Change Management Research Articles

Impact of Posttreatment SPECT/CT on Patient Management During 177Lu-PSMA-617 Radiopharmaceutical Therapy.

177Lu can be imaged after administration using SPECT/CT. Most work to date has focused on using posttreatment imaging to measure normal organ and tumor dose. We aimed to assess the impact of posttreatment SPECT/CT on the management of patients undergoing 177Lu-prostate-specific membrane antigen (PSMA) radiopharmaceutical therapy (RPT). Methods: In this retrospective study, 122 patients underwent PSMA RPT with subsequent SPECT/CT 24 h after treatment. We determined a qualitative response at each cycle and reviewed patient charts to assess the impact that posttreatment SPECT/CT had on patient management. Changes in patient management were classified as changes on the basis of progression and response, and specific cycles when they occurred were noted. Miscellaneous changes in patient management were also evaluated. Results: Among the 122 consecutive patients examined, 42%-56% exhibited stable disease, whereas 19%-39% of patients exhibited response on visual assessment across treatment cycles. In total, 49% (n = 60) of patients experienced changes in management, of which 57% (n = 34) were due to progression, 40% (n = 24) were due to response, and 3% (n = 2) were due to miscellaneous changes. Changes due to disease progression were observed mostly after cycles 2 and 4. Changes due to response to RPT occurred mostly after cycles 3 and 4. Conclusion: At our center, 49% of patients experienced changes in management based on posttreatment SPECT/CT, and most of these changes occurred at cycles 2 and 4. Integrating posttreatment SPECT/CT into routine PSMA RPT protocols can aid in patient management.

Place-based drivers and effective management of population growth and change in regional Australia

Place-based drivers and effective management of population growth and change in regional Australia

Effect of combined rapid access point-of-care intestinal ultrasound clinic on the management of inflammatory bowel disease

BackgroundIntestinal ultrasound (IUS), although less widely practiced in the UK, offers several advantages in inflammatory bowel disease (IBD), particularly with regard to the accessibility of the test and immediate availability...

Digitization Planning for Large Collections and Agencies with Specify 7

The Specify Collections Consortium (SCC) supports research collections around the world with an intuitive, robust, and highly-customizable software platform to digitize their holdings and manage their collections. For over 25 years, Specify has provided and sustained biological research museums and biorepositories with software for managing, integrating, and publishing collections information (Fig. 1). The SCC has increasingly engaged with very large collections managed by institutions ranging from universities to individual government departments to entire federal agencies, to envision a framework that supports standard computerization workflows and best practices. From our involvement in working with these institutions, which have successfully navigated the transition to Specify, we have gathered insights and learned lessons that may be helpful to others to better anticipate and address key data-related issues in their own institution when embarking on a Specify (or any collections management system) implementation. Understanding how to approach data preparation for import into a collections management system is crucial, as collections often face significant challenges in this area. We will discuss some of the key hurdles that collections encounter and methods to overcome them such as unstandardized data within a single collection and between multiple collections, unparsed names for taxonomy and people, and reconciling pre-existing custom data structures with the fixed structure of a collections management system. We will also cover the decision-making process for determining what collection data should be shared between collections versus what should be managed separately (scoping, data sharing, and data exporting). Large institutions often have multiple collections with diverse needs, and finding the right balance between centralized coordination and individual collection autonomy can be complex. The presentation will discuss the factors considered and the strategies employed to navigate this balance, as it can have significant implications for the overall success of a Specify deployment (Fig. 2). In addition to the technical considerations, the presentation will also delve into the human side of transitioning to a new collections management system. Successful collections management platform implementations require not only technical expertise, but also effective communication and collaboration among the collections staff, volunteers, and management. This presentation offers a framework to help other large collections successfully transition to Specify. Our team at the Specify Collections Consortium has extensive experience in supporting the transition of large research collections to their robust and highly customizable software platform. We have gained valuable insights into the key challenges and best practices for data preparation, system implementation, and change management. By sharing the lessons learned from these institutions and the SCC's experience, the presentation provides valuable insights and guidance to support other organizations in their collections management system implementation projects. A better understanding of this process will ultimately contribute to preserving and improving access to natural history collections (and soon geoscience collections) worldwide.

