Performance evaluation of primary care services for the treatment of tuberculosis

Objective Evaluating the performance of primary care services for the treatment of tuberculosis according to the assessment referential of health services (structure/process) in Cabedelo, a port city in the state of Paraíba. Method An evaluation quantitative, cross-sectional study, in which were carried out 117 interviews with health professionals using a structured instrument. The analysis was based on the construction of indicators using a standardized value for the reduced variable (z=1). Results The structural indicators showed regular performance for the following variables: professional training, access to record instruments and coordination with other services. The process indicators related to external actions and information about the disease had unsatisfactory performance. The directly observed treatment and the flows of reference/counter-reference had regular performance. Conclusion The focused professional qualification, the fragmentation of practices and the unsystematic home care constitute obstacles for carrying out actions aimed at providing expanded, continuous and resolute care.



Efeitos da correcção do resultado contabilístico na determinação da matéria colectável: O caso só construções, S.A.

O desmantelamento das barreiras ao comércio mundial traduziu-se no aumento das operações comerciais e financeiras, na crescente necessidade de capitais, na utilização de novos instrumentos financeiros e no consequente desenvolvimento dos mercados de capitais com empresas cotadas em diversos mercados. Este fenómeno contribuiu ainda para a globalização da informação financeira que, para suprir as exigências de um mercado abrangente, teve de encontrar novas formas de difusão, sem contudo descurar as suas qualidades, nomeadamente a compreensibilidade, a comparabilidade e a fiabilidade. O interesse do desenvolvimento deste tema ressalta-se pela importância que a contabilidade nas organizações, recomenda-se ser organizada de forma a possibilitar o conhecimento claro e inequívoco dos elementos necessários ao cálculo do imposto, bem como a permitir o seu controlo, comportando todos os dados necessários ao preenchimento das declarações periódicas dos impostos. A parte prática do trabalho, em resumo, demonstra que, o ponto de partida para o apuramento do lucro tributável é o resultado contabilístico determinado com base nas suas regras próprias. Em Cabo Verde, a lei fiscal, apesar de desactualizada com o SNCRF, estabelece algumas regras próprias para ajustar o resultado contabilístico ao resultado fiscal. Em conclusão, a aplicação do novo normativo contabilístico cabo-verdiano (SNCRF) na correcção e determinação da matéria colectável em sede do IUR veio dar e construir uma base contabilística comum como ponto de partida para o estabelecimento de uma matéria colectável comum, e se concluir neste TFC, que tem todo o sentido. Sendo as demonstrações financeiras elaboradas com base nas NRF e subsidiariamente às NIC´s constituem o ponto de partida neutro para qualquer discussão sobre uma matéria colectável comum. The dismantling of barriers to world trade has resulted in increased commercial and financial transactions, the growing need for capital, and the use of new financial instruments and the consequent development of capital markets with listed companies in various markets. This phenomenon has also contributed for the globalization of financial information to meet the requirements of a comprehensive market had to find new ways of making, without neglecting their qualities, namely understandability, comparability and reliability. The interest of the development of this theme it emphasizes the importance of accounting in organizations, it is recommended to be organized in order to enable the clear and unambiguous understanding of the elements necessary for calculating the tax, as well as to allow its control, behaving all data needed to fill in of the periodic declarations of taxes. The practical part of the work, in short, shows that the starting point to determining taxable income is the accounting income determined based on its own rules. In Cape Verde, the tax law, although outdated with SNCRF establishes some rules themselves to adjust accounting income to taxable income. In conclusion, the application of new accounting standards Cape Verde (SNCRF) in the correction and determination of the tax base in the headquarters of the IUR to come and build a common basis of accounting as a starting point for the establishment of a common tax base, and conclude TFC this, which makes sense. Being the financial statements prepared in accordance with NRF 'and secondarily to NIC's are the neutral starting points for any discussion about a common tax base.

