Variation In Decisions Research Articles

What influences ambulance clinician decisions to pre-alert emergency departments: a qualitative exploration of pre-alert practice in UK ambulance services and emergency departments

BackgroundAmbulance clinicians use pre-alerts to inform receiving hospitals of the imminent arrival of a time-critical patient considered to require immediate attention, enabling the receiving emergency department (ED) or other clinical...

Entrepreneurs’ Variability in Decision-Making and Downstream Consequences for Behavioral Proactivity

Entrepreneurs’ Variability in Decision-Making and Downstream Consequences for Behavioral Proactivity

Primary Elbow Arthroplasty in the Management of Complex Distal Humerus Fractures.

Introduction Complex distal humerus fractures pose significant challenges in orthopedic surgery, especially when traditional open reduction and internal fixation (ORIF) is not feasible. Primary elbow arthroplasty has emerged as an alternative treatment option for these fractures, but its application remains limited. This study aimed to evaluate the functional outcomes, patient selection criteria, and follow-up results of primary elbow arthroplasty in the management of complex distal humerus fractures. Methods A retrospective review was conducted on 15 patients who underwent primary elbow arthroplasty for Orthopaedic Trauma Association (OTA) type C distal humerus fractures between 2017 and 2023 at our institution. Inclusion criteria were patients aged 18 years or older who were offered either total elbow or hemiarthroplasty for acute complex distal humerus fracture. Data were collected from patient medical records, including demographic information, fracture classification, surgical details, and postoperative follow-up. Functional outcomes were assessed using the Oxford Elbow Score (OES) and Mayo Elbow Performance Score (MEPS). Complications were documented, and descriptive statistics were used to summarise the findings. Results The mean age of the patients was 71.8 years (IQR 17 years), with 12 females and three males. The mean time to surgery was 14.7 days post-injury (IQR: 12 days). The mean follow-up duration was 52 weeks (range: 8-234 weeks, IQR: 27 weeks) and variability was noted. The mean flexion-extension arc at the final follow-up was 93° (IQR: 32.5°). The mean OES was 46 (IQR: 22), and the mean MEPS was 75 (IQR: 37), indicating good to excellent functional outcomes. Scores for two patients were not available due to dementia. Reported complications included one case of ulnar sensory symptoms and one case requiring metalwork removal following olecranon osteotomy. Conclusion Primary elbow arthroplasty provides a viable treatment option for complex distal humerus fractures, demonstrating significant functional improvements and high patient satisfaction. However, the variability in follow-up and subjective decision-making underscores the need for standardized protocols. Future multicenter, prospective studies with larger cohorts and standardized follow-up protocols are recommended to confirm these findings and optimize patient care.

The Complex Interplay of Variables in Extubation Decision-Making Following Pediatric Cardiac Surgery: A Narrative Review.

Pediatric cardiac surgery poses significant challenges in developing countries, where a considerable number of children require intervention for congenital heart disease (CHD). The utilization of endotracheal intubation and anesthesia is pivotal in conducting surgical or angiography procedures on patients with CHD exhibiting diverse anatomical and hemodynamic characteristics. The decision to extubate pediatric patients following cardiac surgery remains a crucial element of postoperative care. This article explores the complexities surrounding extubation decision-making in this population, emphasizing the critical role of surgical, physiological, and postoperative factors. Various preoperative and intraoperative factors influence the timing of extubation. Early extubation is increasingly prevalent, offering benefits like reduced length of stay and minimized drug exposure. Multidisciplinary collaboration and protocol-driven strategies contribute to improved extubation outcomes, emphasizing the need for a comprehensive approach in pediatric cardiac surgery. Future research can focus on the implementation and efficacy of standardized extubation procedures involving collaboration among healthcare experts.