Change management through strategic leadership: the mediating effect of knowledge management in public organizations, Ethiopia

The purpose of this study is to investigate the effects of strategic leadership on change management within public organizations, mediated by knowledge management. In this study, an explanatory design and a quantitative approach were employed. A structured questionnaire survey was administered to 366 randomly selected respondents from public organizations in northwest Ethiopia. The reliability and validity of the scale items were rigorously assessed, and the data were analyzed using partial least squares structural equation modeling. The findings reveal the direct effects of strategic leadership and knowledge management on change management, with knowledge management partially mediating the relationship between strategic leadership and change management. The study addresses a significant gap in the literature by shedding light on how strategic leadership drives change in public organizations. Its interdisciplinary approach and examination of mediation offer original insights, paving the way for future studies on challenges within public service contexts. Recommendations underscore the importance of considering local context, embracing adaptive leadership, and integrating knowledge processes for effective change management in public organizations.

Disembedding and Disentangling Grassland Valuation: Insights into Grassland Management Institutions and Ecological Research in China

After two decades of implementing top-down grassland restoration projects focused on reducing livestock numbers and pastoralist populations, the Chinese government’s well-funded efforts have not significantly reversed grassland degradation. This study reviews the institutional changes in grassland management over the past forty years, highlighting the Livestock and Grassland Double Contract Household Responsibility System of the early 1980s and the Grassland Ecological Reward and Compensation Policy introduced in 2011. It demonstrates how these institutional transformations have shaped pastoralists’ evolving understanding of grassland value and reveals that commodifying grassland’s economic and ecological value has led to the capitalization of nature, disembedding husbandry from grassland production, and undermining the effectiveness of conservation projects. This article also showcases the development of grassland ecology research in China, noting its increasing detachment from a holistic understanding of ecosystems and the interdisciplinary needs of management practices. The disjunction between grassland ecology research and practical management has resulted in a lack of techniques aligned with local ecological and socioeconomic contexts. This article champions active engagement with and protection of pastoralist communities to reintegrate grasslands’ true economic and ecological value into management practices, thereby effectively restoring degraded grasslands and achieving sustainable management.

Home-office implementation: challenges and changes in people management

PurposeThis paper investigates how organisations responded to the home office imposition during the recent global health crisis and its impacts on people management, detailing the organisational factors crucial for effective home-office implementation.Design/methodology/approachWe used an exploratory design based on a multiple case study with four companies from two contrasting sectors (manufacturing and information technology (IT)). We interviewed a total of 12 managers, including one HR manager (HRms) and two team managers from each company. We also conducted an online questionnaire with open questions, reaching out to 128 home-office workers from the four participating companies. This diverse group consisted of 67 workers from the IT sector and 61 workers from the manufacturing sector. To ensure a comprehensive analysis, we opted for a qualitative approach to examine the data.FindingsFindings enabled detail of the organisational factor of the Belzunegui-Eraso and Erro-Garcés (2020) extended Baruch and Nicholson’s (1997) model into people management issues: organisational culture, team management and human resources management (HRM) practices, as well as the technological support. The results also revealed that people management benefits from the successful home-office implementation, which boosted the digitalisation of human resources (HR) processes.Originality/valueConsidering the lessons learned from the home-office imposition, this research provides original insights into the field by exploring the roles of supervisors and HR managers, in non-health organisations, with different previous remote work experiences, in a recent global disruptive moment, based on a rich qualitative approach. The paper offers concrete guidelines for companies that intend to implement remote work management programs and contributes to deepen the knowledge of home-office experience, offering a model focusing on managers’ roles (HRms and TMs) and HRM practices.

Treatment Trends and Epidemiologic Changes in Acetabular Fracture Management over the Course of 10 Years: An Analysis Based on 2853 Patients as Treated by the German Pelvic Multicenter Study Group.

