Modified Radical Mastectomy for Contralateral Breast Cancer

Modified Radical Mastectomy for Contralateral Breast Cancer Abstract Breast cancer is the most common malignancy in women worldwide. With improving survival figures and early breast cancer detection, treatment related long term adverse effects of radiotherapy have become a concern. Contralateral breast cancer due to scatter radiation from during radiotherapy of diseased breast is one of them. This prospective clinical study was conducted to measure the dose received by the contralateral breast and compare the different techniques which influence this dose. It was found that in post mastectomy patients, treatment with telecobalt medial tangential field contribute more dose to contralateral breast compared to supraclavicular field and lateral tangential fields. The mean dose received by contralateral breast during irradiation of chest wall was 168.29 cGy which 3.36 percentage of the prescribed dose. Key Words; contralateral breast dose, breast malignancy, thermoluminescent disc, scattered radiation Introduction Breast cancer is the most common malignancy among the women worldwide. [1] With improved survival figures due to early breast cancer detection and multimodality treatment, long term adverse effects in the form of second malignancy of contralateral breast (CLB) has become a concern. In patients getting radiotherapy to the affected breast, CLB also receives radiation in the form of scattered radiation due to scattered from primary. Second malignancy is a late sequel of radiation appearing at an interval of 10-15 years. [2, 3, 4, 5, 6, 7] Since breast is highly radiosensitive structure this dose to CLB is a major concern especially in younger women and patients with longer life expectancy. Although radiation induced malignancy is a stochastic effect but the intensity increases linearly with increase in dose. [8] Studies have measured CLB dose on phantom and patients and have observed that the dose to CLB is more for medial tangential (MT) than supraclavicular field (SCL) field and later al tangential (LT) field. In our centre 22% of female patients are suffering from breast cancer and majority of them belong to low socio economic status and presented with advanced disease. In the present study we measure the dose to CLB in patients receiving radiotherapy following modified radical mastectomy (MRM). The radiation dose to CLB were measured with the help of CaSO4: Dy thermoluminescent discs (TLD). The TLD are highly sensitivity and can measure even very small doses. Materials and methods Measurement of CLB was done in 25 patients undergoing for EBRT by cobalt teletherapy machine (THERATRON 780 C and E) following MRM. Precalibrated TLD (9mmÃâ€"13mm) were placed on the surface of CLB. Total three discs were placed one at the nipple and other vertically on either side of nipple 3 cm apart. We tried our best to place the TLD on the same position each time. Skin tattooing was done to demarcate the exact position at the first sitting and this was used subsequently to replicate the position. After delivery of radiation dose for a particular field the discs were removed and another set of three discs were placed for next reading. In this way total six discs were used daily, three for SCL field and three for MT or LT field as MT and LT fields were treated on alternate days and SCL field was treated daily. For MT and LT fields breast cone was used for half beam block. Total dose delivered was 50 Gy in 25 fractions, 2 Gy per fraction, 5 fractions per week in 5 weeks. The expos ed TLD were stored in radiation free zone and the readings were taken after 24 hours and within 7 days after exposure because after seven days the TLD start to loose electrons. The scattered dose received by TLD were measured on NUCLEONIX TL 10091 TLD reader. After one set of measurement, the discs were annealed by heating 400 degree celcius and then used for next measurement. For each patient, measurements were carried out at first week, third week and last week, total three times during the course of treatment. Statistical Analysis Mean dose calculation received by CLB. Total dose received by CLB, this was calculated by multiplication of mean dose to number of fractions. The percentage of radiation dose received by CLB with respect to the prescribed dose to diseased breast (Total doseÃâ€" 100 / prescribed dose to diseased breast). We also stratified data based on gantry angle at which EBRT was delivered (≠¤50 degree and > 50 degree). The statistical software SPSS version 20.0 was used for the data analysis. Results The age wise distribution of patients and the mean dose received by CLB is shown in table 1. 