From June 2023, all our podcasts will move to https://bjsmbmj.podbean.com.
You can continue with your subscription on your favourite podcast App.

British Journal of Sports Medicine (BJSM) is a multi-media information portal that provides original research, reviews and debate relating to clinically-relevant aspects of sport and exercise medicine. We contribute to innovation (research), education (teaching and learning) and knowledge translation (implementing research into practice and policy). We use web, print, video and audio material to serve the international sport and exercise medicine community.
* The purpose of this podcast is to educate and to inform. The content of this podcast does not constitute medical advice and it is not intended to function as a substitute for a healthcare practitioner’s judgement, patient care or treatment. The views expressed by contributors are those of the speakers. BMJ does not endorse any views or recommendations discussed or expressed on this podcast. Listeners should also be aware that professionals in the field may have different opinions. By listening to this podcast, listeners agree not to use its content as the basis for their own medical treatment or for the medical treatment of others.

BJSM

On this episode of the AMSSM Sports Medcast (T: @TheAMSSM) host Dr. Jacob Wessels, MD is joined by sports medicine researcher and past president of the American College of Sports Medicine, Dr. NiCole Keith, PhD to discuss the topic of Exercise for Post-Menopausal Women.
 
Dr. NiCole Keith (T: @nicolekeithphd) is a Professor from the Department of Kinesiology and associate dean of faculty affairs in the School of Health & Human Sciences at Indiana University-Purdue University Indianapolis. Her research interests include physical activity and health equity. In addition to serving as the current president of the ACSM she has previously served as the vice president of membership, communication, and policy and serves on both the Exercise is Medicine and American Fitness Index advisory boards.
 
In this 20 -minute conversation Dr. Keith addresses the following topics:
·        Discussing the different stages of menopause and the importance of physical activity during these stages 
·        Creating effective exercise prescriptions, including the best physical activity recommendations and strategies
·        The best types of exercises for post-menopausal women and several alternatives, based on potential health and risk factors
·        Addressing health disparities between genders and communities, and making sure individuals can safely engage in physical activity

Exercise for Post-Menopausal Women with Dr. NiCole Keith. EP#512

In this podcast we host Professor Benita Olivier (Twitter @BenitaOlivier). Benita is a lecturer in musculoskeletal physiotherapy at the University of the Witwatersrand and is the Director of the Wits Cricket Research Hub. Benita provides great practical tips for clinicians and researchers to create time and increase access to evidence-based information to bridge the gap between publication and the pitch. We also discuss some of the emerging research in African athletes, and what we can learn from Kenyan endurance runners.  
  
Wits Cricket Research Hub https://www.youtube.com/channel/UCIenu_8XdRB7ttG3lGMLcMw 
Facebook: @witscricketresearchhub https://www.facebook.com/witscricketresearchhub 
Instagram: @witscricketresearchhub https://www.instagram.com/witscricketresearchhub/ 
Twitter: @WitsCricketRH https://twitter.com/WitsCricketRH 
LinkedIn: WITS Cricket Research Hub https://www.linkedin.com/company/wits-cricket-research-hub/ 
   
Knowledge and adherence towards evidence-based sports Physiotherapy standards among physiotherapists in Kenya https://www.ijmhr.org/IntJPhysiotherRes/IJPR.2020.171 
  
A prevalence of running-related injuries among professional endurance runners in the Rift Valley, Kenya https://journals.assaf.org.za/index.php/sajsm/article/view/10690 
  
Musculoskeletal predictors of non-contact injury in cricketers e Few and far between? A longitudinal cohort study https://linkinghub.elsevier.com/retrieve/pii/S1466853X1830021X

Publication to the pitch – we all have a role. Professor Benita Olivier. EP# 513

Dr. Joshua Heerey chats on this podcast to BJSM’s Dr. Liam West about hip joint imaging. Josh gives us a sneak peek into the findings from the “Femoroacetabular impingement & hip OsteoathRitis Cohort (FORCe) study & how they may help clinicians manage their patients with hip and groin pain. The podcast is heavily based around clinical scenarios that are commonly faced in the clinic or sports team settings. 