Background/Objectives: Acetabular fractures, traditionally linked to high-impact trauma in younger adults, are increasingly observed in the elderly due to falls and poor bone quality. This demographic shift necessitates updated treatment approaches. This study analyzes demographic trends and treatment evolution over a decade using the German pelvic fracture registry. Methods: Data on acetabular fractures were analyzed from the German pelvic fracture registry of the German Trauma Society. Parameters included classification, demographics, treatment methods, and surgical details. Trends were assessed by grouping patients based on treatment intervals and age, comparing treatment methods, surgical approaches, and reduction quality across these groups, considering fracture types and treatment volume. Results: The study included 2853 unilateral acetabular fractures with a mean patient age of 61.5 years, showing an increasing age trend. A shift from simple to complex fractures involving the anterior acetabular column was observed. Operative treatment was performed in 62.5% of cases, more common in non-geriatric patients and those with posterior column involvement. The use of anterior intrapelvic approaches increased over time, replacing the Ilioinguinal extrapelvic approach. Anatomical reduction was achieved in 47.4% of cases, with 31.7% having imperfect reductions and 20.9% poor reductions. High-volume centers had significantly better reduction outcomes, particularly for simple fractures. Geriatric patients exhibited worse reduction quality compared to younger patients. In-hospital mortality was stable at 3.3%. Conclusions: The study highlights a demographic shift towards an older patient population, leading to more complex fracture patterns. Despite advancements in surgical techniques and new implant technologies, these demographic changes have resulted in lower reduction quality for complex fractures. Emphasis is placed on careful patient selection for reconstructive surgery or endoprosthetic replacement to ensure high-quality outcomes.

Understanding Local Perspectives on Climate Change and Its Impacts on Small-Scale Fishing Communities in Honda Bay, Palawan, Philippines

Climate change's adverse impacts are already evident, particularly in coastal areas. However, local perception that is essential in formulating policies for mitigating its impacts remains limited. Thus, this study evaluated the level of perception of small fishing communities on climate change and its impacts on livelihood and the environment. The data were obtained using a face-to-face survey with the aid of a structured questionnaire. They were interpreted and analyzed using the Likert point scale, descriptive statistics, and chi-square. A total of 308 male fisherfolks participated in the survey. Majority belong to age 51-60 years old (38%) and 61 years old and above (32%). Most of them (65%) finished elementary and generally (94%) rely on fishing for main source of living. As for income, 47% earned an estimated monthly income of Php 2,501-5,000 and 28% got Php 5,001-7,500. Most of the respondents are full-time fishers (89%) for more than 11 years (87%), and fishing within the municipal water (92%). Majority (90%) have an idea about climate change as reflected by their very high score in Likert Perception (24.3±2.3%). The climate change impacts perceived by the respondents include: increasing sea surface temperature (87%); fish are sensitive to changing climate (87%); and fossil fuel consumption contributes to climate change (84%). They said they got the information from TV/ Radio (99%) and social media (10%). The age (p-value < 0.0032) and source of information (p-value < 0.0348) are among the variables with significant relationship to the perception of respondents on climate change impacts. In total, it appears that majority of fishers are aware of the impacts of climates. It is suggested that effective management actions, such as emergency preparedness schemes and livelihood diversification should be explored to address the specific needs of fishing communities that are vulnerable to the impacts of climate change. Furthermore, an ecosystem-based approach that focuses on socio-economic dynamics and climate-induced changes in assessments and management is essential for the sustainable use of fisheries resources amidst the changing climate.

Evaluation of Different Classification Algorithms for Land Use Land Cover Mapping

For efficient sustainable management and monitoring landscape changes over times, reliable land use land cover (LULC) mapping using the most accurate classification algorithms is required. Increasing innovative classification algorithms and satellite data demands finding the most suitable classifier to create accurate maps of different features efficiently. The challenge addressed in this study is to identify the most accurate algorithm for classifying and generating reliable LULC. The objective of this research was to identify the best classification among several algorithms both overall and in each individual class by using ArcGIS Pro and Google Earth Engine with Landsat 8 and Sentinel-2 datasets for Ranya city as the study area. Support vector machine (SVM), maximum likelihood, random tree, classification and regression tree, K-Nearest Neighbor and iterative self organizing cluster algorithms were used to classify the satellite image of the study area. The kappa coefficient matrix was used to assess the performance of each classifier and method. The study showed that the random tree algorithm achieved highest overall accuracy using Sentinel-2 with 83%. Meanwhile, when the specific class accuracy is priority, the result suggests the use of SVM algorithm using Sentinel-2 for building footprint extraction with 92% accuracy. The result also showed that the outcomes of most algorithms were better using Sentinel-2 rather than Landsat 8, making Sentinel-2 more suitable for accurate LULC mapping. The outcomes of the research assessed different classification algorisms to find the best algorithms and methods that can be used to generate accurate and efficient LULC maps.