19 out of 25 patients in our study were 50 years or younger. 52% patients had left sided breast cancer. Table 2 shows the contribution of SCL, MT and LT field dose with the gantry angle at which the radiation dose was delivered. Total dose received by CLB varies from 1.22% to 5.82% of the prescribed dose of 50 Gy to the affected breast. Mean total dose received by CLB was 105.55 cGy with MT field followed by SCL field, (33.96 cGy) and LT field {(28.97 cGy) as shown in table 2. This data shows that the maximum contribution of dose to CLB was with MT field followed by SCL field and LT field. Mean dose with all three fields received by CLB was 168.48 cGy with SD  ±62.23 which corresponds to 3.36% of prescribed dose to affected breast. 11 patients were treated on cobalt unit with gantry angle ≠¤ 50 degree having 3.00% contribution of CLB dose (table 3). 14 patients treated with gantry angl e > 50 degree had 3.79% contribution of CLB dose (p=0.199). The mean, median and range were 3.66, 3.34 and 4.60 respectively. Discussion It is well known that exposure to ionizing radiation causes carcinogenesis in healthy tissues. Although it is a stochastic effect having no threshold dose but the intensity increases with increase in radiation dose. CLB must be considered as an organ at risk during radiotherapy planning for treatment of cancer breast. Many previous studies conducted to calculate the dose received by CLB, were based on patients, phantom or treatment planning system. Boice et al analyzed the record of 41109 patients of cancer breast and they found the mean CLB dose was 2.82 Gy. [9] They also hypothesized that there was increased relative risk of CLB malignancy due to exposure to ionization given to diseased breast. The relative risk was 1.19 for all patients, however the relative risk was more (1.49) for younger patients who were less than 45 years old. In our study, the maximum dose received by CLB in women below 40 years which was 3.93 percentage (196.437 cGy) of prescribed dose. The minimal dose was received in patients who were above 60 years of age {(1.96 %) (97.875 cGy)}. The possible reason could be the increased laxity of breast tissues in older women cause more lateral shifting of CLB away from the radiation at the time of exposure. Half beam block technique is routinely used while irradiating the breast with tangential beams. [10, 11] Kelly et al measured CLB dose on Alderson Rando phantom using TLD with four different techniques of breast cancer treatment using 6 MV photon beam on linear accelerator. [12] The used half beam block with asymmetrical jaws, custom blocks and symmetrical collimator jaw. Another technique used was isocentric method with non divergent posterior border. They observed highest dose to CLB in MT field with wedge. In our study radiation was delivered using half beam block with breast cone. The dose to CLB was maximum with MT field because in half block beam, the breast cone is placed near to surface of breast which cause increased dose due to secondary collimator scattering. Bhatnagar et al compared dose to CLB during EBRT to chest wall irradiation using conventional tangential technique and intensity modulated radiotherapy (IMRT). [13] They observed 20 percentage reduction of dose to CLB using IMRT. According to a study by Chougule, the average contralateral nipple dose was 152.5-254.75 cGy and the percentage was 3.05-6.05% for a dose of 5000 cGy in 25 fractions for post mastectomy breast cancer. [14] In our study, the measured mean contralateral nipple dose on was 171.88 cGy (55.5-303.80 cGy) which accounts to 3.47% (1.11%-6.07%) of prescribed dose (table 2). Dose to CLB were higher for dose calculated at the level of nipple as compared to dose received by whole CLB. This may be due to TLD at level of nipple being closest to the radiation source. According to Rankel et al with high gantry angle the beam will be closer to the surface leading higher dose to the CLB. [15] In this study, it was found that with gantry angle >50 °, more dose was delivered to the CLB though the difference is not statistically significant (p=0.199). Conclusion In our patient cohort, higher inadvertent CLB dose was delivered in younger patients with MT field; overall, dose being 3.36 percentage of prescribed dose.