Desenvolvimentos estimados de custo amortizado e imparidade, segundo SNCRF - caso prático

O tema do Trabalho de Fim de Curso - “Desenvolvimentos Estimados de Custo Amortizado e Imparidade segundo SNCRF”, insere-se no âmbito da conclusão da Licenciatura em Contabilidade e Administração – Ramo Administração e Controlo Financeiro ministrada pelo ISCEE – Instituto Superior de Ciências Económicas e Empresariais. O trabalho ora apresentado, espelha uma análise sumária das normas internacionais e do novo normativo nacional no que diz respeito aos instrumentos financeiros com foco em tratamento contabilístico dado pelo método de custo amortizado e reconhecimento de perda por imparidade. Foi preparado com base em consulta de bibliografia especializada e normativos estabelecidos no país, pois permitirá ter acesso tanto a conteúdos teóricos como práticos o que implica um estudo mais abrangente de todos os recursos disponíveis. O desenvolvimento da temática foi orientado numa primeira etapa através de pesquisa necessária a construção do referencial teórico centrado por um lado na evolução teórica das normas internacionais sobre os instrumentos financeiros e consequentemente o tratamento dado pela nossa norma. Na segunda etapa, os casos práticos apresentam os principais casos de contabilização dos instrumentos financeiros utilizando o método de custo amortizado, e reconhecimento de imparidade de acordo com o SNCRF, e a conclusão que se chegou é que o custo amortizado implica a utilização do método de taxa de juro efectiva menos qualquer perda por imparidade, sendo que o método de taxa de juro efectiva distribui os pagamentos e recebimentos dos juros ao longo do período do instrumento financeiro aplicando a taxa de juro efectiva ao valor a transportar do activo ou de passivo de cada período, e uma entidade que usa o método de custo amortizado reconhece os activos financeiros e passivos financeiros pelo seu valor líquido no balanço, e à data de cada relato financeiro deve avaliar a imparidade de todos os activos financeiros e reconhecer perdas por imparidade, visto que, a imparidade representa uma redução no valor de um activo financeiro ou seja reflecte a depreciação (perda permanente) do valor de um activo financeiro e verifica quando a quantia recuperável for superior ao seu valor contabilístico.

A diagram of public spaces within urban landscape as a strategy for sustainable urban planning in Chinese cities

Destruction of historical urban fabric in many Chinese cities and towns, without the possibility of its recovery as an urban asset, leads us to consider alternative strategies and criteria for formulating new urban projects, using creative urban planning instruments and strategies to provide a sense of place and identity to the urban landscape. The challenge is to set up an urban structure that constitutes a spatial reference system, a structure consisting of a set of urban landmarks that construct a system of related public spaces, endowed with collective significance and identity. Such a network could include a wide variety of urban typologies and natural elements. An important result of this strategy would be the recovery of the social and cultural values attached to the natural landscape in Chinese civilization. Hangzhou city will be analyzed as a case study

Incremental neural networks for function approximation

A new strategy for incremental building of multilayer feedforward neural networks is proposed in the context of approximation of functions from R-p to R-q using noisy data. A stopping criterion based on the properties of the noise is also proposed. Experimental results for both artificial and real data are performed and two alternatives of the proposed construction strategy are compared.

Le médecin face aux inégalités sociales de santé: quel pouvoir d'action [General practitioners facing social inequalities in health: which power to act?].

The link between social inequalities and health has been known for many years, as attested by Villermé's work on the "mental and physical status of the working class" (1840). We have more and more insight into the nature of this relationship, which embraces not only material deprivation, but also psychological mechanisms related to social and interpersonal problems. Defining our possible role as physicians to fight against these inequalities has become a public health priority. Instruments and leads, which are now available to help us in our daily practice, are presented here.

Do PES Improve the Governance of Forest Restoration?

Payments for Environmental Services (PES) are praised as innovative policy instruments and they influence the governance of forest restoration efforts in two major ways. The first is the establishment of multi-stakeholder agencies as intermediary bodies between funders and planters to manage the funds and to distribute incentives to planters. The second implication is that specific contracts assign objectives to land users in the form of conditions for payments that are believed to increase the chances for sustained impacts on the ground. These implications are important in the assessment of the potential of PES to operate as new and effective funding schemes for forest restoration. They are analyzed by looking at two prominent payments for watershed service programs in Indonesia-Cidanau (Banten province in Java) and West Lombok (Eastern Indonesia)-with combined economic and political science approaches. We derive lessons for the governance of funding efforts (e.g., multi-stakeholder agencies are not a guarantee of success; mixed results are obtained from a reliance on mandatory funding with ad hoc regulations, as opposed to voluntary contributions by the service beneficiary) and for the governance of financial expenditure (e.g., absolute need for evaluation procedures for the internal governance of farmer groups). Furthermore, we observe that these governance features provide no guarantee that restoration plots with the highest relevance for ecosystem services are targeted by the PES

Prioritizing genetic testing in patients with kallmann syndrome using clinical phenotypes.

