Anorexia nervosa (AN) is a harmful, life-threatening illness. Patients with severe AN often receive acute treatment but, upon discharge, experience high relapse rates. Evidence-based, outpatient treatment following acute care is critical to preventing relapse; however, numerous barriers  preclude individuals from accessing treatment. mHealth technologies may help to address these barriers, but research on such digital approaches for those with AN is limited. Further, such technologies should be developed with all relevant stakeholder input considered from the outset. As such, the present study aimed to garner feedback from eating disorder (ED) treatment center providers on (1) the process of discharging patients to outpatient services, (2) their experiences with technology as a treatment tool, and (3) how future mHealth technologies may be harnessed to offer the most benefit to patients in the post-acute period.N = 11, from 7 ED treatment centers across the United States) were interviewed. To analyze the data for this study, each interview was manually transcribed and analyzed using components of Braun and Clarke's six-phase thematic analysis framework .Participants , and mentioned a high level of interest in the development of a new app to be used by patients recently discharged from acute treatment for AN. Participants also offered suggestions of effective and relevant content for a potential app and adjunctive social networking component for post-acute care of AN.Overall, participants expressed positive attitudes toward the integration of an app into the care flow, suggesting the high potential benefit of harnessing technology to support individuals recovering from AN. Accompaand psychological symptoms of the disorder  –17, highAlthough research on the efficacy of mHealth technologies for AN treatment is limited, there is considerable evidence for the benefit of mHealth technologies in the treatment of other eating disorders. For example, Fitzsimmons-Craft et al.  developeWith regard to AN specifically, two studies evaluated the efficacy and acceptability of digital interventions following discharge from acute care. Neumayr et al.  tested tvia social media  examine the discharge process from acute care to outpatient treatment, (2) evaluate how providers currently utilize technology and mental health apps for treatment of patients, and (3) gather feedback on how best to incorporate an app into the post-acute care of AN. Provider feedback will maximize the likelihood that the resultant digital intervention meets the needs of both providers and patients, maximizing potential to increase access to evidence-based care for patients with AN following discharge from acute care.2.2.1.Participants were ED treatment providers or administrators 18 years of age or older. 19 providers from 12 treatment centers around the US  that had agreed to partner with the research team on a project developing and testing an app for individuals with AN ; trial r2.2.via email to schedule a video conference interview. Interviews were approximately 45 min in length and were conducted and recorded through Zoom. Following the study interview, each participant was emailed a $25 Amazon gift code.Treatment center representatives were contacted by email and asked to complete a brief online survey. Upon completion of the initial survey, eligible participants were contacted 2.3.2.3.1.Participants reported their age, gender identity, educational attainment, race, and ethnicity.2.3.2.To gauge interest in an app-based intervention, participants were asked “What is your current interest level in incorporating app-based interventions to support your patients with anorexia nervosa after they are discharged from higher levels of care?” They responded from 1 to 5, with higher scores indicating greater interest in use of an app-based intervention.2.3.3.To gauge comfort with an app-based intervention, participants were asked “What is your comfort level regarding the integration of app-based interventions into post-acute treatment for anorexia nervosa?” They responded from 1 to 5, with higher scores indicating greater comfort with use of an app-based intervention.2.3.4.To address the aims of this study, the research team created a semi-structured interview guide that assessed each treatment center's approach to the discharge of patients to outpatient therapy, the representatives’ opinions on and experiences with technology for eating disorder treatment, and suggestions for the successful integration of technology into the treatment flow see , 33.2.4.To analyze the data for this study, each interview was manually transcribed and analyzed using components of Braun and Clarke's six-phase thematic analysis framework . Themati3.All eleven participants completed the brief eligibility survey and expressed their levels of interest in, and comfort using, an app-based intervention for the post-acute care of AN. On a scale of 1–5, 1 being very disinterested and 5 being very interested, the average interest level was 4.27 (SD = .65). On a scale of 1–5, 1 being very uncomfortable to 5 being very comfortable, the average comfort level among participants was 3.82 (SD = .87).3.1.Five major themes were identified from provider feedback: (1) participant attitudes toward and approaches to outpatient care , (2) barriers to outpatient care, (3) participants' past experiences utilizing technology as a treatment tool, (4) participants' comfort, interest, and skepticism with app-based treatments, and (5) participant suggestions for implementing a self-help, app-based treatment for the post-acute care of AN.3.1.1.The first theme, provider approaches and attitudes toward post-acute care, encompasses referrals to outpatient care, support from treatment centers following discharge, and nutrition and weight recommendations.n = 7) expressed taking proactive steps to connect patients to outpatient care, with the goal of furthering the physical, psychological, and behavioral progress made in intensive treatment. Providers noted that their treatment centers identify outpatient therapists, and when possible, outpatient dietitians, for patients prior to discharge. Participant 5 explained, “We have a discharge planner whose whole job is to…help make sure that people are going to continue their care in a substantial way after they leave.” They connect patients directly to outpatient providers and ensure initial appointments are scheduled upon patient discharge.The majority of participants (n = 2) expressed that their treatment centers take a more hands-off approach, requiring patients to initiate this process. For example, participant 4 noted “A bulk of that is…on the client end. We provide referrals but it”s…on the client to then reach out to those people to see if they have availability.” In this way, some treatment centers place more responsibility on patients to find outpatient care.Although most participants reported this proactive approach of linking patients directly to outpatient providers, some participants (n = 8) reported that their centers offer bridge programming or support groups. Bridge programming allows patients to continue seeing their treatment center therapist while they wait for an outpatient therapist to become available. Support groups, including alumni groups for those discharged from intensive treatment, also help patients navigate the transition from intensive treatment to outpatient care, and allow individuals pursuing ED recovery to connect with one another.In addition to connecting patients with outpatient providers, some participants  mentioned a lack of specialized eating disorder professionals and explained that waiting lists for outpatient therapists are extensive and “The longer someone is on a waitlist the less likely they are to follow up with patient care” (P3). In many cases, it can be months before patients are able to see a therapist. One participant even expressed that, to their knowledge, “A lot of outpatient therapists are full… not accepting new patients, and they don't even have…waitlists” (P5).The second theme of this study encompasses participants' opinions on barriers to finding and accessing outpatient care. Several barriers to outpatient care were noted by participants, the most common of which was availability of outpatient practitioners. Participants (n = 7) identified location as a barrier to outpatient care. Patients from more rural areas often have difficulty accessing residential and inpatient treatment, much less nearby outpatient therapists that specialize in EDs. Thus, patients are offered the next best option, including referral to therapists with other specialties.In addition to availability, participants n = 9), noting that available ED professionals often do not take insurance, and “The out-of-pocket cost is pretty high and there are less resources. So, if people are really relying on their insurance…they”ll be given a very long list of providers, most of whom don”t specialize in EDs, and if they do, they have a long waiting list” (P1). Another financial barrier identified includes a lack of stable income as a result of the debilitating nature of EDs, which precludes individuals from “[having] things like appropriate food to work with their meal plan upon discharge” (P8).Participants also mentioned the prevalence of financial barriers (n = 6) cited patient initiative as a large barrier to following up with an outpatient team. Lack of motivation, denial, disinterest, and unwillingness to take more time off from work or school were all reasons patients did not follow up with an outpatient therapist. Even if their treatment team is driven to set up appointments for an individual, they “Get to the point where [they”re] calling and trying to set appointments up for [the patient], but [the patient] just doesn”t follow through” (P9). Other barriers mentioned less frequently include language barriers for those whose first language was not English, clinician burnout, transportation, and lack of privacy in the era of telehealth. Quotes and subthemes are described further in Additionally, participants (3.1.3.n = 10) had experience with self-monitoring apps for ED symptoms . When asked about the strengths of telehealth, participants cited the convenience of telehealth platforms. Most participants noted a rapid switch to telehealth during the pandemic that resulted in increased accessibility of treatment for patients:The third theme in this study is participants' past experiences and attitudes toward the use of