THE NATIONAL TOBACCO STRATEGY

Facts about harm associated with tobacco and contact information for quit programs provide access to information and support School education programs that focus on assertiveness skills, academic success and developing a negative attitude to smoking all help young people to modify personal behaviors and enhance skills that will be protective against smoking in future Quitting service Creating Supportive environments: Promotion of smoke free messages and regulation of place creates a variety of physical and social support structures accessible to individuals Frightening media campaigns â€Å"every cigarette is doing you damage† maintained powerful antismog attitude in the with advertising of pharmaceutical products, such as nicotine patches, the urgency to quit is implemented by the sense of having a solution readily available. Most indoor and public places are smoke free, providing safe physical and social environments for people to work and interact socially.Non-health initia tives like housing, counseling and anti-violence strategies reduce stress and anxiety that might lead to smoking. Employment and training programs to reduce boredom associated with unemployment-?address socio-cultural and socioeconomic determinants which influence tobacco use. Regulation of place of sale aims to eliminate the sale of tobacco products to minors and aka them less visible: hidden behind counters Strengthening Community action Local educational strategies such as peer support and mentoring programs improve self-esteem and the sense of worth among students which can be protective factors against harm from tobacco use.Families and parents provided with safe places for children to avoid tobacco smoke-?parks Reorienting Health services: ‘Lifestyles' prescription pads are tools used by Gaps to initiate discussions with patients about lifestyle behaviors-?help doctors introduce preventative assuages and recommendations for improving lifestyle behaviors. Building Healthy Public Policy. High levels of taxation on tobacco ensure cigarettes are less affordable, reducing access for younger people in particular Imposition of laws that prevent smoking in most public and indoor environments I. E. No smoking in pubs and clubs Place of drug education in all Australian schools an important cornerstone of public policy. Delivery of anti-smoking messages and development of anti-smoking attitudes as young as possible is critical.

Catholic Sacraments

The Sacraments of the Catholic Church are, the Church teaches, efficacious signs of grace, instituted by Christ and entrusted to the Church, by which divine life is dispensed to us. The visible rites by which the sacraments are celebrated signify and make present the graces proper to each sacrament. They bear fruit in those who receive them with the required dispositions. † Though not every individual has to receive every sacrament[->0], the Church affirms that, for believers as a whole, the sacraments are necessary for salvation, as the modes of grace divinely instituted by Christ[->1] Himself.Through each of them Christ bestows that sacrament's particular grace, such as incorporation into Christ and the Church, forgiveness of sins, or consecration for a particular service. The Church teaches that the effect of a sacrament comes by the very fact of being administered, regardless of the personal holiness of the minister administering it. However, a recipient's own lack of prope r disposition to receive the grace conveyed can block the effectiveness of the sacrament in that person.The sacraments presuppose faith and through their words and ritual elements, nourish, strengthen and give expression to faith. The Catechism of the Catholic Church[->2] lists the sacraments as follows: â€Å"The whole liturgical life of the Church revolves around the Eucharistic sacrifice and the sacraments. There are seven sacraments in the Church: Baptism[->3], Confirmation[->4], Eucharist[->5], Penance[->6], Anointing of the Sick[->7], Holy Orders[->8], and Matrimony[->9]. † Baptism[->10] is the first and basic sacrament of Christian initiation.Baptism is usually conferred today by pouring water three times on the recipient's head, while reciting the baptismal formula: â€Å"I baptize you in the name of the Father and of the Son and of the Holy Spirit[->11]. † The ordinary minister of the sacrament is a bishop or priest, or a deacon. In case of necessity[->12], an yone intending to do what the Church does, even if that person is not a Christian, can baptize. The sacrament frees from original sin[->13] and all personal sins, and from the punishment ue to them. Baptism makes the person share in the Trinitarian life of God through â€Å"sanctifying grace[-;14]†, the grace of justification that incorporates the person into the body of Christ and his Church, also making the person a sharer in the priesthood of Christ. It imparts the theological virtues[->15]: faith[->16], hope[->17], and charity[->18] and the gifts of the Holy Spirit, and marks the baptized person with a spiritual seal or character that indicates permanent belonging to Christ.Baptism is the foundation of communion between all Christians. The many symbols of baptism include a white garment, symbolizing innocence and purity, a candle, symbolizing the Light of Christ, the Oil of Chrism, which is used to anoint the baby or candidate being baptized, and the water, which symboliz es cleansing and the washing away of sin. Confirmation is the second sacrament of Christian initiation. It is called Confirmation because it confirms and strengthens baptismal grace.It is conferred by â€Å"the anointing[-;19] with Sacred Chrism[-;20], which is oil