Strengthening Change Management Principles to Eliminate Corruption in Local Government of the Republic of South Africa. A Case of Ba-Phalaborwa Local Municipality

Change management is crucial in addressing corruption within local governments, particularly in developing countries like South Africa. This study examines the Ba-Phalaborwa Local Municipality, focusing on how intensifying change management principles can effectively eliminate corruption. By analysing various stakeholders' roles, including employees, politicians, and directors, this paper provides a comprehensive overview of the corruption dynamics within the municipality. Using a qualitative research design, the study explores the effectiveness of change management strategies through detailed data collection and analysis. The findings underscore the importance of robust change management in fostering a corruption-free local government environment.

Adaptive interventions for advancing in situ wildlife disease management.

There is a critical need for advancements in disease management strategies for wildlife, but free-living animals pose numerous challenges that can hinder progress. Most disease management attempts involve fixed interventions accompanied by post hoc outcome assessments focused on success or failure. Though these approaches have led to valuable management advances, there are limitations to both the rate of advancement and amount of information that can be gained. As such, strategies that support more rapid progress are required. Sarcoptic mange, caused by epidermal infection with Sarcoptes scabiei mites, is a globally emerging and re-emerging panzootic that exemplifies this problem. The bare-nosed wombat (Vombatus ursinus), a marsupial endemic to southeastern Australia, is impacted by sarcoptic mange throughout its geographic range and enhanced disease management capabilities are needed to improve upon existing in situ methods. We sought to advance in situ wildlife disease management for sarcoptic mange in free-living bare-nosed wombats, implementing an adaptive approach using fluralaner (Bravecto, MSD Animal Health) and a structured process of learning and method-optimisation. By using surveillance of treated wombats to inform real-time management changes, we have demonstrated the efficacy of topically administered fluralaner at 45 and 85 mg/kg against sarcoptic mange. Importantly, we observed variation in the effects of 45 mg/kg doses, but through our adaptive approach found that 85 mg/kg doses consistently reduced mange severity. Through modifying our surveillance program, we also identified individual-level variation in wombat observability and used this to quantify the level of surveillance needed to assess long-term management success. Our adaptive intervention represents the first report of sarcoptic mange management with fluralaner in free-living wildlife and evaluation of its efficacy in situ. This study illustrates how adapting interventions in real time can advance wildlife disease management and may be applicable to accelerating in situ improvements for other host-pathogen systems.

Improving high uncertainty of evapotranspiration products under extreme climatic conditions based on deep learning and ERA5 reanalysis data

Accurate quantification of Terrestrial Evapotranspiration (ET) is crucial for understanding global water resource management amid climate change. However, against the backdrop of frequent global extreme climate events, existing ET products don’t accurately reflect ground data under extreme climate conditions (high temperature and high vapor pressure deficit (VPD)) and no studies have addressed this uncertainty. This study, based on data from 150 flux towers (FLUXNET ET), utilizes four daily-scale ET product datasets (REA, GLEAMv3.6b, REA, ERA5) and ERA5 reanalysis meteorological data as inputs for Convolutional Neural Network (CNN), to explore ways to improve the accuracy of ET products under extreme climatic conditions, while three Machine Learning (ML) models were selected as comparisons. An additional 35 nearby sites provide independent validation for model applicability. The results show that the estimation accuracy of ET products under extreme climatic conditions has an average decrease of 37.5 % in the correlation coefficient (R2) and an average increase of 40 % in the root-mean-square-error (RMSE), whereas the CNN significantly improves this high uncertainty and outperforms the other ML models. The accuracy was significantly improved with the addition of ET products (R2 = 0.924, RMSE=0.323 mm/d) compared to having only meteorological data as input (R2 = 0.888, RMSE=0.369 mm/d). Under extreme climatic conditions, the R2 and RMSE of CNN are 0.786 (171.6 % average improvement) and 0.448 (65.4 % average reduction) compared to ET products, with PBias ranging from −9% to 9 % and the most significant improvement in the America (region), EBF (land cover type), and Cwa (climate type). Furthermore, using ET products as inputs significantly enhances the CNN’s estimation accuracy, yielding R2 and RMSE improvements between 10 % and 30 %. At the 35 independent validation sites, the CNN still performs well, with R2 and RMSE around 0.720 and 0.510 mm/d under extreme climatic conditions, and the accuracy within 500 km is even higher. This study enhances model precision, providing a valuable tool for optimizing water management and tackling climate change. These advancements help formulate precise irrigation strategies and water policies, particularly in extreme weather-prone regions, supporting ecological stability and mitigating water scarcity.