technology during and following treatment. All participants mentioned experience with telehealth and most via telehealth upon discharge.Participants also highlighted greater accessibility of treatment center-implemented support groups and bridge programming, that patients could engage in Along with greater accessibility, participants explained that patients, with telehealth, were able to experience “more authentic therapy” (P2), as they did not need to wear masks with teletherapy. Furthermore, as patients were typically in their home environments, participants expressed that patients tend to feel more comfortable with food exposures (P6). Participants also noted a preference for telehealth themselves, noting the ability to work from home as a benefit.In addition to sharing the benefits of telehealth, participants shared drawbacks. A commonly reported drawback was the unreliability of technology; many participants noted experiences of glitches and connection problems while using a telehealth platform. Furthermore, several participants mentioned that patients could be less engaged while using a telehealth platform as opposed to treatment in person. One participant explained that:Telehealth can lead to this…minimization of the importance or… separateness of the therapy session from the rest of life. That's not always necessary, but I think in some cases especially, if the patients are really struggling or having a hard time getting on board with treatment, it can feel a little bit more difficult to get that engagement over the screen…or make it feel as valued. (P6)Participants also expressed that telehealth makes it easier for patients to hide food, lie about weight, and engage in disordered eating behaviors. Finally, with telehealth, participants reported that some patients find it “harder to be vulnerable and open” (P1).Participants shared strengths and weaknesses of meal tracking/self-monitoring apps , expressing a high regard for the practicality of the apps, the ability to export PDFs from the apps, and additional coping skills offered in apps. As described by one participant, “It”s something that's more subtle, it's so easy for them to…be at school on their phone logging their meal; no one knows what they're doing, right, vs. this big old notebook with their last 20 meals, right?” (P9) This ease of use was a benefit of apps consistently noted by participants.Few weaknesses of apps were mentioned. The main limitation of apps, as cited by participants, is the interface layout. Specifically, several participants expressed available digital resources for EDs tend to be clunky and unsophisticated. Further, one participant expressed that certain apps are no longer being updated and “If you try to suggest anything you get a sorry email “we are no longer working on this app”” (P9). A final weakness of apps mentioned by one participant is cost. Although most apps are free, some cost money, adding a financial barrier to care. However, the participant who expressed the financial burden these apps might impose still expressed that apps are preferable to pen and paper (P7). Quotes and subthemes are described further in 3.1.4.The fourth theme in this study consisted of participants' overall interest in and skepticism of app-based interventions. All participants expressed a high level of interest in app-based treatments to support patients with AN following discharge with acute care, noting numerous benefits. One participant explained that “any kind of evidence-based…eating disorder clinician-reviewed resources that we can provide that are easy to access could pose such a benefit to our patients, especially given…the increased need and lack of resources” (P2). Another participant also expressed excitement about this technology's potential:It's one of the things…we can't escape, and we shouldn't. I have this philosophy that…we shouldn't escape it, we should embrace it. So…if there's a tool out there that can be super helpful and can provide…accountability for our clients, support for our clients, help us or help our clients get more success in our program, I think that's what matters (P11).Further enthusiasm stemmed from a recognized need of continued evidence-based treatment for patients receiving outpatient care. One participant explained that restoring weight and stabilizing patients is a strength of acute care; however, “finding ways to help people be successful in maintaining that for long enough for it to, through whatever mechanism, to get to be easier to maintain,” is the next goal (P10), and app-based treatments hold much potential to continue to support patients in that journey.Regarding comfort with use of apps, participants shared that comfort in an app is heavily dependent upon level of familiarity with that app. Participants stressed the importance of testing an app themselves before introducing it to their clients. Several participants also expressed that change is hard, and sometimes “At the end of the day, you just don't have the extra time that goes with learning one extra tool” (P7), which is a barrier to ultimate comfort in and adoption of an app-based treatment.Other participants also expressed skepticism regarding app-based treatments, particularly surrounding their ability to be successfully implemented. For example, one participant noted:There's been a fair bit of stuff that has been presented to be simple, painless and/or free… but for the most [part]…at least one and often more than of those points has failed to be met (P10).Finally, one participant explained that the relationship between a therapist and their patient could never truly be replaced by an app, and at most, apps can supplement treatment but not serve as treatments themselves (P5). Quotes and subthemes are described further in 3.1.5.The fifth and final theme of this study is participant feedback on implementation, development, and integration of a guided self-help app, based on SB-ED, into the AN treatment framework. Participants, when shown screenshot of the proposed guided self-help app for AN, described several strengths, including the ability to both message and video chat a coach, as well as the usability of the app, describing it as “user-friendly” (P3), “clean” (P2), “streamlined” (P11), and “easy to navigate” (P2). Another identified strength was the comprehensive nature of the app; participants were impressed by the mix of psychoeducation and interactive activities throughout the app. One participant mentioned that the app contains the content that he covers in bridge sessions: “It is literally what I do in the bridge sessions. It's actually… I'm finding it…almost humorous… it's awesome that a robot could potentially replace me, which would be great for my caseload” (P9). In this way, participants noted multiple strengths that indicate high usability and acceptability of a guided self-help app for the post-acute care of AN.Participants also offered feedback on the proposed adjunctive social networking component, and overall, were optimistic about including this alongside the app to further social support. One of the participants noted, “[An eating disorder]…loves secrecy…so it can feel isolating, and like you”re the only one dealing with this, because by nature, you”re trying to hide what”s going on. I think having that network of individuals to be like “Hey there”s other people dealing with this,” can be really helpful for clients to not feel as alone.” (P4) Another participant noted:I support it fully. I think there is very much a fear about putting a bunch of folks with anorexia in the same room; I'm not in that camp…I think the people that want to get better will use that appropriately, the people that don't won't. As long as it's being monitored and someone is keeping tabs on what's being posted and how people are interacting, I see that being really beneficial” (P9).Thus, participants saw much potential for the social networking component to be helpful, so long as it is strictly monitored. These strengths are described further in In terms of suggestions for an app-based treatment for the post-acute treatment of AN, the most common recommendation was to make the app engaging and interactive. Participants suggested incorporation of games, interactive learning activities, multiple forms of media , and a progress bar or reward system to support app users' engagement. Multiple participants also emphasized the importance of integrating different therapeutic approaches  so that patients might focus on what resonates with them.Participants also offered recommendations for specific sessions or activities, including a session on triggers to prepare patients for the transition “To the real world where…people talk about stuff like the gym or calories all the time” (P4), and sessions for body image, body exposures, and food exposures. Furthermore, participants encouraged inclusion of sessions for patients to reflect on reasons for recovery and continued use of the app.Regarding the practicality of the app, participants noted that the ability to upload information from therapy sessions and integrate assessment data from the app and therapy sessions would be beneficial. Participants also expressed a desire for an app that is “Constantly being updated” (P9) and “That takes feedback from both clinicians and the individuals using it” (P9), so that users can access new content, and app experience can consistently be improved. Participants also suggested “clear-as-day” tech support (P9), as well as a comprehensive training for app use. Overall, participants desired a well-functioning app that would be straightforward to use. These suggestions are described further in the In terms of when to introduce the app into the treatment flow, participants had opposing views. Many noted that although the app's psychoeducation components could supplement higher levels of care, the coaching and self-monitoring would not be appropriate at that point in time. Thus, participants were ambivalent about integrating the app into higher levels of care, with most ultimately deciding that the app would be most beneficial in the outpatient settings.Participants were also mixed about who should coach the app. Some were in favor of utilizing in-house providers because the therapist and app user “already had that established relationship” (P6); however, participants noted that this would not be realistically feasible given liability issues, clinician burnout, billing issues/reimbursement, and time constraints. Thus, many participants noted