If you have changed the URLs with trailing slashes, then there are a few things you'll want to do:

• make sure all the internal links on your site are updated to point to the proper version.

• make sure that the sitemap.xml file(s) are correct, pointing to the proper version.

• set up 301 permanent redirects so that the ones with the slash are redirecting to the old URLs.

As long as you have corrected the links internally, updated the sitemap file, and set up the 301 redirects, everything should go "back to normal" within a fairly short period of time. You will need to give it time, though, as Google will need to re-crawl all of those URLs and get it all ironed out.

I tried using it last week and again this week but my location no longer seems to update.

As far as we know, recently Google has changed this feature (turned it off). So, it's very difficult now to use Google to change your location and see results as if you're in another location. Pretty much the only thing you can do now is use a proxy service or VPN to change your location.

The 404 errors and other crawl data is provided by a separate database in Google, so the timing of the links and the data you're seeing isn't exactly "in sync" so to speak. I would do a few things--look at the pages to see if there's something on your site that might be causing the errors.

Another option is to look at the link data to see if there are any links pointing to those pages. I would use another source, such as OSE or Majestic.com to see if there are links pointing to those pages that Google isn't reporting (which is often the case).

I'm not sure how you're blocking Google from crawling external links in the robots.txt file--typically you only block them from crawling internal pages on your site.

If you're using a script, though, to track the clicks on external links and that script is running your site (and you're blocking that script in robot.txt), then that still should be fine. You may want to add a "nofollow" tag on those links, though, so you don't end up passing link "credit" or "link juice" to those affiliates (unless you want to do that?).

As far as external links go, though, it's typically okay (and expected) that you link out to other sites.

For a true 404 error page, Google wouldn't tell you about those errors. You may have a custom 404 error page set up with the tracking code on it and visitors are going to those 404 error page(s). But, since it's JavaScript that must load, then you won't see 404 errors in Google Analytics.

Akira, there really is no direct connection between AdWords and organic rankings. However, there have been studies that show that if you show up in AdWords and in organic search for a search query it will benefit your organic--the visitors will tend to click on your organic listings and on the PPC ads.

Organic is not affected by PPC.

You may be able to pause the low-converting ads while still keeping the higher-converting ones. Furthermore, there may be other keywords that you can bid on that you aren't showing up for. I would look at Google Search Console's Search Analytics report and look at the impressions for organic and see which keywords are getting impressions but not clicks. That may reveal some keywords that you may want to bid on.

All in all, though, if you want to totally pause your AdWords ads it won't affect your rankings.

The duplicate titles are being picked up because all page titles are in English for all 5 languages -

That, there, is the issue. If the page is in French, then the title tag needs to be in French. That's why the title tags are being flagged as duplicates. Because they are duplicates.

The good news, though, is that if you do take the time to update/translate all of your title tags into the proper language, then I bet that your site's search engine rankings will improve quite a bit.

Like others have mentioned, if your site has both the "healthcare solutions" and "healthcare identity solutions" categories (category and subcategory), then it would make sense to keep it that way. We should be able to navigate to each of those pages in the URL.

If you just are referring to the URL, though, the keywords in the URL is such a small part of the search engine algorithms that it really won't make a huge difference--and I hardly believe you'll be penalized for it.

Generally speaking, if you think of the keyword set as part of a large "topic", then you should optimize your site's home page for the main topic in general--and then the sub-topic keyword(s) and the "sub-sub" topic keywords would also be pages, as well. The sub-topic keyword would be linked from the site's home page, and then the sub-sub topic would linked from the sub-topic's page.

I like to think of this as a theme pyramid approach

Main Topic
     Category
          Sub-Topic
     Category
          Sub-Topic