Dr Heerey is a physiotherapist and Hip Osteoarthritis Research and Development Lead at La Trobe University’s Sport and Exercise Medicine Research Centre in Melbourne, Australia. Dr Heerey obtained his PhD in 2021, with his research programme focusing on understanding the relationship between hip joint imaging findings and pain, and risk factors for development of early hip osteoarthritis in football players. He has published numerous articles examining the diagnosis and treatment of intra-articular hip conditions and is a current member of the International Hip-Related Pain Research Network and Young Athlete’s Hip Research Collaboration, which are multi-disciplinary international research teams created to improve the care of people living with hip and groin conditions. 
Dr Heerey works clinically at Lifecare Prahran Sports Medicine Clinic. He has a particular interest in the management of longstanding hip and groin conditions


Relevant links:
- Heerey et al. What is the prevalence of imaging-defined intra-articular hip pathologies in people with and without pain? A systematic review and meta-analysis. Br J Sports Med. 2018;52(9):581-93. http://dx.doi.org/10.1136/bjsports-2017-098264 
- Heerey et al. What is the prevalence of hip intra-articular pathologies and osteoarthritis in active athletes with hip and groin pain compared with those without? A systematic review and meta-analysis. Sports Med. 2019;49:951-972.  https://doi.org/10.1007/s40279-019-01092-y 
 - Heerey et al. Prevalence of early hip OA features in high- impact athletes. The femoroacetabular impingement and hip osteoarthritis cohort (FORCe) study. Osteoarthritis Cartilage. 2021; 29(3): 323-334. https://doi.org/10.1016/j.joca.2020.12.013 
- Heerey et al. The size and prevalence of bony hip morphology do not differ between football players with and without hip and/or groin pain: Findings from the FORCe cohort. J Orthop Sports Phys Ther. 2021; 51(3): 115-125. https://www.jospt.org/doi/10.2519/jospt.2021.9622 
- Heerey et al. Cam morphology is associated with MRI-defined cartilage defects and labral tears: a case–control study of 237 young adult football players with and without hip and groin pain. BMJ Open Sport & Exercise Medicine 2021;7:e001199. http://dx.doi.org/10.1136/bmjsem-2021-001199

Hip joint imaging findings in football players and their relevance in injury management EP#514

Kathryn Dane is a physiotherapist and is a professional Irish rugby union player, and PhD candidate at Trinity College Dublin. We discuss her first PhD publication on the physical, technical, tactical demands and preparatory strategies in female field collision sports. Kathryn draws on her experience as an athlete, clinician, and researcher, and what practitioners should consider when designing training programs for female field collision sports.  

Physical and Technical Demands and Preparatory Strategies in Female Field Collision Sports: A Scoping Review: https://pubmed.ncbi.nlm.nih.gov/35767989/

Tackling the big issues and training smarter in female collision sports with Kathryn Dane. EP#515

On this episode of the AMSSM Sports Medcast (T: @TheAMSSM) host Dr. Jacob Wessels, MD is joined by Dr. Adam Tenforde, MD to discuss the topic of Exercise for Extracorporeal Shockwave Therapy (ESWT) in Musculoskeletal Medicine.
 
Dr. Tenforde recently published a research about best practices for ESWT, which is used in a variety of clinical applications including the management of musculoskeletal conditions. In this conversation, he addresses the following topics and questions about shockwave therapy:
·        What is ESWT?
·        The origins of shockwave therapy use and some of its additional applications
·        Describing the process of shockwave therapy and its effects
·        Some of the factors to consider when performing ESWT, especially to clinicians who have never used this treatment option before
·        Understanding the different types of shockwave therapy and how they can be used to treat injuries
·        What types of providers can administer ESWT, and what are the recommended treatment protocols for medical teams?
·        What is the reimbursement status of shockwave therapy for providers?
·        What are some of the medical conditions that are best treated by ESWT, in both the lower and upper extremities?
 
Additional Resources
Best practices for extracorporeal shockwave therapy in musculoskeletal medicine: Clinical application and training consideration. PM&R 2022 May;14(5):611-619. doi: 10.1002/pmrj.12790. https://doi.org/10.1002/pmrj.12790
Bone stress injuries. Nat Rev Dis Primers. 2022 Apr 28;8(1):26. doi: 10.1038/s41572-022-00352-y. PMID: 3548413
A Systematic Review of Systematic Reviews on the Epidemiology, Evaluation, and Treatment of Plantar Fasciitis. Life (Basel). 2021 Nov 24;11(12):1287. doi: 10.3390/life11121287.