the benefits of having third-party providers be coaches:I think it would be more realistic, less burdensome for the clinics and centers to have a third-party outsider. I recognize that there's a potential for reported drop there, and, at the same time, I think about, sometimes what happens for some of our folks is those bridge sessions become, I don't want to say like kind of an excuse not to follow through with outpatient, right, but like if it becomes too comfortable, too personal, then it does become… “Oh well this is just going to be my therapy,” and it's like “no actually, more is still needed,” right? Like the work has just started. So, I think that…having it be a third-party person that they could build some rapport with potentially, over the course of the time that they're using this app, but they wouldn't get to the point where it's comfortable like they may just try to stay there. I think that could be really helpful (P9).Overall, participants expressed numerous strengths and suggestions for the development, implementation, and integration of a guided self-help, app-based treatment to support patients with AN following intensive treatment.4.The present study used semi-structured interviews to collect experiences, insight, and suggestions from treatment center representatives to inform development of an app for the post-acute care of AN. Treatment center representatives were recruited from academic medical centers and private, multi-level treatment centers that are the current options for intensive ED treatment in the United States. Findings from this study offer an account of participants' current attitudes and approaches to post-acute care, their opinions on barriers to treatment, their past experiences with technology in treatment, their attitudes towards app-based treatments, and their suggestions for the mobile health app our research team is currently developing. The feedback from treatment center representatives supplements feedback received from individuals from the proposed patient population  who would be using the app . The use of participatory research, through which feedback from individuals affected by the research was garnered, will facilitate successful implementation of the app into the care flow , 31.The first goal of the study was to more fully understand, and report on, the transition from acute care to outpatient care. Aligned with past literature , severalAlthough most patients with AN receive the recommendation of continuing outpatient care, as reflected in the responses from these participants, a good portion of patients do not have access to high-quality outpatient providers due to extremely low availability . ParticiThough the barriers to treatment noted by participants of this study are consistent with past literature , technolThus, telehealth may address some barriers, but other technologies must be utilized to close the gap between acute and outpatient care in a sustainable and effective way. For example, app-based interventions allow users to easily access services when it is convenient for them and at a low cost . The selThe final goal of this study was to gather feedback on how to best develop an app-based intervention and adjunctive social networking component for the post-acute treatment of AN, and then integrate it into the post-acute treatment framework for AN. The main suggestions mentioned in the interviews fell under one of three categories: suggestions for improving engagement, suggestions for specific content, and general hopes for how the app would look, function, and offer technological support to users. Current research emphasizes that engagement often centers around simplicity, validity, and customizability , 48. TheParticipants additionally provided feedback on the adjunctive social networking component, emphasizing that a heavily moderated social media group may be beneficial. Specifically, participants emphasized the isolating nature of EDs, and how support through a social media group might help individuals feel less alone. Indeed, individuals with EDs seek connection with other individuals with EDs , and social media offers a scalable way for individuals with EDs to access such social connection . Participants also suggested that any social media group be strictly monitored given the tendency for individuals with EDs to compare with one another. This is also important given the prevalence of pro-ED online communities that may encourage disordered eating behaviors . Suggestions for the app and social networking component will be incorporated into our own app-based intervention for the post-acute care of AN with the hope that provider feedback will enhance the efficacy of the app and offer more benefits to the user.Though the present study offers many important findings, there are still several limitations. Of providers interviewed, all were white and not Hispanic or Latino. Additionally, of the eleven providers, eight were female. The lack of diversity in this sample does not allow us to generalize results to all acute-care providers. In the future, researchers should work to increase the diversity of the sample to obtain the most representative information. Another limitation is the way the future app was explained to participants. The brief overview of the app and the screenshots from the past SB-ED app, which the current app is being adapted from, do not offer as much information to the participant as an app prototype would. Future research should keep this in mind and try to incorporate screenshots from the specific app for which participants are providing feedback, or even offer providers the chance to review prototype apps. Finally, the thematic analysis is limited by the fact that it was conducted by one rater.The findings of the present study offer a myriad of implications for the future of app-based treatment. The insight, feedback, and suggestions for improvement will not only refine and enhance our own app, but can also be used to help app developers and other research labs to design future apps for the treatment of eating disorders, and for mental health treatment in general. Demand for treatment is high and supply is low for most psychological disorders in the world today , 50. Cre


The Portuguese writer and Nobel prize winner José Saramago, is well-known for his sharp depiction and reflection of human condition. The recent events of the COVID pandemic juxtapose with his novel “Blindness” (1995) – original title: “Ensaio sobre a Cegueira”–, where the expression of fear of dehumanization in a globalized world where any contemporary society may lead to the obligation to follow what power structures define and establish. In his epidemic of blindness, an abandoned psychiatric asylum was chosen by the author as a quarantine ward and the centre of the plot. A question imposes: why an asylum? What is the focus of such a place in a cultural postmodernism message?An historic background revision is proposed, glancing at the evolution of the architectural concept of asylum evolved until modern times, while setting a reflection towards today’s mental health services and European models.A narrative review was performed, gathering points of view in the fields of Literature, Architecture, Philosophy, Politics and Economics.Bertolt Brecht claims that “all art is political and the question is simply whether art attacks existing structures of power or refuses such attacks and thereby contributes to the continuation of those structures”. Regarding evolution of Asylum Architecture, and the principles which ought to control Modern Construction, In “Blindness”, the thematic of space appears above all through the reference of Marc Augé’s Non-Place. Initially extended to the city, gives way to the funneling of the space that leads to the “asylum” - a space that centralizes all the action. Through Saramago’s description, the floor plans were designed by Portuguese architect José Cardoso. As the first waves of blind people are imprisoned, it is characterized as a heterotopia, the embodiment of Foucaudian panopticism, as it is constituted as a prison whose role is to isolate, even if this attitude is motivated by despair of the government. A mental healthcare system assumes a multidisciplinary approach to psychiatric disorders. Evidence points to a balance between community-based and modern hospital-based care, with frontline services based in the community and hospitals playing a more specialized role. For most European countries, mental healthcare is financed in the same way as other healthcare services, using either national, regional or local budgets and four ways to purchase mental health services are looked at in depth. Therefore, general decisions about such financing may not be in line with mental health policy-maker or planner.Where culture meets anthropology, social policies, legal boundaries and ethic reflections, a time for a joint dialogue arises. How to surpass the differences and heterogeneity between countries? Is there a place for a common system in mental health care?None Declared


