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This report evaluates whether health related quality of life (HRQoL) and patient-reported arm morbidity one year after axillary surgery are affected by the omission of axillary lymph node dissection (ALND). The ongoing international non-inferiority SENOMAC trial randomizes clinically node-negative breast cancer patients (T1-T3) with 1–2 sentinel lymph node (SLN) macrometastases to completion ALND or no further axillary surgery. For this analysis, the first 1181 patients enrolled in Sweden and Denmark between March 2015, and June 2019, were eligible. Data extraction from the trial database was on November 2020. This report covers the secondary outcomes of the SENOMAC trial: HRQoL and patient-reported arm morbidity. The EORTC QLQ-C30, EORTC QLQ-BR23 and Lymph-ICF questionnaires were completed in the early postoperative phase and at one-year follow-up. Adjusted one-year mean scores and mean differences between the groups are presented corrected for multiple testing. Overall, 976 questionnaires (501 in the SLN biopsy only group and 475 in the completion ALND group) were analysed, corresponding to a response rate of 82.6%. No significant group differences in overall HRQoL were identified. Participants receiving SLN biopsy only, reported significantly lower symptom scores on the EORTC subscales of pain, arm symptoms and breast symptoms. The Lymph-ICF domain scores of physical function, mental function and mobility activities were significantly in favour of the SLN biopsy only group. One year after surgery, arm morbidity is significantly worse affected by ALND than by SLN biopsy only. The results underline the importance of ongoing attempts to safely de-escalate axillary surgery. The trial was registered at clinicaltrials.gov prior to initiation (https://clinicaltrials.gov/ct2/show/ NCT 02240472). [Display omitted] • Omission of ALND significantly reduces patient-reported arm morbidity. • SLNB versus ALND results in significant less pain and better physical function. • HRQoL is not affected by de-escalated axillary surgery. • Complaints from axillary surgery are evaluated with patient-reported outcomes. [ABSTRACT FROM AUTHOR]

This paper examines explicit positive assessments (EPAs) in personal training, that is, the personal trainer's positive evaluations of the client's physical performance, including comments such as bra ('good'). The data consist of video-recorded training-sessions in Swedish from Finland and Sweden. The methodological framework is interactional linguistics, and the study explores the actions that EPAs perform as well as their linguistic design and embodied and sequential environment. The main actions performed by EPAs in personal training include transitioning between activities, encouraging the client, and making positive evaluations. The personal trainer (PT) may vary the lexical, syntactic, prosodic, and embodied features of the EPA to emphasize any of these actions or a combination of them. Overall, EPAs are a central resource for fulfilling the institutional goals of personal training by guiding the clients through the training-program and motivating them. In addition to their use as feedback on actions in the present moment, EPAs also include forward-focusing aspects aimed at guiding clients' future behavior. • Feedback is essential in personal training, as in other pedagogical settings. • We study feedback in the form of PTs' explicit positive assessments (EPAs). • Examples of EPAs are "good" and "well done". • EPAs are used for transitions, encouragement, and evaluations in personal training. • Prosodic and embodied features are especially crucial for the meaning of EPAs. [ABSTRACT FROM AUTHOR]