{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T07:37:33Z","timestamp":1777448253463,"version":"3.51.4"},"reference-count":20,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2023,5,6]],"date-time":"2023-05-06T00:00:00Z","timestamp":1683331200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Robert T. Jones Program"},{"name":"National Institute of Health","award":["NIH T32 Training Grant in Critical Care, NIGMS (5T"],"award-info":[{"award-number":["NIH T32 Training Grant in Critical Care, NIGMS (5T"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The American Surgeon\u2122"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Despite a high prevalence of retained bullet fragments (RBFs) after firearm related injury (FRI) there is limited data on the full spectrum of their consequences, particularly the psychological impacts on those injured. Further, the experiences of FRI survivors with RBFs are missing from existing literature. The objective of this study was to explore the psychological impacts of RBFs on individuals who have experienced recent FRI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Adult (18-65\u00a0years) survivors of FRI with radiographically confirmed RBFs were purposively selected from an urban Level 1 trauma center in Atlanta, Georgia, to participate in an in-depth interview. Interviews were conducted between March 2019 and February 2020. Thematic analysis was used to identify a range of psychological effects from RBFs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Interviews from 24 FRI survivors were analyzed: the majority of participants were Black males (N = 22, 92%) with a mean age of 32\u00a0years whose FRI occurred \u223c8.6\u00a0months prior to data collection. The psychological effects of RBFs were grouped into four categories: physical health (eg, pain, limited mobility), emotional well-being (eg, anger, fear), social isolation, and occupational welfare (eg, disability leading to inability to work). A range of coping mechanisms were also identified.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Survivors of FRI with RBFs experience a range of psychological impacts that are far-reaching and affect daily activities, mobility, pain and emotional wellbeing. Study results indicate a need for enhanced resources to support those with RBFs. Further, changes to clinical protocols are warranted on removal of RBFs and communication about the effects of leaving RBFs in situ.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00031348231171121","type":"journal-article","created":{"date-parts":[[2023,5,6]],"date-time":"2023-05-06T10:55:17Z","timestamp":1683370517000},"page":"3732-3738","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Psychological Impacts of Retained Bullets From the Perspective of Survivors"],"prefix":"10.1177","volume":"89","author":[{"given":"R. N.","family":"Smith","sequence":"first","affiliation":[{"name":"Emory University School of Medicine, Atlanta, GA, USA"},{"name":"Grady Health System, Atlanta, GA, USA"},{"name":"Rollins School of Public Health, Emory University, Atlanta, GA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R. M.","family":"Nedergaard","sequence":"additional","affiliation":[{"name":"Rollins School of Public Health, Emory University, Atlanta, GA, USA"},{"name":"National Health Service, South East London, England, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C. H.","family":"Meyer","sequence":"additional","affiliation":[{"name":"Emory University School of Medicine, Atlanta, GA, USA"},{"name":"Grady Health System, Atlanta, GA, USA"},{"name":"Rollins School of Public Health, Emory University, Atlanta, GA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"N.","family":"DeSousa","sequence":"additional","affiliation":[{"name":"Emory University School of Medicine, Atlanta, GA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Ghosh","sequence":"additional","affiliation":[{"name":"Rollins School of Public Health, Emory University, Atlanta, GA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Q.","family":"Blount","sequence":"additional","affiliation":[{"name":"Emory University School of Medicine, Atlanta, GA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Apte","sequence":"additional","affiliation":[{"name":"Emory University School of Medicine, Atlanta, GA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Resnick","sequence":"additional","affiliation":[{"name":"Kaiser Permanente, Sacramento, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M. M.","family":"Hennink","sequence":"additional","affiliation":[{"name":"Rollins School of Public Health, Emory University, Atlanta, GA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2023,5,6]]},"reference":[{"key":"bibr1-00031348231171121","unstructured":"Centers for Disease Control and Prevention. https:\/\/www.cdc.gov\/nchs\/fastats\/injury.htm. https:\/\/www.cdc.gov\/nchs\/fastats\/injury.htm Accessed January 20, 2023."},{"key":"bibr2-00031348231171121","doi-asserted-by":"publisher","DOI":"10.7326\/M21-2812"},{"key":"bibr3-00031348231171121","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2021.05.022"},{"key":"bibr4-00031348231171121","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000003089"},{"key":"bibr5-00031348231171121","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000002287"},{"key":"bibr6-00031348231171121","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwh074"},{"key":"bibr7-00031348231171121","doi-asserted-by":"publisher","DOI":"10.1186\/1752-1947-1-171"},{"key":"bibr8-00031348231171121","doi-asserted-by":"publisher","DOI":"10.1097\/JTN.0b013e31827757a7"},{"key":"bibr9-00031348231171121","doi-asserted-by":"publisher","DOI":"10.1520\/JFS2003133"},{"key":"bibr10-00031348231171121","doi-asserted-by":"publisher","DOI":"10.1111\/j.1553-2712.1999.tb00157.x"},{"key":"bibr11-00031348231171121","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-200210000-00031"},{"key":"bibr12-00031348231171121","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.9844"},{"key":"bibr13-00031348231171121","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-198466020-00018"},{"key":"bibr14-00031348231171121","doi-asserted-by":"publisher","DOI":"10.1007\/s002689900288"},{"key":"bibr15-00031348231171121","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-199131080-00007"},{"key":"bibr16-00031348231171121","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2017.08.057"},{"key":"bibr17-00031348231171121","unstructured":"Georgia Trauma Foundation. accessed January 30, 2023:http:\/\/georgiatraumafoundation.org\/trauma-locations\/"},{"key":"bibr18-00031348231171121","doi-asserted-by":"publisher","DOI":"10.1177\/0886260520914557"},{"key":"bibr19-00031348231171121","doi-asserted-by":"publisher","DOI":"10.1016\/j.burns.2022.05.001"},{"issue":"6","key":"bibr20-00031348231171121","first-page":"442","volume":"11","author":"Shen W","year":"2021","journal-title":"Int J Burns Trauma"}],"container-title":["The American Surgeon\u2122"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348231171121","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/00031348231171121","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348231171121","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T12:37:27Z","timestamp":1777379847000},"score":1,"resource":{"primary":{"URL":"http:\/\/journals.sagepub.com\/doi\/10.1177\/00031348231171121"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5,6]]},"references-count":20,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2023,9]]}},"alternative-id":["10.1177\/00031348231171121"],"URL":"https:\/\/doi.org\/10.1177\/00031348231171121","relation":{},"ISSN":["0003-1348","1555-9823"],"issn-type":[{"value":"0003-1348","type":"print"},{"value":"1555-9823","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,5,6]]}}}