Extracorporeal Shockwave Therapy in MSK Medicine with Dr. Adam Tenforde EP #516

In this BJSM podcast Brooke Patterson hosts Prof Lorimer Moseley AO and Dr Ebonie Rio, physiotherapists and international leaders in pain science. This is a fascinating discussion about how we increase our ability as clinicians and to “own the modern science” and explain pain to patients. We discuss the “warm-up phenomena” with painful tendons, the competing demands of self-protection and performance, and how we can help change the internal conversations that patients have about their pain.

Less Pain. Better performance using contemporary science to improve both in all athletes EP#517

BJSM’s Dr. Liam West talks to James Alexander about running related knee injuries and what options the current published literature support for managing & preventing these injuries. James & his colleagues have just published a systematic review in the area, and he gives the clinical relevance of his findings within the podcast. You can access their paper using the link below, in addition to other related content.

Review. Strategies to prevent and manage running-related knee injuries: a systematic review of randomised controlled trials: https://bjsm.bmj.com/content/early/2022/09/23/bjsports-2022-105553.abstract

Infographic. Running Myth: recreational running causes knee osteoarthritis:https://bjsm.bmj.com/content/56/6/357

Infographic. Running myth: switching to a non-rearfoot strike reduces injury risk and improves running economy:https://bjsm.bmj.com/content/55/3/175

Infographic running myth: static stretching reduces injury risk in runners:https://bjsm.bmj.com/content/54/17/1058

Infographic. Running myth: strength training should be high repetition low load to improve running performance:https://bjsm.bmj.com/content/54/13/813

Running repairs with James Alexander, get up to speed with the latest research. EP#518

Exercise Medicine and Physical Activity Promotion with Dr. Irfan Asif EP# 519
On this episode of the AMSSM Sports Medcast, host Dr. Devin McFadden, MD, is joined by Dr. Irfan Asif, MD, to discuss the topic of Exercise Medicine and Physical Activity Promotion.
 
Dr. Asif, who is the Chair of the AMSSM Collaborative Research Network, helped lead the 2021 Research Summit, which produced several publications and educational resources related to Exercise Medicine and Physical Activity Promotion. In this conversation, he addresses the following topics and questions:
•	A refresher on the 2021 Research Summit and the significant outcomes from that event
•	How the Exercise Medicine and Physical Activity Promotion Core Curricula originated
•	More details about the interactive and freely available Exercise Medicine & Physical Activity Promotion Modules
•	How can physicians and other medical faculty integrate these resources into their clinical practices?
•	Providing information about the upcoming 2023 Research Summit on Justice, Equity and Inclusion, which takes place in April 2023
•	Future publications, deliverables and other opportunities stemming from the 2021 Research Summit
 
Additional Resources
Exercise Medicine & Physical Activity Promotion Modules tinyurl.com/exercisemodules

Exercise Medicine and Physical Activity Promotion: Core Curricula for US Medical Schools, Residencies and Sports Medicine Fellowships https://bjsm.bmj.com/content/bjsports/56/7/369.full.pdf

Exercise Medicine and Physical Activity Promotion with Dr. Irfan Asif EP# 519

In this BJSM podcast Jackie Whittaker discusses the OPTIKNEE consensus clinical and research recommendations. Jackie is an Associate Professor in the Department of Physical Therapy, at the University of British Columbia. The OPTIKNEE initiative aims to shine the light on post-traumatic osteoarthritis after traumatic knee injury – who is most at risk, what should we be measuring and how, and what interventions should we be using? Jackie encourages clinicians to think about knee and overall health beyond the short-game of injury rehab and return to sport. There are some great tips on how you can set up patients at risk of post-traumatic osteoarthritis with the knowledge, skills, and motivation to self-manage in the long-term. 