How to Define and Meet Blood Pressure Targets After Traumatic Brain Injury: A Narrative Review

BackgroundTraumatic brain injury (TBI) poses a significant challenge to healthcare providers, necessitating meticulous management of hemodynamic parameters to optimize patient outcomes. This article delves into the critical task of defining and meeting continuous arterial blood pressure (ABP) and cerebral perfusion pressure (CPP) targets in the context of severe TBI in neurocritical care settings.MethodsWe narratively reviewed existing literature, clinical guidelines, and emerging technologies to propose a comprehensive approach that integrates real-time monitoring, individualized cerebral perfusion target setting, and dynamic interventions.ResultsOur findings emphasize the need for personalized hemodynamic management, considering the heterogeneity of patients with TBI and the evolving nature of their condition. We describe the latest advancements in monitoring technologies, such as autoregulation-guided ABP/CPP treatment, which enable a more nuanced understanding of cerebral perfusion dynamics. By incorporating these tools into a proactive monitoring strategy, clinicians can tailor interventions to optimize ABP/CPP and mitigate secondary brain injury.DiscussionChallenges in this field include the lack of standardized protocols for interpreting multimodal neuromonitoring data, potential variability in clinical decision-making, understanding the role of cardiac output, and the need for specialized expertise and customized software to have individualized ABP/CPP targets regularly available. The patient outcome benefit of monitoring-guided ABP/CPP target definitions still needs to be proven in patients with TBI.ConclusionsWe recommend that the TBI community take proactive steps to translate the potential benefits of personalized ABP/CPP targets, which have been implemented in certain centers, into a standardized and clinically validated reality through randomized controlled trials.

Pengaruh Green Marketing dan Green Consumerism Terhadap Keputusan Pembelian Produk Ramah Lingkungan

The issue of plastic waste in Indonesia has reached alarming levels with annual production reaching 64 million tons, the majority of which ends up in the oceans, making Indonesia the second largest contributor to global marine plastic pollution after China. Increasing awareness and reducing daily waste generation are crucial to protecting the environment from the serious impacts of plastic's slow decomposition. This research employed accidental sampling with 20 to 30 respondents to investigate the influence of green marketing and green consumerism on purchasing decisions of environmentally friendly products. Data analysis included data exploration to identify patterns and trends, and Ordinary Least Squares (OLS) regression testing to evaluate the linear relationship between independent variables (green marketing and green consumerism) and the dependent variable (purchase decision). The results of multiple linear regression analysis indicate that the Green Consumerism variable (X2) has a positive regression coefficient of 0.260, although it is not statistically significant (p = 0.148), suggesting that consumer adoption of environmentally friendly behavior marginally contributes to purchasing decisions of environmentally friendly products. However, the low Adjusted R Square (0.031) indicates that the model only explains approximately 3.1% of the variability in purchase decisions. Therefore, companies need to consider other factors such as price and product quality, and integrate more holistic marketing strategies to enhance consumer preference for environmentally friendly products. Further research using more sensitive analytical methods could provide deeper insights to support more effective decision-making in dynamic markets.

Litigation in access to universal health coverage for children and adolescents in Brazil.

Brazil's Unified Health System (SUS) ensures universal, equitable, and excellent quality health coverage for all. The broad right to health, supported by the Constitution, has led to excessive litigation in the public sector. This has negatively impacted the financial stability of SUS, created inequality in children and adolescents' access to healthcare, and affected communication between the healthcare system and the judiciary. The enactment of Law Number 13.655 on 25 April 2018, proposed significant changes in judicial decisions. This study aimed to investigate decision-making changes in health litigation involving children and adolescents following the implementation of the new normative model. The study is cross-sectional, analyzing 3753 national judgment documents from all State Courts of Brazil, available on their respective websites from 2014 to 2020. It compares regional legal decisions before and after the promulgation of Law Number 13.655/2018. Data tabulation, statistical analysis, textual analysis, coding, and counting of significant units in the collected documents were performed. The results of data cross-referencing are presented in tables and diagrams. The majority (96.86%) of legal claims (3635 cases) received partial or total provision of what was prescribed by the physician. The Judiciary predominantly handled these cases individually. The analysis indicates that the decisions made did not adhere to the norms established in 2018. Regional heterogeneity in health litigation was observed, and there was no significant variability in decisions during the studied period, even after the implementation of the new normative paradigm in 2018. Technical-scientific support was undervalued by the magistrates. Prioritizing litigants undermines equity in access to Universal Health Coverage for children and adolescents.