mixed with balsam and consecrated by the bishop, which is done by the laying on of the hand of the minister who pronounces the sacramental words proper to the rite. These words refer to a gift of the Holy Spirit[-;21] that marks the recipient as with a seal. Through the sacrament the grace given in baptism is strengthened and deepened.Like baptism, confirmation may be received only once, and the recipient must be in a state of grace meaning free from any known unconfessed mortal sin[-;22] in order to receive its effects. The originating minister of the sacrament is a validly consecrated bishop[-;23]; if a priest confers the sacrament and in special cases, the link with the higher order is indicated by the use of oil bles sed[-;24] by the bishop on Holy Thursday[-;25] itself or on a day close to it. In the East, which retains the ancient practice, the sacrament is administered by the parish priest immediately after baptism.In the West, where administration is normally reserved for those who can understand its significance, it came to be postponed until the recipient's early adulthood; but in view of the earlier age at which children are now admitted to reception of the Eucharist, it is more and more restored to the traditional order and administered before giving the third sacrament of Christian initiation. The Eucharist is the sacrament, the third of Christian initiation, completes Christian initiation by which Catholics partake of the Body and Blood of Jesus[->26] Christ and participate in his one sacrifice.The first of these two aspects of the sacrament is also called Holy Communion. The bread which must be wheaten and wine which must be from grapes used in the Eucharistic rite are, in Catholic fa ith, transformed in all but appearance into the Body and Blood of Christ, a change that is called transubstantiation[->27]. That is, Catholics believe they are sacramentally, though not physically, eating and drinking the human flesh and blood of Jesus Christ. Only a bishop[->28] or priest[->29] is enabled to be a minister of the Eucharist, acting in the person of Christ himself.Deacons[->30] as well as priests are ordinary ministers of Holy Communion, and lay people may be authorized in limited circumstances to act as extraordinary ministers of Holy Communion. The Eucharist is seen as â€Å"the source and summit† of Christian living, the high point of God's sanctifying action on the faithful and of their worship of God, the point of contact between them and the liturgy of heaven. So important is it that participation in the Eucharistic celebration is seen as obligatory on every Sunday and holy day of obligation[-;31] and is recommended on other days.Also recommended for thos e who participate in the Mass is reception, with the proper dispositions, of Holy Communion. This is seen as obligatory at least once a year, during Eastertide. The Sacrament of Penance is the first of two sacraments of healing. The Catechism of the Catholic Church mentions in the following orders different names of the sacrament, calling it the sacrament of conversion, Penance, confession, forgiveness and Reconciliation. It is the sacrament of spiritual healing for a baptized person from the distancing from God resulting from sins committed.If a man sins after baptism, he cannot have baptism as a remedy; Baptism, which is a spiritual regeneration, cannot be given a second time. Reconciliation involves four elements: Contrition the Penitent's sincere remorse for wrongdoing or sin, repentance, without which the rite has no effect; Confession to a Priest with the faculty to hear confessions while it may be spiritually helpful to confess to another, only a Priest has the power to admin ister the sacrament, Absolution by the Priest, and, Satisfaction or Penance.Many sins wrong our neighbor. One must do what is possible in order to repair the harm. Simple justice requires as much. But sin also injures and weakens the sinner himself, as well as his relationships with God and neighbor. Absolution takes away sin, but it does not remedy all the disorders sin has caused. Raised up from sin, the sinner must still recover his full spiritual health by doing something more to make amends for the sin: he must make satisfaction for or expiate his sins. This satisfaction is also called penance.In early Christian centuries, this element of satisfaction was quite onerous and generally preceded absolution, but now it usually involves a simple task for the penitent to perform, to make some reparation and as a medicinal means of strengthening against further temptation. The priest is bound by the seal of confession[->32], which is inviolable. Accordingly, it is absolutely wrong for a confessor in any way to betray the penitent, for any reason whatsoever, whether by word or in any other fashion.A confessor who directly violates the sacramental seal incurs an automatic excommunication whose lifting is reserved to the Holy See[->33]. In some dioceses, certain sins are reserved which means only certain confessors can absolve them. Some sins, such as violation of the sacramental seal, consecration of bishops without authorization by the Holy See, direct physical attacks on the Pope[->34], and intentional desecration of the Eucharist are reserved to the Holy See.A special case-by-case faculty from the Sacred Penitentiary[->35] is normally required to absolve these sins. Anointing of the Sick[->36] is the second sacrament of healing. In this sacrament a priest anoints the sick with oil blessed specifically for that purpose. The anointing of the sick can be administered to any member of the faithful who, having reached the use of reason, begins to be in danger by reas on of