OPTIKNEE Consensus Statement https://www.ncbi.nlm.nih.gov/pubmed/36379676
OPTIKNEE website and links to systematic reviews: bit.ly/OPTIKNEE

Don’t forget the long game after knee injury – OPTIKNEE consensus with Jackie Whittaker EP #520

In this podcast, Dr Brooke Patterson hosts ACL injury and post-traumatic osteoarthritis leading experts Ass. Prof Jackie Whittaker and Dr Stephanie Filbay in part 1 of an ACL myth busting series. In today’s episode you will find out if the following statements are TRUE or FALSE….
●	ACL reconstruction reduces the risk of osteoarthritis compared to non-surgical management 
●	Only patella tendon grafts get patellofemoral osteoarthritis after ACL reconstruction
●	Non-surgical management of an ACL injury increases the risk of future meniscal tears
●	Meniscal lesions at the time of ACL injury/surgery increases the risk osteoarthritis after ACL injury  
●	Higher BMI increases the risk of osteoarthritis after ACL injury
●	People can return to sport without having an ACL reconstruction for their ACL tear
●	Increased laxity increases the risk of osteoarthritis after ACL injury/surgery

Whittaker et al 2022 OPTIKNEE consensus statement https://www.ncbi.nlm.nih.gov/pubmed/36379676
Whittaker et al 2022 OPTIKNEE review of risk factors http://bjsm.bmj.com/content/early/2022/10/05/bjsports-2022-105496.abstract
OPTIKNEE website OPTIKNEE bit.ly https://bit.ly/OPTIKNEE

ACL MYTH BUSTING Part 1 with Prof Jackie Whittaker and Dr Stephanie Filbay EP# 521

In this podcast, Dr Brooke Patterson hosts ACL injury and post-traumatic osteoarthritis leading experts Ass. Prof Jackie Whittaker and Dr Stephanie Filbay in part 2 of an ACL myth busting series. Jackie and Steph provide tips about how you can integrate new evidence into daily practice that may challenge existing beliefs and practices. In today’s episode you will find out if the following statements are TRUE or FALSE….
• ACL tears can heal 
• ACL tears only heal if patients are braced immediately 
• Open chain knee extension exercises are safe to perform in the first 4 weeks after ACLR
• Returning to high impact sports increases the risk of PTOA after ACL injury
• Having an early ACL reconstruction will reduce the risk of future structural OA

Whittaker et al 2022 OPTIKNEE consensus statement https://www.ncbi.nlm.nih.gov/pubmed/36379676
Whittaker et al 2022 OPTIKNEE review of risk factors http://bjsm.bmj.com/content/early/2022/10/05/bjsports-2022-105496.abstract
Filbay et al 2022 ACL healing paper http://dx.doi.org/10.1136/bjsports-2022-105473
OPTIKNEE website OPTIKNEE bit.ly https://bit.ly/OPTIKNEE

ACL MYTH BUSTING Part 2 with Prof Jackie Whittaker and Dr Stephanie Filbay. EP #522

On this episode of the AMSSM Sports Medcast (T: @TheAMSSM) host Dr. Jacob Wessels, MD is joined by Polly de Mille, RN, MA, RCEP, CSCS, USAT, to discuss the topic of Exercise Physiology and how it can help figure out the missing links in training programs.
Polly de Mille is an exercise physiologist and the Director of Performance Services at Hospital for Special Surgery in New York. She will provide the American College of Sports Medicine (T: @ACSMNews) Exchange Lecture titled, “Inside the Running Lab:How to Evaluate Optimal Run Mechanics and Physiology” during the 2023 AMSSM Annual Meeting in Phoenix, AZ.

In this 20-minute conversation, she addresses the following topics:
·	Sharing more information about her work as a certified exercise 
 physiologist at HSS
·	How she and her team can help identify the causes of injuries and help athletes stay healthy in order to reach their goals
·	How her background as a critical care nurse and an avid marathoner led her into the field of exercise physiology
·	The ways she and her colleagues can help improve runner’s outcomes and how many different disciplines come together to play important roles to make that happen
·	The different types of tests used by exercise physiologists and how they use that information to improve performance
·	The possibilities of using nutrition to enhance physiologic training sessions

HSS Sports Rehabilitation and Performance Center: https://www.hss.edu/sports-rehabilitation-and-performance-center.asp

Exercise Physiology with Polly de Mille. EP #523

In this podcast, we host Dr Chloë Williamson (Twitter @Chlobobs). Chloë is a Postdoctoral Fellow in Physical Activity for Health based in the Physical Activity for Health Research Centre at the University of Edinburgh.  Her research (including PhD) over the past 4 years or so has focused on physical activity communication and messaging. We all know that physical activity is important but it is equally important to consider how PA messaging is delivered. Chloë  provides a great overview on the findings of her research to date and her work on the development of a translational tool to bring PA messaging research into practice. In this podcast, we discuss on:
The framework of PA messaging and how to use it
Key points to focus on and consider when delivering PA messages
How we can use the framework findings to engage different partners and organisations 
How we can make PA attractive to our target audience

