Joint Strategic Needs Assessment (JSNA) is a process that identifies current and future health and wellbeing needs in light of existing services, and informs future service planning taking into account evidence of effectiveness at a population, rather than individual level. JSNA identifies "the big picture" in terms of the health and wellbeing needs and inequalities of a local population, it is an essential tool for commissioners to inform joint service planning and commissioning strategies in the Local Authority and the PCT. For the purpose of JSNA, a clear distinction should be made between individual and population need[vii].

11 I am a third-year student nurse and am currently researching a case study based on the biopsychosocial history of a patient who suffers from chronic hepatitis C, which initially occurred as a result of injecting drugs. I am confused about the biological effect of hepatitis: how exactly does it affect the liver?

12 What are the admission criteria for a case of acute viral hepatitis?

13 I would like to know where I can find details on hepatitis B virus (HBV) infection: chronic carrier, asymptomatic [normal liver function tests, HBV DNA/real-time polymerase chain reaction (PCR) 240 copies/mL, core less than 0.1]. Does a patient with such a profile need therapy or fine needle aspiration (FNA) biopsy? What is the possibility of hepatocellular carcinoma (HCC) in such a patient?

14 In chronic hepatitis B virus (HBV) infection, when anti-hepatitis B e antibody (anti-HBe) develops (seroconversion), the antigen disappears and there is a rise in alanine transferase (ALT). However, the graph in your book (K&C 7e, p. 337, Fig. 7.16) seems to show a fall in ALT at this point. Which is correct?

15 Interferon can be used in prophylaxis from hepatitis C after exposure. Could you explain how this can be used, and what degree of success can be expected as a result?

16 What is the latest recommended drug treatment for hepatitis C?

17 Can hepatitis C disease be treated in a carrier state completely by giving interferon? Question 18 I am a carrier of hepatitis C (HCV) and am going to have antiviral treatment soon. Are the side-effects of antiviral treatment for HCV bound to occur? I am very worried.

19 Besides needle-pricks, how else is it possible to contract hepatitis C from a hepatitis C (HCV)-positive patient? Are the patient's skin/sweat (or other bodily secretions) infectious?

20 What is the risk of infection with hepatitis C from blood splashed into the eyes?