Quality of Life for People who Sing

An Exploration of Participant Experiences Singing in Neurological and Community Choirs Across New Zealand

Authors

  • Jordyn Danielle Thompson School of Psychology, Faculty of Science, and Centre for Brain Research, The University of Auckland
  • Alison Talmage School of Music, Faculty of Creative Arts and Industries, and Centre for Brain Research, The University of Auckland, New Zealand
  • Brieonie Jenkins School of Psychology, Faculty of Science, and Centre for Brain Research, The University of Auckland
  • Suzanne Purdy School of Psychology, Faculty of Science, and Centre for Brain Research, The University of Auckland

DOI:

https://doi.org/10.15845/voices.v22i2.3185

Keywords:

choral singing, Quality of Life (QOL), neurological condition, community choir

Abstract

Background: A growing ageing population in New Zealand and worldwide poses a number of challenges, including the predicted strain on public health services due to a consequential increase in neurological conditions, which tend to occur later in life. Diagnosis with a neurological condition is associated with negative psychosocial and quality of life (QOL) outcomes, which medical interventions do not address. There is growing interest in the role of music and singing in improving some of these negative outcomes that provides a rationale for the present research.

Methods: This mixed methods research explores the health-related quality of life (HRQOL) of 90 choir singers who sing in neurological choirs (social singing groups offering choral singing therapy) and community choirs in New Zealand. HRQOL data were obtained using the NZ WHOQOL-BREF and choir involvement perspectives were obtained using a choir participation questionnaire (CPQ). Non-parametric statistical tests were used to explore the NZ WHOQOL-BREF and visual analogue scale (VAS) responses in the CPQ. Qualitative measures were used to explore open-ended responses in the CPQ.

Results: HRQOL was similar across participants on the psychological, social relationships, and environmental domains, and lower for neurological choir members on the physical domain. Choir involvement perspectives showed that choir members perceived several positive benefits associated with choral singing that were often identified under the psychological, social relationships, and environmental domains.

Author Biographies

Jordyn Danielle Thompson, School of Psychology, Faculty of Science, and Centre for Brain Research, The University of Auckland

Jordyn Thompson (she/her) completed her BA (Hons) in Psychology at the University of Auckland – Waipapa Taumata Rau, Aotearoa New Zealand in 2018. Her research explored quality of life for people who sing in neurological and community choirs in Aotearoa, New Zealand. She is currently completing a Master of Arts at the University of Auckland – Waipapa Taumata Rau, Aotearoa New Zealand with research in the field of child and adolescent wellbeing exploring school-wide strategies that support positive mental health outcomes in adulthood and reduce the impact of childhood trauma and adverse childhood experiences. Jordyn has an interest in holistic, person-centred approaches to mental health and wellbeing.

Alison Talmage, School of Music, Faculty of Creative Arts and Industries, and Centre for Brain Research, The University of Auckland, New Zealand

Alison Talmage (she/her) is a music therapist, teacher, and doctoral candidate at the University of Auckland – Waipapa Taumata Rau, Aotearoa New Zealand. She has worked with people with diverse needs across the lifespan. She co-founded the CeleBRation Choir at the University’s Centre for Brain Research (2009), and the Sing Up Rodney community music therapy group (2017). Her current action research study focuses on neurological choirs, that address the social and communication needs of adults with acquired neurogenic communication difficulties.

Brieonie Jenkins, School of Psychology, Faculty of Science, and Centre for Brain Research, The University of Auckland

Brieonie Jenkins (she/her) completed her BA (Hons) in Psychology at the University of Auckland – Waipapa Taumata Rau, Aotearoa New Zealand in 2017. Her research focussed on choir participation for people with neurological conditions. She is currently a doctoral candidate at Massey University – Te Kunenga ki Pūehuroa, Aotearoa New Zealand. Her current research centres on people who care for loved ones with dementia and how aspects of this caregiving role may contribute to quality of life outcomes.

Suzanne Purdy, School of Psychology, Faculty of Science, and Centre for Brain Research, The University of Auckland

Suzanne Purdy (she/her) is Head of School of Psychology at the University of Auckland – Waipapa Taumata Rau, Aotearoa New Zealand. She has a background in neuroscience, clinical audiology and hearing and speech sciences. Her research interests include community-based therapies for people with neurological conditions and communication disorders. She is a Principal Investigator with the University’s Centre for Brain Research which supports the CeleBRation Choir.

