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ࣇࣞ࢖ࣝண㜵ࡢࡓࡵࡢ㌟య⬟ຊၥデ⚊ࡢ㛤Ⓨ
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௒㔝 ᘯつ኱㜰኱Ꮫ኱Ꮫ㝔་Ꮫ⣔◊✲⛉බ⾗⾨⏕Ꮫඹྠ◊✲⪅㸸ᰠⰼ ᏹಙ㸦኱㜰኱Ꮫ኱Ꮫ㝔་Ꮫ⣔◊✲⛉බ⾗⾨⏕Ꮫ㸧      ᏳᒸᐇెᏊ㸦኱㜰኱Ꮫ኱Ꮫ㝔་Ꮫ⣔◊✲⛉බ⾗⾨⏕Ꮫ㸧㸫137㸫ᄂᆮᙲଓ ㉸㧗㱋໬♫఍ࡢᡃࡀᅜ࡟࠾࠸࡚ࠊせ௓ㆤண㜵ࡣࠊ೺ᗣᑑ࿨ᘏఙࡸ་⒪⤒῭ⓗほⅬ࠿ࡽ㔜せ࡞ㄢ㢟࡛࠶ࡿࠋࣉࣞࣇࣞ࢖࣭ࣝࣇࣞ࢖ࣝࠊ࠶ࡿ࠸ࡣࡑࡢ㌟యⓗᚩೃࢆᤊ࠼ࡓࢧࣝࢥ࣌ࢽ
࢔ࡣࠊ⌧ᅾࡲࡓࡣᑗ᮶ࡢ᪥ᖖ⏕άࡢ⮬❧ᗘࡢపୗࠊ᪋タධᡤࠊṚஸ࡞࡝㈇ࡢ೺ᗣ࢔࢘ࢺ࢝
࣒࡜ᙉࡃ㛵㐃ࡍࡿࡇ࡜࠿ࡽࠊせ௓ㆤࡢࣁ࢖ࣜࢫࢡ≧ែ࡜ࡋ࡚ண㜵ᑐ⟇ࡢࢱ࣮ࢤࢵࢺ࡜࡞ࡗ
࡚࠸ࡿࠋࡑࡢࡓࡵࠊࣉࣞࣇࣞ࢖࣭ࣝࣇࣞ࢖ࣝࡢࢫࢡ࣮ࣜࢽࣥࢢࡀ㔜せ࡜࡞ࡿࡀࠊ᪤࡟㛤Ⓨࡉࢀ࡚࠸ࡿ㉁ၥ⣬࡛ࡣࠊ୰ᖺᮇ࠿ࡽせ௓ㆤࣜࢫࢡࢆண

ࡍࡿࡢࡣᅔ㞴࡛࠶ࡿࠋࡑࢀࡣࠊၥ

ࢃࢀࡿ㌟య⬟ຊࣞ࣋ࣝࡢ⠊ᅖࡀ⊃ࡃࠊ୰ᖺᮇ࡛ࡣኳ஭ຠᯝࡀⴭࡋ࠸࠿ࡽ࡜⪃࠼ࡽࢀࡿࠋࡑ
ࡇ࡛ࠊᮏ◊✲࡛ࡣ୰ᖺᮇ࡟࠾࠸࡚ᑗ᮶ࡢࣉࣞࣇࣞ࢖࣭ࣝࣇࣞ࢖ࣝᚩೃࢆᤊ࠼ࡽࢀࡿ㌟య⬟
ຊࡢ㉁ၥ⣬ࢆ㛤Ⓨࡍࡿࡇ࡜ࢆ┠ⓗ࡜ࡋࡓࠋ ᮏ◊✲࡛ࡣࠊᆅᇦఫẸࢆᑐ㇟࡟౑⏝ࡉࢀࡿ㉁ၥ⣬ࠊ≉࡟ࣇࣞ࢖ࣝࡸࡑࡢ୺せ⑓ែ࡛࠶ࡿ
ࢧࣝࢥ࣌ࢽ࢔ࠊ㌟య⬟ຊ࣭㞀ᐖ࡟㛵ࡍࡿ㉁ၥ⣬࡟ࡘ࠸࡚ඛ⾜◊✲ࡢࣞࣅ࣮ࣗࢆ⾜ࡗࡓࠋࡑࡢ⤖ᯝࠊ᪥ᮏㄒ࡛౑⏝ྍ⬟࡞ࢫࢡ࣮ࣜࢽࣥࢢ㉁ၥ⣬ࡀ  ௳ࠊⱥㄒ࡛౑⏝ྍ⬟࡞ࡶࡢࡀ  ௳Ꮡᅾࡋࡓࠋ㛵ಀ⪅࡜ࡢウ㆟ࢆ⤒࡚ࠊ୰ᖺᮇ࠿ࡽࡢࣇࣞ࢖ࣝண㜵ࡢࡓࡵࡢ㌟య⬟ຊၥデ⚊㸦඲ ၥ㸧ࢆ㛤Ⓨࡋࡓࠋ㉁ၥ⣬ࡣ࣮ࣚࣟࢵࣃ  ࠿ᅜ࡛㛤ጞࡉࢀࡓ኱つᶍࢥ࣮࣍ࢺࠕ6+$5( ◊✲ࠖࡢ㉁ၥ㡯┠ࢆྵࡳࠊᅜ㝿ẚ㍑ྍ⬟ᛶࢆ☜ಖࡋ࡚࠸ࡿࠋࡉࡽ࡟ࠊᚑ᮶ࡢ㉁ၥ⣬࡛ࡣᤊ࠼ࡽࢀ࡞࠿ࡗࡓ㌟య⬟ຊࣞ࣋ࣝࢆホ౯ྍ⬟࡜ࡍࡿࡓࡵ࡟ࠊ᪂ࡓ࡟㛤Ⓨࡋࡓ㉁ၥ㡯┠ࢆ㏣ຍࡋ
ࡓࠋࡲࡓࠊ⎔ቃせᅉ࡟ᕥྑࡉࢀ࡟ࡃ࠸ᶵ⬟ⓗືసࡢ㡯┠࡟⤫୍ࡋࡓ㉁ၥ⣬࡜ࡋࡓࠋ
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㸫138㸫

 ᪂ࡓ࡟㛤Ⓨࡋࡓ㌟య⬟ຊၥデ⚊ࡢጇᙜᛶ᳨ウࡢ୍⎔࡜ࡋ࡚ࠊ᪤Ꮡ㉁ၥ⣬ࡢࢦ࣮ࣝࢻ࣭ࢫ
ࢱࣥࢲ࣮ࢻ࡜ࡋ࡚ࠕ⡆᫆ )5$,/ ࢫࢡ࣮ࣜࢽࣥࢢ㉁ၥ⚊ࠖࢆ᥇⏝ࡋࠊᆅᇦఫẸࢆᑐ㇟࡟ணഛ
ㄪᰝࢆ⾜ࡗࡓࠋ ⡆᫆ )5$,/ ࢫࢡ࣮ࣜࢽࣥࢢ㉁ၥ⚊ࡣタၥᩘࡀ  ၥࡢࡓࡵࠊẚ㍑ⓗ኱つᶍ࡟ணഛㄪᰝࡀྍ
⬟࡛ࠊ⛅⏣┴஭ᕝ⏫ࡢ⏨ዪ  ே㸦 ṓࠊ ṓࡢ๭ྜ ࠊᖹᆒᖺ㱋  ṓࠊዪᛶࡢ๭ྜ 㸣㸧ࢆᑐ㇟࡟ᐇែㄪᰝࢆ⾜ࡗࡓࠋᖹᆒᚓⅬࡣ  Ⅼ㸦 Ⅼ‶Ⅼࠊ➨  ᅄศ఩Ⅼ
ࠝ4ࠞ Ⅼࠊ➨  ᅄศ఩Ⅼࠝ4ࠞ Ⅼ㸧࡜࡞ࡗࡓࠋࡲࡓࠊᑐ㇟㞟ᅋࡢ⬟ຊ್ࢆ♧ࡍᣦᶆ㸦DELOLW\㸸ࡍ࡭࡚ࡢᅇ⟅࡛ࠕ࡛ࡁࡿࠖ࡜ᅇ⟅ࡋࡓேࡢ๭ྜ㸧ࢆ⟬ฟࡋࡓ࡜ࡇࢁࠊ㸣㸦4㸣ࠊ4㸣㸧࡛඲࡚ࠕ࡛ࡁࡿࠖ࡜࠸࠺ᅇ⟅࡛࠶ࡗࡓࠋࡇࢀࡣᙉ࠸ኳ஭ຠᯝࡢᏑᅾࢆ♧ࡍᡤぢ࡛࠶ࡿࠋ
 ௚᪉ࠊ᪂ࡓ࡟㛤Ⓨࡋࡓ㌟య⬟ຊၥデ⚊ࡢᑐ㇟ࡣࠊ୰ᖺᮇ࠿ࡽࡢࣜࢫࢡᚩೃࢆᤊ࠼ࡿୖ࡛
๓ᥦ᮲௳࡜࡞ࡿኳ஭ຠᯝ࠾ࡼࡧᗋຠᯝࡢ⛬ᗘࢆ☜ㄆࡍࡿᚲせࡀ࠶ࡗࡓࡓࡵࠊ㹼 ṓࡢ୰ᖺᒙࡢ⏨ዪ  ேࢆᑐ㇟࡟ணഛㄪᰝࢆ⾜ࡗࡓࠋࠕ࡛ࡁࡿࠖࢆ  Ⅼࠊࠕ࡞ࢇ࡜࠿࡛ࡁࡿࠖࢆ
 Ⅼࠊࠕ࡛ࡁ࡞࠸࣭ࠖࠕࢃ࠿ࡽ࡞࠸ࠖࢆ  Ⅼ࡜ࡋࡓ⤖ᯝࠊᖹᆒ⥲ᚓⅬࡣ  Ⅼ‶Ⅼ࡛  Ⅼ㸦4 Ⅼࠊ4 Ⅼ㸧࡛࠶ࡗࡓࠋࡲࡓࠊᑐ㇟⪅ࡢ⬟ຊ್ࢆ♧ࡍᣦᶆ㸦DELOLW\㸸ࡍ࡭࡚ࡢᅇ⟅࡛ࠕ࡛ࡁࡿࠖ࡜ᅇ⟅ࡋࡓேࡢ๭ྜ㸧ࢆ⟬ฟࡋࡓ࡜ࡇࢁࠊ㸣㸦4㸣ࠊ4㸣㸧ࡀࡍ࡭࡚ࠕ࡛ࡁࡿࠖ࡜࠸࠺ᅇ⟅࡛࠶ࡗࡓࠋࡇࡢ⤖ᯝࡣࠊࢦ࣮ࣝࢻ࣭ࢫࢱࣥࢲ࣮ࢻ࡛࠶ࡿ⡆᫆)5$,/ ࢫࢡ࣮ࣜࢽࣥࢢ㉁ၥ⚊ࡢ⤖ᯝ࡛࠶ࡿ 㸣㸦4㸣ࠊ4㸣㸧࡜ẚ㍑ࡍࡿ࡜ኳ஭ຠ
ᯝࡀᢚไࡉࢀ࡚࠾ࡾࠊᗋຠᯝࡶᙅ࠸ࡇ࡜ࡀ♧ࡉࢀࡓࠋ
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㸫139㸫

 ḟᖺᗘࡣࠊࡉࡽ࡟୰ᖺ⪅ᒙࡢ⿵඘࡟ຍ࠼ࠊ㧗㱋⪅ᒙ࡟ㄪᰝᑐ㇟ࢆᣑ኱ࡋࠊ
ࠕ᫆ࣇࣞ࢖ࣝࠖ
≧ែࢆᐃ⩏ࡍࡿ࢝ࢵࢺ࢜ࣇ್ࢆỴᐃࡍࡿࠋࡲࡓࠊࠕ᫆ࣇࣞ࢖ࣝࠖ≧ែࡢᇶᮏ≉ᛶࡢ≉ᚩ㸦⫋ᴗ⤒Ṕࡸ೺デᡤぢ࡞࡝㸧ࢆศᯒࡍࡿணᐃ࡛࠶ࡿࠋ
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㸫140㸫