Surgeon perceptions of personality as an influencing factor on anastomotic decision-making: A qualitative analysis.

Surgeon personality is a factor influencing rectal anastomotic decision-making. However, it is unclear how or why this may be the case, or what aspects of personality are involved. The aim of this study was to investigate the views of colorectal surgeons on how their individual personality may influence variation in anastomotic decision-making. Purposive sampling was used to invite certified UK-based colorectal surgeons to participate, with individual interviews used for data collection. Participants were recruited until ongoing data review indicated no new codes were generated (i.e. data sufficiency). Data were analysed thematically following Braun and Clarke's six-step framework. Seventeen colorectal surgeons (eight female, nine male) participated. Two key themes relating to personality and decision-making were identified: (1) surgeon development and training and (2) patient-surgeon interactions, each with relevant subthemes. Surgeons described how their personality may influence patients' postoperative outcomes (e.g. decision-making, team working and communication) and potential mechanisms for how their personality may influence operative risk-taking. Following anastomotic leakage, surgeons described a disproportionate sense of guilt and responsibility. There appears to be a significant transition in responsibility from trainee to newly appointed consultant, which may be part of the 'hidden curriculum' of surgical training. Colorectal surgeons have described their perceptions of how personality traits may impact variation in decision-making and patient outcomes for the first time. Early career surgeons felt ill-prepared for the level of guilt experienced when managing complications. Surgeons appear open to personality assessment if this was through an educational lens, with the aim of improving decision-making following complications and overall performance.

Diagnostic Decision-Making Variability Between Novice and Expert Optometrists for Glaucoma: Comparative Analysis to Inform AI System Design.

While expert optometrists tend to rely on a deep understanding of the disease and intuitive pattern recognition, those with less experience may depend more on extensive data, comparisons, and external guidance. Understanding these variations is important for developing artificial intelligence (AI) systems that can effectively support optometrists with varying degrees of experience and minimize decision inconsistencies. The main objective of this study is to identify and analyze the variations in diagnostic decision-making approaches between novice and expert optometrists. By understanding these variations, we aim to provide guidelines for the development of AI systems that can support optometrists with varying levels of expertise. These guidelines will assist in developing AI systems for glaucoma diagnosis, ultimately enhancing the diagnostic accuracy of optometrists and minimizing inconsistencies in their decisions. We conducted in-depth interviews with 14 optometrists using within-subject design, including both novices and experts, focusing on their approaches to glaucoma diagnosis. The responses were coded and analyzed using a mixed method approach incorporating both qualitative and quantitative analysis. Statistical tests such as Mann-Whitney U and chi-square tests were used to find significance in intergroup variations. These findings were further supported by themes extracted through qualitative analysis, which helped to identify decision-making patterns and understand variations in their approaches. Both groups showed lower concordance rates with clinical diagnosis, with experts showing almost double (7/35, 20%) concordance rates with limited data in comparison to novices (7/69, 10%), highlighting the impact of experience and data availability on clinical judgment; this rate increased to nearly 40% for both groups (experts: 5/12, 42% and novices: 8/21, 42%) when they had access to complete historical data of the patient. We also found statistically significant intergroup differences between the first visits and subsequent visits with a P value of less than .05 on the Mann-Whitney U test in many assessments. Furthermore, approaches to the exam assessment and decision differed significantly: experts emphasized comprehensive risk assessments and progression analysis, demonstrating cognitive efficiency and intuitive decision-making, while novices relied more on structured, analytical methods and external references. Additionally, significant variations in patient follow-up times were observed, with a P value of <.001 on the chi-square test, showing a stronger influence of experience on follow-up time decisions. The study highlights significant variations in the decision-making process of novice and expert optometrists in glaucoma diagnosis, with experience playing a key role in accuracy, approach, and management. These findings demonstrate the critical need for AI systems tailored to varying levels of expertise. They also provide insights for the future design of AI systems aimed at enhancing the diagnostic accuracy of optometrists and consistency across different expertise levels, ultimately improving patient outcomes in optometric practice.