Context: The complexity of genetic testing in Kallmann syndrome (KS) is growing and costly. Thus, it is important to leverage the clinical evaluations of KS patients to prioritize genetic screening. Objective: The objective of the study was to determine which reproductive and nonreproductive phenotypes of KS subjects have implications for specific gene mutations. Subjects: Two hundred nineteen KS patients were studied: 151 with identified rare sequence variants (RSVs) in 8 genes known to cause KS (KAL1, NELF, CHD7, HS6ST1, FGF8/FGFR1, or PROK2/PROKR2) and 68 KS subjects who remain RSV negative for all 8 genes. Main Outcome Measures: Reproductive and nonreproductive phenotypes within each genetic group were measured. Results: Male KS subjects with KAL1 RSVs displayed the most severe reproductive phenotype with testicular volumes (TVs) at presentation of 1.5 ± 0.1 mL vs 3.7 ± 0.3 mL, P < .05 vs all non-KAL1 probands. In both sexes, synkinesia was enriched but not unique to patients with KAL1 RSVs compared with KAL1-negative probands (43% vs 12%; P < .05). Similarly, dental agenesis and digital bone abnormalities were enriched in patients with RSVs in the FGF8/FGFR1 signaling pathway compared with all other gene groups combined (39% vs 4% and 23% vs 0%; P < .05, respectively). Hearing loss marked the probands with CHD7 RSVs (40% vs 13% in non-CHD7 probands; P < .05). Renal agenesis and cleft lip/palate did not emerge as statistically significant phenotypic predictors. Conclusions: Certain clinical features in men and women are highly associated with genetic causes of KS. Synkinesia (KAL1), dental agenesis (FGF8/FGFR1), digital bony abnormalities (FGF8/FGFR1), and hearing loss (CHD7) can be useful for prioritizing genetic screening.

Quantification of the least limiting water range in an oxisol using two methodological strategies

The least limiting water range (LLWR) has been used as an indicator of soil physical quality as it represents, in a single parameter, the soil physical properties directly linked to plant growth, with the exception of temperature. The usual procedure for obtaining the LLWR involves determination of the water retention curve (WRC) and the soil resistance to penetration curve (SRC) in soil samples with undisturbed structure in the laboratory. Determination of the WRC and SRC using field measurements (in situ ) is preferable, but requires appropriate instrumentation. The objective of this study was to determine the LLWR from the data collected for determination of WRC and SRC in situ using portable electronic instruments, and to compare those determinations with the ones made in the laboratory. Samples were taken from the 0.0-0.1 m layer of a Latossolo Vermelho distrófico (Oxisol). Two methods were used for quantification of the LLWR: the traditional, with measurements made in soil samples with undisturbed structure; and in situ , with measurements of water content (θ), soil water potential (Ψ), and soil resistance to penetration (SR) through the use of sensors. The in situ measurements of θ, Ψ and SR were taken over a period of four days of soil drying. At the same time, samples with undisturbed structure were collected for determination of bulk density (BD). Due to the limitations of measurement of Ψ by tensiometer, additional determinations of θ were made with a psychrometer (in the laboratory) at the Ψ of -1500 kPa. The results show that it is possible to determine the LLWR by the θ, Ψ and SR measurements using the suggested approach and instrumentation. The quality of fit of the SRC was similar in both strategies. In contrast, the θ and Ψ in situ measurements, associated with those measured with a psychrometer, produced a better WRC description. The estimates of the LLWR were similar in both methodological strategies. The quantification of LLWR in situ can be achieved in 10 % of the time required for the traditional method.