Get the Message? A scoping review of physical activity messaging. https://ijbnpa.biomedcentral.com/articles/10.1186/s12966-020-00954-3

A modified Delphi study to enhance and gain international consensus on the Physical Activity Messaging Framework (PAMF) and Checklist (PAMC): https://ijbnpa.biomedcentral.com/articles/10.1186/s12966-021-01182-z

Physical Activity Messaging Framework (PAMF) and Checklist (PAMC): International consensus statement and user guide. https://ijbnpa.biomedcentral.com/articles/10.1186/s12966-021-01230-8

How can we better promote physical activity to the public through messaging? https://blogs.bmj.com/bjsm/2020/11/10/how-can-we-better-promote-physical-activity-to-the-public-through-messaging/

Infographic: Walking on sunshine: scoping review of the evidence for walking and mental health: https://bjsm.bmj.com/content/53/14/903

Let's Get Physical Activity Messaging Right With Dr Chloë Williamson EP# 524

BJSM’s Liam West talks to Dr. Richard Weiler about concussion in Para Sport. Dr. Weiler and colleagues have investigated concussion experiences of blind male footballers turning up some very interesting results. To ensure that these findings are accessible to visually impaired individuals, they have gone down the novel route of creating an audio file of the entire paper – the link for this can be found below.

Links -

"Concussion through my eyes" audio paper
https://on.soundcloud.com/XQb2T

Concussion in para sport: the first position statement of the Concussion in Para Sport (CIPS) Group - https://bjsm.bmj.com/content/55/21/1187

https://bjsm.bmj.com/content/early/2023/02/14/bjsports-2022-106256

BJSM Concussion through my eyes, Dr Richard Weiler on blind football and concussion. ep #525

On this episode of the AMSSM (T: @TheAMSSM) Sports Medcast, host Dr. Devin McFadden, MD (T: @ArmySportsDoc), is joined by Dr. Adam Tenforde, MD (T: @AdamTenfordeMD), to discuss the a recently published manuscript titled “Bone Stress Injuries in Runners Using Carbon Fiber Plate Footwear.”

In this conversation, Dr. Tenforde addresses the following topics related to the article:

●	Explanation of the use of Carbon Fiber Plate (CFP) technology in footwear and why it’s become so popular
●	Addressing the rapid changes and progression of record-breaking performance in the running community as a result of this footwear
●	Discussing his article featuring a case series of navicular bone stress injuries in runners using CFP footwear
●	Providing some general recommendations for safely using CFP footwear, as well as raising awareness on the possible health concerns of this new technology

Additional Resources:

Bone Stress Injuries in Runners Using Carbon Fiber Plate Footwear https://link.springer.com/article/10.1007/s40279-023-01818-z

Return to Sport Following Low-Risk and High-Risk Bone Stress Injuries: A Systematic Review and Meta-Analysis
https://bjsm.bmj.com/content/early/2023/01/24/bjsports-2022-106328

Potential Bone Stress Injuries in Runners Using Carbon Fiber Plate Footwear. EP# 526

In this BJSM Podcast, we host Associate Professor Hanna Lindblom, who is a physiotherapist, researcher, and lecturer at Linkoping University in Sweden. 

We discuss Hanna’s paper, which evaluated the preventive efficacy of an extended version of the Knee Control injury prevention exercise program compared with an adductor strength program in amateur adolescent and adult male and female football (soccer) players. 

Coaches and player representatives received a printed and digital program material, and a practical workshop to show them how to use the programs. 

The novelty of this trial is they also compared the extended Knee Control to a second comparison group; where the teams were where the teams already used a self-selected program and did not receive workshop or program material. Many of these comparison teams (50%) said they were self-using the old Knee Control program, providing a “real world” comparison and proven benefits of the Extended Knee Control program. 

Hanna has hands-on experience designing and delivering injury prevention in a range of sports and has some great advice for clinicians looking to implement Knee Control and similar programs in amateur sports settings. 

