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Background: Cheyne-Stokes respiration frequently occurs in patients with congestive heart failure (CHF). Adaptive servoventilation (ASV) is a novel therapy with potential benefits. This prospective randomized trial investigated the effects of ASV on myocardial function and physical capacity. Methods: Patients with severe CHF, despite optimal cardiac medication and/or left ventricular ejection fraction (LVEF) ≤40% and Cheyne-Stokes breathing for >25% of sleeping time were included. Fifty-one patients, age 57-81 years (4 were women), were randomized to either an ASV or a control group; 30 patients completed the study (15 from each group). The primary end point was any change in LVEF. The secondary end points were alterations in physical capacity according to the 6-min walk test or the New York Heart Association (NYHA) class. Results: In the ASV-treatment group, LVEF improved from baseline (32 ± 11%) to study end (36 ± 13%), p = 0.013. The 6-min walk test improved from 377 ± 115 to 430 ± 123 m (p = 0.014) and the NYHA class from 3.2 (3.0-3.0) to 2.0 (2.0-3.0) (p < 0.001). No changes occurred in the control group. Conclusion: Three months of ASV treatment improved LVEF and physical capacity in CHF patients with Cheyne-Stokes respiration. These results suggest that ASV may be a beneficial supplement to standard medication in these patients.

The objective of this transformative action research project was to explore and develop sustainable methods to promote female empowerment through science education in rural, disadvantaged sectors of South Africa. In an attempt to achieve this we collaborated with local community members to develop and implement a contextualized science curriculum at a school in the aforementioned setting. As soon as the project was launched it became increasingly clear that although the ideology of 'empowerment through science education' seemed a promising venture, it could also be an extremely complex and often frustrating undertaking. This was especially true when working within an unfamiliar cultural setting. Numerous challenges, such as the lack of teacher motivation, malnutrition amongst the learners, and conflicts stemming from differences between the indigenous knowledge and the western concept of science, greatly impeded the delivery of quality education in the area. These challenges had to be addressed both in pedagogical and practical terms before any attempt towards libratory education could be made. This article sheds light on the complex inter-relationship between the human factor and the organizational and physical infrastructure at a school. It begins with a brief description of the local context and goes on to identify the theoretical underpinnings and chosen methodology for the project. The article concludes with a review of the complexities involved in possible attempts to initiate and foster educational and social transformations in a rural South African setting. We contend that it is essential to first be thoroughly familiar with the background, culture, and needs of any community before any attempts are made towards social justice.