Research in creative industries is mostly focused on urban and metropolitan areas. However, various authors have approached the creative industries from a regional, rural, or remote point of view. The objective of this study is to map and analyze research on creative industries in low-density areas and to identify the main theories and current and future trends within this theme. For data collection, only articles published in the Web of Science and SCOPUS databases were used, from which a set of 152 documents was obtained. For this study, we used R Bibliometrix software to assist in result analysis and VOSViewer software, to create a reference co-citation’s map, which allowed us to identify three clusters, whose themes we analyzed in detail. The results allowed to show (i) an increase in investigations into creative industries in low-density areas in recent years, (ii) the main journals and authors that have contributed the most to this theme, (iii) the identification of the theories most used in these studies, and (iv) finally, the identification of three clusters: remoteness and place relations with the creative industries (cluster 1), critical perspectives and the spatial distribution of talent (cluster 2), and cultural policies and the genesis of the creative class (cluster 3). This study contributes to mapping and critically summarizing the existing literature linking the creative industries and low-density areas. In addition, the study made it possible to identify current and future trends in order to enhance new lines of investigation. The Rise of the Creative Class  and/or specific countries   9 articles were excluded because the keywords were being wrongly applied since we used the keywords “creative,” “industry,” “economy,” and “work” separately, and some results were using compound terms like “creative destruction,” “creative recovery,” or “creative social work,” all concepts that are not relevant to this research; (2) we excluded 4 articles that, although the terms are being correctly used, the global subject of the article was discrepant from ours, like articles whose theme was intellectual property or healthcare in the digital age; (3) 5 articles were excluded because their geographic focus was metropolitan areas and their goal was to analyze the growth and impact of creative industries in large urban areas. We kept all other articles mentioning “city,” “urban,” or “metropolitan” because, besides focusing on those areas, they also presented a regional and wider approach. After this second phase, we reached our final 152 results, from which 148 were classified as articles and 4 as literature reviews.After establishing this final body of documents, the results were exported in two BibTex files. Using R Studio software , we confirmed the elimination of duplicates and joined both files in a single database, which we verified to ensure that authors and keywords did not have inconsistencies or unnecessary repetitions. For example, the keywords creative industries  and creative industry (singular) were homogenized for creative industries. For this study, we used R Bibliometrix software (version 3.0) to assist in results analysis and VOSViewer software (version 1.6.15), to create a reference co-citation map, which allowed us to identify three clusters, whose themes we will analyze in detail.The urban bias in creative industry research  and until 2021 (n = 16) has been increasing and that close to half of the results (52.5%) were published in the last 4 years. The number of published articles grew significantly in 2017 and has been higher than 15 articles per year ever since. More meaningful than this growth is the increase in results’ citations from 2005 (n = 2) to 2021 (n = 475), which reflects a growing interest in the subject of creative industries in low-density areas.In Fig. International Journal of Cultural Policy, Regional Studies, and Creative Industries Journal.The research about creative industries crosses a wide range of subjects; thus, when we focus its relation with low-density areas, it is expected that this multidisciplinarity is kept. So, with this literature review, we seek to be as inclusive as possible, to not restrict areas of research, and to include all areas of the SSCI . The results obtained encompass 109 different journals, from which 5 have 5 or more published articles. Of the top 5 journals published on the subject Fig. , 3 are jOur research used as keywords “creative industry,” “creative economy,” and “creative work,” so the documents found reply primarily to that criteria; however, this choice did not eliminate other keywords and synonyms like “creative class,” “cultural industries,” “cultural policies,” “cultural economy,” “creative clusters,” or “creativity.” This variety of keywords shows that even limiting our initial query, the terminology clutter , followed by the UK (n = 26), China (n = 17), the USA (n = 14), Indonesia (n = 12), and Italy (n = 9).The documents obtained are from 35 different countries. In Fig. n = 103) stands out first, followed by Asia (n = 38) and Oceania (n = 29). It is interesting to compare these results with those obtained by Cho et al. (n = 246), followed by the UK (n = 183) and Australia (n = 111), while the results of the top 7 countries in Asia are grouped (n = 46). This shows us that while the USA produces more scientific research on creative industries, countries such as the UK or Australia focus more on the topic of creative industries in regional context or remote areas; at the same time, the opposite is true for the proportion of articles from China and Indonesia, which stand out here in top places, while in the review by Cho et al.  but also from other areas of the knowledge-based economy, like engineering, healthcare, education, research, programming, science, or the law. One of the key points of Florida’s thesis is that this special class is attracted to places with high levels of tolerance, diversity, and amenities, which opposes the traditional view of the attractiveness of places by wealth and employment .This theory was presented by Richard Florid in his book The creative class theory quickly became popular and caused a large number of cities to start investing in creative and cultural policies to capture the interest of this new class, sometimes uncritically Peck, . The cren = 12), followed by Fleischmann (n = 7), Welters (n = 5), and Slach (n = 4). Of these, the first three authors are based in Australia and have published collaborative papers; their focus is on the economic and social impact of the creative industries at a regional level, as well as their networks and key players, particularly in northern Australian cities such as Darwin, Cairns, and Townsville, which are geographically distant from major Australian urban centers , is the cluster most closely related to the theme of this review and focuses on the relationship of creative and cultural industries to places, in particular suburban, rural, and remote places. The second cluster, with 8 articles , gathers critical articles that focus on geographical dispersion and the agglomeration of talent; finally, the third cluster, with 8 articles , focuses on cultural policies and the genesis of the creative class.This first cluster includes various studies about creative industries and places, in particular remote, rural, regional, and suburban places. It is the key cluster to understand the relationship between creative industries and low-density areas Table .Table 4TFlew and Cunningham  draw theJayne  criticalAbout the tendency of creative industries for agglomeration, Jayne  refers tDrake  aims to “Locality is important (…) but not primarily because of its potential as a source of signs, ideas, and prompts. The attributes of the locality are perceived as important in terms of reduced costs, marketing advantages, social or family networks, familiarity or local infrastructure.” Drake, , p. 517.His interviews with works from the metalworking and the digital sectors  led Drake  to definIn cluster 2, various critical perspectives are grouped, particularly directed to Florida’s creative class theory . Both clusters function as theoretical fundamentals for cluster 1, where geography and places gain ground.Clusters 2 and 3 have a strong connection. Various articles from cluster 2 criticized the creative class theory, presented by the most relevant publication in our co-citation’s map, which belongs to cluster 3 , followed by the popularization of creativity in public policy and its consequences, the growing urban bias, and the critic of both this trends (cluster 2) and finally the attempt to expand and apply scientific research to peripheral, rural, regional, and suburban territories (cluster 1).This SLR gave us a birds’ view on the subject of creative industries in low-density areas; however, there are still areas of that subject that would benefit from further research.Firstly, it would be important to draw the profile of the creative worker who moves to low-density areas. McGranahan and Wojan  suggest Also, in a further phase, following what was made by Townsend et al.  with theWith the various studies on the economic impact of creative industries, we can infer that, in areas with more fragile economies, this impact can be even more notorious for various reasons. Besides that, as demonstrated by Drake , the plaThe COVID-19 pandemic boosted remote work in many areas, including the creative industries, whose agents became even more dependent on wi-fi connection and less on place and geography. Has this change had any impact in motivating the migration of the creative industries?Finally, the creative industries are connected to public policies. Various authors studied policies in a regional context , critical perspectives and the spatial distribution of talent (cluster 2), and cultural policies and the genesis of the creative class (cluster 3).The results used in this review, as with any in the area of creative industries, are multidisciplinary and were published in a wide variety of indexed journals; however, this review shows the lack of other literature reviews on the subjects of creative industries in low-density areas; a flaw, we hoped, contributed to fill.The research on creative industries in low-density areas shares some of the same challenges of the wider research on creative industries: the terminology clutter, the emphasis on agglomeration and clustering, and the debate around policies and their relation to culture. Like the cities of the twenty-first century, rural areas are affected by the same crisis and the same changes in paradigms, and the local policies lean on converging to the creative economy ideas (Bell & Jayne, This study brings three important theoretical contributions to the existing literature. First, this study led to a survey and mapping of the main investigations on creative industries and low-density territories. Second, this study presents some current and future trends in this area, allowing it to be a starting point for further investigations. Finally, it contributed to the suggestion of future investigations based on the gaps that still exist in the literature. Regarding the practical implications, this SLR suggests that the relationship between creative industries and low-density areas is an emerging and important issue for regional development and that needs to have more attention from the governments, through specific policies to support this type of entrepreneurs.In the course of this investigation, some limitations were found. The first limitation to take into account is subjectivity, despite having taken all precautions; this type of study always presents some subjectivity, both in the classification of articles and in the choice of keywords and the steps to be followed. Another limitation is related to the fact that book chapters, books, and conference articles were not included in the analyzed documents, since most of them are not easy to access.


