Mixed methods study protocol to explore acculturation, lifestyles and health of immigrants from the Community of Portuguese-Speaking Countries in two Iberian contexts: how to face uncertainties amidst the COVID-19 pandemic.

INTRODUCTION: Studies which focus on the process of acculturation in the lifestyles, nutritional status and health of immigrants from the Community of Portuguese-Speaking Countries (CPLP) in the Iberian Peninsula are still scarce. This study aims to explore the influence of the acculturation process and dietary acculturation on the lifestyle and nutritional and health status of CPLP immigrants in Portugal and Spain, focusing on two Iberian contexts: Lisbon Metropolitan Area and the Basque Country. METHODS AND ANALYSIS: A mixed methods sequential explanatory design, combining cross-sectional studies and semistructured interviews. Official data will also be analysed. Primary data will be collected through a questionnaire and assessment of nutritional status and body composition. The estimated samples sizes are 1061 adults (≥18 years old) in the Lisbon Metropolitan Area and 573 in the Basque Country. Time-location sampling will be used for the quantitative component and non-probabilistic sampling for the qualitative component. If safety conditions are not guaranteed due to the COVID-19 pandemic, online studies will be conducted. The semistructured interviews will complement the questionnaire data and extend knowledge about the process of acculturation of CPLP immigrants and their relationship with eating habits and physical activity. Thematic analysis will be used for qualitative data. Triangulation of data derived from different methods will be carried out. An integrative approach will be used to address potential discrepancies in findings and limitations inherent to the study design. As inter-method discrepancies may occur, triangulation protocol will be used, elaborating a 'convergence coding matrix' to display findings emerging from each component of the study. ETHICS AND DISSEMINATION: Ethical approval was obtained through the IHMT Ethics Council (Doc No 20/2020), Portugal, and it was submitted to the Ethics Committee of the UPV/EHU (Doc No under revision), Spain.

COVID-19: Nothing is Normal in this Pandemic.

This manuscript brings attention to inaccurate epidemiological concepts that emerged during the COVID-19 pandemic. In social media and scientific journals, some wrong references were given to a "normal epidemic curve" and also to a "log-normal curve/distribution". For many years, textbooks and courses of reputable institutions and scientific journals have disseminated misleading concepts. For example, calling histogram to plots of epidemic curves or using epidemic data to introduce the concept of a Gaussian distribution, ignoring its temporal indexing. Although an epidemic curve may look like a Gaussian curve and be eventually modelled by a Gauss function, it is not a normal distribution or a log-normal, as some authors claim. A pandemic produces highly-complex data and to tackle it effectively statistical and mathematical modelling need to go beyond the "one-size-fits-all solution". Classical textbooks need to be updated since pandemics happen and epidemiology needs to provide reliable information to policy recommendations and actions.

The Unlikely Saviour: Portugal's National Health System and the Initial Impact of the COVID-19 Pandemic?

What is the impact of COVID-19 on Portugal's Serviço Nacional de Saúde (SNS), the country's national health service? The story, still unfolding, has all the elements of a recipe for disaster: one of the most elderly populations in the world; a weakened SNS, the result of a litany of policies and interventions by the 'Troika' (the European Commission, the European Central Bank and the International Monetary Fund); a health care delivery system focused on non-communicable diseases and long-term care; the growing public distrust in public services, compared to private, hotel-like health care facilities. We are aware that these are still the early days of the epidemic, yet it is safe to say that algorithmic scenarios of doom and gloom have so far been averted. In the past six months of the pandemic, the level of trust of the Portuguese population in the SNS and its health personnel has significantly improved, while the government has started to provide additional funding and to work for the expansion of the public system. At the very inception of the pandemic, private hospitals practically closed their doors to COVID-19 patients. Unexpectedly a new disease, COVID-19, by definition the foe of any health system, has granted the opportunity for a rare consensus amongst different key political and/or corporate actors in a long-called-for reform of the SNS. Social science and humanities, with their analytical tools and theoretical-conceptual frameworks, are mandatory in providing well-funded answers to such riddles and better grasping the reasons for the twist and turns.