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㉸㧗㱋໬♫఍ࡢᡃࡀᅜ࡟࠾࠸࡚ࠊせ௓ㆤண㜵ࡣࠊ೺ᗣᑑ࿨ᘏఙࡸ་⒪⤒῭ⓗほⅬ࠿ࡽ㔜せ࡞ㄢ㢟࡛࠶ࡿࠋᖹᡂ  ᖺᗘࡢෆ㛶ᗓࡢ㧗㱋♫఍ⓑ᭩࡟ࡼࡿ࡜ࠊ⿕ಖ㝤⪅࡟༨ࡵࡿせ௓ㆤ㧗㱋⪅ࡣࠊ㹼 ṓࡢ㸱㸮㸣ࠊ ṓ௨ୖࡢ㸰㸱㸳㸣࡟ㄆࡵࡽࢀࠊ ṓ௨ୖ࡛ᛴ⃭࡟ቑຍࡍࡿࠋࡑࡋ࡚ࠊࣇࣞ࢖ࣝ㧗㱋⪅ࡣࠊ㹼 ṓ࡛㸵㹼㸶㸣ࠊ㹼 ṓ࡛㸯㸲㹼㸱㸯㸣࡟㐩ࡍࡿ㸦<DPDGD $UDLࠊ㸧ࠋࣉࣞࣇࣞ࢖࣭ࣝࣇࣞ࢖ࣝࠊ࠶ࡿ࠸ࡣࡑࡢ㌟యⓗᚩೃࢆᤊ࠼ࡓࢧࣝࢥ࣌ࢽ࢔ࡣࠊ⌧ᅾࡲࡓࡣᑗ᮶ࡢ᪥ᖖ⏕άࡢ⮬❧ᗘࡢపୗࠊ᪋タධᡤࠊṚஸ࡞࡝㈇ࡢ೺ᗣ࢔࢘ࢺ࣒࢝࡜ᙉࡃ㛵㐃ࡍࡿࡇ࡜࠿ࡽࠊせ௓ㆤࡢࣁ࢖ࣜࢫࢡ≧ែ࡜ࡋ࡚ὀ┠ࡉࢀ࡚࠸ࡿࠋࡋ࠿ࡋ࡞ࡀࡽࠊࣇࣞ࢖ࣝ㧗㱋⪅࡟ᑐࡍࡿ௓ධ࡟ࡣከ኱࡞ேⓗ࣭⤒῭ⓗ㈇ᢸࡀᚲせ࡜࡞ࡿࠋ7KHRX ࡽࡣ㸲㸵௳ࡢ㛵㐃ㄽᩥࡢ⣔⤫ࣞࣅ࣮ࣗ࡟ࡼࡗ࡚ࠊࣇࣞ࢖ࣝ㧗㱋⪅࡬ࡢ௓ධ࡟ࡘ࠸࡚
ࡣࠊ㧗㢖ᗘ㸦㐌㸱ᅇ௨ୖ㸧ࠊ㛗ᮇ㛫㸦㸱࠿᭶௨ୖ㸧ࠊ࠿ࡘᑓ㛛⫋࡟ࡼࡿ⥲ྜⓗ௓ධ㸦㐠ື⒪ἲࠊᰤ㣴⿵ຓ㣗ရࡢᦤྲྀࠊ᪥ᖖ⏕άᣦᑟ࡞࡝ࢆྵࡴ㸧ࢆ᥎ዡࡋ࡚࠸ࡿ㸦7KHRXࡽࠊ㸧ࠋ
ࡲࡓࠊ6WXFN ࡽ㸦㸧ࡢ௓ධ◊✲࡛ࡣࠊ ṓ௨ୖࡢ㧗㱋⪅ࡢ㞀ᐖⓎ⏕ࡢ㸯ᖺ㛫ඛᘏࡤࡋ࡟ࡣᖺ㸴㸯୓෇ࡀᚲせ࡜᥎ᐃࡋ࡚࠸ࡿࠋ㧗㱋ᮇ࡟Ⓨ⏕ࡋࡓࣇࣞ࢖ࣝ࠿ࡽࡢᅇ᚟ࡣᐜ࡛᫆ࡣ
࡞ࡃࠊᑓ㛛ᐙ࡟ࡼࡿ௓ධ࡟኱ࡁࡃ౫Ꮡࡍࡿࠋࡑࡢࡓࡵࠊࡑࡢ㈝⏝ࡶከ㢠࡟࡞ࡿࠋ
ࣇࣞ࢖࣭ࣝࣉࣞࣇࣞ࢖ࣝࡼࡾࡶࡼࡾ᪩ᮇࡢẁ㝵ࠊ୰ᖺᮇࡢẁ㝵࡛ࡑࡢᚩೃࢆᤊ࠼ࡽࢀࡿࡇ࡜ࡶ㔜せ࡜ᛮࢃࢀࡿࠋ୰ᖺᮇุ࡛ᐃࡍࡿࣉࣞࣇࣞ࢖࣭ࣝࣇࣞ࢖ࣝ࡟࡞ࡾ᫆࠸≧ែࢆࠕ᫆ࣇࣞ࢖ࣝࠖ࡜௬࡟ᐃ⩏ࡍࡿ࡜ࠊࡇࡢ≧ែࢆᢕᥱ࡛ࡁࡿ⡆౽࡞᳨ᰝࡀᚲせ࡛࠶ࡿࠋ
ࣇࣞ࢖ࣝࡣ㌟యⓗせ⣲ࠊㄆ▱ᚰ⌮ⓗせ⣲ࠊ♫఍ⓗせ⣲࡜࠸ࡗࡓከせ⣲࠿ࡽᵓᡂࡉࢀࡿࠋ

㸫141㸫ࡑࡢ୰࡛ࡶࠊࣇࣞ࢖ࣝࡢ㌟యⓗせ⣲ࡣࠊ᭱ࡶᐈほⓗ࡞ホ౯᪉ἲࡀ☜❧ࡋ࡚࠾ࡾࠊࡑࡢ௦⾲౛ࡀࢧࣝࢥ࣌ࢽ࢔㸦➽⫗ῶᑡ⑕㸧࡛࠶ࡿࠋࡋ࠿ࡋࠊ᪤Ꮡࡢၥデ⚊࡛ࡣࠊࣉࣞࣇࣞ࢖࣭ࣝࣇ
ࣞ࢖ࣝࡢ๓ẁ㝵ࡢุᐃࡣ༑ศ࡟⾜࠸ᚓ࡞࠸ࠋࡓ࡜࠼ࡤࠊ6$5&)㸦ࢧࣝࢥ࣌ࢽ࢔⮫ᗋ⑕≧ࢫࢡ࣮ࣜࢽࣥࢢ㸧ࡢタၥࢆࡳࡿ࡜ࠊ㸯㸧㸲ࠥ㸳NJࡢࡶࡢࢆᣢࡕୖࡆ࡚㐠ࡪࡢࡀ࡝ࡢࡃࡽ࠸ᅔ
㞴࡛ࡍ࠿㸸඲ࡃᅔ㞴࡛࡞࠸ࠊᑡࡋᅔ㞴ࠊ࡜࡚ࡶᅔ㞴࣭ࡲࡓࡣ඲ࡃ࡛ࡁ࡞࠸㸹㸰㸧㒊ᒇࡢ୰ࢆṌࡃࡢࡀ࡝ࡢࡃࡽ࠸ᅔ㞴࡛ࡍ࠿㸸඲ࡃᅔ㞴࡛࡞࠸ࠊᑡࡋᅔ㞴ࠊ࡜࡚ࡶᅔ㞴࣭⿵ຓලࡀᚲ
せ࣭ࡲࡓࡣ඲ࡃṌࡅ࡞࠸㸹㸱㸧᳔Ꮚࡸ࣋ࢵࢻ࠿ࡽ⛣ືࡍࡿࡢࡀ࡝ࡢࡃࡽ࠸ᅔ㞴࡛ࡍ࠿㸸඲ࡃᅔ㞴࡛࡞࠸ࠊᑡࡋᅔ㞴ࠊ࡜࡚ࡶᅔ㞴࣭ࡲࡓࡣຓࡅࡀ࡞࠸࡜⛣ື࡛ࡁ࡞࠸㸹㸲㸧㝵ẁࢆ㸯㸮ẁࡢࡰࡿࡢࡀ࡝ࡢࡃࡽ࠸ࡓ࠸࡬ࢇ࡛ࡍ࠿㸸඲ࡃᅔ㞴࡛࡞࠸ࠊᑡࡋᅔ㞴ࠊ࡜࡚ࡶᅔ㞴࣭ࡲࡓࡣࡢࡰࢀ࡞࠸㸹㸳㸧ࡇࡢ㸯ᖺ࡛ఱᅇ㌿ಽࡋࡲࡋࡓ࠿㸸࡞ࡋ㸦㸮ᅇ㸧ࠊ㸯ࠥ㸱ᅇࠊ㸲ᅇ௨ୖࠊ࡜࡞ࡗ࡚࠾ࡾࠊ㸯㸮Ⅼ‶Ⅼ୰㸲Ⅼ௨ୖ࡛ࠕࢧࣝࢥ࣌ࢽ࢔⮫ᗋ⑕≧࠶ࡾࠖ࡜ࡋ࡚࠸ࡿ
ࡀࠊ㸰㸧࣭㸱㸧࣭㸲㸧࡞࡝᪥ᖖࡢᇶᮏືసࡀ୺࡛ࠊ୰ᖺ⪅࡛㝧ᛶ࡜࡞ࡿࡇ࡜ࡣࡲࢀ࡛࠶ࡿࠋࡲࡓࠊ)UDPLQJKDP+HDUW6WXG\ ࡛ࡣࠊ㧗㱋⪅ࡢືస㞀ᐖࡢᢕᥱࡢࡓࡵࠊ1DJL ࡢ㞀ᐖศ㢮ࡢࠕᶵ⬟ⓗไ㝈ࠖ࡟఩⨨ࡍࡿືస⩌࡟╔┠ࡋࡓၥデ⚊ࢆ⏝࠸࡚࠸ࡿࡀ㸦0XUDELWR ࡽࠊ㸧ࠊ㐠ື㈇Ⲵ㔞ࡸ㞴᫆ᗘࡢ⠊ᅖࡀ㝈ᐃⓗ࡛ࠊྠࡌࡃ୰ᖺ⪅ࡢࣇࣞ࢖ࣝࡢᚩೃࢆᤊ࠼ࡿ࡟ࡣ㐺ࡉ࡞࠸ࠋᐇ㝿࡟⏝࠸ࡽࢀ࡚࠸ࡿືస⩌ࡣࠊ኱ࡁ࡞≀ࢆᢲࡍ࣭ᘬࡃࠊయࢆ࠿ࡀࡵࡿ࣭ࡋࡷࡀࡴࠊ
ࡲࡓࡣ⭸❧ࡕࡍࡿࠊ⫪ࡢ㧗ࡉࡼࡾ㧗ࡃ⭎ࢆ࠶ࡆࡿࠊᩥᏐࢆ᭩ࡃࠊࡲࡓࡣᑠࡉ࡞≀ࢆࡘࡲࡴ࣭
ྲྀᢅ࠺ࠊ㸯㸳ศ௨ୖ❧ࡕ⥆ࡅࡿࠊ㸯᫬㛫௨ୖᗙࡾ⥆ࡅࡿ࡛࠶ࡗࡓࠋࡉࡽ࡟ࠊせ௓ㆤண㜵ࡢ◊✲ࡢከࡃࡀ  ṓࡸ  ṓ௨ୖࡢ㧗㱋⪅ࢆᑐ㇟࡟ࡍࡿ₯ᅾⓗཎᅉࡢࡦ࡜ࡘ࡜ࡋ࡚ࡶࠊ᪤Ꮡ
ࡢࣉࣞࣇࣞ࢖࣭ࣝࣇࣞ࢖ࣝၥデ⚊ࡀࠊ୰ᖺᮇࡢᚩೃࢆᤊ࠼࡟ࡃ࠸ࡇ࡜ࡀᣲࡆࡽࢀࡿࠋ