To develop prevention programs or early interventions to reduce alcohol consumption and related problems among college students, it is essential to understand their motivations for drinking and the spontaneous (effective and non-effective) strategies they employ to control, considering the social and cultural contexts influence. This study aimed to explore these factors and the student’s application of selfcare in different situations and environments, as well as to identify their reasons for not drinking.The students were invited to participate using a snowball sampling, up to the theoretical saturation point. Qualitative individual semi-structured interviews were carried out and the interviews contents were analyzed using the NVivo software. The participants were 23 college students between 18 and 24 years old, with diverse patterns of alcohol use (low-risk to suggestive of dependence).Data analysis highlighted three main themes: (a) Contexts  and consumption patterns; (b) Protective Strategies ; (c) Motivations to control drinking . Protective strategies and motivation to control drinking were perceived to be less prominent in specific contexts that favor high alcohol consumption, as open bar parties.Motivations and protective strategies varied according to the drinkers’ profile, social situations and settings in which they consumed alcohol. The results highlight the need for preventive interventions planned for specific drinking patterns and contexts. Alcohol consumption among young people is a behavior that poses several risks to their safety. Even though alcohol use in Brazil is forbidden for those under 18 years of age, 34.3% of adolescents from 12 to 17 years old reported having drunk alcohol in the last twelve months, according to the 3rd National Survey on Drug Use by the Brazilian population [A previous study in São Paulo State (Brazil) with college students  reportedEckschmidt et al. (2013)  comparedProtective behavioral strategies (PBS) are cognitive and behavioral strategies aimed at decreasing heavy alcohol use and alcohol problems. The most common types of strategies include limiting or stopping drinking, drinking control or adopting harm reduction –14. PBS Motivations can be defined as reasons, conscious or not, for behaving in a certain way . StudiesThere are different theoretical models that aim to clarify how behaviors are expressed in social contexts. The influences of psychosocial and cognitive-behavioral parameters can be interpreted from the perspective of the social norms theory , 22, whiIn addition to the normative social context, alcohol use among college students is influenced by motivations that can be external or internal . ExternaA recent study by Stevens et al. (2021)  pointed Given these gaps in the literature, this study used a qualitative approach to analyze Brazilian college students’ protective behavioral strategies and motivations to control drinking, taking into account internal and external factors associated with alcohol consumption, in a sample of urban college students with “low” or “at risk” levels of alcohol consumption in diverse drinking settings.Qualitative research procedures were used for this study to describe and analyze college students’ beliefs and behaviors about alcohol consumption. Content analysis allows evaluating the phenomenon using the subjects’ conceptual framework , 35.An intentional criterion sampling was used for selecting the participants, who were 23 college students over 18 years old. The exclusion criteria were evident cognitive impairment or psychiatric disorder that could bias the interview. They were enrolled in universities in the city of São Paulo (N = 18) and the surrounding area (N = 5) and a criteria for inclusion was to had consumed alcoholic beverages, at least occasionally. Convenience sampling and snowball sampling techniques were used to include participants. This sampling technique consists of creating a chain of new participants starting from the first respondent who, in turn, suggests another college student to be interviewed . The firHow do you perceive alcohol consumption among college students?”, “In what contexts does consumption occur?”, “How does consumption occur?”, “How do you realize that you’ve crossed the line?”, “What are the motivations for not crossing the line?”, “What measures of self-care do you take ?”.Semi-structured individual interviews took 24 min on average and started after had granted permission for the interview to be recorded. All interviews were carried out by the first author, a psychology student, trained and supervised by researchers with extensive experience in qualitative studies. All the interviews were conducted in public environments with little movement or noise, in coffee shops or isolated places on the university campus. The interviews were carried out before the COVID-19 pandemic, between August 2019 and February 2020. After the interviews, the first author completed the field diaries with comments about the participants’ behaviors and interview process. The interviews were audio-recorded for the subsequent transcription of their full content. The transcripts were not returned to participants for comment or correction. The interviews followed a semi-structured script which included open questions about the contexts of alcoholic beverage consumption, motivations to drink or not and protective behavioral strategies used by the participants. Cognitive-behavioral approaches and the theory of social norms were used to design the interview script , 23, 25.low-risk (< 8), hazardous use (8–15), harmful use (16–19) or suggestive of dependence (> 19).Although the participants had reported their alcohol consumption during the interview, to classify their pattern of use, after the interview we asked them to complete the Brazilian version of the Alcohol Use Disorders Identification Test (AUDIT) . The AUDSelf-care strategies, Group dynamics and Memories of personal experiences. All the data were fully transcribed and inserted in NVivo 12 software [All stages of data collection and analysis were triangulated and supervised. In the data collection stage the authors analyzed the data in depth to create categories and determine the theoretical saturation point  The catesoftware , to orgasoftware , 35. In interview number (order of interviews), the gender of the respondent , the stage of the college course they are in , the general area of the course  and the educational institution . Therefore, a participant with the code “06MSH1” would mean: sixth interview (06), male respondent (M) in the second half of the course (S), main area Humanities (H) at a public institution [In order to ensure the confidentiality of the information provided by the participants, an alphanumeric code was defined to identify the interviews using: Before starting the interview, all participants signed an informed consent form and had the opportunity to ask for any additional information if they had doubts about the research project. They were informed about their right to request partial or final data of the research as well as the exclusion of their data from the research at any stage of the project. The study was submitted to and approved by the UNIFESP Research Ethics Committee (Report 2.450.631/2018).low-risk zone; four women (36.4%) and three (23.1%) men in the hazardous use zone; one woman (9%) and no man in the harmful use zone, and no woman and three men (23.1%) in the suggestive of dependence zone (AUDIT scores > 19).The participants were between 18 and 24 years old, with an average age (mean ± SD) of 20.2 ± 1.6 (women) and 21.6 ± 1.7 years (men). Out of the 23 students interviewed, eleven (47.8%) were female. Most of the students (78.2%) were from private institutions, enrolled in Humanities courses (66.8%). The others were in the same proportion from Health (16.6%) and Exact Sciences (16.6%) areas. Most of them (60.8%) were in the second half of the course. As regards alcohol consumption and related problems, their average AUDIT scores were in the beginning of the hazardous use zone  and women presented lower means  than men . Among the 23 participants, just one woman but no men reported not having been using alcohol recently. Most of the participants, five women (45.5%) and seven men (53.8%) were classified in the AUDIT Contexts and alcohol consumption patterns”; “Protective strategies”; “Motivations for controlling alcohol consumption” and “Influence of patterns of alcohol use and the environment”. All participants reported having already attended environments where alcohol consumption was available.The participants answers to the questions about their perception of alcohol consumption among college students, their motivations for controlling it and the contexts where they drink were submitted to a qualitative analysis. We identified four main themes: “). The main places of use they mentioned were bars, “open bar” parties (admission fee includes free drink consumption), cash-bar parties (pay for each drink), nightclubs, living spaces in the university, meetings at fraternities or friends’ houses, and in street environments (including street meeting points and consumption in front of convenience stores or bars).When participants were asked about the contexts in which their alcohol consumption happened, most of them associated the pattern of use with the environments where it is consumed, as well as with the people present in the specific place and the kind of social interaction at the time of consumption Table . The maiThe participants considered bars as a relatively controlled consumption environment, used with the main purpose of socializing through conversations. On the other hand, “open bar” parties were reported as an environment of more intense consumption. Participants recognized in these places the presence of many environmental triggers for alcohol consumption such as unlimited drinks, music, wide range of drinks and associated them with a high frequency of risky behaviors due to the high consumption. Cash-bar places were referred to as relatively controlled consumption environment, in which consumption is limited by the amount of money available. The use of alcohol on the streets surrounding the university and drinking in get-together spaces were reported by a smaller number of participants, who considered this context as an environment for socializing with friends and classmates where alcohol is frequently present. Drinking in get-together places was reported only by students from public universities.