An ecological assessment of decision-making under risk and ambiguity through the virtual serious game Kalliste Decision Task

Traditional methods for evaluating decision-making provide valuable insights yet may fall short in capturing the complexity of this cognitive capacity, often providing insufficient for the multifaceted nature of decisions. The Kalliste Decision Task (KDT) is introduced as a comprehensive, ecologically valid tool aimed at bridging this gap, offering a holistic perspective on decision-making. In our study, 81 participants completed KDT alongside established tasks and questionnaires, including the Mixed Gamble Task (MGT), Iowa Gambling Task (IGT), and Stimulating & Instrumental Risk Questionnaire (S&IRQ). They also completed the User Satisfaction Evaluation Questionnaire (USEQ). The results showed excellent usability, with high USEQ scores, highlighting the user-friendliness of KDT. Importantly, KDT outcomes showed significant correlations with classical decision-making variables, shedding light on participants’ risk attitudes (S&IRQ), rule-based decision-making (MGT), and performance in ambiguous contexts (IGT). Moreover, hierarchical clustering analysis of KDT scores categorized participants into three distinct profiles, revealing significant differences between them on classical measures. The findings highlight KDT as a valuable tool for assessing decision-making, addressing limitations of traditional methods, and offering a comprehensive, ecologically valid approach that aligns with the complexity and heterogeneity of real-world decision-making, advancing research and providing insights for understanding and assessing decision-making across multiple domains.

How Healthcare Providers Decide on a Referral Location in Telephone Triage: A Cross-sectional Study.

Approximately 25% of patients that present to the emergency department (ED) do so after contact with a healthcare professional. Many of these patients could be effectively managed in non-ED ambulatory settings. Aligning patients with safe and appropriate outpatient care has the potential to improve ED overcrowding, patient experience, outcomes, and costs. Little is understood about how healthcare providers approach triage decision-making and what factors influence their choices. To evaluate how providers think about patient triage, and what factors influence their decision-making when triaging patient calls. Cross-sectional survey-based study in which participants make triage decisions for hypothetical clinical scenarios. Healthcare providers in the specialties of internal medicine, family medicine, or emergency medicine within a large integrated healthcare system in the Southeast. Differences in individual training and practice characteristics were used to compare observed differences in triage outcomes. Free-response data were evaluated to identify themes and factors affecting triage decisions. Out of 72 total participants, substantial variability in triage decision-making was observed among all patient cases. Attending physicians triaged 1.4 fewer cases to ED care compared with resident physicians (p < 0.001, 95% CI 0.62-2.1). Academic attendings demonstrated a trend toward fewer cases to ED care compared with community attendings (0.61, p = 0.188, 95% CI - 0.31-1.5). Qualitative data highlighted the complex considerations in provider triage and led to the development of a novel conceptual model to describe the cognitive triage process and the main influencing factors. Triage decision-making for healthcare providers is influenced by many factors related to clinical resources, care coordination, patient factors, and clinician factors. The complex considerations involved yield variability in triage decisions that is largely unexplained by descriptive physician factors.

ATP dependence of decision-making capacity in a fine-grained model of gene regulatory networks

Cellular decision-making is fundamental to life, from developmental biology to environmental responses and antimicrobial resistance. Many regulatory processes that drive cellular decisions rely on gene expression, which requires energy in the form of ATP. As even genetically identical cells can have dramatically different ATP levels, bioenergetic status can be an important source of variability in cellular decision-making. Existing studies have investigated this energy dependence but often use coarse-grained modelling approaches (which are not always readily connected to the underlying molecular processes of gene regulation). Here, we use a fine-grained mathematical model of gene expression in a two-gene decision-making regulatory network to explore cellular decision-making capacity as energy availability varies. We simulate both a deterministic model, to explore the emergence of different cell fate attractors as ATP levels vary, and a stochastic case to explore how ATP influences the noisy dynamics of stochastic cell decision-making. Higher energy levels typically support increased decision-making capacity (higher numbers of, and more separated, cell states that can be selected), and the fine-grained modelling reveals some differences in behaviour from previous coarse-grained modelling approaches.