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Ⴘႎ

ᮏ◊✲ࡣࠊ୰ᖺᮇ࡟࠾࠸࡚ࣉࣞࣇࣞ࢖࣭ࣝࣇࣞ࢖ࣝࡢ๓≧ែ࡜ࡋ࡚ࡢࠕ᫆ࣇࣞ࢖ࣝ (DV\IUDLOW\㸦௬⛠㸧ࠖࢆุᐃࡍࡿၥデ⚊ࢆ㛤Ⓨࡍࡿࡇ࡜ࢆ┠ⓗ࡜ࡍࡿࠋࡲࡓࠊ୰ᖺᒙࢆྵࡴᆅ
ᇦఫẸࢆᑐ㇟࡜ࡋࡓᐇែㄪᰝ࡟ࡼࡾࠊ㐺ษ࡞タၥࡢ㑅ᢥ࡜᫆ࣇࣞ࢖ࣝࡢ≉ᚩศᯒࢆ⾜࠺ࡇ࡜࡛ࠊせ௓ㆤண㜵࡟ྥࡅࡓຠᯝⓗ࣭ຠ⋡ⓗ࡞௓ධ᪉ἲࡢ᳨ウࢆྍ⬟࡜ࡍࡿࡇ࡜ࢆ┠ⓗ࡜ࡍࡿࠋᅜ㝿ⓗ࡟౑⏝ࡉࢀ࡚࠸ࡿࣇࣞ࢖ࣝࢫࢣ࣮࡛ࣝ࠶ࡿ 5RRNZRRG ࡽࡢ⪃᱌ࡋࡓ &OLQLFDO
)UDLOW\6FDOH㸦⾲㸧ࡢ㸯࠿ࡽ㸷ࡢ≧ែീࡢ࠺ࡕࠊࣉࣞࣇࣞ࢖࣭ࣝࣇࣞ࢖ࣝ㸦⾲୰㸲࠿ࡽ㸷㸧࡜ኊ೺㸦⾲୰㸯㸧ࡢ㛫࡟఩⨨࡙ࡅࡽࢀࡿࠕ᫆ࣇࣞ࢖ࣝ (DV\IUDLOW\㸦௬⛠㸧ࠖࡢ≧ែࢆุᐃࡍࡿၥデ⚊ࢆ㛤Ⓨࡋࠊᐇែㄪᰝ࡟ࡼࡾ㐺ษ࡞タၥࡢ㑅ᢥ࡜᫆ࣇࣞ࢖ࣝࡢ≉ᚩศᯒࢆ⾜࠺ࠋලయⓗ࡟ࡣࠊᚋ㏙ࡍࡿձ࠿ࡽմࡢ◊✲ࢆᐇ᪋ࡍࡿࠋ◊✲ձ࡛ࡣࠊᆅᇦఫẸࢆᑐ㇟࡟౑⏝ࡉࢀ࡚࠸ࡿࣉࣞࣇࣞ࢖࣭ࣝࣇࣞ࢖ࣝࡸࡑࡢ୺せ⑓ែ࡛࠶ࡿࢧࣝࢥ࣌ࢽ࢔ࠊࡲࡓࡣ㌟య⬟ຊ࣭㞀ᐖ࡟㛵ࡍࡿ᳨ᰝࡸၥデ⚊࡟㛵ࡍࡿ⣔⤫ࣞࣅ࣮ࣗࢆ⾜࠺ࠋ◊✲ղ࡛ࡣࠊ◊✲ձ࡟ࡼࡗ࡚ᢳ
ฟࡉࢀࡓ᳨ᰝࡸၥデ⚊ࢆཧ⪃࡟ࠊࠕ᫆ࣇࣞ࢖ࣝࠖࢆ᳨ฟࡍࡿ㌟య⬟ຊၥデ⚊ࢆ㛤Ⓨࡍࡿࠋ◊✲ճ࡛ࡣࠊ᪤Ꮡࡢࣇࣞ࢖ุࣝᐃ࡜᪂ᑻᗘࡢ㌟య⬟ຊၥデ⚊ࢆ⏝࠸࡚ࠊᆅᇦఫẸ⣙㸯㸱㸮㸮ேࢆᑐ㇟࡜ࡋࡓᐇᆅㄪᰝ࡟ࡼࡾ㐺ษ࡞タၥࡢ㑅ᢥࢆ⾜࠺ࠋࡑࡋ࡚ࠊ◊✲մ࡛ࡣࠊࠕ᫆ࣇ
ࣞ࢖ࣝࠖࡢᇶᮏ≉ᛶ࡜ࡋ࡚ࠊᛶ࣭ᖺ㱋ࡢࡳ࡛࡞ࡃࠊ⫋ᴗࡸ೺デᡤぢ࡜ࡢ㛵㐃ࢆホ౯ࡍࡿࠋ



㸫143㸫

   ᘙ

Clinical Frailty Scale ࡜ᮏ◊✲ࡢ┠ᣦࡍศ㢮ࡢ㛵ಀClinical Frailty Scale*ஜᄂᆮƷႸਦƢЎ᫏

1

ኊ೺ Very fit

೺ᖖ Well2

೺ᖖ Well3ඖẼ࡞≧ែẐତἧἾỶἽ Easy frailtyẑ

Managed well4⬤ᙅVulnerable

5㍍ᗘࡢࣇࣞ࢖ࣝ

ࣉࣞࣇࣞ࢖ࣝ Pre-frail

Mildly frail
6ࣇࣞ࢖ࣝ Frail୰➼ᗘࡢࣇࣞ࢖ࣝ
Moderately frail

7㔜ᗘࡢࣇࣞ࢖ࣝ Severely

㸦せ௓ㆤ㸧

frail
8

㠀ᖖ࡟㔜ᗘࡢࣇࣞ࢖ࣝ Veryseverely frail

9⑌ᝈࡢ⤊ᮎᮇ Terminally ill  *ฟ඾ Rockwood, et al., 2005 modified by Morley, et al., 2013, frailty consensus. ヂ ఍⏣⸅Ꮚ ᮏ✏࡛ࡣࠊึᖺᗘ㸦ᖹᡂ  ᖺᗘ㸧ࡢᡂᯝሗ࿌ࢆ⾜࠺ࠋ૾ඥᮏ◊✲࡛ࡣࠊ◊✲ձ࠿ࡽ◊✲մࢆᐇ᪋ࡍࡿ㸦ᅗ㸯㸧ࠋ◊✲ճ࠿ࡽ◊✲մ࡛ࡣࠊWKH
&LUFXODWRU\5LVNLQ&RPPXQLWLHV6WXG\ &,5&6 ◊✲ࡢ  ṓ௨ୖࡢᚠ⎔ჾ೺デཷデ⪅ᖺ࠶ࡓࡾ⣙㸯㸳㸮㸮ேࢆᑐ㇟ࡢᐇᆅㄪᰝ࡟ࡼࡗ࡚ጇᙜᛶࢆ᳨ウࡍࡿࠋᖹᡂ㸰㸷ᖺᗘࡣ◊✲ձ࠿ࡽ◊✲ղࢆ᏶஢ࡋࠊ◊✲ճࢆ୍㒊㛤ጞࡋࡓ㸦᪂㉁ၥ⣬ㄪᰝཬࡧ⡆᫆ࢫࢡ࣮ࣜࢽࣥࢢ
ㄪᰝ㹼 ṓ⏨ዪ  ே㸧ࠋᖹᡂ㸱㸮ᖺᗘࡣ◊✲ճ࡜ࡋ࡚  ṓ௨ୖ⏨ዪ⣙  ே࡜ 㸫144㸫㹼 ṓ⏨ዪ㸦⣙  ேࡢぢ㎸ࡳ㸧࡬ࡢྠᵝࡢㄪᰝ࡜◊✲մࡢ೺デᡤぢ࣭⫋ᴗศ㢮ࡢ᝟ሗࢆ㞟ࡵࡿࡇ࡜࡛ࠊ᭱⤊ࡢࢹ࣮ࢱゎᯒ࡜ㄽᩥ໬ࢆ⾜࠺ࠋ‫׋‬Ძ ᮏ◊✲ࡢ඲యീଢ଼஢৯৓ ใோ峘ਫ਼ਪ峮ਖ൧௠峘્ඉ峼峟峨岲岝崿嵔崽嵔崌嵓嵣崽嵔崌嵓峘৐஺మ峒峁峐岣ಔ崽嵔崌嵓 (DV\IUDLOW\岤峘૾ଙ峼ਫ਼ল峃峵ମ৬ચৡਖ൧௠峼੿ਛ峃峵ଢ଼஢ձ岩 ମ ৬ ચ ৡ ਖ ൧ ௠ 峘 ੿ ਛ  岪ใோਫ਼ਪ峮ਖ൧௠峘

ଢ଼஢ղ

ଢ଼஢ճ

ଢ଼஢մ

௺ଁ嵔崻嵍嵤ਝਖ੿ਛৗჃ২峘ਝਖ峘৭උৗীథ峘્ඉীෲ

嵣ਫ਼ด崐嵛崠嵛 0HGOLQH嵣௧୅૙峕峲峵嵣崿嵔崽嵔崌嵓嵣崽嵔崌嵓峒峘嵣૙঵ীథ峒峘ঢ়৴ਫ਼ୈভ଍஄ਙ峘௬੼

嵣ਫ਼ดୁ IUDLO嵣ਈ৵ඨ৯ਯ峘ਫ਼ୈVDUFRSHQLD嵣৉ୠકড়峕峲峵

SK\VLFDO

嵊崳崧嵒嵛崘崮崡崰

IXQFWLRQHWF嵣௏൧ਚৄ峒峘ঢ়৴৉ୠકড়৺  য峑峘পૠெ峔ৰ৉৹ਪ峘ৰ઱಺ௌ਋岵峳峘๻峉岷峴嵣ਏஂ૧੒ଆ峕๾൴峃峵ᄂᆮĬଏ‫܍‬౨௹ǍբᚮᅚƷኒወȬȓȥȸᲢ࠯঺  ࠰ࡇ‫ܦ‬ʕᲣᆅᇦఫẸࢆᑐ㇟࡟౑⏝ࡉࢀ࡚࠸ࡿࣇࣞ࢖ࣝࡸࡑࡢ୺せ⑓ែ࡛࠶ࡿࢧࣝࢥ࣌ࢽ࢔ࠊࡲࡓࡣ
㌟య⬟ຊ࣭㞀ᐖ࡟㛵ࡍࡿ᳨ᰝࡸၥデ⚊࡟㛵ࡍࡿ⣔⤫ࣞࣅ࣮ࣗࢆ⾜ࡗࡓࠋᩥ⊩᳨⣴࡟ࡣ
0HGOLQH ࢆ⏝࠸ࠊ㛵㐃ㄽᩥࡣࣁࣥࢻࢧ࣮ࢳ࡛㐺ᐅ㏣ຍࡍࡿࠋ᳨⣴ㄒࡣࠕIUDLOࠖࠊࠕVDUFRSHQLDࠖࠊࠕSK\VLFDO IXQFWLRQࠖࠊࠕGLVDELOLW\ࠖࠊࠕIXQFWLRQDO DVVHVVPHQWࠖࠊࠕIXQFWLRQDOTXHVWLRQQDLUHࠖࠊࠕDFWLYLWLHVRIGDLO\OLYLQJࠖࠊࠕGLVDELOLW\ࠖࠊࠕLPSDLUPHQWࠖࠊࠕIXQFWLRQDOGHFOLQHࠖࠊࠕFRPPXQLW\GZHOOLQJSHRSOHࠖࢆೃ⿵࡜ࡋࡓࠋྲྀ㎸ࡴㄽᩥࡣࠊ