illness or old age. A new illness or a worsening of health enables a person to receive the sacrament a further time.When, in the Western Church, the sacrament was conferred only on those in immediate danger of death, it came to be known as Extreme Unction[->37], Final Anointing, administered as one of the Last Rites. The other Last Rites are Confession if the dying person is physically unable to confess, at least absolution, conditional on the existence of contrition, is given, and the Eucharist, which when administered to the dying is known as Viaticum[->38], a word whose original meaning in Latin[->39] was provision for a journey.Holy Orders[->40] is the sacrament by which a man is made a bishop[->41], a priest[->42], or a deacon[->43], and thus dedicated to be an image of Christ[->44]. A bishop is the minister of this sacrament. Ordination as a bishop confers the fullness of the sacrament, making the bishop a member of the body of successors of the Apostles, and giving him the mission to teach, sanctify, and govern, along with the care of all the Churches.Ordination as a priest configures the priest to Christ the Head of the Church and the one essential High Priest, and conferring on him the power, as the bishops' assistant, to celebrate the sacraments and other liturgical acts, especially the Eucharist. Ordination as a deacon configures the deacon to Christ the Servant of All, placing him at the service of the bishop, especially in the Church's exercising of Christian charity towards the poor and preaching of the word of God.Aspirants to the priesthood are required by canon law[->45] to go through a seminary[->46] program that includes, as well as graduate level philosophical and theological studies, a formation program that includes spiritual direction[->47], retreats[->48], apostolate experience, etc. The course of studies in preparation for ordination as a permanent deacon is decided by the Episcopal conference[->49] concerned. Matrimony[->50], or Marriage, like Holy Orders, is a sacrament that consecrates for a particular mission in building up the Church, and that provides grace for accomplishing that mission.This sacrament, seen as a sign of the love uniting Christ and the Church, establishes between the spouses a permanent and exclusive bond, sealed by God. Accordingly, a marriage between baptized[->51] people, validly entered into and consummated, cannot be dissolved. The sacrament confers on them the grace they need for attaining holiness in their married life and for responsible acceptance and upbringing of their children.As a condition for validity, the sacrament is celebrated in the presence of the local Ordinary[->52] or Parish Priest[->53] or of a cleric delegated by them or in certain limited circumstances a lay person delegated by the diocesan Bishop with the approval of the Episcopal Conference[->54] and the permission of the Holy See[->55] and at least two other witnesses, though in the theological tradition o f the Latin Church the ministers of the sacrament are the couple themselves.For a valid marriage, a man and a woman must express their conscious and free consent to a definitive self-giving to the other, excluding none of the essential properties and aims of marriage. If one of the two is a non-Catholic Christian, their marriage is licit only if the permission of the competent authority of the Catholic Church is obtained. If one of the two is not a Christian, the competent authority's dispensation is necessary for validity.

The Role That Globalization of Television Has Played in the Construction of Cosmopolitan Identities - Free Essay Example

Sample details Pages: 7 Words: 2114 Downloads: 3 Date added: 2017/09/14 Category Advertising Essay Did you like this example? Beatriz Ramirez Lopez s3231464 The role that Globalization of Television has played in the Construction of Cosmopolitan Identities. In this essay, I will expose my thoughts, arguments and ideas of how global television has constructed an identity in which people refer and familiarize that doesn? t necessarily belong the same place. During the last decades television had to face the crucial change that the world has faced known as globalization. This change in the media needs to be understood in the wider context of the globalization of capitalist modernity, since global television is constituted by and of the inherently globalizing nature of modernity (Barker, 1997). Modernity, as Marx and Weber theorized, is a period marked by change, motivation and dynamism. If modernity is a period in which capitalism, industrialism, surveillance and military power (Giddens,1990) can be found, I should say that we have passed that point beyond. We live in a period in which postmodernism as a cultural form can be seen as a radicalized modernity. Don’t waste time! Our writers will create an original "The Role That Globalization of Television Has Played in the Construction of Cosmopolitan Identities" essay for you Create order Nevertheless, this postmodernity doesn? t have to be composed of the same meaning as what it is known as the postmodernity concept in a historical period. This is because in the postmodern culture different concerns have emerged at the same time that a global compression of time and space had took place in the late modernity. Chris Barker describes the culture of global television as postmodern in form and argue that the institutions of transnational television, which are institutions of modernity, are globalizing a postmodern cultural form. (Barker, 1997, p. 1) The institutions that are part of a capitalist modernity had been facing the globalization challenge in which they had to act in order to be part of this