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In the US, the role of the nurse practitioner is long established. In the UK, the role is not as well developed and there is neither a separate registry nor a recordable qualification to recognise NPs on the Nursing and Midwifery Council register. This has hindered the development of NPs as there is no specified level of training or scope of practice that applies to all nurses in posts labelled "nurse practitioner". This article examines the differences in NP training, licensing and practice between the US and the UK; recommendations are made for using the lessons learnt in the US to help promote the development of NPs in the UK.

The population in Britain is ageing and creating a burden on healthcare that will require the NHS and social care to deliver innovative strategies. This article outlines a visit to Slovenia to view a model of care that fits in well with the Department of Health's integrated care approach to the care of older people and those with long term conditions.

This article evaluates how clients with severe and enduring mental illness in the USA and Eire are managed within the philosophy of 'partial hospitalisation', a total care package that is delivered part of the time in a mental health unit, instead of a traditional inpatient mental health service. The author visited McLean Hospital, Boston, which is a centre of excellence for the partial hospitalisation philosophy (Sederer, 1992), and Harvard Medical School, Massachusetts. This is compared with a visit to St Joseph's Hospital, County Limerick, and Newcastle Hospital, County Wicklow, which evolved from institutional care philosophies and sustained the highest bed population in the world for patients with mental illness (Commission of Inquiry, 1996).

How are newborn babies affected by their mothers' use of drugs nursed in specialist units the USA? A Nursing Times/Birmingham Hospitals Saturday Fund travel award allowed Karena Fellowes to find out.

How can clinical pathways benefit patient care? With her NT/BHSF travel award, Karen Parsley travelled across the world to learn how Australian clinicians implement the system.

Many reports have been published in the UK about the reform movement in the Italian mental health system, but there has been a relative dearth of information on the practice of psychiatric nursing. Here the author reflects on differences and similarities with Italian colleagues and calls for greater dialogue between psychiatric nurses in the two countries.