(Table ).When participants were asked about effective self-care or protection strategies, they reported drinking slowly, consuming beverages with low alcohol content, short no-drinking intervals or alternating alcoholic beverages with water; eating before or during drinking, returning home in the company of friends, drinking in the presence of friends or trusted persons and inducing vomiting when feeling sick Table .When participants were asked about university students’ motivations to control alcohol consumption, they reported motivations related to themselves or others, which could be grouped into three factors: psychosocial, cognitive-behavioral, and self-monitoring Table .psychosocial factors category, we included issues related to the social systems in which the individual is inserted, mainly those related to religious issues, relationships with friends or family. The cognitive-behavioral category included perception, memories, self-belief, or other person’s beliefs, self-care, fear of judgment, a sense of commitment and responsibility, as well as bad memories of personal experiences. The self-monitoring category was related to feedback and behavior maintenance, occurring through self-perception of the physical and behavioral effects of alcohol, or through group dynamics, when friends warn them about their state of inebriation.In the The truth is that my friends are always the ones who take care of me” (12MSHL2). Only those participants characterized as low or moderate alcohol users mentioned “responsibility” as a motivation to control the consumption.The use of protective strategies, motivation and sense of responsibility varied according to the student’s profile regarding patterns of drinking, and the drinking environment. Students with high alcohol consumption (AUDIT zones 2 and 3) and those with scores suggestive of dependence (AUDIT zone 4), reported low motivation to control alcohol consumption, frequency of use of protective strategies, and sense of responsibility. This situation is illustrated by the comment of one participant who said: ““I think that alcohol consumption changes according to the environment. If I’m at a party, I drink more than if I’m doing something more casual with friends in the afternoon, for example.” (19FFH2). “(…) I drink a lot (at open bar parties), first to make the ticket price worthwhile, second because “open bar” parties are something that do not happen every day (…) the best thing to do is drink like a crazy (…)” (16MFH2).The environment was also mentioned as a factor that influenced the motivation to control alcohol consumption and adopt protective strategies. Environments associated with high availability of alcohol, such as “open bar” parties, were also reported as triggers of high alcohol consumption, low motivation to control drinking or employment of protective strategies. The following comments exemplify this situation: When I drink alcohol, you know, those social locks, they shrink, so like, one thing… when I got into college, I was very shy, and I didn’t go to bars (…) I started going, you know, and feeling comfortable in those environments because of alcohol, you know, interacting with people I don’t know, sometimes I end up using alcohol as a good-luck charm (…) and I believe most college students do it, too! (…)” (06MSH1) “Like I said, the motivation  both not to make a fool of myself in front of my friends, then motivation like for the money, the “great, I’m partying, I’m here, I paid for that, and if I get sick I will have to go home and I’m going to waste money” you know, I think it is more those two things! (…)” (06MSH1).Participants mentioned some motivations for controlling alcohol consumption: “(…) ““(…) in the Atlética* we already do that, you know, we have a party that is famous, “the Shower”, I don’t know if you’ve heard about it, then it’s an open bar party that lasts for ten, twelve hours on end, everybody knows the party because everybody gets sick, then there are moments when the open bar stops, then they give food, they give things with a high glycemic index for the people really hold on a little longer and go back a little sober” (09FSHL1).The use of protective strategies was related to the context and the pattern of alcohol consumption *Atlética: Atlética is a university organization that aims to promote the social integration of students through sports.The originality of this qualitative study on the main motivations for drinking, or not, and protective strategies employed by college students to control their alcohol consumption is the inclusion of participants with diverse levels of associated risks. Interviewing not only those classified as “at risk” or “suggestive of dependence” but also those with occasional, low consumption or currently abstainers brought new information on their behavior and influence of different contexts. The participants’ reports highlighted the importance of understanding the influence of both the context in which alcohol is used and peers’ behaviors. The students’ reports also allowed to explore their main motivations to drink, or not, and how they use protective strategies. These aspects are affected by individual  and contextual  factors that interact in different ways, leading to higher or lower alcohol consumption and associated problems. Among the external factors that favor heavy use of alcohol, open bar parties and peer pressure stand out, while among the internal aspects factors such as low self-esteem and a desire to fit in emerge. These external and internal factors can contribute to a lower probability of using protective strategies in alcohol contexts. Overall, our findings are in line with those of Lorant at al (2013) . AccordiA study carried out in the USA showed that engagement in protective behavior strategies (PBS) can increase or decrease depending on the celebration of a holiday, the time of year and the context of alcohol use . AccordiPrevious studies carried out with Brazilian college students confirmed that university parties, especially open bar ones, were associated with high consumption of alcoholic beverages and associated risk behaviors . They arOn the other hand, some studies showed that most of college students, despite intense alcohol consumption in some specific contexts, in general, present a low-risk consumption pattern. , 47. MosThe psychosocial and cognitive-behavioral motivations observed in this study are aligned with the categories of external and internal motivators, previously described in other countries and cultures –19. ThesOne of the main strengths of this study is its focus on the variables that may affect the students use of protective strategies for alcohol consumption. Through the qualitative analysis of the participants’ reports, it was possible to detect that the protective strategies can be influenced by contexts, motivations, and consumption patterns. These strategies were reported to be less used by people with a high consumption pattern, positive motivations for drinking and who were in environments that encourage the consumption of beverages, such as open bar parties. Therefore, understanding the factors that encourage drinking, the strategies that are already used by individuals to restrict their consumption of alcohol, and the patterns of consumption of the population is extremely important to develop more effective interventions.The college students who participated in the study were mostly from middle-class and private institutions. To understand the phenomenon in other populations, further studies must be carried out in other samples with diverse cultural and socioeconomic characteristics. Regarding the level of risk associated with alcohol consumption, our sample had only one person classified as a “harmful user” and only a few men classified as “suggestive of dependence” users.In summary, to develop preventive approaches and early interventions to reduce alcohol related problems among specific populations, it is crucial to have a comprehensive understanding of student´s motivations to drink, or not, as well the spontaneous strategies they employ to control their consumption. It is important to develop preventive programs considering the specificities of university alcohol consumption contexts, patterns of alcohol consumption, motivations for consuming and controlling alcohol ingestion strategies already existing among college students. Preventive programs in the university context can enhance the frequency of strategic protective behavior in this population, as well as interventional programs for self-care, body self-perception, and financial education. In this study students reported that saving money was one of the reasons for drinking less. Therefore, financial education seems to be an important factor to minimize consumption and its associated risks.“Considering motivations and preventive strategies may vary according to the context and the pattern of use. As a result, they may impact targeting preventive damage reduction actions. In open bar parties, for example, the care should involve protective resources that do not depend on the decision-making of heavy drinkers. In this context, damage control actions such as wide availability of free water and food establish considerable protective relevance” , 19, 46.This study identified protective behavioral strategies and motivations to control drinking among Brazilian college students and found they were less used in contexts where there is an overall high alcohol consumption. These findings corroborate other recent studies in the area that point in the same direction , 15 and


L’assassinat du président Carnot, by the French physicianAlexandre Lacassagne. A few months before the book was published, in June 1894,the president of France, Sadi Carnot, had been killed by the Italian anarchistSante Geronimo Caserio. Lacassagne was called upon to perform the autopsy ofCarnot’s body and a psychiatric examination of Caserio. The results of these twoanalyses were published in the aforementioned book. He made his observations onthe anarchist in the broader context of criminological debates pursued in thelate nineteenth century, which were not restricted solely to the authors ofItalian criminology.This article analyzes the way anarchism and its followers were understood in On June 23, 1894, a baker of Italian origin set off on a journey to Lyon from Sète, asmall town in southern France, with the aim of avenging the death of comrades of hisexecuted by the French judiciary for their involvement in a series of bombings ofconcern to the authorities.Sante Geronimo Caserio (1873-1894), as the baker was called, was just 20 years old. Ofhumble origins, he had become an anarchist militant after coming into contact withlibertarian ideas. He arrived by train at the Vienne commune on the morning of thefollowing day, having ensconced in his clothing a dagger with an ornate wooden handleand a Damascus steel blade some 28cm long by 25mm wide, which he had acquired with hisown savings a few days earlier ,p.18.From Vienne, a small commune 30km from Lyon, Caserio continued on foot to Lyon. Atnightfall, he made his way to rue de la République, a street in the center of the citybetween the Saône and Rhône rivers. There, he took his place among the excited crowdassembled there to see President Sadi Carnot, who was on a routine visit to the region,as he passed down the street with his entourage. When his vehicle finally came near,Caserio moved forward, stepped onto the step at the side of the carriage and with hisleft hand pulled out the dagger from within his clothing. With a swift downwardmovement, he plunged the blade into the victim’s chest, damaging his heart and hisportal vein near the liver ,p.14-16Le PetitJournal reported on the episode with wealth of detail . The New York Times published the front-page headline“CARNOT KILLED ... Cesare Santo, an Italian Anarchist, the Murderer. The People ofLyons, Infuriated, Make An Attack on the Italian Consulate. An Italian restaurantsacked” .O Paiz emblazoned its front cover with a