change. Television, as a capitalist institution, has also contribute to this challenge through the world-wide circulation of images and discourses. Nowadays, television programs offer a wide range of entertainment, information and persuasion. It also offers a simple re? ecti on of the world with forms of knowledge that represent speci? c constructions of ideas that we receive every time we turn on our Tv. Global television plays a direct role because it penetrates into the local systems and display alternative understandings of time and space. According to Chris Barker; The dynamism of modernity is founded upon its re? exive nature, the continual re-evalutation of knowledge. Re? exivity refers to the use of knowledge about social life as a constitutive element of it and refers to the constant revision of social activity in the light of new knowledge On a more institutional level television has been increasingly re? exive about its own status and production techniques. Television has a history and repeats that history within across channels, this articulation of styles and histories contributes to the viewers understanding of TV history Television contributes to our increasing re? exivity about ourselves, our culture and the history, conditions and techniques of cultural production. (1997, p. 15-16) As a result, television gives us the opportunity to be world travelers in the comfort of our own space being part of a society that lives in a world as a whole, or better described as a globalized space. However, what happens when one half of the world? s largest economic units are nations and the other half are transnational corporations belong to the same nation? Is society changing to a global postmodern culture or just is it becoming a follower of an identity from an speci? c country(ies)? â€Å"Globalization is mainly an economic phenomenon and refers to the economic activity on a global scale and is an aspect of time-space compression or the shrinking world†. (Barker, 1997). This argument is fairly true; although, the process of creating a world economy has grown in an uneven way. Representation, identity and cultural meaning are some issued that are also concerned by globalization. The values and meanings can remain signi? cant, but speaking of a globalized society, these values and meanings can extend far beyond their locations suffering a transformation from its very real meaning. As Hedbidge (1990) argues, cosmopolitanism is an aspect of our every day life. Diverse cultures are becoming more accessible today. That? s how we can choose what type of food we can eat or which artist can we listen to, dress a speci? brand coming from a trendy country or just watch the Tv shows from speci? c countries. We are becoming a global culture but Barker indicates that if by global culture we mean a unitary world culture, or a bounded culture connected to a world state, then we are a long way from that scenario. Cultural values and feelings refer to three main components that are based in a shared experience. These components associate the shared memories of speci? c eve nts and people, sense of generational continuity and a common sense of destiny on the part of the collectivity. In terms of a global culture, a process of integration and disintegration represent an homogenization of a culture. This effect can be well placed in the consumer culture. Brands like Coca-Cola, Starbucks, KFC and many others ring our bell regardless the nation we come from. An interesting point to mention is that in the consumer culture as in the global tv an speci? c country owns the majority of these brands which displays an american way of life. The globalization of television is an aspect of dynamism of modernity in? ected with the logic of capitalism. Capitalism is a system of commodity production premised upon the private owner-ship and control of the means of production whereby the owners of the means of production employ wage labour to produce commodities, which have exchange value, for sale in the market Television is bound up with capitalist modernity both as a set of economic activities and as a cultural force constituted by and constitutive of modernity. The rise of transnational television since the mid-1980s is, thus, an aspect of capitalist globalization whereby this essentially economically riven set of activities is also a set of cultural practices involving the circulation of ideas and images around the world. (Barker, 1999, p. 20-21) Television promotes the capitalism in the postmodern society. There is money to be made from production and sale of programs, from selling the technological hardware of television, and to deliver audiences to advertisers for their target market so that television can be the centre of wid er commercial activities. Particularly the media ? ts into this global economy by supporting transnational corporations. Global television also refers to television in which technology, ownership, program distribution and audiences operates across the boundaries of a nation. But what happens when a nation doesn? t want to be part of that global culture? A clear example is the communist nation Cuba, since Fidel Castro? s dictatorship the media is limited to the national broadcast organization; the government is the one in charge of controlling the media power whereas in some other Latin countries such as Mexico the media power is absolutely independent from the government which allows the exchange of programs distributed in all over the world. National broadcasting systems had to face the concern of international trade in television taking them to be part of the global television. For example, the soap operas, game