When such investments are required, it is crucial for communities to find a company or non-governmental organization that reflects the philosophy of ecotourism; sensitive to their concerns and willing to cooperate at the expense of profit. The basic assumption of the multiplier effect is that the economy starts off with unused resources, for example, that many workers are cyclically unemployed and much of industrial capacity is sitting idle or incompletely utilized. By increasing demand in the economy, it is then possible to boost production. If the economy was already at full employment, with only structural, frictional, or other supply-side types of unemployment, any attempt to boost demand would only lead to inflation. For various laissez-faire schools of economics which embrace Says Law and deny the possibility of Keynesian inefficiency and under-employment of resources, therefore, the multiplier concept is irrelevant or wrong-headed. As an example, consider the government increasing its expenditure on roads by $1 million, without a corresponding increase in taxation. This sum would go to the road builders, who would hire more workers and distribute the money as wages and profits. The households receiving these incomes will save part of the money and spend the rest on consumer goods. These expenditures, in turn, will generate more jobs, wages, profits, and so on with the income and spending circulating around the economy. The multiplier effect arises because of the induced increases in consumer spending which occur due to the increased incomes — and because of the feedback into increasing business revenues, jobs, and income again.
In the erect penis, trauma results from stretching and narrowing of the tunica albuginea, which can undergo segmental rupture of one or both of the corpora cavernosa, constituting a penile fracture.In the ultrasound examination, a lesion of the tunica albuginea presents as an interruption in (loss of continuity of) the echoic line representing it (Figure 4). Small, moderate, or broad hematomas demonstrate the extent of that discontinuity. Intracavernous hematomas, sometimes without the presence of a tunica albuginea fracture, can be observed when there is a lesion of the smooth muscle of the trabeculae surrounding the sinusoid spaces or the subtunical venular plexus. In 10-15% of penile traumas, there can be an accompanying urethral lesion. When blood is observed in the urethral meatus, contrast-enhanced evaluation of the urethra is necessary. In cases in which the ultrasound findings are inconclusive, the use of magnetic resonance imaging can facilitate the diagnosis and is recommended by various authors. Treatment
Penile fracture is a medical emergency, and emergency surgical repair is the usual treatment. Delay in seeking treatment increases the complication rate. Non-surgical approaches result in 10–50% complication rates including erectile dysfunction, permanent penile curvature, damage to the urethra and pain during sexual intercourse, while operatively treated patients experience an 11% complication rate.In some cases, retrograde urethrogram may be performed to rule out concurrent urethral injury. Legal issues
In the United States, the case of Doe v. Moe, 63 Mass. App. Ct. 516, 827 N.E.2d 240 (2005), tested liability for a penile fracture injury caused during sexual intercourse.