㸫145㸫

඲ᩥࡀ㜀ぴྍ⬟࡞ⱥㄒㄽᩥ࡜ࡋࡓࠋ᳨⣴⤖ᯝࢆ୍ぴ࡟ࡋࠊࢱ࢖ࢺ᳨ࣝ⣴ࢆ࠾ࡇ࡞࠸ࠊ㔜」
ࢆ㝖࠸ࡓ㛵ಀㄽᩥ࡟⤠㎸ࢇࡔࠋᄂᆮĭ ៲˳ᏡщբᚮᅚƷᚨբ˺঺Ტ࠯঺  ࠰ࡇ‫ܦ‬ʕᲣ◊✲ձ࡟ࡼࡗ࡚ᢳฟࡉࢀࡓ᳨ᰝࡸၥデ⚊ࢆཧ⪃࡟ࠊࠕ᫆ࣇࣞ࢖ࣝࠖࢆ᳨ฟࡍࡿ㌟య⬟ຊၥデ⚊ࢆ㛤Ⓨࡋࡓࠋ᳨ウẁ㝵࡛ࡣ㸱㸮㡯┠࠿ࡽ㸲㸮㡯┠⛬ᗘࢆᥦ᱌ࡋࠊ᭱⤊ⓗ࡞㡯┠ᩘ࡜ࡋ࡚ࡣ㸰㸴㡯┠࡜ࡋࡓࠋタၥෆᐜࡣࠊཎ๎࡜ࡋ࡚ࠊㄡࡶࡀ᪥ᖖࡢ⠊␪࡛⤒㦂ࡋᚓࡿືస࡜
ࡋࠊᆅᇦࡸᩥ໬ࡢᙳ㡪ࢆཷࡅ࡟ࡃ࠸ືసࢆඃඛࡋࡓࠋࡲࡓࠊ㹼 ṓ࡛ᨭ㞀ࡢ࡛ࡿືసࢆ
ྵࡴࠋලయⓗ࡟ࡣࠊ1DJL ࡢ㞀ᐖศ㢮࡟࠾ࡅࡿᶵ⬟ⓗไ㝈࡟఩⨨ࡍࡿືస⩌㸦ᒆࡃ࣭ࡘ࠿ࡴࠊ
ᣢࡕୖࡆࡿ࣭㐠ࡪࠊᢲࡍ࣭ᘬࡃࠊ᭤ࡆࡿ࣭࠿ࡀࡴࠊᅇࡍ࣭ࡦࡡࡿࠊᢞࡆࡿ࣭ཷࡅࡿࠊ㌿ࡀࡿࠊ❧ࡘࠊࡋࡷࡀࡴ࣭ࡦࡊࡲࡎࡃࠊ❧ࡕୖࡀࡿ࣭ᗙࡿࠊᐷࡿ࣭㉳ࡁୖࡀࡿࠊ㏺࠺࣭Ṍࡃ࣭㉮ࡿࠊ㝵ẁࢆ᪼ࡿ࣭㝆ࡾࡿࠊ㊴ࡡࡿ࣭㊴ࡪࠊ㋾ࡿ㸧࠿ࡽ㸯ࡘࠊࡲࡓࡣ㸰ࡘ௨ୖࡢ⤌ྜࡏ࡛ྍ⬟࠿࡝࠺࠿ࢆᑜࡡࡿタၥ࡜ࡋࡓࠋࡓ࡜࠼ࡤࠊࠕ㝵ẁࢆ᪼ࡿࠖ࡜ࠕ㉮ࡿࠖࡢࡑࢀࡒࢀ࡜ࠊ
ࠕ㝵ẁࢆ࠿ࡅ㊊࡛᪼ࡿࠖࢆຍ࠼ࡓࠋࡇࡢሙྜࠊࠕ㝵ẁࢆ࠿ࡅ㊊࡛᪼ࡿࠖࡀ᭱ࡶ㐠ື㈇Ⲵ㔞ࡸ㞴᫆ᗘࡢ㧗࠸タၥ࡜࡞ࡿࠋᶵ⬟ⓗไ㝈ࡣࠊ㞀ᐖศ㢮ࡢ࡞࠿࡛ࡶࠊᶵ⬟㞀ᐖ࡜⬟ຊ㞀ᐖ㸦άືไ㝈㸧ࡢ㛫࡟఩⨨ࡋࠊ⬟ຊ㞀ᐖࡸ♫఍ⓗ୙฼㸦ཧຍไ⣙㸧࡯࡝ಶேᅉᏊ㸦౯್ほࡸࣛ࢖ࣇࢫࢱ࢖ࣝ࡞࡝㸧ࡸ⎔ቃᅉᏊ㸦ᩥ໬ࡸᆅᇦ࡞࡝㸧࡟ᙳ㡪ࡉࢀ࡟ࡃ࠸ඹ㏻ࡢືస⩌࡜⪃࠼ࡽࢀ࡚࠸ࡿࠋࡲࡓࠊᅇ⟅᪉ἲ࡟ࡣ㸰௳ἲ㸦࡛ࡁࡿ࣭࡛ࡁ࡞࠸㸧࠿ࡽࠊ㸱௳ἲ㸦ᨭ㞀࡞ࡃ࡛ࡁࡿ࣭ᨭ㞀࠶ࡿࡀ࡛ࡁࡿ࣭࡯࡜ࢇ࡝࡛ࡁ࡞࠸㸧࡞࡝ࢆ᳨ウࡋࠊ᭱⤊ⓗ࡟ࠕၥ㢟࡞ࡃ࡛ࡁࡿ࣭
࡞ࢇ࡜࠿࡛ࡁࡿ࣭࡛ࡁ࡞࠸࣭ࢃ࠿ࡽ࡞࠸ࠖࡢ  ௳ἲ࡜ࡋࡓࠋ
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㸫146㸫

ᄂᆮĮ ៲˳ᏡщբᚮᅚƷܱ‫ע‬ᛦ௹ƴǑǔૼ‫ࡇݿ‬ƷᚨբƷᢠ৸Ტ࠯঺  ࠰ࡇᲣ᪤Ꮡࡢࣇࣞ࢖ุࣝᐃ࡜᪂ᑻᗘࡢ㌟య⬟ຊၥデ⚊ࢆ⏝࠸࡚ࠊᆅᇦఫẸࡢ୰㧗ᖺ⪅⣙㸯㸮㸮㸮ேࢆᑐ㇟࡜ࡋࡓᐇᆅㄪᰝࢆ⾜࠺㸦ᖹᡂ㸰㸷ᖺᗘ࡟  ே㐙⾜῭ࡳࠊ㸱㸮ᖺᗘ࡛඲ᩘ࡟
ᣑࡆࡿ㸧ࠋᅇ⟅⤖ᯝࡣⅬᩘ໬ࡋࠊ೺ᖖࠊࠕ᫆ࣇࣞ࢖ࣝࠖࠊࣉࣞࣇࣞ࢖࣭ࣝࣇࣞ࢖ࣝ࡟ศ㢮ࡍࡿၥデ⚊࡜ࡋ࡚㐺ษ࡞タၥࢆ㑅ᢥࡍࡿࠋ᪂ศ㢮࡛࠶ࡿࠕ᫆ࣇࣞ࢖ࣝࠖࢆ᳨ฟࡍࡿ᪤Ꮡࡢ
ၥデ⚊ࡣᏑᅾࡋ࡞࠸ࡓࡵࠊ೺ᖖࠊࣉࣞࣇࣞ࢖࣭ࣝࣇࣞ࢖ࣝ࡜ࡢ⥺ᙧᛶ࡜ྛ⩌㛫ࡢ⤫ィᏛⓗ᭷ពᕪࢆࡶࡗ᳨࡚ฟࡍࡿ㸦ᅗ㸰㸧ࠋලయⓗ࡟ࡣࠊ᪂ᑻᗘ࡜᪤Ꮡࡢࣇࣞ࢖ุࣝᐃࡢၥデ⚊࡛࠶ࡿ )5$,/ ࢫࢡ࣮ࣜࢽࣥࢢࢶ࣮ࣝ㸦0RUOH\ ࡽࠊ㸹ࠊ⪁ᖺ་Ꮫࡢ୺せᶵ㛵࡟ࡼࡿࢥࣥࢭࣥࢧࢫ఍㆟࡛᥎ዡࡉࢀ࡚࠸ࡿၥデ⚊㸧ࢆ඲ဨ࡟ᐇ᪋ࡋࠊࡲࡎࠊᚋ⪅ࡢ )5$,/ ࡟ࡼࡾࣉࣞࣇࣞ࢖࣭ࣝࣇࣞ࢖ࣝࠊࡑࢀ௨እ࡟ศ㢮ࡍࡿࠋḟ࡟ࠊ᪂ᑻᗘࡢศ㢮ࡈ࡜ࡢᖹᆒⅬࢆ⟬ฟࡋࠊྛศ㢮㛫࡟⤫ィᏛⓗ᭷ពᕪࡀ⏕ࡌࡿࡇ࡜ࢆ☜ㄆࡍࡿࠋࡑࡢᚋࠊᮏ◊✲࡛సᡂࡍࡿ㌟య⬟ຊၥデ⚊࡟ࡼࡗ࡚ࣉࣞࣇࣞ࢖࣭ࣝࣇࣞ࢖ࣝ࡜ࡢ⥺ᙧᛶ࡜ྛ⩌㛫ࡢ⤫ィᏛⓗ᭷ពᕪࡀಖࡓࢀࡿ
ࠕ᫆ࣇࣞ࢖ࣝࠖࡢศ㢮ࢆ᳨ฟࡍࡿࠋࡲࡓࠊࡑࢀࡽࡢ᮲௳ࢆ‶ࡓࡍ᭱ᑠ㝈ࡢタၥᩘ➼࡟ࡘ࠸᳨࡚ウࡋࠊᅇ⟅ࡢ㈇ᢸ㍍ῶࡸỗ⏝ᛶࢆ㧗ࡵࡿࡓࡵࡢᕤኵ࡟༑ศ࡟㓄៖ࡍࡿࠋ࡞࠾ࠊࡇࡢ᪂
ᑻᗘ࡟ࡼࡿศ㢮࡛ࡣࠊྛศ㢮࡛ᛶᖺ㱋ศᕸࡀ೫ࡿࡇ࡜ࡀண᝿ࡉࢀࡿࠋᛶᖺ㱋ㄪᩚ࡟ࡘ࠸࡚
ࡣࠊ୍⯡⥺ᙧࣔࢹࣝ࡟ᇶ࡙࠸ࡓඹศᩓศᯒࢆ⏝࠸࡚ࡢᛶᖺ㱋ㄪᩚࠊࠕ᫆ࣇࣞ࢖ࣝࠖヱᙜ⪅࡟ྜࢃࡏࡓᒙู↓సⅭᢳฟ࡟ࡼࡿᑐ↷㞟ᅋ࡜ࡢẚ㍑࡞࡝ࠊ㐺ษ࡞᪉ἲࢆ⏝࠸ࡿࠋࡑࡋ࡚ࠊ
ୖグࡢㄪᰝᑐ㇟⪅ࡢ୍㒊࡟࠾࠸࡚ࠊ➽⫗㔞ࠊᥱຊࠊṌ⾜⬟ຊ➼ࡢ㐠ືᶵ⬟᳨ᰝࢆᐇ᪋ࡋࠊ
᪂ᑻᗘࡢጇᙜᛶࡢ᳨ドࢆ⾜࠺ࠋ



㸫147㸫

‫׋‬Წ ᮏ◊✲࡛సᡂࡍࡿ㌟య⬟ຊၥデ⚊ࡢタၥࡢ㑅ᢥ᪉ἲ৉ୠકড়৺  য峘ৰ৉৹ਪ

岧ਝਖ峘৭උ্১岨‫پ‬ৗীథ岣ಔ崽嵔崌嵓岤峼ਫ਼ল峃峵ใோ‫پ‬ৗীథ岣ಔ崽嵔崌嵓岤峼ਫ਼ল峃峵ใோ峘ਖ൧௠峙ோ૔峁峔岮峉峫岝崽嵔崌嵓嵣崿嵔崽嵔崌嵓嵣௏ଞ峒峘଍஄ਙ峒૚ীథ৑峘ଁੑ৾৓થਔ୷峼૖੯峕ਝਖ峼৭උ峃峵岞মଢ଼஢峑੿ਛ峃峵ମ৬ચৡਖ൧௠峒‫پ‬ෘ୳崯嵤崧峕峲峵੿௕ใோ峘ਖ൧௠)5$,/ 崡崗嵒嵤崳嵛崘崬嵤嵓௥ਡ崿嵔崽嵔崌嵓崽嵔崌嵓ମ৬ચৡਖ൧௠峘੕ਡ峘ীഘ岵峳ৗীథ峑岬峵岣ಔ崽嵔崌嵓岤峒௏ଞ峼ਫ਼ল峃峵