shows etc that have their version in the country that is going to be consumed, such as Big Brother, The Biggest Loser and many others. Soap operas in the global television are programs that can in? uence the most in creating some patterns with their content. The soap? s ability to deploy a wide range of characters allows multiple identi? cations by the audience who can familiarize with some characters. These programs are often structured by the tension between realism and melodrama (Barker, 1997). The content can represent social issues such as AIDS, race gender, homosexuality, unemployment, drugs addiction etc. Some others include in their content speci? c environments in which the audience expect to be close to the reality. For example, the ? rst time I saw Neighbours, I found that they used a lot of great outdoors scenes such as the beach, their dress-code and the activities that the characters can have which made me think of a holiday. The narrative of soap operas frequently focus on women characters and are structured in a way tends to familiarize a woman? s point of view. In Latin America, Mexico and Brazil are the main countries that export their soap operas to other countries in the continent as well as to Europe and Asia. These programs also show an unrealistic scenery where the audience can identify with some characters and impose trends in which people will follow this type of identity and adapt it to their own necessities. Another thing to mention is that some tv programs can be produced to the immigrant audience promoting some of their values in order to maintain them alive. Another example of global television, besides soap operas, are global news that in the last ten years had played a fundamental role in creating opinions and thoughts in the audience. The terrorist attacks of 9/11 made CNN, BBC, Reuters and other international broadcasters ? owed information in all over the world. This event marked the world because the message that was delivered in every place created a con? ct between cultures giving as a result the prejudgement of islamic people associating them as terrorists. According to Chris Barker argument in Television as a global space. Electronic media break the traditional bonds between geographic place and social identity since mass media provide us with increasing sources of identi? cation which are situated beyond the immediacy of speci? c places. For example, the way in which televi sion brings the outside world into the home rede? nes the boundaries between the private and the public onstitutive of identity in that young people negotiate through talk shared understandings about how to â€Å"go on† in their society as persons within social relationships. (1999, p. 119) The concept of the audience is a social construction, the idea of an audience is never merely an innocent description if the sum total of individuals. In the market the audience is considered the target consumer. â€Å"The most common conception of the audience within the media industries is as a conglomeration of potential and potentially overlapping markets†. Grossberg, 1998, p. 209). Media industries usually spend enormous amount of time and money in order to convince media consumers to buy a particular media product. As a result, media create stereotypes in which a global society ? ts and consumes. The media provides pictures of people, descriptions of different social groups an d of their social identities. This pictures are kept in our head and help us to identify where does the person belong to. Lawrence Grossberg points a de? nition of stereotypes; Stereotypes can de? ne some people? expectations of how, for example, women, or Hispanics, or other groups in the society are supposed to behave. In this sense, stereotypes are neither avoidable nor necessarily bad. In the modern world, the media are obviously a major source of such pictures In this sense, stereotyping is the process of distorting the portrayal of some social group in the media image. That media contribute to stereotypes (and even create stereotypes of groups) is assumed to be the result of systematic biases in the portrayals of social groups. (1998, p. 21) Stereotypes have a real and important consequence in the global cultures. They can affect the self-esteem of those being stereotyped, they can also determine by mistake the way some people think and behave, but the worst is that creates an arti? cial idea in society that will link that group with the stereotypes that can hardly get rid of. Although identities are created in the culture of an speci? c time and space in which a society lives, the new global culture has faced the identity crisis because of the power of the media in the people? lives. Media produces people? s identities of who they are and who others are. â€Å"There are many dimensions on which people have a sense of themselves, a sense of their own identity† (Grossberg, 1998. p. 206) In conclusion media can produce identities in a political, social, cultural, and economic way in order to ? t in the global economy and global culture that the new technologies have challenged a postmodern society. 2025 words References Barker, C (1997). Global Television, an Introduction. Malden, Massachussetts: Blackwell Publishers. Barker, C (1999). Television, Globalization and Cultural Identities. Buckingham, Philadelphia: Open University Press. Giddens, A (1990). The Consequences of Modernity. Cambridge: Polity Press. Grossberg, L (1998). Media Making Mass Media in a Popular Culture. London: SAGE. Hebdige, D (1990). Fax to the Future, Marxism Today. January. Murdock, G (2007). Media in the Age of Marketization. Broadway, New Jersey: Hampton Press.