The aim of this study is to explore family members' perceptions of their immediate needs following admission of a relative to a critical care unit in Hong Kong. A convenience sample of 30 family members was drawn from those available during the first 96 hours of hospitalization of their relative. Self-reported questionnaires, consisting of a demographic data sheet, a modified Chinese version of the 45-item Critical Care Family Needs Inventory (CCFNI) and semistructured interviews, are the instruments used to examine family members' perceptions of need importance and to ascertain whether or not these needs are met. Doctors and nurses are identified as the most suitable people to meet most immediate family needs. Conclusions are drawn as to the best focus of nursing interventions in order to provide quality care to patients and families.

Medicare-eligible physicians at primary care practices (PCP) that did not implement an electronic health record (EHR) system by the end of 2015 face stiff penalties. One year prior to the 2015 deadline, approximately half of all primary clinics have not implemented a basic EHR system. The purpose of this phenomenology study was to explore rural primary care physicians and physician assistants’ experiences regarding overcoming barriers to implementing EHRs. Complex adaptive systems formed the conceptual framework for this study. Data were collected through face-to-face interviews with a purposeful sample of 21 physicians and physician assistants across 2 rural PCPs in the southeastern region of Missouri. Participant perceptions were elicited regarding overcoming barriers to implementing EHRs systems as manadated by federal legislation. Interview questions were transcribed and processed through qualitative software to discern themes of how rural PCP physicians and physician assistants might overcome barriers to implementing electronic health records. Through the exploration of the narrative segments, 4 emergent themes were common among the participants including (a) limited finances to support EHRs, (b) health information exchange issues, (c) lack of business education, and (d) lack of change management at rural medical practices. This study may provide rural primary care physicians and administrators with strategies to promote the adoption of EHRs, provide cost efficient business services, and improve change management plans.

Preventable medical errors result in the loss of 200,000 lives per year with associated financial and operational burdens on organizations and society. Widespread preventable patient harm occurs despite increases in healthcare regulations. High reliability organization theory contributes to improved safety and may potentially reverse this trend. This single case study explored the introduction of a safety culture and subsequent improvements in patient safety in a reliability-seeking organization. Fourteen participants from a subacute nursing facility were selected using purposeful sampling criterion. Data were collected through participant interviews, document reviews, and group observation. Five themes emerged from an analysis of collected data including process standardization, checks and redundancy, authority migration, communication, and teamwork. The themes uncovered the need for extensive education and training, communication, and teamwork to improve patient safety. The results of the study may be useful to improve safety and enhance leadership to promote a culture of safe patient care.

Using stock market and economic data from 1900 to 2008 from 27 separate presidential administrations in the United States (U.S.), including 15 Republican and 12 Democratic, this paper examines the relationships between the market return after each Election Day and economic performance during the presidential term. Using the theoretical framework of political economy, the authors examine how Wall Streets reaction to a presidential election acts as a predictive measure of future economic performance. The analysis shows that the after-election market movement has progressively been more accurate in predicting the future Gross Domestic Product (GDP) growth but not the future unemployment rates. Given that the results show a higher correlation over time, the model appears to provide a good starting point for judging the economic potential of future presidential administrations.

The behavior of the long-term interest rates is a practical problem for private and public organizations. Organizations need to estimate interest rates for purposes of assigning value to long-term obligations such as defined benefit plans and long-term leases and making decisions related to long term capital purchases. The purpose of this study was to analyze the determinants of long-term interest rates in the United INTRODUCTIONconomists and practitioners are interested in how to predict trends long-term interest rates (LTI) and interest rates trends (Wade, 2010). The ability to understand interest rate trends is of interest to policymakers, financial analysts, corporation leaders, and individuals who must make decisions based upon future interest rates (Adrian & Shin, 2009;Blinder, 2010;Wade, 2010). LTI affect key interest-rate sensitive sectors of the U.S. economy, such as housing, auto, and investment; interest rates also affect corporate decisions related to pension and asset valuation (Saher & Herbert, 2010).Especially since the beginning of our current financial crisis starting in 2007, it is clear that interest rates impact the economic recovery. Unfortunately, the lack of accurate information related to future trends of LTI impairs the ability of organizations to accurately plan for the future (Adrian & Shin, 2009). Policymakers, financial analysts, and organizations need to make specific decisions that are based, in part, on future interest rates trends.Understanding determinants of LTI is critical for individuals who make decisions based upon LTI trends. The goal of this study is to increase our understanding of determinants of LTI in the United States by extending prior research by Saher and Herbert (2010) who examine determinants of LTI in Pakistan.We examine the relationship between LTI (30-year U.S. Treasury constant securities rate) and overnight interest rate along with other key macroeconomic variables including GDP, inflation, net capital inflow, and budget deficit for the United States during a period from 1999-2009. We conduct our analysis in three steps: (a) a Johansen co-integration test (Johansen, 1988), (b) time series regression analysis with normalized co-integration coefficients, and finally (c) time series regression analysis with a vector error correction model to test our hypothesis. We find that overnight interest rates, budget deficit, net capital inflow, and inflation positively affect long-term interest rate whereas GDP negatively affects the long-term interest rate. In addition, our results indicate that overnight interest rates, inflation, net capital inflow, budget deficit, and GDP jointly explain, in part, the behavior of long-term interest LTI in the United States. 258 © 2012 The Clute InstituteThis study contributes to the understanding of determinants of LTI. In addition, this study has a direct impact on accounting and finance. Accounting practitioners need to develop models that predict LTI for the financial statements presentation of long-term debt obligatio...