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岤 ӐӣӞӐӞҶӝ ӐӞҶӝ௏ଞ 岣ಔӐӞҶӝ岤岣ಔ崽嵔崌嵓岤ᄂᆮį ៲˳ᏡщբᚮᅚƴǑǔžତȕȬǤȫſƷཎࣉЎௌᲢ࠯঺  ࠰ࡇᲣ᪂ศ㢮࡛࠶ࡿࠕ᫆ࣇࣞ࢖ࣝࠖࡢᇶᮏ≉ᛶ࡜ࡋ࡚ࠊᛶ࣭ᖺ㱋࡟ຍ࠼࡚ࠊ⫋ᴗࡸ೺デᡤぢ࡜ࡢ㛵㐃ࢆホ౯ࡍࡿࠋ⫋ᴗศ㢮࡟ࡣࠊ᪥ᮏᶆ‽⫋ᴗศ㢮㸦2009㸧ࢆ⏝࠸ࠊ᭱㛗ᚑ஦࡜⌧ᅾࡢ⫋ᴗࡢ୧᪉ࢆၥデ࡛⪺ࡁྲྀࡾࠊ㸯㸮ࡢ኱㡯┠㸸ᑓ㛛ᢏ⾡ⓗᚑ஦⪅࣭⟶⌮ⓗ⫋ᴗ࣭஦ົᚑ஦
⪅࣭㈍኎ᚑ஦⪅࣭ࢧ࣮ࣅࢫ࣭ಖᏳ⫋ᴗᚑ஦⪅࣭㎰ᯘ⁺ᴗసᴗ⪅࣭㐠㍺㏻ಙᚑ஦⪅࣭⏕⏘ᕤ⛬ປົసᴗ⪅࣭↓⫋࡟ศ㢮ࡍࡿࠋ᭱㛗ᚑ஦ࢆࡑࡢேࡢ⫋ᴗ࡜ࡋࠊ୰ᑠ௻ᴗ࣭⮬Ⴀᴗ㸦⟶⌮࣭஦ົ⣔࣭ࢧ࣮ࣅࢫ࣭⌧ᴗ⣔࡞࡝ྵࡴ㸧ࠊ㎰ᴗᚑ஦⪅ࠊ↓⫋㸦୺፬ྵࡴ㸧࡟ศ㢮ࡍࡿࠋ೺デᡤぢ࡜ࡋ࡚ࠊ㐣య㔜࣭⫧‶ࠊ㧗⾑ᅽࠊ㧗⾑⢾࣭⢾ᒀ⑓ࠊ⬡㉁␗ᖖ⑕ࠊ࠾ࡼࡧ࣓ࢱ࣎ࣜࢵࢡ
ࢩࣥࢻ࣮࣒ࣟࡢ᭷↓ࢆ⏝࠸ࡿࠋ࣓ࢱ࣎ࣜࢵࢡࢩࣥࢻ࣮࣒ࣟࡢデ᩿ࡣࠊ࣓ࢱ࣎ࣜࢵࢡࢩࣥࢻ
࣮࣒ࣟデ᩿ᇶ‽᳨ウጤဨ఍㸦2005㸧ࡢデ᩿ᇶ‽࡟‽ࡌࠊ࢚࢘ࢫࢺ࿘ᅖᚄࡀᇶ‽್㸦⏨ᛶ㸶㸫148㸫

㸳㹡㹫௨ୖࠊዪᛶ㸷㸮㹡㹫௨ୖ㸧ࢆୖᅇࡾࠊ࠿ࡘࠊ㧗⾑ᅽ࣭㧗⾑⢾࣭⬡㉁␗ᖖ⑕ࡢ࠺ࡕ㸰ࡘ௨ୖ࡟ヱᙜࡋࡓሙྜ࡜ࡍࡿࠋ

ᮏ◊✲ࡣ &,5&6 ◊✲ࡢ୍⎔࡜ࡋ࡚ᐇ᪋ࡉࢀࡿࠋ&,5&6 ◊✲࡟ࡘ࠸࡚ࡣ኱㜰኱Ꮫ኱Ꮫ㝔་Ꮫ⣔◊✲⛉࣭་Ꮫ㒊་Ꮫ೔⌮ጤဨ఍㸦ᢎㄆ␒ྕ㸸㸯㸲㸰㸶㸳㸧࠾ࡼࡧ኱㜰ࡀࢇᚠ⎔ჾ⑓ண㜵ࢭࣥࢱ࣮ࡢ೔⌮ጤဨ఍ࡢᢎㄆࢆᚓ࡚࠸ࡿ㸦ᢎㄆ␒ྕ㸸㸰㸴㸫೔⌮㸫㸯㸧ࠋኽௐᮏ◊✲㸦ึᖺᗘ㸧࡛ࡣࠊᆅᇦఫẸࢆᑐ㇟࡟౑⏝ࡉࢀࡿ㉁ၥ⣬ࠊ≉࡟ࣇࣞ࢖ࣝࡸࡑࡢ୺せ⑓ែ࡛࠶ࡿࢧࣝࢥ࣌ࢽ࢔ࠊ㌟య⬟ຊ࣭㞀ᐖ࡟㛵ࡍࡿ㉁ၥ⣬࡟ࡘ࠸࡚ඛ⾜◊✲ࡢࣞࣅ࣮ࣗࢆ
⾜ࡗࡓࠋࡑࡢ⤖ᯝࠊ᪥ᮏㄒ࡛౑⏝ྍ⬟࡞ࢫࢡ࣮ࣜࢽࣥࢢ㉁ၥ⣬ࡣ  ௳㸦ᩥᮎ㸸⿵㊊㈨ᩱ㸯㸫㸯࠾ࡼࡧ㸯㸫㸰㸧ࠊࡲࡓࠊⱥㄒ࡛౑⏝ྍ⬟࡞ࡶࡢࡣ  ௳Ꮡᅾࡋࡓ㸦ᩥᮎ㸸⿵㊊㈨ᩱ㸰㸫㸯㹼㸰㸫㸱㸧ࠋ㛵ಀ⪅࡜ࡢウ㆟ࢆ⤒࡚ࠊ୰ᖺᮇ࠿ࡽࡢࣇࣞ࢖ࣝண㜵ࡢࡓࡵࡢ㌟య⬟ຊၥデ⚊㸦඲  ၥ㸧ࢆ㛤Ⓨࡋࡓ㸦ᩥᮎ㸸ᅗ㸱㸧ࠋ㉁ၥ⣬ࡣ࣮ࣚࣟࢵࣃ  ࠿ᅜ࡛㛤ጞࡉࢀࡓ኱つᶍࢥ࣮࣍ࢺࠕ6+$5( ◊✲ࠖࡢ㉁ၥ㡯┠ࢆྵࡳࠊᅜ㝿ẚ㍑ྍ⬟ᛶࢆ☜ಖࡋ࡚࠸ࡿࠋࡉࡽ࡟ࠊ
ᚑ᮶ࡢ㉁ၥ⣬࡛ࡣᤊ࠼ࡽࢀ࡞࠿ࡗࡓ㌟య⬟ຊࣞ࣋ࣝࢆホ౯ྍ⬟࡜ࡍࡿࡓࡵ࡟ࠊ᪂ࡓ࡟㛤Ⓨ
ࡋࡓ㉁ၥ㡯┠ࢆ㏣ຍࡋࡓࠋࡲࡓࠊ⎔ቃせᅉ࡟ᕥྑ᭷ࡉࢀ࡟ࡃ࠸ᶵ⬟ⓗືస㸦ືసࡑࡢࡶࡢ㸧ࡢ㡯┠࡟⤫୍ࡋࡓ㉁ၥ⣬࡜ࡋࡓࠋ
 ᪂ࡓ࡟㛤Ⓨࡋࡓ㌟య⬟ຊၥデ⚊ࡢጇᙜᛶ᳨ウࡢ୍⎔࡜ࡋ࡚ࠊ᪤Ꮡ㉁ၥ⣬ࡢࢦ࣮ࣝࢻ࣭ࢫ

㸫149㸫

ࢱࣥࢲ࣮ࢻ࡜ࡋ࡚ࠕ⡆᫆ )5$,/ ࢫࢡ࣮ࣜࢽࣥࢢ㉁ၥ⚊㸦ᩥᮎ㸸⿵㊊㈨ᩱ㸱㸧ࠖࢆ᥇⏝ࡋࠊᆅᇦఫẸࢆᑐ㇟࡟ணഛㄪᰝࢆ⾜ࡗࡓࠋ ⡆᫆ )5$,/ ࢫࢡ࣮ࣜࢽࣥࢢ㉁ၥ⚊࡟ࡘ࠸࡚ࡣࠊタၥ  ၥࡢࡓࡵẚ㍑ⓗ኱つᶍ࡞ணഛㄪᰝ
ࡀᐇ⌧࡛ࡁࠊ⛅⏣┴஭ᕝ⏫ࡢ⏨ዪ  ே㸦 ṓࠊ ṓࡢ๭ྜ ࠊᖹᆒᖺ㱋  ṓࠊዪᛶࡢ๭ྜ 㸣㸧ࢆᑐ㇟࡟ᐇែㄪᰝࢆ⾜ࡗࡓ㸦ᩥᮎ㸸⾲㸰㹼㸲㸧ࠋᖹᆒᚓⅬࡣ  Ⅼ㸦
Ⅼ‶Ⅼࠊ➨  ᅄศ఩Ⅼࠝ4ࠞ Ⅼࠊ➨  ᅄศ఩Ⅼࠝ4ࠞ Ⅼ㸧࡜࡞ࡗࡓࠋࡲࡓࠊᑐ㇟㞟ᅋࡢ⬟ຊ್ࢆ♧ࡍᣦᶆ㸦DELOLW\㸸ࡍ࡭࡚ࡢᅇ⟅࡛ࠕ࡛ࡁࡿࠖ࡜ᅇ⟅ࡋࡓேࡢ๭ྜ㸧ࢆ⟬ฟࡋࡓ࡜ࡇࢁࠊ㸣㸦4㸣ࠊ4㸣㸧࡛ࡍ࡭࡚ࠕ࡛ࡁࡿࠖ࡜࠸࠺ᅇ⟅࡛࠶ࡗࡓࠋࡇࢀࡣᙉ࠸
ኳ஭ຠᯝࡀᏑᅾࡍࡿࡇ࡜ࢆ♧ࡍᡤぢ࡛࠶ࡿࠋ
 ᪂ࡓ࡟㛤Ⓨࡋࡓ㌟య⬟ຊၥデ⚊ࡢᑐ㇟ࡣࠊ୰ᖺᮇ࠿ࡽࡢࣜࢫࢡᚩೃࢆᤊ࠼ࡿୖ࡛๓ᥦ᮲
௳࡜࡞ࡿኳ஭ຠᯝ࠾ࡼࡧᗋຠᯝࡢ⛬ᗘࢆ☜ㄆࡍࡿᚲせࡀ࠶ࡗࡓࡓࡵࠊ㹼 ṓࡢ୰ᖺᒙࡢ⏨ዪ  ேࢆᑐ㇟࡟ணഛㄪᰝࢆ⾜ࡗࡓ㸦ᩥᮎ㸸⾲㸳࣭㸴㸧ࠋࠕ࡛ࡁࡿࠖࢆ  Ⅼࠊࠕ࡞ࢇ࡜
࠿࡛ࡁࡿࠖࢆ  Ⅼࠊࠕ࡛ࡁ࡞࠸࣭ࠖࠕࢃ࠿ࡽ࡞࠸ࠖࢆ  Ⅼ࡜ࡋࡓ⤖ᯝࠊᖹᆒ⥲ᚓⅬࡣ  Ⅼ‶Ⅼ࡛  Ⅼ㸦4 Ⅼࠊ4 Ⅼ㸧࡛࠶ࡗࡓࠋࡲࡓࠊᑐ㇟⪅ࡢ⬟ຊ್ࢆ♧ࡍᣦᶆ㸦DELOLW\㸸ࡍ࡭࡚ࡢᅇ⟅࡛ࠕ࡛ࡁࡿࠖ࡜ᅇ⟅ࡋࡓேࡢ๭ྜ㸧ࢆ⟬ฟࡋࡓ࡜ࡇࢁࠊ㸣㸦4㸣ࠊ4㸣㸧ࡀࡍ࡭࡚ࠕ࡛ࡁࡿࠖ࡜࠸࠺ᅇ⟅࡛࠶ࡗࡓࠋࡇࡢ⤖ᯝࡣࠊࢦ࣮ࣝࢻ࣭ࢫࢱࣥࢲ࣮ࢻ࡛࠶ࡿ⡆᫆ )5$,/ ࢫࢡ࣮ࣜࢽࣥࢢ㉁ၥ⚊ࡢ⤖ᯝ࡛࠶ࡿ 㸣㸦4㸣ࠊ4㸣㸧࡜ẚ㍑ࡍࡿ࡜ኳ஭ຠᯝࡀᢚไࡉࢀ࡚࠾ࡾࠊᗋຠᯝࡶᙅ࠸ࡇ࡜ࡀ♧ࡉࢀࡓࠋ


