Moneyworks, from Cognito Software in New Zealand. It works like a manual system, whilst harnessing the power of a computer. It works for me. My largest client handles her own A/P and A/R so I just maintain the nominal ledger. Their entry-level software is designed for US cash basis and can, of course, be used for accrual basis. My other business clients have no need for other than nominal ledger. Their basic offering is free. You just have to sign up for a trial then convert it - you can't "buy" it directly.
Now that Acclivity is ending support for the Mac, this is the only desktop software I am aware of that supports communication between Mac and PC.