40/60 mg on line. Treatment was performed by "scanning" the therapy region with the applicator; that is erectile dysfunction unable to ejaculate proven levitra with dapoxetine 40/60 mg, by moving the applicator both horizontally and vertically over the therapy region to ensure uniform tissue treatment. For group B, skin elasticity results measured at the end of the therapy revealed a 73% increase (P. At the 3- and 6-month follow-ups, skin elasticity had improved by 95% and 105%, respectively (P. By contrast, the improvement in skin properties achieved with chemical skin care products (creams or lotions) generally ranges between 12% and 25% and may reach just over 30% in individual cases. According to Voss and Schlippe,2 an improvement of more than 40% is to be considered an exceptional result. Changes in the connective tissue structure in the corium and at the interface with the subcutis were identified by using the DermaScan C ultrasound system (Cortex Technology, Hadsund, Denmark). The basic requirement for the measurement and analysis of ultrasound images is that all images are produced with the same system and by using identical amplification settings. Because the ultrasound reflection intensity is related to the relative density of the targeted tissue, it also provides information on the arrangement of the collagen and elastic fibers. The color scale indicates the intensity of ultrasound reflection; white indicates the highest reflection, and black indicates the lowest reflection. Measurements conducted in this study were performed with the DermaLab system (Cortex Technology). For this purpose, the skin is sucked into the probe cavity (approximately 10 mm) to a reproducible level by applying a vacuum. Measurements were always performed before each therapy session and at the same skin location and marked with a special body marker. Values in the medical literature were investigated for comparison with the measurements in our observation series; however, there were few examples and these differed significantly between each other. The lack of standardized measurement methods for the determination of mechanical skin properties has frequently been criticized. Photographs were taken of the treated body regions at each therapy and follow-up session. The result of the objective visual evaluation by independent reviewers is summarized in Figure 4. The evaluation revealed an upward trend in the visually determined skin tissue density values, which had significantly increased from baseline. Wilcoxon signed rank test: group A, 6 therapy sessions, 3months follow-up after last therapy session. The measurement values of 1 patient had to be excluded from the statistics because of nonparticipation in one of the therapy sessions. Wilcoxon signed rank test: group B, 8 therapy sessions, 6month follow-up after the last therapy session. Two patients had to be excluded from the group because of the lack of treatment data. Evaluation of score ratings of DermaScan ultrasound images, including follow-up examinations. After therapy (Figure 5,B), the skin tissue has become measurably more compact, indicating a strengthening of the connective tissue. Side Effects Acoustic waves have only minimal side effects, such as minor pain during therapy or slight skin reddening. This minimal pain was observed 2 to 3 days before the menstrual period of the female patients. It relies on long-term positive experience and on reports in the scientific literature confirming the effectiveness of shock wave therapy. This noninvasive therapy method has been successfully used in urology for more than 25 years and has also proven its efficacy in the treatment of orthopedic disorders. In the validation of the side effects of this therapy, the "healing effect" of shock waves in cases of nonunion of bone fractures was first detected by Valchanou and Michailov.

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The model then suggests that both proponents and opponents of reorientation therapy experienced benefits impotence for males discount 40/60 mg levitra with dapoxetine overnight delivery, including finding and connecting with individuals in similar situations erectile dysfunction causes weight levitra with dapoxetine 40/60mg discount, having a framework by which to beta blocker causes erectile dysfunction buy levitra with dapoxetine 40/60mg mastercard understand why they experienced same-sex attraction (same-sex attractions were primarily explained as occurring due to age related erectile dysfunction treatment order levitra with dapoxetine 40/60mg visa unmet same-sex emotional needs), and experiencing increased identification with their gender (Beckstead & Morrow, 2004). After therapy, the model highlights a number of possible experiences that may include vacillating between different identities, disillusionment, developing or solidifying values, and eventually finding self-acceptance. Finally, the model specifies a number of possible outcomes that range from adopting a positive sexual identity. Based on the findings, Beckstead and Morrow (2004) conclude that the potential harms of reorientation therapy are considerable and outweigh the benefits, which could be obtained in other types of therapy. Shidlo and Schroeder (2002) interviewed 202 individuals who had undergone some kind of reorientation therapy and were recruited through advertisements in newspapers, online, and through e-mail Listservs. As with previous research, women were largely underrepresented, comprising only 10% of their sample. Unlike other samples, there was a representation of nonreligious individuals, with 24% of the sample identifying as nonreligious. Participants had spent an average of 26 months in reorientation treatment, ending the last treatment episode an average of 12 years before their interview (Shidlo & Schroeder, 2002). Shidlo and Schroeder reported that many of the individuals that they interviewed said that at one point in time they would have identified themselves as reoriented, but that with time they realized that this was not the case. Shidlo and Schroeder found that persons who had gone through reorientation therapy had mixed experiences with the therapy, with many reporting that they had been both harmed and helped from the same episode of therapy. Shidlo and Schroeder (2002) developed a model for a pathway to perceived treatment failure or success. The model begins with the preentry period, which was the time during which the participant became motivated to enter treatment. Strong motivators that were reported were a search for a social group where he or she felt comfortable, religious reasons, desire to hold together a marriage and family, threatened expulsion from a religious academic institution if treatment was refused, and mood or anxiety symptoms. For the latter group that sought therapy for mood or anxiety symptoms, they reported that their therapists suggested reorientation therapy in response to their symptoms. Overall, reorientation therapy was suggested to the client by the therapist in 26% of the interventions reported. The model then puts forth division into two groups: persons who perceive themselves as successful and persons who perceive themselves as failing, 13% and 87%, respectively, within the sample. Notably, of the eight individuals in the successful heterosexual shift phase, seven were providers of counseling to individuals who were reorienting or reoriented (Shidlo & Schroeder, 2002). For individuals who saw themselves as not having reoriented, the honeymoon phase was followed by a time of disillusionment (Shidlo & Schroeder, 2002). At this time, the authors state that participants experienced a deadening of sexual desire, or they experienced strong feelings of same-sex sexual desire and felt disappointed in their treatment progress. The latter group often engaged in dangerous impulsive behaviors including substance use, suicidality, or unsafe sexual behaviors. From this point, Shidlo and Schroeder saw the participants as reestablishing a gay or lesbian identity with considerable residual reorientation therapy harm (n = 155) or with considerable renewal and strength (n = 21). First, in contrast to the controversial Spitzer (2003) study, the present study involved recruiting individuals who went through reorientation therapy and did not report a change in sexual orientation. To date, no studies have specifically focused on ex-ex-gay individuals, or those who have entered reorientation therapy at one point, then later reclaimed a gay or lesbian identity. Second, this study differs from the studies conducted by Beckstead and Morrow (Beckstead, 2001; Beckstead & Morrow, 2004) in that participants in the present study were not recruited on the basis of one particular religious identity, and therefore may represent a broader group of individuals who went through reorientation interventions. Finally, in contrast to the model-building approach of Shidlo and Schroeder (2002), the recruitment strategy of the present study was designed to capture individuals who perceived themselves as successful, not in having achieved sexual orientation conversion, but in having reclaimed a new identity as gay or lesbian. The purpose of this study is to thematically examine the experiences of people who have undergone reorientation therapy and have determined that an ex-gay life is not for them: ex-ex-gay (or ex-ex-lesbian) individuals. This study seeks to identify the reasons that led these individuals to seek reorientation therapy and the reasons that they later chose to claim a gay or lesbian identity. Additionally, this study aims to determine how reorientation therapy was perceived to be beneficial or harmful to the individual. Recruitment efforts targeted several online sources over a period of approximately 12 months in 2008 and 2009.

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