References

Anderson, C. S., Carter, K. N., Hackett, M. L., Feigin, V., Barber, P. A., Broad, J. B., & Bonita, R. (2005). Trends in stroke incidence in Auckland, New Zealand, during 1981 to 2003. Stroke, 36(10), 2087-2093. https://doi.org/10.1161/01.STR.0000181079.42690.bf

Ansdell, G. (2002). Community Music Therapy and the winds of change. Voices: A World Forum for Music Therapy, 2(2). https://doi.org/10.15845/voices.v2i2.83

Ascherio, A., & Schwarzschild, M. A. (2016). The epidemiology of Parkinson’s disease: Risk factors and prevention. The Lancet Neurology, 15(12), 1257-1272. https://doi.org/10.1016/S1474-4422(16)30230-7

Backhouse, T. (2010). Freeing the song: An approach to directing vocal groups. École de Fromage.

Bertram, L., & Tanzi, R. E. (2005). The genetic epidemiology of neurodegenerative disease. The Journal of Clinical Investigation, 115(6), 1449-1457. https://doi.org/10.1172/JCI24761

Billington, R., Landon, J., Krägeloh, C. U., & Shepherd, D. (2010). The New Zealand World Health Organization Quality of Life (WHOQOL) Group. The New Zealand Medical Journal, 123(1315), 65-70. PMID: 20581932

Brandt, A., Gebrian, M., & Slevc, R. L. (2012). Music and early language acquisition. Frontiers in Psychology, 3(327), 1-17. https://doi.org/10.3389/fpsyg.2012.00327

Buetow, S. A., Talmage, A., McCann, C., Fogg, L., & Purdy, S. (2013). Conceptualizing how group singing may enhance quality of life with Parkinson's disease. Disability and Rehabilitation, 36(5), 430-433. https://doi.org/10.3109/09638288.2013.793749

Campbell Burton, C. A., Murray, J., Holmes, J., Astin, F., Greenwood, D., & Knapp, P. (2013). Frequency of anxiety after stroke: A systematic review and meta‐analysis of observational studies. International Journal of Stroke, 8(7), 545-559. https://doi.org/10.1111/j.1747-4949.2012.00906.x https://doi.org/10.1159/000200461

Carod-Artal, F. J., & Egido, J. A. (2009). Quality of life after stroke: The importance of a good recovery. Cerebrovascular Diseases, 27(1), 204-214. https://doi.org/10.1159/000200461

Connolly, B. S., & Lang, A. E. (2014). Pharmacological treatment of Parkinson disease: A review. JAMA, 311(16), 1670-1683. https://doi.org/10.1001/jama.2014.3654

Conrad, C. (2010). Music for healing: From magic to medicine. Lancet, 376(9757), 1980-1981. https://doi.org/10.1016/s0140-6736(10)62251-9

Creswell, J. W. & Poth, C. N. (2018). Qualitative inquiry and research design: Choosing among five approaches (4th ed.). Sage.

Cross, I. (2001). Music, cognition, culture and evolution. Annals of the New York Academy of Sciences, 930(1), 28-42. https://doi.org/10.1111/j.1749-6632.2001.tb05723.x

Cross, I., & Morley, I. (2002). Music and evolution: The nature of the evidence. Proceedings of the 7th International Conference on Music Perception and Cognition, 416-419. https://www.academia.edu/16654426/Music_and_evolution_the_nature_of_the_evidence

Di Benedetto, P., Cavazzon, M., Mondolo, F., Rugiu, G., Peratoner, A., & Biasutti, E. (2009). Voice and choral singing treatment: A new approach for speech and voice disorders in Parkinson’s disease. European Journal of Physical and Rehabilitation Medicine, 45(1), 13-19. PMID: 18987565.