㸫150㸫

ᎋ‫ݑ‬ ᮏ◊✲ࡣࠊ୰ᖺ⪅࡟࠾ࡅࡿࣇࣞ࢖ࣝᚩೃࢆᤊ࠼ࡿࡓࡵࡢၥデ⚊ࢆ㛤Ⓨࡍࡿࡇ࡜ࢆ┠ⓗ࡜ࡋࡓࠋ௒ᖺᗘ㸦ึᖺᗘ㸧ࡣࠊඛ⾜◊✲ࢆࣞࣅ࣮ࣗࡋࠊ୰ᖺᮇ࠿ࡽࡢࣉࣞࣇࣞ࢖࣭ࣝࣇࣞ࢖
ࣝண㜵ࡢࡓࡵࡢ㌟య⬟ຊၥデ⚊ࡢ᱌ࢆసᡂࡋࡓࠋࡲࡓࠊࣉࣞࣇࣞ࢖࣭ࣝࣇࣞ࢖ࣝࡢࢫࢡࣜ
࣮ࢽࣥࢢ㉁ၥ⣬ࡢࢦ࣮ࣝࢻ࣭ࢫࢱࣥࢲ࣮ࢻ࡜ࡋ࡚⡆᫆ )5$,/ ࢫࢡ࣮ࣜࢽࣥࢢ㉁ၥ⚊ࢆ㑅ᢥࡋࠊ୧⪅ࢆ⏝࠸࡚ணഛㄪᰝࢆ㛤ጞࡋࡓࠋ ࡲࡓࠊ᪂ࡓ࡞㌟య⬟ຊၥデ⚊ࡣࠊ6+$5( ◊✲ࡢၥデ㡯┠ࢆ࣮࣋ࢫ࡟సᡂࡋ࡚࠸ࡿࠋ6+$5(◊✲ࡣ࣮ࣚࣟࢵࣃᅪ࡟Ꮡᅾࡍࡿせ௓ㆤࡸ㧗㱋⪅ࡢ೺ᗣၥ㢟ࢆྲྀࡾᢅ࠺ࢥ࣮࣍ࢺ◊✲ࡢ⤫ྜࢆᅗࡗ࡚࠾ࡾࠊࡑࡢᑐ㇟ேᩘࡣ㸱୓ே௨ୖ࡜㛵㐃㡿ᇦ࡛ࡣ᭱ࡶ኱つᶍ࡞◊✲࡜࡞ࡗ࡚࠸
ࡿࠋࡲࡓࠊྠࡌ࣮ࣚࣟࢵࣃᅪෆࡢ (/6$ ◊✲ࡸࠊḢ⡿ࡢ +56 ◊✲࡜ࡢẚ㍑ྍ⬟࡞㉁ၥ㡯┠ࢆከࡃ᭷ࡋ࡚࠸ࡿࠋ࡞࠾ࠊ:KLWH+DOO6WXG\ ࡞࡝㌟య⬟ຊ࡟㛵ࡍࡿ㡯┠ࡀ᪥ᖖ⏕άືసࡢ㡯┠࡟㝈ࡽࢀࡿ◊✲࡜ࡢẚ㍑ࡣᅔ㞴࡛࠶ࡿࡀࠊᮏ◊✲ࡢᑐ㇟ᒙ࡛ࡇࢀࡽࡢ㡯┠ࡣ㝜ᛶࡀண᝿ࡉࢀࡿࡓࡵ࠶࠼࡚ྲྀࡾᢅࢃࡎࠊᶵ⬟ⓗไ㝈ࡢືస㡯┠ࡢࡳࢆྲྀࡾᢅࡗ࡚࠸࡚࠸ࡿࠋᶵ⬟ⓗไ㝈࡜ࡣ❧ࡕୖࡀࡿࠊ㝵ẁࢆ᪼ࡿ࡞࡝ࢆྵࡴືసࡑࡢࡶࡢ࡛࠶ࡾࠊ᪥ᖖ⏕άືస࡜ࡣࠊ
㒊ᒇ࡛ࡢ⛣ືࠊ㣗஦ࠊ᤼ἥ࡞࡝ᐇ㝿ࡢ⏕άືసࡢࡇ࡜࡛࠶ࡿࠋᑟධᩥࡸ㑅ᢥ⫥ࡣࠊ⌧ሙ࡛ᢅ࠸ࡸࡍࡃࠊ᪥ᮏேࡀᅇ⟅ࡋࡸࡍ࠸ࡼ࠺ᨵኚࡋࡓⅬ࡟ࡣ␃ពࡍࡿᚲせࡀ࠶ࡿࠋ
 6+$5( ◊✲࡟ࡣ↓ࡃࠊ᪂つ࡛㏣ຍࡋࡓ㡯┠࡟ࡣࠊ୰ᖺᮇ࠿ࡽࡢணഛຊࢆホ౯ࡍࡿࡓࡵࠊ
ࡼࡾࣁ࢖ࣞ࣋ࣝ࡞ࠊ࠶ࡿ࠸ࡣ」㞧࣭ᕦ⦓ⓗ࡞㡯┠࡜ࡋࡓࠋࡑࡢ⤖ᯝࠊ᪂ࡓ࡞㌟య⬟ຊၥデ⚊ࡣࠊ୰ᖺᮇࡢ೺デཷデ⪅ࡢ⬟ຊࢆホ౯ࡍࡿୖ࡛ጇᙜ࡞

ᐃ⠊ᅖࢆ᭷ࡋ࡚࠸ࡿࡇ࡜ࡀศ࠿

ࡗࡓࠋࡘࡲࡾࠊࡍ࡭࡚ࡢ㡯┠࡛ࠕ࡛ࡁࡿࠖ࡜࠸࠺ᅇ⟅⪅ࡢ⬟ຊ್ࢆ 㸣࡜ࡋࡓሙྜࠊ᪂

㸫151㸫

ࡓ࡞㌟య⬟ຊၥデ⚊ࡣᖹᆒ࡛ 㸣㸦4㸣ࠊ4㸣㸧࡛࠶ࡾࠊࢦ࣮ࣝࢻ࣭ࢫࢱࣥࢲ࣮ࢻ
࡛࠶ࡿ⡆᫆ )5$,/ ࢫࢡ࣮ࣜࢽࣥࢢ㉁ၥ⚊ࡢᖹᆒ࡛ 㸣㸦4㸣ࠊ4㸣㸧࡜ẚ㍑ࡋ࡚ࠊ
᪂ࡓ࡞㌟య⬟ຊၥデ⚊࡛ኳ஭ຠᯝࡀࡼࡾᢚไࡉࢀ࡚࠸ࡿࡇ࡜ࡀ᫂ࡽ࠿࡜࡞ࡗࡓࠋศᕸࡢ୰
࡟ࡣࠊ᭱㧗ᚓⅬ  Ⅼࢆྵࡳࠊ᭱పᚓⅬࡣ  Ⅼࡶࢃࡎ࠿࡟Ꮡᅾࡋࡓࠋ Ⅼ࡟ࡘ࠸࡚ࡣࠊ௒ᅇ
ࡢ⤖ᯝ࡟ࡣྵࢇ࡛ゎᯒࡋࡓࡀ⌧ᐇⓗ࡞ᐃࡀ࡛ࡁ࡚࠸࡞࠸ྍ⬟ᛶࡀ࠶ࡿࠋ௒ᚋࠊ␗ᖖᅇ⟅ࡢᐃ⩏ࢆᐃࡵࡿᚲせࡀ࠶ࡿࠋࡲࡓࠊ⡆᫆ )5$,/ ࢫࢡ࣮ࣜࢽࣥࢢ㉁ၥ⚊࡟ࡼࡗุ࡚ᐃࡉࢀࡓ
ࣉࣞࣇࣞ࢖ࣝࡢ๭ྜࡣ඲యࡢ 㸣࡛࠶ࡾࠊ᝿ᐃࡼࡾࡶከࡃᏑᅾࡋࡓࠋࡋ࠿ࡋࠊࣉࣞࣇࣞ࢖
ࣝࢆุᐃࡍࡿ  Ⅼ࡜  Ⅼࡢศᕸࢆࡳࡿ࡜ࠊ Ⅼ࡟඲యࡢ 㸣ࠊ Ⅼ࡟ 㸣࡛࠶ࡾࠊከࡃࡀ Ⅼ࡟ヱᙜࡋ࡚࠸ࡓ㸦ෆヂ㸸 Ⅼ ࠊ Ⅼ ࠊ Ⅼ ࠊ Ⅼ ࠊ Ⅼ 㸧ࠋࡲࡓࠊヱᙜ⪅ࡢῶⅬ㡯┠ࡣࠕ⑂ປឤࠖ࡜ࠕయ㔜ῶᑡࠖࡀከ࠿ࡗࡓࠋࡑࡢ௚ࡢᐈほⓗᡤぢ࠿ࡽࠊᮏᑐ㇟
⪅ࡢ୰࡛ࡢෆⓗጇᙜᛶࡶ᳨ドࡍࡿᚲせࡀ࠶ࡿࠋ
௒ᚋ㸦᭱⤊ᖺᗘ㸧ࡣࠊ᪂ࡓ࡟㛤Ⓨࡋࡓ㌟య⬟ຊၥデ⚊࡟ࡼࡿㄪᰝᑐ㇟ࢆ㧗㱋⪅ᒙ 㹼ṓ⣙  ே࡟ᣑ኱ࡋࠊࡉࡽ࡟ 㹼 ṓࡢ㏣ຍㄪᰝ⣙  ேࡢᐇែㄪᰝࢆ⾜࠸ࠊࠕ᫆ࣇࣞ
࢖ࣝࠖ≧ែࢆᐃ⩏ࡍࡿ࢝ࢵࢺ࢜ࣇ್ࢆỴᐃࠊࠕ᫆ࣇࣞ࢖ࣝࠖ≧ែࡢᇶᮏ≉ᛶࡢ≉ᚩ㸦⫋ᴗ⤒Ṕࡸ೺デᡤぢ࡞࡝㸧ࢆㄪ࡭ࡿணᐃ࡛࠶ࡿࠋ


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ࡾ. 2016; 3: 11-8.
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ᅗ㸱 ㌟య⬟ຊ㉁ၥ⣬㸦඲  ၥ㸧៲˳ᏡщƴƭƍƯƷƓƨƣƶ‒‒ ˌɦƷǑƏƳଐࠝѣ˺ƴƭƍƯŴƋƯƸǇǔǋƷ  ƭƴŹǛƭƚƯƘƩƞƍŵ‒ᲫᲪᲪO Ǜ˞ǇƣƴഩƘਖ਻峔岹峑岷峵 峔峽峒岵峑岷峵峑岷峔岮峹岵峳峔岮

ᲫᲪᲪᲪ᳧ˌɥǛ˞ǇƣƴഩƘਖ਻峔岹峑岷峵 峔峽峒岵峑岷峵峑岷峔岮峹岵峳峔岮ᲫᲪᲪO Ǜ˞Ǉƣƴឥǔਖ਻峔岹峑岷峵 峔峽峒岵峑岷峵峑岷峔岮峹岵峳峔岮

ᲫᲪᲪᲪ᳧ˌɥǛ˞Ǉƣƴឥǔਖ਻峔岹峑岷峵 峔峽峒岵峑岷峵峑岷峔岮峹岵峳峔岮

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ᏑƢơǛƷƹƠƯŴᇌƬƨ‫ۋ‬ѬǛ  Ўᆉࡇ̬ƭਖ਻峔岹峑岷峵 峔峽峒岵峑岷峵峑岷峔岮峹岵峳峔岮

ౝ‫܇‬ƴƠƹǒƘࡈƬƨࢸƴᇌƪɥƕǔਖ਻峔岹峑岷峵 峔峽峒岵峑岷峵峑岷峔岮峹岵峳峔岮

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Ძ᨞ЎƷ᨞െǛ˞Ǉƣƴଞǔਖ਻峔岹峑岷峵 峔峽峒岵峑岷峵峑岷峔岮峹岵峳峔岮