The Interrelation between Obesity Management and Climate Change in Greece

Two major global problems of our era are climate change and obesity. Both are interlinked and interconnected having undesired social, economic, environmental impacts as well as harmful impacts on human health. The rate of obesity and overweight in children and adults in Greece is high compared to other EU countries causing many health, social and economic problems. Climate change is foreseen to have severe and harmful impacts in Greece as well as in other Mediterranean countries altering the climate conditions. Obesity and its treatment mitigate climate change, mainly due to the change in the dietary pattern of the treated patients. The proposed diets for managing obesity, based on Mediterranean dietary patterns, have less GHG emissions and lower climate footprint. Climate change makes more difficult the treatment of obesity, mainly due to the rising temperatures. Climate change has undesired and harmful impacts on obesity treatment in Greece while obesity treatment results in the mitigation of climate change in the country. Future policies for climate change mitigation and managing obesity in Greece should take into account their mutual interconnections and interlinkages in order to maximize their effectiveness in treating these two severe pandemics in the country.

Crucial competencies for crisis management: the importance of middle leaders’ conceptual skills in navigating turbulent times

ABSTRACT In the contemporary landscape characterized by volatility, uncertainty, complexity, and ambiguity (VUCA), crises can arise, placing organizations at risk. To prevent such failures, organizations must have capable leaders who possess the necessary crisis management competencies to handle such situations. Effective crisis management involves four crucial competencies: improvisation skills, analytical thinking skills, strategic planning skills, and change management skills. This study purposes to evaluate the essential leadership competencies required for effective crisis management, with a specific focus on conceptual competencies among middle leaders in Malaysia’s Ministry of Education (MOE). Utilizing the Fuzzy Delphi Method (FDM), this research seeks to obtain expert consensus on the most critical competencies required for effective crisis management. An instrument containing a list of conceptual competencies was presented to a diverse panel of 15 experts, including those with expertise in crisis management and education. The four elements tested surpassed the required conditions set in FDM. The defuzzification process also rearranged all the elements. In conclusion, this study successfully identified four crisis management competencies that are crucial for middle leaders in educational organizations. The study’s findings have benefits for theoretical evolution, policy development for organizational education, and practice, especially for middle leaders in educational organizations towards sustainable education.

Competencias y capacidades organizacionales para una gestión efectiva de la innovación

Introduction / objective: Evaluating the effectiveness of innovation programmes, particularly in terms of their long-term impact on companies, is inherently complex. This study aims to develop a comprehensive measurement model that effectively captures the long-term innovation and sustainability outcomes of such programmes. By focusing on a broad spectrum of organisational competencies and capabilities, this model seeks to provide a holistic assessment of innovation effectiveness within participating companies. Methodology: To construct the measurement model, a thorough literature review was conducted. Relevant articles were analysed to identify patterns and themes, leading to the classification of essential dimensions, processes, tools, and indicators of organisational competencies and capabilities that are critical for fostering innovation. Results: The study proposes a reference model of organisational competencies, named the 8Cs, to evaluate companies’ innovation performance and potential. This model includes 27 indicators across key dimensions: Cognisance/Knowledge Management, Critical Thinking, Creativity, Innovation Capabilities, Collaboration, Innovative Culture, Change Management and Communication. Conclusions: The 8C model significantly enhances innovation management by providing a comprehensive assessment framework for companies’ innovation practices and their long-term impact. It highlights specific competencies and capabilities essential for sustained innovation and competitiveness, enabling companies to identify focus areas, assess innovation sustainability, and allocate resources effectively.

Role of emotions in change and change management in an emergency department: a qualitative study

BackgroundChanges in emergency departments are frequently implemented to improve efficiency and reduce costs. However, staff acceptance and adoption are crucial for the intended success of changes.ObjectivesThis study explored staff perceptions...