Evaluation of different machine learning algorithms for extraction decision in orthodontic treatment.

The extraction decision significantly affects the treatment process and outcome. Therefore, it is crucial to make this decision with a more objective and standardized method. The objectives of this study were (1) to identify the best-performing model among seven machine learning (ML) models, which will standardize the extraction decision and serve as a guide for inexperienced clinicians, and (2) to determine the important variables for the extraction decision. This study included 1000 patients who received orthodontic treatment with or without extraction (500 extraction and 500 non-extraction). The success criteria of the study were the decisions made by the four experienced orthodontists. Seven ML models were trained using 36 variables; including demographic information, cephalometric and model measurements. First, the extraction decision was performed, and then the extraction type was identified. Accuracy and area under the curve (AUC) of the receiver operating characteristics (ROC) curve were used to measure the success of ML models. The Stacking Classifier model, which consists of Gradient Boosted Trees, Support Vector Machine, and Random Forest models, showed the highest performance in extraction decision with 91.2% AUC. The most important features determining extraction decision were maxillary and mandibular arch length discrepancy, Wits Appraisal, and ANS-Me length. Likewise, the Stacking Classifier showed the highest performance with 76.3% accuracy in extraction type decisions. The most important variables for the extraction type decision were mandibular arch length discrepancy, Class I molar relationship, cephalometric overbite, Wits Appraisal, and L1-NB distance. The Stacking Classifier model exhibited the best performance for the extraction decision. While ML models showed a high performance in extraction decision, they could not able to achieve the same level of performance in extraction type decision.

An evaluation of ChatGPT compared with dermatological surgeons' choices of reconstruction for surgical defects after Mohs surgery.

ChatGPT is an open-access chatbot developed using artificial intelligence (AI) that generates human-like responses. To evaluate the ChatGPT-4's concordance with three dermatological surgeons on reconstructions for dermatological surgical defects. The cases of 70 patients with nonmelanoma skin cancer treated with surgery were obtained from clinical records for analysis. A list of 30 reconstruction options was designed by the main authors that included primary closure, secondary skin closure, skin flaps and skin grafts. Three dermatological surgeons who were blinded to the real reconstruction, along with ChatGPT-4, were asked to select two reconstruction options from the list. Seventy responses were analysed using Cohen's kappa, looking for concordance between each dermatologist and ChatGPT. The level of agreement among dermatological surgeons was higher compared with that between dermatological surgeons and ChatGPT, highlighting differences in decision making. In the selection of the best reconstruction technique, the results indicated a fair level of agreement among the dermatologists, ranging between κ 0.268 and 0.331. However, the concordance between ChatGPT-4 and the dermatologists was slight, with κ values ranging from 0.107 to 0.121. In the analysis of the second-choice options, the dermatologists showed only slight agreement. In contrast, the level of concordance between ChatGPT-4 and the dermatologists was below chance. As anticipated, this study reveals variability in medical decisions between dermatological surgeons and ChatGPT. Although these tools offer exciting possibilities for the future, it is vital to acknowledge the risk of inadvertently relying on noncertified AI for medical advice.

The Influence of Prices and the Application of Shopee Live Features on Consumer Purchase Decisions on the Shoppe Marketplace in Kediri City

The quicker innovative improvement makes businesses develop, one of which is E-Commerce. Ecommerce makes it simpler for buyers to shop. Cost is one important variables in customer purchase decision. To attract the attention of buyers, e-commerce is progressively creating its features, one of which is the Live Streaming Shopping feature that gives the impression of real life to customers. This study points to test costs and Live Streaming Features on Shopee Customer Purchasing Decisions in Kediri City. Information collection was carried out through the distribution of questionnaires distributed to 110 Shopee customers in Kediri City with random sampling techniques and the analysis method used was multiple linear regression with the assistance of SPSS tools. The results of the study found that price features a significant impact on customer purchasing decisions, while Live Streaming does not have a significant effect on buyer purchasing decisions, but partially Cost and Live Streaming Shopping Together have a significant impact on consumer purchase decision.

