Nouns, adjectives and prepositions do not change their endings in English to indicate how they relate to each other. Words can be stressed in speech, but although underlining and italics will indicate stress in writing they are devices to use sparingly. Some journals will not accept italicized emphases. In written English, meaning is determined first by the positions, or presumed positions, of words, phrases and clauses, and second by the punctuation between them.

Consider this simple example.

Readers expect near to qualify the word next to it, clinical. Although it takes only a moment to realize that the sense is of a clinical near-disaster and not of a disaster that was nearly clinical, the expression is a jolt to the flow of understanding. The example is better as The policy was changed after there was nearly a clinical disaster.

Sometimes the interpreted meaning may be far from the intended one, as in this letter from a firm of solicitors to a general practice:

Note the ‘lazy slash’, which is better replaced with and: see p. 178.

Missing words

Words are often left out but their position is assumed and understood by readers as if they were there: