NANCY J GIBBSHead, Acquisitions Department Duke University Durham, North Carolina As with any university or college campus, research needs will change, grow or evolve each year. New faculty members come who have slightly different interests, other faculty change the 'flavor' of their research and need different resources, and still other faculty leave for other institutions. In the past, the TRLN Libraries were able to meet those changing research needs with existing collections budgets, but in the late 1990s it was becoming apparent that serials costs were escalating faster than our budgets. The mechanics of each deal were:■ Elsevier: TRLN licensed this product in 1999 with a three-year deal and then extended it for one additional year.We had access to a shared collection among all four schools with one percent cancellation clause across all four schools; a cap on pricing; ability to add new journals to our Elsevier stable but could not cancel more than one percent of the total contract's worth over the course of the entire contract. In Duke's case that amounted to ten thousand dollars over three years.■ Blackwell: this product was licensed each year; it began in 1999 for the 2000 subscription year.We had access to the complete Blackwell journal collection but had a no cancellation clause.An important component of each contract was the ability for our readers to have access to all titles subscribed to by our consortia libraries. We knew we had overlap amongst our title lists but those title lists were based on print subscriptions, and collection development librarians were comfortable knowing the journals selected on their individual campuses met the teaching and research needs of their faculty and students. The non-subscribed, non-shared titles our patrons would have access to as a result of licensing these two packages were nice, but were not considered crucial to collection building on each campus.Statistics showed, in Duke's case, that our patrons did access other titles but the predominant use by our patrons was of our core list of titles, those subscribed to and paid for by Duke. Later this became an important component in our release from these big deals.Blackwell and Elsevier made it clear during the autumn of 2003 negotiations that cancellation of titles in order to subscribe to new titles was not an option; each would allow changes from print to electronic only to make some budgetary headway. The amount that would be saved, however, was not sufficient to respond to new research needs by the faculty and graduate students. With minimal increases to the collections budgets at each institution, and in some instances declines in budgets, it was becoming almost impossible to add new journals to meet new research needs without the cancellation of a similarly priced journal.By the time renewal contracts were discussed in the late summer and early autumn of 2003, the situation was becoming very serious. Cuts in budgets and support for new programs were meeting head on with rising journal pricing, especially in...

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SUMMARY. Serials in electronic formats often require contractualagreements governing their use. Librarians need to be educated consumers and understand the issues and concerns of the producerhendor community to secure reasonable agreements for electronic access. Standard contracts often do not meet the needs of different libraries and may contain provisions chat should be questioned or clarified.Database producers and vendors have their own contractual and legal obligations which must be considered when negotiating with individual libraries.

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In this paper, Winnicott and Gibbs present two cases, one under the care of Winnicott and Gibbs of varicella encephalitis, and the other a case under the care of Dr H. B. Russell of vaccinia encephalitis. Both cases were patients at the Queen’s Hospital for Children. The two cases are very similar in type and looked clinically like rather severe cases of typical epidemic encephalitis lethargica; in both cases, there was complete recovery.