The threshold of rural placement frequency and duration: A repeated cross-sectional study examining rural career aspirations among student nurses

AimThis study aimed to explore what changes rural placement had on the perceptions of nursing students and the impact of placement frequency and duration on student considerations for rural practice. BackgroundA strong rural healthcare workforce is a global concern and has led countries to look for creative ways to address this challenge. One approach is to train more health professionals, however, nursing students who grew up or lived in metropolitan or urbanised areas are suggested to be less inclined to pursue a rural career. As such it is posited that recurrent exposure to rural settings may exert a positive impact on future intention for rural practice. However, there is a need to explore the specific thresholds related to both the frequency and duration of rural placement exposure, as well as the cumulative impact multiple rural placements may have on the intention to engage in rural practice. DesignA repeated cross-sectional design. MethodsAll nursing students from an Australian regional university were invited to complete an online questionnaire between 2019 and 2023. Demographic and placement specific questions were included. A modified version of the Nursing Community Apgar tool also measured the importance of key variables in rural career decision-making. Data were analysed using independent sample t-tests and one-way ANOVAs. Significance was determined at two-tailed p≤.05. ResultsAmong the 835 respondents (response rate 15.4%), the average number and duration of rural placements was 2.45 placements and 3.01 weeks respectively. Rural placements did not have an impact on students who resided rurally or regionally. However, among metropolitan students who had experienced more than three rural placements, or more than sixteen cumulative weeks of placement, were significantly more likely to consider rural employment. Greater number of rural placements and longer cumulative duration had the greatest impact. ConclusionIssues related to the nursing rural workforce are dynamic and complex. Understanding the unique drivers that improve the rural experiences among students, particularly metropolitan students, can have an impact on decision-making to pursue employment in rural environments. Importantly, whilst professional and clinical motivation and experiences are influential factors, the socialisation, environment and community features are essential elements that influence students’ decisions to pursue a career in rural practice. Undertaking a nuanced approach that facilitates rural practice understanding among students may help shape future employment decision-making.

Does Self-Control and Over-Confidence Influence Investment Decision: The Mediating Role of Fundamental and Technical Analysis

This study investigates the influence of self-control and over-confidence on investment decision-making, with a focus on the mediating role of fundamental and technical analysis. The respondents of the study are institutional investors operating in the Pakistan Stock Exchange Market (PSX), which includes the Lahore Stock Exchange, Karachi Stock Exchange, and Islamabad Stock Exchange. The behavior of these investors is assessed to determine the impact of stock market fluctuations on their investing decisions. The unit of analysis in this research is the institutional investors themselves. The study aims to examine the behavioral consequences of integrating self-control and overconfidence variables in investment decisions, particularly in relation to market instability and variations in fundamental and technical analysis. To select the sample, both stratified sampling and cluster sampling techniques were employed. Cluster sampling was used to save costs, while stratified sampling ensured that the sample accurately reflects the population. The states were divided into clusters to facilitate the use of cluster sampling. In terms of sample size, the study solely focuses on institutional investors in the Pakistan stock exchange PSX. Therefore, the sample consists of 375 institutional investors. Data collection for this study utilized a 5-point Likert scale, which is a commonly used measurement instrument for determining the relationship between variables. The scale allows respondents to provide their opinions on a continuum from strongly disagree to strongly agree. This approach enhances the originality and reliability of the data while minimizing respondent annoyance. Overall, this study aims to contribute to the understanding of how self-control and over-confidence influence investment decisions, with fundamental and technical analysis serving as mediators in the context of the Pakistan Stock Exchange Market. The findings from this research can provide valuable insights for institutional investors in their decision-making processes. Integrating self-control and over-confidence in investment decision-making aligns with SDG Goal 8: Decent Work and Economic Growth, by promoting responsible and sustainable investment practices.

Exploring Parental Knowledge, Attitudes, and Factors Influencing Decision-Making in Stem Cell Banking: Rising the Future of Medical Treatment.

