---

Introduction: Health care industry consists of an unexpected and confusing environment in which quality events play the important role. In such conditions, the necessary changes should be made. Excellence models are general oriented frameworks that are able to achieve the above intention. Materials & Methods: This study is a descriptive cross-sectional study. Data gathered by a standard checklist of Baldrige Model through interview of the chief managers of Hasheminejad Hospital. Results: In the health care field this hospital obtained 426 of 1000 scores. Within major criteria, the highest score was related to the standard of focusing on staff obtaining %51 of the total score of this model and the leadership standard obtained the lowest score (38 percent). This hospital obtained 222 of the total 1000 points of the Malcolm Baldrige score in the educational field. Findings also show those main criteria of strategic planning and the focus on students, interest groups and markers obtained the maximum score. Since, each of them obtained 33 percent of the total score of the model and the minimum score, 18 percent, belonged to the results of organizational performance criterion. Conclusion: The result indicates the necessity of paying more attention towards organization’s performance, especially education. Barldrige model can be applied as a comprehensive model for evaluating the performance of medical-educational hospitals.

---

Introduction: Depression as a disorder is relatively common in all societies several factors are involved in depression development, that shift work is one of these factors. This study compared the frequency of depression in different shifts of nurses in hospitals of Yazd University of medical sciences. Materials & Methods: This study is a descriptive analytical study. Based on statistical methods, 150 nurses participated in this study. The research tool was a questionnaire that included 15 personal questions and 21 questions related to Beck test. The results were analysed by SPSS software. Results: 13.3% of all subjects were males and 86.7% were females. Results showed that, there is no significant relationship between gender, education, type of job, employment status and satisfaction levels of income with depression. Marital status (P-Value = 0.009 and F = 6.93), shift work (day working and shift work) (P-Value = 0.032 and F = 1.11), job satisfaction (P-Value = 0.000 and F = 7.641) and the satisfaction of the employer (P-Value = 0.001 and F = 5.414) were significantly associated with depression. 3.49% of the nurses were in normal status, 7.26% had mild depression, 3.9% required consultation with the psychiatrist,% 7.8% suffered from moderate depression, 75.4% from severe depression and 3.1% from very severe depression. Conclusion: It seems that shift work can not cause depression alone, but depression is the result of the interaction of several factors.

---

Introduction: Identifying training needs and implementing appropriate courses is one of the important steps to empower managers and experts specialists. This has the most important role in improving organizational performance. In this study, considering the importance of training programs effectiveness, the training needs of managers and experts and their relation to individual and institutional factors was determined in the Health Departments of Universities of Health and Medical Sciences. Methods: This retrospective study was conducted in spring 2010. Communities of this research were the staff of Universities' Health Departments in the field of Health Deputy. They were selected from 13 universities by random systematic and stratified methods. All available directors and experts were responsibly elected and interviewed as the census. The questionnaire included individual and organizational variables and 28 management topics that confirmed validity and reliability. Results: In total 293 managers and expert specialists were studied, the average require education based on 26 (92.9 %) out of 28 subjects review, was respectively more than 3.5 (total score 5). Declaring level of training needs in a few cases had significant difference with type of universities, sex, age, work experience, educational level, MPH courses, headquarters units and the current location of the people. (P<0.05) Conclusion: According to the very high level of announced requirements, it is suggested to have short term and long term management training courses.

---

Introduction: Cost estimation is a important tool which assist the managers to plan and to control the economic functions of the organization. The present study aims to identify the cost of a cesarean surgery in one of the first class public hospitals in Iran. Methodology: Reviewing all expenses of the hospital documents in the financial unit, the cost of a cesarean surgery was determined through real costing. Results: the findings revealed that the cost of such a surgery is 1812636 rials, among which the highest level was related to the direct labor possesses with 63 percent and overhead costs with 37 percent of the total costs. Conclusion: Reducing the number of women who like cesarean surgery causes a reduction in costs of the surgery. Mitigating the tendency toward this surgery is possible through changing in the women’s beliefs about the vaginal delivery along with the enhancements in facilities and standards of the vaginal delivery. It is suggested to educate and consult with the families through health centers and media.

---

Introduction: Zinc plays a vital role in various biological functions and physical growth. More than 300 enzymes in body need zinc for proper function. In this study, the concentration of the zinc micronutrient in breast milk was evaluated and analyzed at the first month of breastfeeding. Materials and Methods: This was a descriptive study of 150 breastfeeding mothers in the 2014 who had given birth in Yazd and were sampled in a simple way. Sampling was done exclusively in the health and treatment centers in the city, in the spring of 2014. 10- 20 ml samples of breast milk were taken manually in the morning and before infants' feeding, in 3 times of 5, 15 and 30 days after delivery, to measure the micronutrient of zinc. The concentration of zinc was measured by atomic absorption spectroscopy.Data obtained by questionnaires and atomic absorption was analyzed by ANOVA test. Results: The average age of mothers was 27.40 ± 4.67 years. The average level of zinc in breast milk was 2.60 ± 0.35 mg/l. The zinc concentration of breast milk was at the bottom of the standard range of zinc in breast milk.There was no significant relationship between zinc averages in milk with education, age, BMI and mothers' job. But, there was a direct relationship between zinc levels of breast milk with mothers' BMI. Conclusion: According to the results of this study, it seems that addition of zinc to the diet of breastfeeding mothers helps to prevent zinc deficiency in mothers' blood serum as well as children's nutrition.