The Status of Multi-Dimensional Core-Collapse Supernova Models

Models of neutrino-driven core-collapse supernova explosions have matured considerably in recent years. Explosions of low-mass progenitors can routinely be simulated in 1D, 2D, and 3D. Nucleosynthesis calculations indicate that these supernovae could be contributors of some lighter neutron-rich elements beyond iron. The explosion mechanism of more massive stars remains under investigation, although first 3D models of neutrino-driven explosions employing multi-group neutrino transport have become available. Together with earlier 2D models and more simplified 3D simulations, these have elucidated the interplay between neutrino heating and hydrodynamic instabilities in the post-shock region that is essential for shock revival. However, some physical ingredients may still need to be added/improved before simulations can robustly explain supernova explosions over a wide range of progenitors. Solutions recently suggested in the literature include uncertainties in the neutrino rates, rotation, and seed perturbations from convective shell burning. We review the implications of 3D simulations of shell burning in supernova progenitors for the ‘perturbations-aided neutrino-driven mechanism,’ whose efficacy is illustrated by the first successful multi-group neutrino hydrodynamics simulation of an 18 solar mass progenitor with 3D initial conditions. We conclude with speculations about the impact of 3D effects on the structure of massive stars through convective boundary mixing.

Midwifery-led antenatal care models: mapping a systematic review to an evidence-based quality framework to identify key components and characteristics of care

Background: Implementing effective antenatal care models is a key global policy goal. However, the mechanisms of action of these multi-faceted models that would allow widespread implementation are seldom examined and poorly understood. In existing care model analyses there is little distinction between what is done, how it is done, and who does it. A new evidence-informed quality maternal and newborn care (QMNC) framework identifies key characteristics of quality care. This offers the opportunity to identify systematically the characteristics of care delivery that may be generalizable across contexts, thereby enhancing implementation. Our objective was to map the characteristics of antenatal care models tested in Randomised Controlled Trials (RCTs) to a new evidence-based framework for quality maternal and newborn care; thus facilitating the identification of characteristics of effective care.

Methods: A systematic review of RCTs of midwifery-led antenatal care models. Mapping and evaluation of these models’ characteristics to the QMNC framework using data extraction and scoring forms derived from the five framework components. Paired team members independently extracted data and conducted quality assessment using the QMNC framework and standard RCT criteria.

Results: From 13,050 citations initially retrieved we identified 17 RCTs of midwifery-led antenatal care models from Australia (7), the UK (4), China (2), and Sweden, Ireland, Mexico and Canada (1 each). QMNC framework scores ranged from 9 to 25 (possible range 0–32), with most models reporting fewer than half the characteristics associated with quality maternity care. Description of care model characteristics was lacking in many studies, but was better reported for the intervention arms. Organisation of care was the best-described component. Underlying values and philosophy of care were poorly reported.

Conclusions: The QMNC framework facilitates assessment of the characteristics of antenatal care models. It is vital to understand all the characteristics of multi-faceted interventions such as care models; not only what is done but why it is done, by whom, and how this differed from the standard care package. By applying the QMNC framework we have established a foundation for future reports of intervention studies so that the characteristics of individual models can be evaluated, and the impact of any differences appraised.