Dingle, G. A., Clift, S., Finn, S., Gilbert, R., Groarke, J. M., Irons, Y. J., Bartoli, A. J., Lamont, A., Launay, J., Martin, E. S., Moss, H., Sanfilippo, K. R., Shipton, M., Stewart, L., Talbot, S., Tarrant, M., Tip, L., & Williams, E. J. (2019). An agenda for best practice research on group singing, health, and well-being. Music and Science, 2, 1-5. https://doi.org/10.1177/2059204319861719

Dissanayaka, N. N. W., Sellbach, A., Matheson, S., O'Sullivan, J. D., Silburn, P. A., Byrne, G. J., Marsh, R., & Mellick, G. D. (2010). Anxiety disorders in Parkinson's disease: Prevalence and risk factors. Movement Disorders, 25(7), 838-845. https://doi.org/10.1002/mds.22833

Dissanayaka, N. N. W., Sellbach, A., Silburn, P. A., O'Sullivan, J. D., Marsh, R., & Mellick, G. D. (2011). Factors associated with depression in Parkinson's disease. Journal of Affective Disorders, 132(1), 82-88. https://psycnet.apa.org/doi/10.1016/j.jad.2011.01.021

Edwards, J. (2016). Conceptualizing music therapy: Five areas that frame the field. Oxford University Press. https://doi.org/10.1093/oxfordhb/9780199639755.013.32

Elefant, C., Baker, F. A., Lotan, M., Lagesen, S. K., & Skeie, G. O. (2012). The effect of group music therapy on mood, speech, and singing in individuals with Parkinson's disease: A feasibility study. Journal of Music Therapy, 49(3), 278-302. https://doi.org/10.1093/jmt/49.3.278

Fogg, L., & Talmage, A. (2011). The CeleBRation Choir: Establishing community group choral singing for people living with neurological conditions. Psychomusicology: Music, Mind and Brain, 21(1-2), 264-267. https://doi.org/10.1037/h0094030

Fogg-Rogers, L., Buetow, S., Talmage, A., McCann, C. M., Leāo, S. H. S., Tippett, L., Leung, J., McPherson, K. M., & Purdy, S. C. (2015). Choral singing therapy following stroke or Parkinson’s disease: An exploration of participants’ experiences. Disability and Rehabilitation, 38(10), 952-962. https://doi.org/10.3109/09638288.2015.1068875

Gick, M. L. (2011). Singing, health and well-being: A health psychologist’s review. Psychomusicology: Music, Mind and Brain, 21(1-2), 176-207. https://doi.org/10.1037/h0094011

Golden, J., Conroy, R. M., Bruce, I., Denihan, A., Greene, E., Kirby, M., & Lawlor, B. A. (2009). Loneliness, social support networks, mood and wellbeing in community‐dwelling elderly. International Journal of Geriatric Psychiatry, 24(7), 694-700. https://doi.org/10.1002/gps.2181

Haddad, M. (2009). Depression in adults with a chronic physical health problem: Treatment and management. International Journal of Nursing Studies, 46(11), 1411-1414. https://doi.org/10.1016/j.ijnurstu.2009.08.007

Hoffmann, T., Bennett, S., Koh, C. L., & McKenna, K. T. (2010). Occupational therapy for cognitive impairment in stroke patients. Cochrane Database of Systematic Reviews, 9, CD006430. https://doi.org/10.1002/14651858.CD006430.pub2

Hornsten, C., Molander, L., & Gustafson, Y. (2012). The prevalence of stroke and the association between stroke and depression among a very old population. Archives of Gerontology and Geriatrics, 55(3), 555-559. https://doi.org/10.1016/j.archger.2012.04.012

Hurkmans, J., de Bruijn, M., Boonstra, A. M., Jonkers, R., Bastiaanse, R., Arendzen, H., & Reinders-Messelink, H. A. (2012). Music in the treatment of neurological language and speech disorders: A systematic review. Aphasiology, 26(1), 1-19. https://doi.org/10.1080/02687038.2011.602514

Irons, J. Y., Hancox, G., Vella-Burrows, T., Han, E.-Y., Chong, H.-J., Sheffield, D., & Stewart, D. E. (2021). Group singing improves quality of life for people with Parkinson’s: An international study. Aging & Mental Health, 25(4), 650-656. https://doi.org./10.1080/13607863.2020.1720599

Jankovic, J. (2008). Parkinson’s disease: Clinical features and diagnosis. Journal of Neurology, Neurosurgery and Psychiatry, 79(4), 368-376. https://jnnp.bmj.com/content/79/4/368

Jansen, G. (2019). Sing New Zealand: The story of choral music in Aotearoa. Massey University Press.