Paper link: https://bjsm.bmj.com/content/57/2/83.abstract

BJSM Real World Injury Prevention In Amateur Soccer With Hanna Lindblom. EP#527

In this podcast, Brooke Patterson hosts Dr Erik Denison (PhD, Research Fellow Monash University) and Neil Hay (Rugby Victoria President) about a trial published in the BJSM which tested the effectiveness of an education program delivered by professional rugby players designed to stop homophobic language. They discuss openly and honestly the challenges in changing behaviour in community sport. It is not too often we get to chat to sports administrators more broadly about what is needed to drive change – whether it be related to health, safety, inclusion, or diversity. Should we be using the carrot or stick? What other strategies might work? What is your role as a clinician in creating a safe environment? 

https://bjsm.bmj.com/content/early/2023/02/09/bjsports-2022-105916
https://bjsm.bmj.com/content/early/2023/02/07/bjsports-2022-105917

Carrot or Stick? Driving change to create safe sport spaces with Dr Erik Denison and Neil Hay EP#528

On this episode of the AMSSM Sports Medcast, host Dr. Jake Wessels, MD, is joined by Dr. Katie Rizzone, MD, MPH, and Dr. Megan Burleson, DO, to discuss the upcoming 2023 Collaborative Research Network (CRN) Research Summit on Justice, Equity and Inclusion.

Dr. Burleson and Dr. Rizzone are members of Summit Planning Committee for the one-day conference, which takes place Friday, April 28, in Phoenix, AZ. This conference, will emphasize specific areas within sports and exercise medicine where health disparities have been previously identified or where they need to be further investigated. It will also highlight best practices for conducting meaningful research in the field of sports and exercise medicine through an equity lens.

In this conversation, they address the following topics and questions:
* Origin and mission of the Collaborative Research Network
* The primary aims of the 2023 CRN Research Summit
* The current lack of available research regarding health disparities and how this conference seeks to explore those topics
* Some of the potential outcomes and future research directions of the Summit, and why they will be based on the conversations that happen during the conference
* The inclusive nature and applicability of the Research Summit, especially for clinicians who are not heavily involved in research
* Some of the biggest surprises the organizers have experienced while preparing for the Research Summit and the biggest highlights to look forward to

In-person and virtual attendance options are still available for the summit. Find complete details about the Research Summit and register here: https://annualmeeting.amssm.org/researchsummit.php

Examining Health Disparities in SEM with Drs. Megan Burleson and Katie Rizzone. EP#529

On this episode of the AMSSM (T: @TheAMSSM) Sports Medcast, host Dr. Jake Wessels, MD, is joined by Dr. Stacy Sims, MSc, PhD (Insta: @drstacysims), to discuss her upcoming lectures on how nutrition affects performance during the 2023 AMSSM Annual Meeting.

Dr. Sims is an international exercise physiologist and nutrition scientist. She has directed research programs at Stanford, AUT University, and the University of Waikato, focusing on female athlete health and performance and pushed to improve research on all women. Her contributions to the international research environment and the sports nutrition industry has established a new niche in sports nutrition; and established her reputation as the expert in sex differences in training, nutrition and health. Dr. Sims has published over 70 peer-reviewed papers and several books.

In this conversation, Dr. Sims addresses the following topics:
* How her athletic background impacted her journey into the field of nutrition and performance
* Sharing a starting point for medical professionals to think about optimizing nutrition for athletes
* Ways to encourage athletes to be aware of their nutrition and how to effectively structure training sessions and nutritional plans
* Her standard approach on supplementation and why less can often be more

Learn more about her work and publications on her website (drstacysims.com), and register to attend the 2023 AMSSM Annual Meeting in-person or virtually at annualmeeting.amssm.org.

Using Nutrition to Optimize Performance with Dr. Stacy Sims. EP#530

Dr Kerry Costello and Dr Deepak Kumar discuss a BSJM paper that investigated gait and physical activity predictors of cartilage worsening in people with knee osteoarthritis from the MOST study, using a machine learning model. Kerry and Deepak do a brilliant job of explaining the biomechanical variables, and the advantages of machine learning, and what these findings might mean for clinicians treating people with knee osteoarthritis. 

Link to paper: https://bjsm.bmj.com/content/early/2023/03/02/bjsports-2022-106142
Connect with Kerry: https://mae.ufl.edu/people/faculty/primary/profiles/kerry-costello/

BJSM

BMJ talk medicine