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There is more to primary care than solely medical and nursing services. Models of Child Health Appraised (MOCHA) explored the role of the professions of pharmacy, dental health and social care as examples of affiliate contributors to primary care in providing health advice and treatment to children and young people. Pharmacies are much used, but their value as a resource for children seems to be insufficiently recognised in most European Union (EU) and European Economic Area (EEA) countries. Advice from a pharmacist is invaluable, particularly because many medicines for children are only available off-label, or not available in the correct dose, access to a pharmacist for simple queries around certain health issues is often easier and quicker than access to a primary care physician or nursing service. Preventive dentistry is available throughout the EU and EEA, but there are few targeted incentives to ensure all children receive the service, and accessibility to dental treatment is variable, particularly for disabled children or those with specific health needs. Social care services are an essential part of health care for many extremely vulnerable children, for example those with complex care needs. Mapping social care services and the interaction with health services is challenging due to their fragmented provision and the variability of access across the EU and EEA. A lack of coherent structure of the health and social care interface requires parents or other family members to navigate complex systems with little assistance. The needs of pharmacy, dentistry and social care are varied and interwoven with needs from each other and from the healthcare system. Yet, because this inter-connectivity is not sufficiently recognised in the EU and EEA countries, there is a need for improvement of coordination and with the need for these services to focus more fully on children and young people.

The COVID-19 pandemic has disrupted the ‘real’ world and substantially impacted the virtual world and thus the Internet ecosystem. It has caused a significant exogenous shock that offers a wealth of natural experiments and produced new data about broadband, clouds, and the Internet in times of crisis. In this chapter, we characterise and evaluate the evolving impact of the global COVID-19 crisis on traffic patterns and loads and the impact of those on Internet performance from multiple perspectives. While we place a particular focus on deriving insights into how we can better respond to crises and better plan for the post-COVID-19 ‘new normal’, we analyse the impact on and the responses by different actors of the Internet ecosystem across different jurisdictions. With a focus on the USA and Europe, we examine the responses of both public and private actors, with the latter including content and cloud providers, content delivery networks, and Internet service providers (ISPs). This chapter makes two contributions: first, we derive lessons learned for a future post-COVID-19 world to inform non-networking spheres and policy-making; second, the insights gained assist the networking community in better planning for the future.

Given that the workforce constitutes a principal resource of primary care, appraisal of models of care requires thorough investigation of the health workforce in all Models of Child Health Appraised (MOCHA) countries. This chapter explores this in terms of workforce composition, remuneration, qualifications and training in relation to the needs of children and young people. We have focused on two principal disciplines of primary care; medicine and nursing, with a specific focus on training and skills to care for children in primary care, particularly those with complex care needs, adolescents and vulnerable groups. We found significant disparities in workforce provision and remuneration, in training curricula and in resultant skills of physicians and nurses in European Union and European Economic Area Countries. A lack of overarching standards and recognition of some of the specific needs of children reflected in training of physicians and nurses may lead to suboptimal care for children. There are, of course, many other professions that also contribute to primary care services for children, some of which are discussed in Chapter 15, but we have not had resources to study these to the same detail.

The rapid advancement of technology poses many social challenges including the emerging issue of technology-facilitated abuse (TFA) and violence. In Australia, women from culturally and linguistically diverse (CALD) backgrounds are found to be more vulnerable to domestic violence (DV) and abuse, including TFA. This chapter presents a snapshot of CALD women's technology-facilitated domestic abuse (TFDA) experiences in Melbourne through the eyes of a small group of DV practitioners. Findings show CALD women experience TFA similar to that of the mainstream, with tracking and monitoring through the use of smartphone and social media most common. Their migration and financial status, and language and digital literacy can increase their vulnerability to TFDA, making their experience more complicated. Appropriate digital services and resources together with face-to-face support services can be a way forward. Further research should focus on better understanding CALD women's perceptions of and responses to TFDA and explore ways to improve engagement with and use of community media channels/platforms.

Equity is an issue that pervades all aspects of primary care provision for children and as such is a recurring theme in the Models of Child Health Appraised project. All European Union member states agree to address inequalities in health outcomes and include policies to address the gradient of health across society and target particularly vulnerable population groups. The project sought to understand the contribution of primary care services to reducing inequity in health outcomes for children. We focused on some key features of inequity as they affect children, such as the importance of good health services in early childhood, and the effects of inequity on children, such as the higher health needs of underprivileged groups, but their generally lower access to health services. This indicates that health services have an important role in buffering the effects of social determinants of health by providing effective treatment that can improve the health and quality of life for children with chronic disorders. We identified common risk factors for inequity, such as gender, family situation, socio-economic status (SES), migrant or minority status and regional differences in healthcare provision, and attempted to measure inequity of service provision. We did this by analysing routine data of universal primary care procedures, such as vaccination, age at diagnosis of autism or emergency hospital admission for conditions that can be generally treated in primary care, against variables of inequity, such as indicators of SES, migrant/ethnicity or urban/rural residency. In addition, we focused on the experiences of child population groups particularly at risk of inequity of primary care provision: migrant children and children in the state care system.

The Models of Child Health Appraised (MOCHA) project identified the different models of primary care that exist for children, examined the particular attributes that might be different from those directed at adults and considered how these models might be appraised. The project took the multiple and interrelated dimensions of primary care and simplified them into a conceptual framework for appraisal. A general description of the models in existence in all 30 countries of the EU and EEA countries, focusing on lead practitioner, financial and regulatory and service provision classifications, was created. We then used the WHO ‘building blocks’ for high-performing health systems as a starting point for identifying a good system for children. The building blocks encompass safe and good quality services from an educated and empowered workforce, providing good data systems, access to all necessary medical products, prevention and treatments, and a service that is adequately financed and well led. An extensive search of the literature failed to identify a suitable appraisal framework for MOCHA, because none of the frameworks focused on child primary care in its own right. This led the research team to devise an alternative conceptualisation, at the heart of which is the core theme of child centricity and ecology, and the need to focus on delivery to the child through the life course. The MOCHA model also focuses on the primary care team and the societal and environmental context of the primary care system.

In this world of complexity, disruption, multi-layered crises and insecurity, people seek orientation, stability and meaning. This desire exists in everyday life, in working environments and even more in vacation time. Therefore, the way we see the world and how we interact with each other and with nature should also be reflected by tourist destinations. ‘Destination Conscience’ seems to be a promising conception that offers the desired contemporary design of destination realities and travel experiences. Accordingly, destinations and their products should be characterised by authenticity, meaning, sensitivity and humaneness on all levels. In this chapter, the concept of ‘integral ecology’ as a holistic worldview and new paradigm is presented. Integral ecology can be a source of perception and wisdom that enriches the ‘conscience’ of a destination and all its actors. Hence, this chapter addresses the question of how integral ecology can contribute to Destination Conscience. The essay uses the methods of literature review, application, transfer and case study.

Firstly, the concept of integral ecology will be presented. In the second part, this worldview will be applied to destinations. The enrichment of Destination Conscience by the principles of integral ecology can manifest in the destination's self-image and in the interaction in business relations and business actions. It can find expression in the operational management, organisation and development of a destination and in the design of the touristic services and products. In the third part, the case study of a Catholic monastery in the Altmühltal will be presented for further illustration.