Jasinska-Myga, B., Putzke, J. D., Wider, C., Wszolek, Z. K., & Uitti, R. J. (2010). Depression in Parkinson's disease. The Canadian Journal of Neurological Sciences, 37(1), 61-66. PMID:https://www.ncbi.nlm.nih.gov/pubmed/20169775

Jenkins, B., Storie, S., & Purdy, S. (2017). Quality of life for individuals with a neurological condition who participate in social/therapeutic choirs. New Zealand Journal of Music Therapy, 15, 59-94. https://www.musictherapy.org.nz/journal/2017-2

Johnson, J. K., Louhivuori, J., Stewart, A. L., Tolvanen, A., Ross, L., & Era, P. (2013). Quality of life (QOL) of older adult community choral singers in Finland. International Psychogeriatrics, 25(7), 1055-64. http://doi.org/10.1017/S1041610213000422

Jørgensen, T. S., Wium-Andersen, I. K., Wium-Andersen, M. K., Jørgensen, M. B., Prescott, E., Maartensson, S., Kragh-Andersen, P., & Osler, M. (2016). Incidence of depression after stroke, and associated risk factors and mortality outcomes, in a large cohort of Danish patients. JAMA Psychiatry, 73(10), 1032-1040. https://doi.org/10.1001/jamapsychiatry.2016.1932

Kelly, H., Brady, M. C., & Enderby, P. S. (2010). Speech and language therapy for aphasia following stroke. Cochrane Database of Systematic Reviews, 5, CD000425. https://doi.org/10.1002/14651858.CD000425.pub2

Kern, P., & Tague, D. (2017). Music therapy practice status and trends worldwide: An international survey study. Journal of Music Therapy, 54(3), 255-286. https://doi.org/10.1093/jmt/thx011

Krägeloh, C. U., Kersten, P., Billington, D. R., Hsu, P. H.-C., Shepherd, D., Landon, J., & Feng, X. J. (2010). The New Zealand version of the WHOQOL-BREF: Confirming the factor structure and making multi-group comparisons. Quality of Life Research, 19, 68-68. https://doi.org/10.1007/s11136-012-0265-9

Lee, P., Stewart, D., & Clift, S. (2018). Group singing and quality of life. In B. L. Bartleet, & L. Higgins (Eds.), The Oxford handbook of community music. (pp. 503-524). Oxford University Press. https://doi.org/10.1093/oxfordhb/9780190219505.013.22

Massey, F. J. J. (1951). The Kolmogorov-Smirnov test for goodness of fit. Journal of the American Statistical Association, 46(253), 68-78. https://doi.org/10.1080/01621459.1951.10500769

Matthews, R. (2018). Acoustic, respiratory, cognitive and wellbeing comparisons of two groups of people with Parkinson's disease participating in voice and choral singing group therapy (VCST) versus a music appreciation activity [Unpublished Doctoral Thesis]. The University of Auckland. http://hdl.handle.net/2292/37599

Matthews, R., Purdy, S. C., & Tippett, L. J. (2019). Song choice and vocal exercises in group singing for people with Parkinson’s disease: The perspective of a speech-language therapist/ musician. New Zealand Journal of Music Therapy, 17, 25-41. https://www.musictherapy.org.nz/journal/2019-2

Moss, H., Lynch, J., & O’Donoghue, J. (2018). Exploring the perceived health benefits of singing in a choir: An international cross-sectional mixed-methods study. Perspectives in Public Health, 138, 160–168. https://doi.org/10.1177/1757913917739652

Mutai, H., Furukawa, T., Nakanishi, K., & Hanihara, T. (2016). Longitudinal functional changes, depression, and health‐related quality of life among stroke survivors living at home after inpatient rehabilitation. Psychogeriatrics, 16, 185-190. https://doi.org/10.1111/psyg.12137

New Zealand Institute of Economic Research. (2020). The social and economic costs of stroke in New Zealand – 2020 update NZIER report to the Stroke Foundation. https://nzier.org.nz/static/media/filer_public/b4/6f/b46f7e92-be19-477d-b23c-7ba042d7cccd/social_and_economic_costs_of_stroke_-_2020_update.pdf

Office of Disease Prevention and Health Promotion. (2010). Health-related quality of life and wellbeing. https://www.healthypeople.gov/2020/about/qolwbabout.aspx

Parkinson’s New Zealand. (2021). What is Parkinson’s? https://www.parkinsons.org.nz/understanding-parkinsons/what-parkinsons