Ძ᨞ЎƷ᨞െǛ˞ǇƣƴƔƚឱưଞǔਖ਻峔岹峑岷峵 峔峽峒岵峑岷峵峑岷峔岮峹岵峳峔岮

Ძ᨞ЎƷ᨞െǛ˞Ǉƣƴ  െៃƼưଞǔਖ਻峔岹峑岷峵 峔峽峒岵峑岷峵峑岷峔岮峹岵峳峔岮

Ძ᨞ЎƷ᨞െǛ˞ǇƣƴᲯMI ˌɥƷཋᲢ᫢૰Լưɟ஽Ʒ᣻ƍᘥƳƲᲣǛਤƬƯଞǔਖ਻峔岹峑岷峵 峔峽峒岵峑岷峵峑岷峔岮峹岵峳峔岮

Ჭ᨞ЎƷ᨞െǛ˞Ǉƣƴଞǔਖ਻峔岹峑岷峵 峔峽峒岵峑岷峵峑岷峔岮峹岵峳峔岮

ɲឱưƱƼៃƶǔਖ਻峔岹峑岷峵 峔峽峒岵峑岷峵峑岷峔岮峹岵峳峔岮

ਖ਻峔岹峑岷峵 峔峽峒岵峑岷峵峑岷峔岮峹岵峳峔岮

ᲢȩǸǪ˳દƷȔȧȳȔȧȳƳƲᲣ༾ឱưƱƼៃƶǔᲢƚǜƚǜƢǔᲣ


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ᲢӫɥƴƭƮƘᲣᲢƭƮƖᲣ









ᏑɶǛ‫ٻ‬ƖƘࢸǖƴӒǒƢᲢࢸ‫މ‬ƢǔᲣਖ਻峔岹峑岷峵 峔峽峒岵峑岷峵峑岷峔岮峹岵峳峔岮

ɶ᏿ƴƳǔ

ਖ਻峔岹峑岷峵 峔峽峒岵峑岷峵峑岷峔岮峹岵峳峔岮

ᏹǛᏅǑǓ᭗Ƙਫƛǔਖ਻峔岹峑岷峵 峔峽峒岵峑岷峵峑岷峔岮峹岵峳峔岮

ǽȕǡƷǑƏƴ‫ٻ‬ƖƳཋǛ਀ƠƨǓࡽƍƨǓƢǔਖ਻峔岹峑岷峵 峔峽峒岵峑岷峵峑岷峔岮峹岵峳峔岮

ᲯMI ˌɥƷཋᲢ᫢૰Լưɟ஽Ʒ᣻ƍᘥƳƲᲣǛਤƪɥƛƨǓᢃǜƩǓƢǔਖ਻峔岹峑岷峵 峔峽峒岵峑岷峵峑岷峔岮峹岵峳峔岮

ᒵཋǛ᪽ǑǓ᭗ƍˮፗǇưਤƪɥƛǔਖ਻峔岹峑岷峵 峔峽峒岵峑岷峵峑岷峔岮峹岵峳峔岮

ȆȸȖȫƳƲƔǒᲫόྚǛƭǇǈɥƛǔਖ਻峔岹峑岷峵 峔峽峒岵峑岷峵峑岷峔岮峹岵峳峔岮

ȯǤǷȣȄǍȖȩǦǹƳƲƷȜǿȳƷƔƚ‫ٳ‬ƠǛɲ৖ưƢǔਖ਻峔岹峑岷峵 峔峽峒岵峑岷峵峑岷峔岮峹岵峳峔岮

ȯǤǷȣȄǍȖȩǦǹƳƲƷȜǿȳƷƔƚ‫ٳ‬ƠǛ༾৖ưƢǔਖ਻峔岹峑岷峵 峔峽峒岵峑岷峵峑岷峔岮峹岵峳峔岮

ȚȃȈȜȈȫƳƲƷȕǿǛ᧏ƚǔਖ਻峔岹峑岷峵 峔峽峒岵峑岷峵峑岷峔岮峹岵峳峔岮

ǿǪȫǍᩃࠉǛƠƬƔǓƠǅǔਖ਻峔岹峑岷峵 峔峽峒岵峑岷峵峑岷峔岮峹岵峳峔岮



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ਖ਻峔岹 峔峽峒岵 峑岷峔岮 峹岵峳৚௦ য  峑岷峵   峑岷峵    峔岮    ᲫᲪᲪO Ǜ˞ǇƣƴഩƘ  ᲫᲪᲪᲪ᳧ˌɥǛ˞ǇƣƴഩƘ  ᲫᲪᲪO Ǜ˞Ǉƣƴឥǔ  ᲫᲪᲪᲪ᳧ˌɥǛ˞Ǉƣƴឥǔ  ᇌƪഥǇǒƣഩƘᡦɶư᳏ǿȸȳƢǔ  ᇌƬƨǇǇƦƷ‫ئ‬ưᲫ‫᠃ׅ‬Ƣǔ  Წ଺᧓ᆉࡇࡈƬƯƍǔ  ᏑƢơǛƷƹƠƯŴᇌƬƨ‫ۋ‬ѬǛ  Ўᆉࡇ̬ƭ  ౝ‫܇‬ƴƠƹǒƘࡈƬƨࢸƴᇌƪɥƕǔ  ࠿ǍုƴƠƹǒƘࡈƬƨࢸƴᇌƪɥƕǔ  Ძ᨞ЎƷ᨞െǛ˞Ǉƣƴଞǔ  Ძ᨞ЎƷ᨞െǛ˞ǇƣƴƔƚឱưଞǔ  Ძ᨞ЎƷ᨞െǛ˞Ǉƣƴ  െៃƼưଞǔ

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  Ძ᨞ЎƷ᨞െǛ˞ǇƣƴᲯMI ˌɥƷཋᲢ᫢૰Լưɟ஽Ʒ᣻ƍᘥƳƲᲣǛਤƬƯଞǔ  Ჭ᨞ЎƷ᨞െǛ˞Ǉƣƴଞǔ  ɲឱưƱƼៃƶǔᲢȩǸǪ˳દƷȔȧȳȔȧȳƳƲᲣ  ༾ឱưƱƼៃƶǔᲢƚǜƚǜƢǔᲣ ᏑɶǛ‫ٻ‬ƖƘࢸǖƴӒǒƢᲢࢸ‫މ‬ƢǔᲣ ɶ᏿ƴƳǔ ᏹǛᏅǑǓ᭗Ƙਫƛǔ ǽȕǡƷǑƏƴ‫ٻ‬ƖƳཋǛ਀ƠƨǓࡽƍƨǓƢǔ 