report onthe assassination, claiming that the attack had been the “criminal” work of anarchists,“a horde of madmen” .With his hands covered in blood, Caserio then cried out “Long live the revolution!” and“Long live anarchy!” until he was pinned down by the president’s bodyguards, whoarrested and detailed him. Still alive, President Carnot was rushed off and underwentminor surgery, but to no avail, dying a few hours after the attack. The news of theattack was soon reported in the world’s press. The French newspaper The autopsy of Carnot was performed by a select group of French physicians, which thefamous criminologist and leading exponent of French criminology, Alexandre Lacassagne(1843-1924), was invited to join.L’assassinat duprésident Carnot  and Gli anarchici (1894) (From the theses Lacassagne put forward in m Brazil  and elsem Brazil  that havi (1894) . DespiteL’assassinat du présidentCarnot, its evidence was studied for homogeneity, meaning, and logic toenable a historicization and interpretation of Alexandre Lacassagne’s criminologicalconcepts and ideas about anarchists.To this end, this study situates the history of criminology in the field of intellectualhistory in connection with the history of science.L’assassinat du président Carnot, in whichLacassagne writes about the attack on President Carnot and makes a profoundinvestigation of the practice of anarchism.The article is divided into three sections. The first discusses the broader circumstancesof the anarchist movement in central Europe at the time when Caserio carried out theattack. The second presents an analysis of how criminology was organized in the 1890s,putting particular emphasis to the work of Lacassagne and other French criminologists.The third focuses on The anarchist movement gained prominence as of the mid-1800s, once its main ideas hadtaken shape, and soon spread to different countries . By the Propaganda by action was a strategy of insurrection advocated by the Italians CarloCafiero (1846-1892) and Errico Malatesta (1853-1932), the latter of whom was aleading exponent of anarchism, which was also supported by the Russian anarchistPiotrpot Krokin (1842-1921). This revolutionary strategy aimed to “teach socialismthrough facts, through the lessons of things” , p.336. modus operandi wouldrender the need to form large organizations obsolete, since violent acts of thisnature could perfectly well be planned and executed by small clandestine groups.Still, some activists, such as Kropotkin and Malatesta, continued to defend the needfor both types of organization, since larger ones had the power to rally workers andcarry out libertarian propaganda . Indeed, some of theanarchists even concluded that adopting this opaganda , p.115.In 1881, a congress was held in the City of London that was attended by delegatesfrom various parts of Europe and America. Despite the participation of militants ofdifferent anarchic orientations, the meeting was marked by the superimposition ofradical ideas that would influence some branches of anarchism for almost two decades, p.196, So it was that a series of attacks by more radical activists took place at the verysame time that the leading lights of anarchism were debating theoretical questionsabout the use of violence. The targets of these attacks, carried out in the late1870s and early 1880s, were public figures in several parts of Europe. According toThe wave of attacks peaked in the 1890s, recurring in different locations and underthe pretext of being a response to the economic, social, and political realityexperienced by the proletariat in the main European capitals. For Daniel In France, where anarchist ideas had gained prominence among workers, this radicalturn was marked by the publication of small newspapers and pamphlets by differentanarchist groups to spread “incendiary” articles, songs, and poetry. An example ofthe extreme action includes a sequence of terrorist acts carried out under theinfluence of an attack by Ravachol in March 1892.In November 1893, an anarchist cobbler Léauthier seriously injured a Serbian ministeron a diplomatic visit to Paris. One month later, Auguste Vaillant threw a bomb inPalais Bourbon, home of the lower house of the French legislature, in revenge forthe execution of Ravachol. In February of 1894, Émile Henry lobbed explosivematerial into Café Terminus, also in the French capital. And the following month,the Belgian Amédeé Pauwels died when some dynamite intended for an attack on theMadeleine church went off accidentally , p.12-14As this period of extreme anarchism assailed Europe, concern with these occurrencesprompted physicians, jurists, and other intellectuals involved in researchingcriminals to publicize their work in order to sketch out a scientific explanationfor the “attraction” anarchy exerted over some subjects. These studies took place inthe context of the development of European criminology in the late nineteenthcentury.In addition to the proletarian uprisings raging in the main European capitals,another social phenomenon was a cause for concern among the political elites of thenineteenth century. The economic contradictions spawned by capitalism were not onlyawakening political resistance on the part of the working class, but were alsoresponsible for a vertiginous increase in urban crime  and subsequently by his student of German originJohann Spurzheim (1776-1832), these two medical sciences made importantcontributions to the criminological theories produced by both criminal anthropologyand the French criminologists , p.22-23Throughout the second half of the nineteenth century, the science of criminology wasa movement with different strands and approaches , p.310. The American historian David Horn points out that discussions of this duality betweenthe “Italian” and “French” schools were first raised in the debates on criminologyback in the late nineteenth century. Horn  also mentions that thisbifurcation ended up being reinforced in the historiography from the 1970s and1980s, which produced very reductionist interpretations. However, this oppositionhas since been contested by foreign researchers, who have relativized thedifferences between the two “schools.”L’uomodelinquente, in which he defended the “theory of atavism.” Years later,in 1899, he produced a compendium for the general public entitled Le crime,causes et remèdes, compiling all his ideas in the field of criminology andRaffaele Garofalo (1852-1934) .In 1876Homo sapiens . The roots of this atavism could be attested bythe morphology of some parts of the body of delinquents, which Lombroso claimed werevery similar to the those found in some carnivorous plants, rodents, primates, andalso fetuses of  sapiens , p.54. A sapiens , p.86.Despite the criticisms levelled against them, Lombroso’s studies became so popularthat between the 1870s and 1940s they were appropriated, debated, and challenged invarious countries. In line with other actors, Lombroso contributed actively to theconstitution of criminology in a transnational, interdisciplinary field , p.10.French criminology also took shape as of the second half of the nineteenth century.Like criminal anthropology, its proponents came from a variety of backgrounds,ranging from physicians, jurists, lawyers, and magistrates to social theorists andpublic figures. This diversity lent the group a quite plural character, resulting inthe formulation of different theories about crime and criminals , p.98.Archives de l’Anthropologie Criminelle, whichcirculated between 1886 and 1914  nature. Under the strong influence of the theoryof degeneration and neo-Lamarckian ideas, they set great store by environmentalconditions  asthe origins of deviant behaviors .The leading figure of French criminology in this context was Alexandre Lacassagne. Heargued that pernicious social conditions had the power to alter the organicconstitution of the brain over several generations, resulting in changes in behaviorand socially “maladjusted” conduct. As a product of the social milieu, individualswith such a constitution also contributed to the formation of a harmful environment,in that they helped to propagate degeneration via hereditary transmission.Lacassagne therefore always considered biological factors in his analyses; but,unlike Lombroso, “he saw physical and psychic anomalies of criminals as theconsequences of an unfavorable [degenerate] social environment ... and as notetiological factors of crime” , p.193.Between the late nineteenth and early twentieth centuries, some conferences oncriminal anthropology were held in Europe, attracting the top experts on thesubject. Eight international events of this nature were planned between 1885 and1914, each hosted by a different city: Rome (1885), Paris (1889), Brussels (1892),Geneva (1896), Amsterdam (1901), Turin (1906), Cologne (1911), and Budapest (1914),although this last event did not take place .Homo criminalis. The criticisms came fromthe “Lyon criminologists,” represented by Lacassagne. Although the friction betweenthe French and Italians came to a head, it is worth bearing in mind that there wassome common ground in the ideas formulated by these two groups, as mentioned above.As Martine The first congress, in Rome, represented the culmination of Lombroso’s career andItalian criminology. However, the second event, held in Paris, was marked by strongopposition to the idea of L’assassinat du président Carnot, a workwhose subject matter was very much in vogue at the turn of the century.The emergence of criminological discourses and the anarchist attacks in the late1800s led to an increase in the number of studies and publications devoted tounderstanding the social origins of anarchism and, in most cases, setting aboutproving that the activities and ideas of anarchists went against the “foundations ofsocial order.” Physicians and other specialists keen to shed light on “deviant”subjects turned their attention to “political delinquents,” social agitators, andrevolutionaries in general. Influenced by theories that correlated crime withmadness, they looked for a scientific solution to the “problem” that was theanarchist movement, especially in its most radical actions . It was In this short, 111-page book published in Lyon by A. Storck, which had numeroustitles in the field of criminology, Lacassagne began by addressing the reasons thathad apparently led Caserio, an anarchist militant, to attack Carnot. First, hepresented his concept of crime. For Lacassagne, criminal conduct should beunderstood as any “act detrimental to the existence of a human community.” Despitebeing quite generic, this definition had the advantage of typifying any conductconsidered prejudicial to society “at any time in history” as an offense.Basing himself on this definition, Lacassagne went on to argue that the acts ofanarchist militants should therefore be considered “essentially criminal.” Theseindividuals’ desire to “change the functioning of ordinary life, the relations ofcapital and labor” was Lacassagne’s  main argument for thecriminalization of anarchy. Moreover, he interpreted the ideas of having a societybased on collective ownership and the sharing of goods produced as “aphorisms”advocated by “young men, almost children;” that is, by naïve people whose youth madethem blind to the real and practical needs