Tipping points and farmer decision-making in European permanent grassland (PG) agricultural systems

Permanent grasslands (PG) provide multifunctional ecosystem services (ES) in Europe and globally, which are threatened by both increased farming intensity and land use change in marginal areas. Farm management decisions can represent critical thresholds, or behavioural “tipping points”, in the agricultural system. Decisions are influenced by a combination of agronomic, policy and social factors. Transformation of PG systems can be facilitated through positive tipping points and relevant policy implementation to ensure sustainable PG systems. The aim of this research was to understand the drivers of decisions regarding land use changes and management towards critical positive and negative tipping points across five biogeographic zones in Europe. Interview methodology assessed farmers’ preferences and priorities regarding the adoption of sustainable PG systems. Participants were selected from five case study countries, each representing a different biogeographic zone in Europe (Continental/Pannonian: Czech Republic, Boreal: Sweden, Mediterranean: Spain, Alpine: Switzerland, and Atlantic: UK). The sample also covered three farming intensity types within these biogeographic zones: high input/intensive conventional farms (≥1.0 LU/ha); low input/extensive conventional farms (<1.0 LU/ha); and certified organic farms. In total, 373 farm interviews were obtained from the case study countries between October 2020 and October 2021. The analysis focuses on drivers of change and considers tipping points across these countries, considering case studies of land use changes (specifically land abandonment) and land management practices (specifically changes in stocking rates). The most common reasons for PG management changes towards either intensification or extensification were economic. Farmers require policy support to increase provision of non-market ES, while rebalancing subsidies can deliver environmental ES at scale through abandonment (e.g., through the creation of specific habitats that support some threatened species). Agri-environment schemes (AES)and subsidies could be more flexible to allow farmers to better adapt grassland management to local production conditions and unpredictable circumstances such as droughts, floods, or market shocks. To maintain PG that delivers more goods and services, financial compensation for ES delivery was perceived to be the most significant support mechanism needed, while easier access to ES provision expertise through extension or consultancy services is considered important factor.

Risk management for viral clearance: A case study on adoption of platform validation approach and risk management of process changes

Viral clearance (VC) studies are routinely required prior to entering clinical trials or for commercial launch of biopharmaceuticals. With increasing prior knowledge and experience, platform validation can be used to eliminate some VC studies and such strategy has been updated into industry guidelines, such as ICH Q5A (R2). In addition, process changes can happen during life-cycle management of a product. In these circumstances, high-risk process parameters need to be identified and corresponding control strategies need to be defined to ensure viral safety of the product. This work describes the design of a science-based risk management tool and how this tool is employed for platform validation and process change scenarios.

Исследования динамики медицинской эффективности функционирования лечебно-профилактических учреждений региона с использованием индекса Малмквиста

The paper provides assessments of the dynamics of the medical efficiency of the functioning of medical institutions in the Khanty-Mansiysk Autonomous Okrug in the period from 2013 to 2021 using the Malmquist index. Purpose of the study. The purpose of the study is to analyze the dynamics of the values of medical efficiency of the functioning of medical institutions of the Khanty-Mansiysk Autonomous Okrug - Ugra, united on an administrative-territorial basis, using the Malmquist index together with shell data analysis. Materials and methods. Direct assessments of the medical effectiveness of these institutions were carried out using shell data analysis. The set of input and output data of the analyzed institutions characterized the effectiveness of the provision of medical services in inpatient and outpatient settings of the institutions. The multiplicative decomposition of the Malmquist index made it possible to analyze the nature and level of influence on its values of such factors as technological changes in the subject area, the efficiency of the management of medical institutions and changes in their scale, i.e. volumes of medical services provi¬ded. Results. Based on the results of the study, it was established that changes in the values of the technological component of the decomposition of the Malmquist index have the greatest influence on changes in the medical efficiency of the functioning of medical institutions. The decomposition component, which characterizes the efficiency of the management of these institutions, is practically neutral. This indicates that the management of regional medical institutions has accumulated quite a large and successful management experience. The influence of the scale component depends on fluctuations in both the volume of medical services provided and the number of medical personnel in institutions. This was especially evident during the pandemic, characterized by strict quarantine restrictions. Conclusion. The use of the Malmquist index and the component of its multiplicative decomposition allows external and internal stakeholders to not only assess the medical effectiveness of the functioning of medical institutions, which is important from he point of view of their use of allocated funding, but also to identify the bearers of “best practices” in terms of the development and implementation of technologies provision of medical services, management of a medical institution and adaptation to changing internal and external conditions of its functioning.