Processus de reconnaissance et d'identification de personnes décédées

Recognition and identification processes for deceased persons. Determining the identity of deceased persons is a routine task performed essentially by police departments and forensic experts. This thesis highlights the processes necessary for the proper and transparent determination of the civil identities of deceased persons. The identity of a person is defined as the establishment of a link between that person ("the source") and information pertaining to the same individual ("identifiers"). Various identity forms could emerge, depending on the nature of the identifiers. There are two distinct types of identity, namely civil identity and biological identity. The paper examines four processes: identification by witnesses (the recognition process) and comparisons of fingerprints, dental data and DNA profiles (the identification processes). During the recognition process, the memory function is examined and helps to clarify circumstances that may give rise to errors. To make the process more rigorous, a body presentation procedure is proposed to investigators. Before examining the other processes, three general concepts specific to forensic science are considered with regard to the identification of a deceased person, namely, matter divisibility (Inman and Rudin), transfer (Locard) and uniqueness (Kirk). These concepts can be applied to the task at hand, although some require a slightly broader scope of application. A cross comparison of common forensic fields and the identification of deceased persons reveals certain differences, including 1 - reverse positioning of the source (i.e. the source is not sought from traces, but rather the identifiers are obtained from the source); 2 - the need for civil identity determination in addition to the individualisation stage; and 3 - a more restricted population (closed set), rather than an open one. For fingerprints, dental and DNA data, intravariability and intervariability are examined, as well as changes in these post mortem (PM) identifiers. Ante-mortem identifiers (AM) are located and AM-PM comparisons made. For DNA, it has been shown that direct identifiers (taken from a person whose civil identity has been alleged) tend to lead to determining civil identity whereas indirect identifiers (obtained from a close relative) direct towards a determination of biological identity. For each process, a Bayesian model is presented which includes sources of uncertainty deemed to be relevant. The results of the different processes combine to structure and summarise an overall outcome and a methodology. The modelling of dental data presents a specific difficulty with respect to intravariability, which in itself is not quantifiable. The concept of "validity" is, therefore, suggested as a possible solution to the problem. Validity uses various parameters that have an acknowledged impact on teeth intravariability. In cases where identifying deceased persons proves to be extremely difficult due to the limited discrimination of certain procedures, the use of a Bayesian approach is of great value in bringing a transparent and synthetic value. RESUME : Titre: Processus de reconnaissance et d'identification de personnes décédées. L'individualisation de personnes décédées est une tâche courante partagée principalement par des services de police, des odontologues et des laboratoires de génétique. L'objectif de cette recherche est de présenter des processus pour déterminer valablement, avec une incertitude maîtrisée, les identités civiles de personnes décédées. La notion d'identité est examinée en premier lieu. L'identité d'une personne est définie comme l'établissement d'un lien entre cette personne et des informations la concernant. Les informations en question sont désignées par le terme d'identifiants. Deux formes distinctes d'identité sont retenues: l'identité civile et l'identité biologique. Quatre processus principaux sont examinés: celui du témoignage et ceux impliquant les comparaisons d'empreintes digitales, de données dentaires et de profils d'ADN. Concernant le processus de reconnaissance, le mode de fonctionnement de la mémoire est examiné, démarche qui permet de désigner les paramètres pouvant conduire à des erreurs. Dans le but d'apporter un cadre rigoureux à ce processus, une procédure de présentation d'un corps est proposée à l'intention des enquêteurs. Avant d'entreprendre l'examen des autres processus, les concepts généraux propres aux domaines forensiques sont examinés sous l'angle particulier de l'identification de personnes décédées: la divisibilité de la matière (Inman et Rudin), le transfert (Locard) et l'unicité (Kirk). Il est constaté que ces concepts peuvent être appliqués, certains nécessitant toutefois un léger élargissement de leurs principes. Une comparaison croisée entre les domaines forensiques habituels et l'identification de personnes décédées montre des différences telles qu'un positionnement inversé de la source (la source n'est plus à rechercher en partant de traces, mais ce sont des identifiants qui sont recherchés en partant de la source), la nécessité de devoir déterminer une identité civile en plus de procéder à une individualisation ou encore une population d'intérêt limitée plutôt qu'ouverte. Pour les empreintes digitales, les dents et l'ADN, l'intra puis l'inter-variabilité sont examinées, de même que leurs modifications post-mortem (PM), la localisation des identifiants ante-mortem (AM) et les comparaisons AM-PM. Pour l'ADN, il est démontré que les identifiants directs (provenant de la personne dont l'identité civile est supposée) tendent à déterminer une identité civile alors que les identifiants indirects (provenant d'un proche parent) tendent à déterminer une identité biologique. Puis une synthèse des résultats provenant des différents processus est réalisée grâce à des modélisations bayesiennes. Pour chaque processus, une modélisation est présentée, modélisation intégrant les paramètres reconnus comme pertinents. À ce stade, une difficulté apparaît: celle de quantifier l'intra-variabilité dentaire pour laquelle il n'existe pas de règle précise. La solution préconisée est celle d'intégrer un concept de validité qui intègre divers paramètres ayant un impact connu sur l'intra-variabilité. La possibilité de formuler une valeur de synthèse par l'approche bayesienne s'avère d'une aide précieuse dans des cas très difficiles pour lesquels chacun des processus est limité en termes de potentiel discriminant.