of life.Lacassagne continues his analysis by investigating the origins of the ideals defendedby the anarchists. Diverging from the position of other specialists, libertarians,in general, could not be understood as a group of subjects who were exalted ormentally imbalanced. Rather, he argued, anarchism was a social phenomenon, a malaisecaused by emerging inequalities affecting the proletariat in large urbancenters:But where do these tendencies, these ideas, come from? It is not, as we oftenrepeat, the state of spirit of a few individuals, more or less overexcited orunbalanced.No, it is the sign of a social malaise resulting from several causes that we canglimpse, but which are difficult to pin down and whose influence cannot bespecified. It is like the demonic agitation, possession, witchcraft, whichoccupied the entire Middle Ages. We were then concerned about the fate of thesoul during this life, especially after death, but we accepted socialinequalities. Today, it is the body ... that must be satisfied: we havenecessities and we wish to enjoy the relationships of modern life , p.4.The desire to satisfy the “necessities” of life, however, could not be unrestrictedto the point of producing discourses and ideas that encouraged the expropriation ofgoods, demanding the end of private property, as the socialist workers’ movementsdesired. Also, according to Lacassagne, such actions deserved due socialdisapprobation for being “the manifestation of selfish instincts” of individuals whodesired only “their own well-being, to the detriment of others,” to which end theynourished ambitions “driven by destructive instincts” .As we can see, the anarchist typified by Lacassagne was a person of “unruly pride,full of feelings of rage and envy, in a state of chronic anger.” Among young people,this rage was reinforced by an “abhorrence of all authority, and particularlymilitarism.” However, Lacassagne admitted that the “evils of civilization” existingin big cities had the power to curb the “gentleness, courtesy and benevolencepresent in men,” causing “pride, or the instinct of domination, to progress andgrow” to the point that individuals “no longer feel obliged to follow rules.” The“unruly” pride in turn acted on the destructive instinct, which explained “thelanguage of violence and anarchist actions” .Il delitto politico e le rivoluzioni in rapporto al diritto,all’antropologia criminale ed alla scienza di governo. In it, theycomment that political crime, in its anthropological sense, should not be understoodonly as an attack on a particular political institution. For them, the true essenceof such crime was to establish “violent opposition to political, religious, orsocial misoneism,”In 1890, Cesare Lombroso and the lawyer Rodolfo Laschi (1850-1950) published the bookThe perception that insurrections were sudden and abrupt, and thus incompatible withhuman nature, was also explored and revisited by At the end of the section that explores the main etiological factors of anarchism andtheir interface with political crimes, In the third part of his work, Lacassagne analyzes the social trajectory of theassassin, the pathological history of his ancestors, his anthropometric data, andwhether his contact with libertarian ideas was the result of a “deranged mind.” Inso doing, he intends to raise hypotheses that might explain the criminal act and,above all, enable a conclusion to be drawn as to whether Caserio was insane or actedunder the influence of strong emotion, both of which would protect him againstcriminal liability.impromptuomicidio was, he claims, “a common export item” to neighboringcountries, especially France  by the physician EmmanuelRégis (1855-1918), Alexandre Another etiological factor he considered in his analysis was Caserio’s youth (20years old). Referencing the then famous study of 1890 on regicide . Caserio underwent “forced feeding of readings, of whichhe had retained only a few sentences” that sounded “good to his ear.” For their“eminently simplistic” essence, the “incendiary” anarchist ideas were “enough foodfor his mind” and because they were easy to understand “he avidly read thenewspapers and pamphlets of this vulgar and hotheaded sect” (p.28).Again chiming with Tarde’s studies, Lacassagne argues that news about the executionsof other convicted anarchists was responsible for “germinating in his brain theideas of hatred and revenge.” The discourse spread through the libertarian press wasso pessimistic that it made its readers feel “tired of life” and begin to considerthe possibility of committing suicide. However, because “anarchic individuals” werepossessed of “immeasurable vanity,” they sacrificed everything for their cause,“putting their heads on the line and showing their comrades” how “strong andresolute” they were. Thus, concludes Lacassagne , Caserio was not a regicide: “his crime was ‘indirect suicide’.”The category of “indirect suicide” had been formulated by Emmanuel Régis todistinguish it from true regicide. In this kind of act, a person who is “fearful andhopeless with life” kills a politician or a monarch with the aim of being condemnedand executed, and thus indirectly achieving “his own death, which was his only goal”. On the other hand, the acts performed by the true regicidesshould not be seen as sudden or heedless. On the contrary, they were logical,“conceived with full lucidity, premeditated, and prepared over a long time.” Despitethis distinction, these perpetrators were “sick, unbalanced, weak-willed, slaves totheir obsession and, driven by a blind and fatal force, are not free to resist”(p.20).Alexandre Lacassagne notes that Sante Caserio had never been “restrained or guided bythe influence of friendship or love,” indicating that the humble baker from Lombardy“was frigid, uncouth, and insensitive to platonic love.” Indeed, in his indifferencehe had not expressed any sense of remorse or regret for the assassination. Hislimited education, “his limited wit, incapacity to elaborate an observation orreflection, and his complete absence of feelings of affection” revealed him to beimpulsive. Caserio was therefore similar to “these individuals with muscles ofsteel” who therefore had “no fear of obstacles, were insubordinate, excitable, withblood like dynamite,” making them as dangerous as “bombs in the hands of anarchistleaders” .After tracing Caserio’s criminological profile, Lacassagne made a number ofconjectures about his sanity. However, he preceded this with the view that“criminals of the like of Caserio are not mad” or completely degenerate. He alsoruled out the possibility of his having epilepsy because he did not display any ofthe telltale signs:But what kind of madness could he have? ... Is he prey to one of the forms ofepilepsy? He is the son of an epileptic; this heredity is established, andeveryone knows it is oppressive.Therefore, let us ascertain whether Caserio has the symptoms or stigma.He does not have the characteristics of epileptogenic asymmetry described byLasègue. He does, however, have a rounded, dimpled chin. His face has no otherparticularities except for this continuous, contracted, satanic laughter, whichproduced a painful impression on me. Was that laughter affected by thecircumstances, or was it usual for him? A similar, continuous laugh is a kind oftic. We must beware of those who cannot laugh: they are wicked anddeceitful.Recall that his girth far exceeds his height , thathe has overlapping fingers (Lombroso), that when standing he has a stancereminiscent of that of quadrumans, with his feet apart to give himself a widerbase for support (Féré).... We never noticed any unconsciousness ... there is no trace of hallucinations,visions, nightmares, crises ... In sum, from the information we have, we can saythat Caserio was not an epileptic , p.32-33Summing up, Lacassagne concludes that “Caserio is not a fool” but that he is“possessed of some features of degenerates.” This case was one of a “fanaticalkiller,” “a human beast, defective in its origins” who was “corrupted by thetheories of the anarchist party, which made him an antisocial being.” For Caserio,the assassination of President Sadi Carnot was “a means of terrorism, the revenge ofa group, the satisfaction of hatred and, at the same time, the consecration of areputation” among his comrades. On the basis of this opinion, he concluded thatCaserio should be held criminally responsible, having acted in full possession ofhis faculties at the time of the event. As he could be held to account for the crimecommitted against the French head of state, it was “right and proper that he receivethe punishment” reserved for such an offense in French criminal law .The anarchist Sante Caserio was prosecuted, convicted, and sentenced to death by thecourt. His execution took place on August 16, 1894. According to the press, Caseriowalked slowly to the scaffold, holding firm, showing no rancor or weakness. Livid,he was assisted by two men to approach the guillotine. In their almost cinematicdescription, the papers reported that as the blade slowly pressed into his neck, “ahoarse voice, strangled by fear” could be made out, saying “courage, comrades, longlive anarchy!” .L’assassinat du président Carnot, brought anarchism to thecenter of the criminological debates taking place in France, Italy, Germany, Spain,and other parts of Europe in the second half of the nineteenth century. Based ontheories associating crime with madness, the ideas Lacassagne expressed in the bookaimed to give multifactorial explanations for the phenomenon of anarchism , while also suggesting ways to curb the spreadof libertarian ideas. Although Caserio was not declared insane, much of the analysismade by Lacassagne demonstrates an intention to fit the anarchist into the realm ofmental “deviations.”This article sought to show that the growth of radical actions, such as theassassination perpetrated by Sante Caserio and explored in Alexandre Lacassagne’sbook By the beginning of the twentieth century, libertarian ideas and practices had partedways, affecting the forms of organization and action of the working classes.According to Bert Altena, the fact that anarchism was a social movement allows us tounderstand its adaptability and mutability in response to new social demands. Thiswould also explain its “staying power in the long run,” notwithstanding some periodsof latency . In this sense, after the cycle of “acts of terror,”the propositions initially spawned in the 1870s survived in the form of an anarchistmovement in symbiosis with experiments in syndicalism. The interlocution of thesetwo fields forged the foundations of “revolutionary syndicalism,” in which workers’associations were organized around national or regional federations, adopting thesame nonpartisan and internationalist model advocated in the First International(One consequence of the attacks was a strong backlash against the anarchist movementin an effort orchestrated jointly by some countries, which signed internationalagreements aimed at the exchange of police information and the passing of lawscriminalizing and expelling individuals who maintained some link with anarchism. HoweverAs another consequence, the specter of the “dynamite-wielding anarchist,” exploitedto exhaustion by an emerging sensationalist press hungry for crime-related news, was ins