Patel, V., & Prince, M. (2001). Ageing and mental health in a developing country: Who cares? Qualitative studies from Goa, India. Psychological Medicine, 31(1), 29-38. https://doi.org/10.1017/s0033291799003098

Pongan, E., Tillmann, B., Leveque, Y., Trombert, B., Getenet, J. C., Auguste, N., Dauphinot, V., Haouari, H. E., Navez, M., Dorey, J.-M., Krolak-Salmonb, P., The LACMé Group, Laurent, B., & Rouch, I. (2017). Can musical or painting interventions improve chronic pain, mood, quality of life, and cognition in patients with mild Alzheimer’s disease? Evidence from a randomized controlled trial. Journal of Alzheimer’s Disease, 60, 663-667. https://doi.org/10.3233/JAD-170410

Power, M. J. (2003). Quality of life. In S. J. Lopez & C. R. Snyder (Eds.), Positive psychological assessment: A handbook of models and measures (pp. 427–441). American Psychological Association. https://doi.org/10.1037/10612-027

Power, M. J., Green, A. M., & The WHOQOL-Dis Group. (2010). Development of the WHOQOL disabilities module. Quality of Life Research, 19, 571-584. https://doi.org/10.1007/s11136-010-9616-6

Rahman, S., Griffin, H. J., Quinn, N. P., & Jahanshahi, M. (2008). Quality of life in Parkinson’s disease: The relative importance of the symptoms. Movement Disorders, 23(10), 1428-1434. https://doi.org/10.1002/mds.21667

Schlaug, G., Altenmüüller, E., & Thaut, M. (2010). Music listening and music making in the treatment of neurological disorders and impairments. Music Perception: An Interdisciplinary Journal, 27(4), 249-250. https://doi.org/10.1525/MP.2010.27.4.249

Skevington, S. M., Lotfy, M., & O’Connell, K. A. (2004). The World Health Organization’s WHOQOLBREF quality of life assessment: Psychometric properties and results of the international field trial. A Report from the WHOQOL Group. Quality of Life Research, 13(2), 299-310. https://doi.org/10.1023/B:QURE.0000018486.91360.00

Statistics New Zealand. (2020). National population projections: 2020 (base) – 2073. https://www.stats.govt.nz/information-releases/national-population-projections-2020base2073

Talmage, A. (2017). CBR Music Therapy Week Neurological Choirs Workshop [Report]. The University of Auckland Centre for Brain Research.

Talmage, A. (2022). Singing all together in the CeleBRation Choir: A music therapist’s perspective on community singing for adults who have neurogenic communication difficulties. In C. Miller & M. Torkington (Eds.), Arts therapists in international practice: Exploring the behavioural and neurological benefits of therapy (pp. 138-151). Routledge.

Talmage, A., Fogg-Rogers, L., Leāo, S. H. S., & Purdy, S. (2014). Choral singing therapy for a client with Parkinson’s disease. In C. Miller (Ed.), Assessment and outcomes in the arts therapies: A person-centred approach. (pp. 54-66). Jessica Kingsley Publishers.

Talmage, A., Ludlam, A., Leāo, S., Fogg-Rogers, L. A., Purdy, S. C. (2013). Leading the CeleBRation choir: The choral singing therapy protocol and the role of the music therapist in a social singing group for adults with neurological conditions. The New Zealand Journal of Music Therapy, 11, 7-50.

Talmage, A., & Purdy, S. C. (2021). Leading choirs and singing groups for adults living with neurogenic communication difficulties: Semi-structured interviews with current and potential facilitators in New Zealand. New Zealand Journal of Music Therapy, 19, 54-85. https://www.musictherapy.org.nz/journal/2021-2

Tamplin, J., Baker, F. A., Jones, B., Way, A., & Lee, S. (2013). ‘Stroke a chord’: The effect of singing in a community choir on mood and social engagement for people living with aphasia following a stroke. Neurorehabilitation, 32(4), 929-941. https://doi.org/10.3233/NRE-130916

Tamplin, J., Morris, M., Marigliani, C., Baker, F., & Vogel, A. (2019). ParkinSong: A controlled trial of singing-based therapy for Parkinson’s disease. Neurorehabilitation and Neural Repair, 33(6), 453-463. https://doi.org/10.1177/1545968319847948