Stem cellbanking (SCB) is a promising area of modern medicine with the potential to yield innovative treatments and cures. To effectively educate parents and implement laws and regulations that address parental concerns and encourage informed decision-making, it is imperative to emphasize parental viewpoints and their consequences for future healthcare. The study aims to establish the Saudi Arabian population's level of understanding regarding SCB and to comprehend the elements influencing parental knowledge, attitudes, and SCB decision-making processes. A cross-sectional study was conducted among the population in the Makkah region of Saudi Arabia. Demographic data, knowledge levels, attitudes, and decision-making variables were gathered from 380 respondents. The study reveals a lack in their comprehension of the objectives and possible uses of SCB, together with the main sources of information on those banks and conveniently available banking choices. It showed varied results regarding attitudes about considering an SCB for their children. In addition, the majority of respondents had not made a consent decision about SCB for their children. It also illuminates the factors that could influence participants' decisions about SCBfor their children and shows that a lack of information and understanding is the main obstacle faced by parents regarding SCB. It highlights that participants were generally in favor of learning more about SCB for their children. This study broadens our understanding of parental decision-making toward SCB and clarifies the elements influencing parents' opinions and worries and offers significant ramifications for lawmakers, medical professionals, and SCB. These implications can be utilized to enhance communication strategies, create instructional programs, and ease the fears of concerned parents.

Analysis of Consumer Considerations Regarding Disaster Risk in Making Residential Choice Decisions in Padang City

Considering that the city of Padang is the capital city of West Sumatra province which apart from being the center of government, is also the center for economic activities, education, trade and other informal sectors, the need for housing for the community needs attention. Because proper housing is a basic need for humans to carry out life and daily activities. The geographical condition of the city of Padang is in the area along the earthquake path following the 6,500 km subduction zone to the west of Sumatra Island. Apart from earthquakes, there are many disasters that have the potential to occur in the city of Padang such as tsunamis, landslides, floods, flash floods, tornadoes, and others. These potential disasters must be considered by consumers in making decisions in choosing housing that is appropriate and has a small disaster risk. The purpose of this research is to identify the reasons for consumers in making decisions about choosing housing in the city of Padang and also to analyze consumer considerations regarding disaster risk in making decisions about choosing housing in the city of Padang. The study was conducted on 60 respondents with 33 indicators which were divided into six general variables, namely price, location, building architecture, ease of transportation, environmental facilities and infrastructure and psychology then two disaster risk variables, namely disaster-free locations and building structures. In this study, the most influential variables in consumer decision making in choosing housing in the city of Padang sequentially were disaster-free locations, building structures, building architecture, environmental facilities and infrastructure, psychology, price, location and ease of transportation. And also the six general variables regarding consumer considerations in making decisions on choosing housing in Padang City simultaneously or as a whole have an influence on the two disaster risk variables studied, namely disaster-free locations and building structures.

Pengaruh Harga, Promosi, Lokasi dan Kualitas Pelayanan terhadap Keputusan Rahin Memilih Gadai Emas di PT Bank BJB Syariah KCP Arcamanik Bandung

Based on the results of initial research, that the background of this study is the fluctuation in the number of rahin. This is thought to have something to do with price, promotion, location and quality of service to rahin's decision. This study aims to determine how the influence of price, promotion, location and service quality on rahin's decision to choose a gold pawn at PT Bank BJB Syariah KCP Arcamanik Bandung, both partially and simultaneously. The object of research is rahin at PT Bank BJB Syariah KCP Arcamanik Bandung. Research is quantitative associative. Population rahin 125 people, determination of samples with the Slovin formula amounted to 56 people. Data collection techniques include observation, interviews, literature studies and questionnaires. The questionnaire was distributed through google form, then data analysis using the help of SPSS. The results showed that each variable either partially or simultaneously had an influence on the decision of rahin to have a gold pawn at PT Bank BJB Syariah KCP Arcamanik Bandung. Partially the price variable has an effect 20,3%, promotion has an effect 10,8. %, location has an influence 54,4 %, service quality matters 83,5% against the decision of the trahin. While simultaneously the independent variables affect 32,8% on the variability of rahin decision.