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The foregoing documents constitute the entire Agreement of the parties pertaining to the Project hereof and is intended as a complete and exclusive statement of promises, representations, discussions and agreements oral or otherwise that have been made in connection therewith. No modifications or amendment to this Agreement shall be binding upon the parties unless the same is in writing, conforms to Fulton County Policy and Procedure 800-6 governing change orders, is signed by the County's and the Contractor's duly authorized representatives, and entered upon the meeting minutes of the Fulton County Board of Commissioners. If any portion of the Contract Documents shall be in conflict with any other portion, the various documents comprising the Contract Documents shall govern in the following order of precedence: 1 ; the Agreement, 2 ; the RFP, 3 ; any Addenda, 4 ; change orders, 5 ; the exhibits, and 6 ; portions of Contractor's proposal that was accepted by the County and made a part of the Contract Documents. The Agreement was approved by the Fulton County Board of Commissioners on [Insert Board of Commissioners approval date and item number]. ARTICLE 2. SEVERABILITY If any provision of this Agreement is held to be unenforceable for any reason, the unenforceability thereof shall not affect the remainder of the Agreement, which shall remain in full force and effect, and enforceable in accordance with its terms. ARTICLE 3. DESCRIPTION OF PROJECT: County and Contractor agree the Project is to provide Pharmaceutical Services. All exhibits referenced in this agreement are incorporated by reference and constitute an integral part of this Agreement as if they were contained herein. ARTICLE 4. SCOPE OF SERVICES Unless modified in writing by both parties in the manner specified in the agreement, duties of Contractor shall not be construed to exceed those services specifically set forth herein. Contractor agrees to provide all services, products, and data and to perform all tasks described in Exhibit C, Scope of Services. ARTICLE 5. DELIVERABLES Contractor shall deliver to County all reports prepared under the terms of this Agreement that are specified in Exhibit D, Project Deliverables. Contractor shall provide to County all deliverables specified in Exhibit D, Project Deliverables. Deliverables shall.
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Or is the girl showing symptoms of a a sign of psychological difficulties requiring more serious problem? immediate attention. The Most experts will say that Recognition and Prevention some moodiness is normal RAP ; Program at The ation form For more in r Hillside in adolescents reaching Zucker Hillside ucke about The Z line at major developmental Hospital is specially tal, visit us on Hospi lij northshore milestones. But persisequipped to identify and www tent changes in thoughts, treat adolescents and feelings and behavior can be young adults showing early signs of serious mental illness. "Our focus is recognizing mental illness at its earliest stages, before psychosis develops or takes hold, " said Barbara Cornblatt, PhD, MBA, director of the RAP Program. "As with any other medical condition, the earlier continued on page 2, for instance, blood pressure.
Hormones that can contribute to sexual arousal disorder. The vaginal thinning and dryness which can contribute to this may develop in HIV-positive women at younger ages than is the norm due to the earlier than usual development of perimenopause or menopause that so often occurs. Inappropriate use of too-high doses of testosterone especially through injections ; can ultimately lead to a shutdown of the body's natural production of testosterone, resulting in impotence. Inappropriate use of other anabolic steroids can also cause impotence. Neuropathy. A form of neuropathy called autonomic neuropathy causes a number of serious symptoms in some HIV + people, including impotence in some men and possibly sexual arousal disorder in some women as well as digestive dysfunction, bladder problems, and orthostatic hypotension ; . Because autonomic neuropathy is more common than is generally recognized, it may be contributing to sexual dysfunction in far more HIV + people than has been reported to date. Researchers have found that HIV-positive men with neuropathy whether asymptomatic or symptomatic ; have nerve conduction problems that may explain their impotence. Normally, nerve signals propagate in pulses along nerves at a certain rate. Researchers have found that this rate is diminished in the dorsal back ; nerve of the penis in HIV + people with neuropathy. In contrast, the penile brachial index that measures blood pressure appears to be unimpaired. This indicates that the problem lies in the nerves, not in the blood supply to the penis. [For more information, see Neuropathy.] Medications. Many different medications can cause sexual problems. Included on the list of drugs that may be problematic are protease inhibitors, as well as a very long list of other medications. In a recent study of 254 HIV-positive men, the rate of sexual problems erectile dysfunction and or loss of libido ; was shown to be increased during any protease inhibitor therapy, with the rate most elevated in those using ritonavir, followed by indinavir, nelfinavir, and saquinavir. There was no apparent association of sexual dysfunction with the use of NNRTIs non-nucleoside reverse transcriptase inhibitors ; or NRTIs nucleoside analogue reverse transcriptase inhibitors or nukes ; . There are many other drugs that are known to have possible sexual side effects. In a compilation by Consumer Reports On Health March 2002 ; , common drugs that may cause sexual dysfunction were listed as the following note that this list does not include sexual dysfunction that may be caused by interactions between drugs ; : Drugs that may cause decreased sexual desire: Q Anti-anxiety drugs: alprazolam Xanax ; and diazepam Valium ; Q Anticonvulsants: carbamazepine Tegretol ; , phenytoin Dilantin ; , and primidone Myidone, Mysoline ; Q Antidepressants: amitriptyline Elavil ; , amoxapine Asendin ; , clomipramine Anafranil ; , desipramine Norpramin ; , fluoxetine Prozac ; , imipramine Norfranil, Tofranil ; , phenelzine Nardil ; , sertraline Zoloft ; , venlafaxine Effexor ; Q Antihypertensives blood pressure meds ; : atenolol Tenormin ; , chlorthalidone Hygroton, Thalitone ; , clonidine Catapres ; , hydrochlorothiazide Esidrix, HydroDIURIL ; , labetalol Normodyne, Trandate ; , methyldopa Aldomet ; , metoprolol Lopressor ; , propranolol Inderal ; , spironolactone Aldactone ; Q Enlarged-prostate drug: finasteride Proscar ; Q Hair loss male pattern baldness ; drug: finasteride Propecia ; Q Heartburn drugs: cimetidine Tagamet, Tagamet HB ; , famotidine Pepcid, Pepcid AC ; , nizatidine Axid, Axid AR ; , ranitidine Zantac, Zantac 75 ; Q Heart failure drug: amiodarone Cordarone ; Drugs that may cause erectile dysfunction or vaginal dryness: Q Anticonvulsants: carbamazepine Tegretol ; , phenytoin Dilantin ; , and primidone Myidone, Mysoline ; Q Antidepressants: amitriptyline Elavil ; , amoxapine Asendin ; , clomipramine Anafranil ; , desipramine Norpramin ; , fluoxetine Prozac ; , imipramine Norfranil, Tofranil ; , paroxetine Paxil ; , phenelzine Nardil ; , sertraline Zoloft ; , venlafaxine Effexor ; Q Antihypertensives blood pressure meds ; : atenolol Tenormin ; , chlorthalidone Hygroton, Thalitone ; , clonidine Catapres ; , hydrochlorothiazide Esidrix, HydroDIURIL ; , labetalol Normodyne, Trandate ; , methyldopa Aldomet ; , metoprolol Lopressor ; , propranolol Inderal ; , spironolactone Aldactone ; Q Enlarged-prostate drug: finasteride Proscar ; Q Hair loss male pattern baldness ; drug: finasteride Propecia ; Q Heartburn drugs: cimetidine Tagamet, Tagamet HB ; , famotidine Pepcid, Pepcid AC ; , nizatidine Axid, Axid AR ; , ranitidine Zantac, Zantac 75 ; Q Heart failure drug: amiodarone Cordarone ; Q Muscle relaxant: baclofen Lioresal and efavirenz.
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