Thaut, M. H., McIntosh, G. C., & Hoemberg, V. (2015). Neurobiological foundations of neurologic music therapy: Rhythmic entrainment and the motor system. Frontiers in Psychology, 5, 1185. https://doi.org/10.3389/fpsyg.2014.01185

Thompson, N., Storie, S., & Purdy, S. (2016). “Catching the tune or channelling the beat”: A pilot study investigating the role of rhythm in therapeutic singing for aphasia. New Zealand Journal of Music Therapy, 14, 122-161. https://www.musictherapy.org.nz/journal/2016-2

Tomczak, M., & Tomczak, E. (2014). The need to report effect size estimates revisited. An overview of some recommended measures of effect size. Trends in Sport Science, 1(21), 19-25. http://www.wbc.poznan.pl/Content/325867/5_Trends_Vol21_2014_%20no1_20.pdf

Unützer, J. (2007). Late-life depression. New England Journal of Medicine, 357(22), 2269-2276. https://psycnet.apa.org/doi/10.1056/NEJMcp073754

Valvanne, J., Juva, K., Erkinjuntti, T., & Tilvis, R. (1996). Major depression in the elderly: A population study in Helsinki. International Psychogeriatrics, 8(03), 437-443. https://psycnet.apa.org/doi/10.1017/S1041610296002797

Wan, C. Y., Rüber, T., Hohmann, A., & Schlaug, G. (2010). The therapeutic effects of singing in neurological disorders. Music Perception: An Interdisciplinary Journal, 27(4), 287-295. https://doi.org/10.1525/mp.2010.27.4.287

Waterhouse, D., & Waterhouse, S. (Directors). (2016). A therapeutic choir [Video] Christchurch, New Zealand: Cantabrainers Choir and Therapy Professionals Inc. https://vimeo.com/145326646

World Health Organization. (1994). Development of the WHOQOL: Rationale and current status. International Journal of Mental Health, 23(3), 24-56. https://doi.org/10.1080/00207411.1994.11449286

World Health Organization. (‎1998)‎. Programme on mental health: WHOQOL user manual, 2012 revision. https://apps.who.int/iris/handle/10665/77932

World Health Organization. (2006). Neurological disorders: Public health challenges. https://www.who.int/publications/i/item/9789241563369

World Health Organization. (2017). Mental health of older adults. https://www.who.int/en/news-room/fact-sheets/detail/mental-health-of-older-adults

World Health Organization. (2021). Stroke, cerebrovascular accident. http://www.emro.who.int/health-topics/stroke-cerebrovascular-accident/index.html

Yinger, O. S., & Lapointe, L. L. (2012). The effects of participation in a group music therapy voice protocol (G-MTVP) on the speech of individuals with Parkinson's disease. Music Therapy Perspectives, 30(1), 25-31. https://doi.org/10.1093/mtp/30.1.25

Zar, J. H. (1972). Significance testing of the Spearman Rank Correlation Coefficient. Journal of the American Statistical Association, 67(339), 578-580. https://doi.org/10.2307/2284441

Zimmerman, D. W. (1987). Comparative power of Student T test and Mann-Whitney U test for unequal sample sizes and variances. The Journal of Experimental Education, 55(3), 171-174. https://doi.org/10.1080/00220973.1987.10806451

Zumbansen, A., Peretz, I., Anglade, C., Bilodeau, J., Généreux, S., Hubert, M., & Hébert, S. (2017). Effect of choir activity in the rehabilitation of aphasia: A blind, randomised, controlled pilot study. Aphasiology, 31(8), 879-900. https://doi.org/10.1080/02687038.2016.1227424

Photo of the four authors Thompson, Talmage, Purdy and Jenkins

Downloads

Published

2022-07-01

How to Cite

Thompson, J. D., Talmage, A., Jenkins, B., & Purdy, S. (2022). Quality of Life for People who Sing: An Exploration of Participant Experiences Singing in Neurological and Community Choirs Across New Zealand. Voices: A World Forum for Music Therapy, 22(2). https://doi.org/10.15845/voices.v22i2.3185

Issue

Vol. 22 No. 2 (2022)

Section

Research

License

Copyright (c) 2022 Jordyn Danielle Thompson, Suzanne Purdy, Alison Talmage, Brieonie Jenkins

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Articles published prior to 2019 are subject to the following license, see: https://voices.no/index.php/voices/copyright