Development of EDMI Calibration Baseline, HR-241, 1984

Electronic distance measuring instruments (EDMI) are used by surveyors in routine length measurements. The constant and scale factors of the instrument tend to change due to usage, transportation, and aging of crystals. Calibration baselines are established to enable surveyors to check the instruments and determine any changes in the values of constant and scale factors. The National Geodetic Survey (NGS) has developed guidelines for establishing these baselines. In 1981 an EDMI baseline at ISU was established according to NGS guidelines. In October 1982, the NGS measured the distances between monuments. Computer programs for reducing observed distances were developed. Mathematical model and computer programs for determining constant and scale factors were developed. A method was developed to detect any movements of the monuments. Periodic measurements of the baseline were made. No significant movement of the monuments was detected.

La salut reproductiva de la dona immigrant: una anàlisi des de la influència cultural

El progressiu increment del flux migratori en els darrers anys a Catalunya genera un major percentatge de dones en estat fèrtil que requereixen d’una atenció vinculada a la seva salut reproductiva. D’aquesta manera, els professionals sanitaris es veuen sotmesos a treballar sota una diversitat cultural que moltes vegades genera un “xoc intercultural” dificultant la relació assistencial entre professional i usuari. Per aquest motiu, el següent estudi pretén donar una aproximació de la influència cultural de la dona immigrant (marroquina i subsahariana) en quatre àmbits: embaràs, part, post-part i maternitat.Hipòtesis: S’identifiquen necessitats bàsiques assistencials no resoltes satisfactòriament en el grup de dones immigrants (marroquines i subsaharianes) en el període del part, puerperi immediat i intermedi, a més d’un impacte intercultural associat.Objectiu principal: Conèixer les vivències, percepcions i conductes de les dones marroquines i subsaharianes en l’embaràs, el part, el post-part, la maternitat dins el seu marc cultural i com influeixen en l’atenció sanitària del nostre país.Material i mètodes: S’ha realitzat un estudi de disseny mixt. Per una banda s’ha disposat d’una metodologia qualitativa descriptiva que utilitza la teoria fonamentada “Grounded Theory” com a instrument metodològic, i per l’altra, s’ha optat per una metodologia quantitativa per analitzar les dades clíniques i epidemiològiques de gestants immigrants que havien donat a llum al Servei d’Obstetrícia-Sala de Parts de l’Hospital Sta. Caterina (Girona), durant el període comprès entre el mes de novembre de 2012 i gener de 2013.La recollida de dades s’ha realitzat sota una entrevista semiestructurada i una observació participant com a instruments qualitatius, i el suport del “carnet de l’embaràs” i la “història obstètrica” de cada dona per elaborar l’estudi quantitatiu. Pel que fa a l’anàlisi de les dades en l’estudi qualitatiu s’ha seguit el procés analític plantejat per la Teoria fonamentada i en el cas de l’estudi quantitatiu, s’ha comptatamb el suport d’una tesi doctoral per comparar els resultats amb els de les dones autòctones, dels quals fa referència la tesi.Resultats: En l’estudi qualitatiu, s’han trobat especificitats culturals en relació a la percepció del part, desenvolupament del part ( a nivell conductual), implicació en el post-part, valoració de l’atenció sanitària rebuda i el concepte de maternitat. Pel que fa a l’estudi quantitatiu comparatiu, s’han indentificat diferències entre el col·lectiu de la mostra estudiada i les dones autòctones referent als antecedents obstètrics i paritat, al control gestacional i al desenvolupament del part ( a nivell fisiològic)

Pycnodysostosis. A report of 3 clinical cases

Pycnodysostosis is a rare clinical entity, first described in 1962 by Maroteaux and Lamy. It is a genetic disorder, usually diagnosed at an early age. However, the diagnosis is sometimes late, made as a result of bone fracture, given the severe bone fragility resulting from increased bone density. Oral and maxillofacial manifestations of this disease are very clear. The head is usually large, the nose beaked, the mandibular angle obtuse, and both maxilla and mandible hypoplastic. Dental abnormalities and impaction are observed, as well as alterations in eruption and frequent dental crowding. The differential diagnosis is established with osteopetrosis, cleidocranial dysplasia and idiopathic acro-osteolysis. This article reviews the clinical and radiographic characteristics of pycnodysostosis based on three clinical cases of patients with this disease.

