Background and Purpose-Early treatment is a critical determinant of successful intervention in acute stroke. The study was designed to find current patterns of stroke care by determining delays in time from onset of signs or symptoms to arrival at the emergency department and to initial evaluation by physicians and by identifying factors associated with these delays. Methods-Data were prospectively collected by nurses and physicians from patients, patients' family members, and medical records from 10 hospitals of the Robert Wood Johnson Health System in New Jersey. Results-A total of 553 patients who presented with signs or symptoms of acute stroke were studied. Thirty-two percent of patients arrived at the emergency department within 1.5 hours of stroke onset. Forty-six percent of patients arrived within 3 hours and 61% within 6 hours. Delays in arrival time were significantly associated with sex, race, transportation mode, and history of cardiovascular disease. Patients arriving by ambulance were more likely to present earlier (odds ratio [OR] 3.7 for arrival within 3 hours; OR 4.5 for arrival within 6 hours). Patients arriving by ambulance (OR 2.3 within 15 minutes; OR 1.7 within 30 minutes) and those requiring admission to intensive care units (OR 4.5 within 15 minutes and OR 5.2 within 30 minutes) were examined sooner by physicians. Conclusions-Despite national efforts to promote prompt stroke evaluation and treatment, significant delays still exist. The lack of improvement throughout the past decade underscores the need for implementation of effective public health programs designed to minimize the time to evaluation and treatment of stroke.

Attribution theory deals with how individuals infer causality between events and has been used to explain various social psychological phenomena such as achievement, sex stereotyping, and the impact of reward on behavior. But the direct application of the theory to entrepreneurship has been made only recently. The present study tests for the existence of a self-serving attribution bias among entrepreneurs when they enumerate the factors that contribute to or impede their business success as well as for the presence of an actor-observer attribution bias. Three samples are compared. Two are samples of entrepreneurs: one of independent pharmacists and the other a broadly based sample of business owners. A third sample is of experts. The presence of a self-serving attribution bias is shown in the two business owners' samples. In addition, clear differences are shown between the entrepreneurs and the experts, confirming the expectation of an actor-observer attribution bias.

When supported by their practice environments, nurses employ practices that can assist in interrupting medication errors before they reach the patients.

Understanding the impact of patient factors on blood pressure (BP) management is an important step to developing interventions to improve cardiovascular health. The National Health and Nutrition Examination Survey (NHANES) 1999-2002 was used to identify predictors of hypertension awareness, treatment, and control. An estimated 63.3 million (31.0%) US adults currently have BP exceeding 140/90 mm Hg, and prevalence is higher for blacks than for other racial/ethnic subgroups. Among antihypertensive medication-treated patients, 51.3% are controlled. Treated blacks and Mexican Americans have the lowest rates of BP control. Mexican Americans are 0.62 times as likely to be aware and 0.61 times as likely to be treated as white persons with hypertension. Compared with whites, treated Mexican Americans are 0.71 times as likely and treated blacks 0.59 times as likely to achieve BP control. Hypertension treatment and BP control in the United States remain suboptimal, and significant racial/ethnic disparities persist. Effective interventions targeting Mexican Americans and blacks as well as whites are essential to improving hypertension management.