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Integrated health and social care initiatives are increasing and health and social care systems are aiming to improve health and social outcomes in disadvantaged groups. There is a global dialogue surrounding improving services by shifting to an integrated health and social care approach. There is consensus of what is “health care”; however, the “social care” definition remains less explored. The authors describe the state of “social care” within the current integrated care literature and identify the depth of integration in current health and social care initiatives.

A narrative literature review, searching Medline, PsychINFO, CINAHL, PubMed, Scopus and Cochrane databases and grey literature (from 2016 to 2021), employing a search strategy, was conducted.

In total. 276 studies were eligible for full-text review, and 33 studies were included and categorised in types: “social care as community outreach dialogues”, “social care as addressing an ageing population”, “social care as targeting multimorbidity and corresponding social risks factors” and “social care as initiatives addressing the fragmentation of services”. Most initiatives were implemented in the United Kingdom. In total, 21 studies reported expanding integrated governance and partnerships; 27 studies reported having health and social care staff with clear integrated governance; 17 had dedicated funding and 11 used data-sharing and the integration of systems’ records.

The authors' demonstrate that social care approaches are expanding beyond the elderly, and these models have been used to respond to multimorbidity [including coronavirus disease 2019 (COVID-19)], targeting priority groups and individuals with complex presentations.

In July 2002 a new EC Preparations Directive came into force requiring suppliers of preparations to consider the environmental impact of their preparations. The environmental assessment can be made through consideration of the individual substances used in the preparation. A review of additives used in the formulation of metalworking fluids has highlighted that there are a number of substances that give cause for concern, especially surfactants or basefluids that are derivatives of C12‐15 or C13‐15 alcohols, such as ethoxylates, propoxylates and EO/PO copolymers. Some reformulation may be required in order to prevent preparations being classified either as; dangerous for the environment; or as very toxic/toxic/harmful to aquatic organisms; or as may cause long‐term adverse effects in the environment. The new directive will require suppliers of preparations to make available material safety data sheets for preparations classified as dangerous for the environment or for preparations containing at least one dangerous substance at a concentration of = >1 per cent. The new directive will also require suppliers to use new packaging labels for; preparations classified as dangerous for the environment; preparations containing at least one dangerous substance at a concentration of =>1 per cent; and for preparations containing =>0.1 per cent of a substance classified as a sensitiser.

Arthur Schlessinger (1983) suggested that the contradictions and paradoxes of American foreign policy reflected contradictions and paradoxes in the underlying character of the people. We would go further to suggest that the early years of colonial life, much like the early years of a person's life, had major consequences ever since. The intersection of Puritanism, available land, and eventually the rise of a commercial culture would forge a unique trajectory of what would be called “American Exceptionalism”, reflecting an “American character”, which itself is subject to three paradoxes or polarities, individualism vs. community, toughness vs. compassion, and moralism vs. pragmatism. The effect of this legacy and the dialectical aspect of American character were first evident when Winthrop proclaimed the city on the hill as the new Jerusalem. The legacy of that vision is taking place today in Iraq.