ᲯMI ˌɥƷཋᲢ᫢૰Լưɟ஽Ʒ᣻ƍᘥƳƲᲣǛਤƪɥƛƨǓᢃǜƩǓƢǔ ᒵཋǛ᪽ǑǓ᭗ƍˮፗǇưਤƪɥƛǔ ȆȸȖȫƳƲƔǒᲫόྚǛƭǇǈɥƛǔ ȯǤǷȣȄǍȖȩǦǹƳƲƷȜǿȳƷƔƚ‫ٳ‬ƠǛɲ৖ưƢǔ ȯǤǷȣȄǍȖȩǦǹƳƲƷȜǿȳƷƔƚ‫ٳ‬ƠǛ༾৖ưƢǔ ȚȃȈȜȈȫƳƲƷȕǿǛ᧏ƚǔ ǿǪȫǍᩃࠉǛƠƬƔǓƠǅǔ஭ʥ࢝ࣼ‫ޔ‬೘͢ͱ͏ΖͪΌ߻‫ܯ‬ͺචͥ͢΍  ͳͺ͵Δ͵͏⾲㸴 ⥲ᚓⅬ࠾ࡼࡧಶேࡢ⬟ຊ DELOLW\ ࢆ♧ࡍᣦᶆẚ⋡થ஍৚௦ য  ਴಑ዮࢽໜᲢ᳸ ໜƷር‫׊‬Უμ‫ׅ‬ሉƷƏƪžբ᫆ƳƘưƖǔſƱ‫ׅ‬ሉƠƨൔྙ
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㻝㻠㻚䛚Ⲕ䜔Ồ≀➼䛷䜐䛫䜛䛣䛸䛜䛒䜚䜎䛩䛛䚹㻌 䛿䛔㻛䛔䛔䛘㻌㻝㻡㻚ཱྀ䛾Ῥ䛝䛜Ẽ䛻䛺䜚䜎䛩䛛䚹㻌 䛿䛔㻛䛔䛔䛘㻌㻝㻢㻚㐌䛻 㻝 ᅇ௨ୖ䛿እฟ䛧䛶䛔䜎䛩䛛䚹㻌 䛿䛔㻛䛔䛔䛘㻌㻝㻣㻚᫖ᖺ䛸ẚ䜉䛶እฟ䛾ᅇᩘ䛜ῶ䛳䛶䛔䜎䛩䛛䚹㻌 䛿䛔㻛䛔䛔䛘㻌㻝㻤㻚࿘䜚䛾ே䛛䜙䛂䛔䛴䜒ྠ䛨஦䜢⪺䛟䛃䛺䛹䛾≀ᛀ䜜䛜䛒䜛䛸ゝ䜟䜜䜎䛩䛛䚹㻌 䛿䛔㻛䛔䛔䛘㻌㻝㻥㻚⮬ศ䛷㟁ヰ␒ྕ䜢ㄪ䜉䛶䚸㟁ヰ䜢䛛䛡䜛䛣䛸䜢䛧䛶䛔䜎䛩䛛䚹㻌 䛿䛔㻛䛔䛔䛘㻌㻞㻜㻚௒᪥䛜ఱ᭶ఱ᪥䛛䜟䛛䜙䛺䛔᫬䛜䛒䜚䜎䛩䛛䚹㻌 䛿䛔㻛䛔䛔䛘㻌㻞㻝㻚䠄䛣䛣 㻞 㐌㛫䠅ẖ᪥䛾⏕ά䛻඘ᐇឤ䛜䛺䛔䚹㻌 䛿䛔㻛䛔䛔䛘㻌㻞㻞㻚䠄䛣䛣 㻞 㐌㛫䠅䛣䜜䜎䛷ᴦ䛧䜣䛷䜔䜜䛶䛔䛯䛣䛸䛜ᴦ䛧䜑䛺䛟䛺䛳䛯䚹㻌 䛿䛔㻛䛔䛔䛘㻌䝣䝺䜲䝹 㻣 Ⅼ௨ୖ㻌 䈜䝥䝺䝣䝺䜲䝹ᐃ⩏䛿୙ᐃ㻌䝥䝺䝣䝺䜲䝹 㻝䡚㻞 Ⅼ㻛䝣䝺䜲䝹 㻟 Ⅼ௨ୖ㻌㻝㻚䠄䛣䛣 㻞 㐌㛫䠅䜟䛡䜒䛺䛟⑂䜜䛯䜘䛖䛺ឤ䛨䛜䛧䜎䛩䛛㻌 䛿䛔䞉䛔䛔䛘㻌
㻞㻚䠍㝵䛛䜙䠎㝵䜎䛷䛾䜂䛸䛴䛵䛝䛾㝵ẁ䜢ୖ䜎䛷䛾䜌䜚䛝䜛䛣䛸䛜䛷䛝䜎䛩䛛㻌 䛷䛝䜛䞉䛷䛝䛺䛔㻌㻟㻚㻠㻜㻜䡉䠄㻝 ༊㛫䠅Ṍ䛡䜎䛩䛛㻌 Ṍ䛡䜛䞉Ṍ䛡䛺䛔㻌㻠㻚㻡 䛴䜘䜚ከ䛔✀㢮䛾⑓Ẽ䛻䛛䛛䛳䛶䛔䜎䛩䛛㻌 㻡 䛴䜘䜚ከ䛔䞉㻡 䛴䜘䜚ᑡ䛺䛔㻌᭱㏆ 㻢 䞄᭶㛫䛷 㻞ࠥ㻟㼗㼓 ௨ୖ䠄㻡㻑䜢㉸䛘䜛䠅య㔜䛾ῶᑡ䛜䛒䜚䜎䛧䛯䛛䚹㻌 ῶᑡ䛜䛒䛳䛯㻛䛺䛛䛳䛯ཌ⏕ປാ┬㻧㻌 㻌㻹㼛㼞㼘㼑㼥㻌㻒㻌㻭㼐㼍㼙㼟㻚㻌㻞㻜㻝㻡㻧㻌㻹㼛㼞㼘㼑㼥㻘㻌㼑㼠㻌㼍㼘㻚㻌㻞㻜㻝㻞㻚㻌ӋༀΨЙ‫ؕܭ‬แ
ཎࣉᚨբʼᜱؕஜȁǧȃǯȪǹȈቇତ (4#+. ǹǯȪȸȋȳǰឋբᅚӸᆅᙀឱ᝻૰ᲫᲧᲫ ᪥ᮏㄒ࡛౑⏝ྍ⬟࡞ࣇࣞ࢖ࣝࡢࢫࢡ࣮ࣜࢽࣥࢢ㉁ၥ⣬ࡢ୍ぴ㻝㻚 㻝 ᪥୰ᐙ䛾እ䛻䛿ฟ䛪䚸ᐙ䛾୰䛷㐣䛤䛩䛣䛸䛜ከ䛔䛷䛩䛛䚹㻌 䛿䛔㻛䛔䛔䛘㻌㻞㻚 䜅䛰䜣䚸௙஦䠄㎰సᴗ䜒ྵ䜑䜛䠅䚸㈙䛔≀䚸ᩓṌ䚸㏻㝔䛺䛹䛷እฟ䛩䜛䠄ᐙ䛾እ䛻ฟ䜛䠅㢖ᗘ䛿䛹䜜䛟䜙䛔䛷䛩䛛䚹㻌 㻞䡚㻟 ᪥䛻 㻝 ᅇ⛬ᗘ㻛㻝 㐌㛫䛻 㻝 ᅇ⛬ᗘ௨ୗ㻌㻟㻚 ᐙ䛾୰䛒䜛䛔䛿ᐙ䛾እ䛷䚸㊃࿡䞉ᴦ䛧䜏䞉ዲ䛝䛷䜔䛳䛶䛔䜛䛣䛸䛜䛒䜚䜎䛩䛛䚹㻌 䛿䛔㻛䛔䛔䛘㻌㻠㻚 ぶ䛧䛟䛚ヰ䛧䛜䛷䛝䜛㏆ᡤ䛾ே䛿䛔䜎䛩䛛䚹㻌 䛿䛔䞉䛔䛔䛘㻌㻡㻚 ㏆ᡤ䛾ே௨እ䛷䚸ぶ䛧䛟⾜䛝᮶䛩䜛䜘䛖䛺཭㐩䚸ูᒃᐙ᪘䜎䛯䛿ぶᡉ䛿䛔䜎䛩䛛䚹㻌 䛿䛔㻛䛔䛔䛘㻌㻢㻚 䛣䛾୍ᖺ㛫䛻㌿䜣䛰䛣䛸䛜䛒䜚䜎䛩䛛䚹㻌 䛿䛔䞉䛔䛔䛘㻌㻣㻚 㻝㼗㼙 䛠䜙䛔䛾㊥㞳䜢⥆䛡䛶Ṍ䛟䛣䛸䛜䛷䛝䜎䛩䛛䚹㻌 ୙⮬⏤䛺䛟䛷䛝䜛㻛䛷䛝䜛䛜㞴൤䛩䜛䞉䛷䛝䛺䛔㻌㻤㻚 ┠䛿ᬑ㏻䛻ぢ䛘䜎䛩䛛䚹㻌 ὀ䠅║㙾䜢౑䛳䛯≧ែ䛷䜒䜘䛔䚹㻌 䜅䛴䛖䛻ぢ䛘䜛䠄ᮏ䛜ㄞ䜑䜛䠅㻛䛒䜎䜚ぢ䛘䛺䛔䞉䜋䛸䜣䛹ぢ䛘䛺䛔㻌㻥㻚 ᐙ䛾୰䛷䜘䛟䛴䜎䛪䛔䛯䜚䚸⁥䛳䛯䜚䛧䜎䛩䛛䚹㻌 䛿䛔㻛䛔䛔䛘㻌㻝㻜㻚㌿䜆䛣䛸䛜ᛧ䛟䛶እฟ䜢᥍䛘䜛䛣䛸䛜䛒䜚䜎䛩䛛䚹㻌 䛿䛔㻛䛔䛔䛘㻌㻝㻝㻚䛣䛾୍ᖺ㛫䛻ධ㝔䛧䛯䛣䛸䛜䛒䜚䜎䛩䛛䚹㻌 䛿䛔㻛䛔䛔䛘㻌㻝㻞㻚᭱㏆㣗ḧ䛿䛒䜚䜎䛩䛛䚹㻌 䛿䛔㻛䛔䛔䛘㻌㻝㻟㻚⌧ᅾ䚸䛹䜜䛟䜙䛔䛾䜒䛾䛜ჶ䜑䜎䛩䛛䚹㻌 ὀ䠅ධ䜜ṑ䜢౑䛳䛶䜒䜘䛔䚹㻌 䛯䛔䛶䛔䛾䜒䛾䛿ჶ䜣䛷㣗䜉䜙䜜䜛䞉䛒䜎䜚ჶ䜑䛺䛔䛾䛷㣗䜉≀䛜㝈䜙䜜䜛㻌㻝㻠㻚䛣䛾 㻢 䛛᭶㛫䛻 㻟㼗㼓 ௨ୖ䛾య㔜ῶᑡ䛜䛒䜚䜎䛧䛯䛛䚹㻌 䛿䛔㻛䛔䛔䛘㻌
㻝㻡㻚䛣䛾 㻢 䛛᭶㛫䛻䚸௨๓䛻ẚ䜉䛶䛛䜙䛰䛾➽⫗䜔⬡⫫䛜ⴠ䛱䛶䛝䛯䛸ᛮ䛔䜎䛩䛛䚹㻌 䛿䛔㻛䛔䛔䛘㻌㛗ᡤ䠖ᅜෆ䛷ỗ⏝䠄ⲡὠ◊✲䚸ᮾ ◊✲䛷౑⏝䠅㻌▷ᡤ䠖㡯┠ᩘ䛜ከ䛔䚸ᅜ㝿ẚ㍑䛻㞴Ⅼ䛒䜚㻌䝣䝺䜲䝹 㻠 Ⅼ௨ୖ㻌 䈜䝥䝺䝣䝺䜲䝹䛿ᮍᐃ⩏㻌᪂㛤┬஧䠊㻞㻜㻝㻟㻌ʼᜱʖ᧸ȁǧȃǯȪǹȈ㸫㸫᫂グ䛺䛧㻌㛗ᡤ䠖ᅜẸ೺ᗣ䞉ᰤ㣴ㄪᰝ䛾⤖ᯝ䛸ẚ㍑ྍ⬟䚸㡯┠ᩘ䛜ᑡ䛺䛔䚸㻌▷ᡤ䠖ጇᙜᛶ᳨ド䛣䜜䛛䜙䚸ᅜ㝿ẚ㍑䛻㞴Ⅼ䛒䜚㻌㻝㻚᪥⏝ရ䛾㈙䛔≀䜢䛧䛶䛔䜎䛩䛛䚹㻌 䛿䛔㻛䛔䛔䛘㻌㻞㻚཭ே䛾ᐙ䜢ゼ䛽䛶䛔䜎䛩䛛䚹㻌 䛿䛔㻛䛔䛔䛘㻌㻟㻚᫖ᖺ䛸ẚ䜉䛶እฟ䛾ᅇᩘ䛜ῶ䛳䛶䛔䜎䛩䛛䚹㻌 䛿䛔㻛䛔䛔䛘㻌㻠㻚᳔Ꮚ䛻ᗙ䛳䛯≧ែ䛛䜙ఱ䜒䛴䛛䜎䜙䛪䛻❧䛱ୖ䛜䛳䛶䛔䜎䛩䛛䚹㻌䛿䛔㻛䛔䛔䛘㻌 䛣䛾䠍ᖺ㛫䛷㌿䜣䛰䛣䛸䛜䛒䜚䜎䛩䛛䚹㻌 䛿䛔㻛䛔䛔䛘䝥䝺䝣䝺䜲䝹 㻝䡚㻞 Ⅼ㻛䝣䝺䜲䝹 㻟 Ⅼ௨ୖ㻌㛗ᡤ䠖㡯┠ᩘ䛜ᑡ䛺䛔䚸㻲㼞㼕㼑㼐 䛾ุᐃᇶ‽䛻ἢ䛳䛶䛔䜛㻌▷ᡤ䠖ᅜ㝿ẚ㍑䛻㞴Ⅼ䛒䜚䚸ୖグㄽᩥ䛷ጇᙜᛶ᳨ド䛒䜚㻌 㻌㻝㻚㻢 䞄᭶㛫䛷 㻞ࠥ㻟㼗㼓 ௨ୖ䛾య㔜ῶᑡ䛜䛒䜚䜎䛧䛯䛛䚹㻌 㻌 㻌䛿䛔㻛䛔䛔䛘㻌
㻞㻚௨๓䛻ẚ䜉䛶Ṍ䛟㏿ᗘ䛜㐜䛟䛺䛳䛶䛝䛯䛸ᛮ䛔䜎䛩䛛䚹㻌 㻌䛿䛔㻛䛔䛔䛘㻌
㻟㻚䜴䜷䞊䜻䞁䜾➼䛾㐠ື䜢㐌䛻 㻝 ᅇ௨ୖ䛧䛶䛔䜎䛩䛛䚹㻌 㻌䛿䛔㻛䛔䛔䛘㻌
㻠㻚㻡 ศ๓䛾䛣䛸䛜ᛮ䛔ฟ䛫䜎䛩䛛䚹㻌 㻌䛿䛔㻛䛔䛔䛘㻌
㻡㻚䠄䛣䛣 㻞 㐌㛫䠅䜟䛡䜒䛺䛟⑂䜜䛯䜘䛖䛺ឤ䛨䛜䛩䜛䚹㻌 㻌䛿䛔㻛䛔䛔䛘㻌

ᅜẸ೺ᗣᰤ㣴ㄪᰝ௻⏬ゎᯒ᳨ウ఍䠄㻞㻜㻝㻣㻛㻞㻛㻞䠅䜘䜚㼅㼍㼙㼍㼐㼍㻌㻒㻌㻭㼞㼍㼕㻚㻌㻞㻜㻝㻢㻌ӋༀΨЙ‫ؕܭ‬แ
ཎࣉᚨբ‫׎‬ൟͤࡍȷ௿᫱ᛦ௹ဃ෇፼ॹᛦ௹ᅚᲢకᲣ

ȕȬǤȫȷǤȳȇȃǯǹӸᆅᙀឱ᝻૰ᲫᲧᲬ ᪥ᮏㄒ࡛౑⏝ྍ⬟࡞ࣇࣞ࢖ࣝࡢࢫࢡ࣮ࣜࢽࣥࢢ㉁ၥ⣬ࡢ୍ぴ 䡚NJ 䛾䜒䛾䜢ᣢ䛱ୖ䛢䛶㐠䜆䛾䛜䛹䛾䛟䜙䛔ᅔ㞴䛷䛩䛛䠛㻌 ඲䛟ᅔ㞴䛷䛺䛔ᑡ䛧ᅔ㞴䛸䛶䜒ᅔ㞴䞉䜎䛯䛿඲䛟Ṍ䛡䛺䛔 㒊ᒇ䛾୰䜢Ṍ䛟䛾䛜䛹䛾䛟䜙䛔ᅔ㞴䛷䛩䛛䠛㻌 ඲䛟ᅔ㞴䛷䛺䛔ᑡ䛧ᅔ㞴䛸䛶䜒ᅔ㞴䞉⿵ຓල䛜ᚲせ䞉䜎䛯䛿඲䛟Ṍ䛡䛺䛔 ᳔Ꮚ䜔䝧䝑䝗䛛䜙⛣ື䛩䜛䛾䛜䛹䛾䛟䜙䛔ᅔ㞴䛷䛩䛛䠛㻌 ඲䛟ᅔ㞴䛷䛺䛔ᑡ䛧ᅔ㞴䛸䛶䜒ᅔ㞴䞉⿵ຓල䛜ᚲせ䞉䜎䛯䛿඲䛟Ṍ䛡䛺䛔 㝵ẁ䜢  ẁ䛾䜌䜛䛾䛜䛹䛾䛟䜙䛔䛯䛔䜈䜣䛷䛩䛛䠛㻌 ඲䛟ᅔ㞴䛷䛺䛔ᑡ䛧ᅔ㞴䛸䛶䜒ᅔ㞴䞉䜎䛯䛿ຓ䛡䛜䛺䛔䛸⛣ື䛷䛝䛺䛔㻢㻚 䛣䛾  ᖺ䛷ఱᅇ㌿ಽ䛧䜎䛧䛯䛛䠛㻌 䛺䛧䠄 ᅇ䠅䡚 ᅇ ᅇ௨ୖ㻌㛗ᡤ䠖ᅜẸ೺ᗣ䞉ᰤ㣴ㄪᰝ䛾⤖ᯝ䛸ẚ㍑ྍ⬟䚸㡯┠ᩘ䛜ᑡ䛺䛔䚸㻌▷ᡤ䠖ጇᙜᛶ᳨ド䛣䜜䛛䜙䚸ᅜ㝿ẚ㍑䛻㞴Ⅼ䛒䜚㻌᫂グ䛺䛧㻌

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