Sähkösalkun tuotteistaminen ja salkunhallinnan menestyksen seuranta

Sähkömarkkinoiden vapautumisen ja pörssimuotoisen kaupankäynnin myötäyhä useampi toimija on siirtynyt perinteisistä kiinteähintaisista sopimuksista salkkumuotoiseen sähkönhankintaan. Aktiivisen salkunhallinnan myötä kanava markkinoille pysyy jatkuvasti avoimena ja ostopäätös voidaan jakaa pidemmälle ajanjaksolle, jolloin riippuvaisuus vain yhden hetken hintatasosta pienenee. Sähkön hankintahinnan suojaamiseen käytettävien finanssituotteiden määrä pörssissä ja OTC-markkinalla on kasvanut viime vuosina merkittävästi. Tämän seurauksena myös käytettävien instrumenttien valinta ja perustelu asiakkaalle vaatii entistä tarkempaa huomiota. Työssä käsiteltävän tuotteistuksen tavoitteena oli luoda salkunhallinnan perustapauksille yksinkertaiset rungot, joita voidaan täydentää erilaisillalisäominaisuuksilla. Tuotteistuksella pyritään myös selkeyttämään asiakkaalle muodostuvaa mielikuvaa tarjolla olevista vaihtoehdoista sekä edesauttamaan markkinointia. Diplomityön toisena tavoitteena oli kehittää salkunhallinnan menestyksen seurantaa varten mittarit, joiden avulla sekä asiakas että salkunhoitaja pystyvät seuraamaan salkunhallinnan onnistumista. Mittarit toteutettiin Excel-ympäristössä ja testattavat salkut koostuivat pääasiassa lopullisista tuotteistettaviksi valituista salkuista. Työn pohjalta on määrä toteuttaa olemassa olevan internet-pohjaisen salkunhallintapalvelun osaksi sovellus, joka mahdollistaa salkunhallinnan menestyksen jatkuvan seurannan.

Valuuttakurssiriskin hallinta Yhdysvaltoihin listautuneessa sähkövoima- ja automaatioteknologia yrityksessä

Tutkimuksen päätavoite on tutkia ja kehittää Case -yrityksen valuuttakurssiriskin hallintaa. Tavoitteiden saavuttamiseksi tutkitaan kirjoitetunteorian ja tutkimusten pohjalta valuuttamarkkinoita ja -kursseja sekä valuuttakurssiriskin tunnistamista, suojaamista ja kirjaamis-ta. Eri suojausinstrumentteja ja US GAAP:in mukaista suojauslaskentaa tarkastellaan. Teoriat tarjoavat viitekehyksen Case -yrityksen valuuttahallinnan lähempään tarkasteluun. Pääpaino on empiirisessä, historiallisessa valuuttapositiotutkimuksessa, jonka tarkoituksena on selvittää yrityksessä vallinneiden valuuttasuojausten taso. Empiirinen tutkimus osoittaa joidenkin yksiköiden valuuttapolitiikan mukaisissa suojauskäytännöissä olevan parantamisen varaa. Suuriakin valuuttakurssimuutoksille alttiita avoimia positioita muodostuu johtuen liian vähäisestä tai liiallisesta suojaustoiminnasta (finanssitransaktioista). Joidenkin valuuttojen suojaaminen osoittautuu olevan vaikeampaa kuin toisten. Kirjoitetun teorian ja empiirisen tutkimuksen pohjalta tehdään valuuttariski-analyysi, pohditaan termiinien soveltuvuutta riskinhallinnan välineenä ja annetaan kehitys-ehdotuksia yrityksen nykyiselle valuuttahallinnolle ja johdon päätöksenteon tueksi. Case -yrityksen tulevia haasteita on kattavan valuuttapositio -seurantajärjestelmän kehittäminen.