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Punctuation 101

Apostrophes — Use to indicate possession (the doctor’s, the nurse’s), or omitted letters or figures (don’t, ’50s). Do not use to indicate plurals in numerals or acronyms: 1990s, HMOs, RNs.
Capitalization — In titles, capitalize principal words, including prepositions and conjunctions of four or more letters; capitalize words of fewer than four letters if used as the first or last word in the title.
In a series — Use commas to separate elements in a series, but do not place a comma before the conjunction in a simple series of three or more: patients, visitors and staff. The flag is red, white and blue. Use commas to separate each element: Webster’s New World College Dictionary is the first reference for spelling, style, usage and foreign geographic names.
Put a comma before the concluding conjunction in a series, however, if an integral element of the series requires a conjunction: I had orange juice, toast, and ham and eggs for breakfast.
Use a comma before the concluding conjunction in a complex series of phrases: The main points to consider are whether the athletes are skillful enough to compete, whether they have the stamina to endure the training, and whether they have the proper mental attitude.
Parenthetic expressions — Sentences with brief descriptive phrases must use the apposition comma. The Employee Survey, coordinated by a multidisciplinary task force, will be fielded in September 2010.
With dates — Use a comma between the day and year and after the year: July 18, 1902, is the Hospital’s anniversary. Do not use a comma between the month and year: July 1902.
With quotes — Commas and periods always go within quotations: “Don’t leave the gurney in the hall,” the orderly said.
With states — Use commas before and after state names when used with city names: Sacramento, CA, and Los Angeles, CA, are in the metropolitan area.
Em Dash(—) and En Dash(–) — An em dash is roughly the length of a lowercase letter m and is generally used to replace colons, commas, hyphens, semi-colons and parentheses. Our style includes a space between em dashes: UCLA — an academic medical center in Los Angeles — is respected around the world for research and patient education.
An en dash is roughly the length of a lowercase letter n and is typically used to denote a span of time or in the place of a colon to create compounds (see example below).  Follow these guidelines:
Use Em Dashes:

  • Abrupt change — To denote an abrupt change in thought in a sentence or an emphatic pause.
  • Series within a phrase — When a phrase that otherwise would be set off by commas contains a series of words that must be separated by commas.

Use En Dashes:

  • To create compounds — For example, the California–Mexico border.
  • Do not use to denote a span of time — For example, Monday–Thursday should be Monday to Thursday. Refer to the Time entry for further clarification.

Ellipses (. . .) (sing. ellipsis) — In general, treat an ellipsis as a three-letter word, constructed with three periods and two spaces.
Use an ellipsis to indicate the deletion of one or more words in condensing quotes, texts and documents. Be especially careful to avoid deletions that would distort the meaning.

  • When writing for print, capitalize principal words, including prepositions and conjunctions of four or more letters
  • Capitalize words of fewer than four letters if used as the first or last word in the title. Don’t abbreviate unless the readers will understand.
  • When writing for digital, only capitalize the first word.


Headline in Print

Once Fragile Newborns, They Return Years Later to Give Thanks

Headline in Digital

Once Fragile Newborns, They Return Years Later to Give Thanks

Subhead in Digital

400 families reunite at a reunion

Hyphen (-) — Hyphens are joiners. Use them to avoid ambiguity or to form a single idea from two or more words.
As compound modifier — Use when two or more words that express a single concept precede a noun (use hyphens to link all the words in the compound): a first-quarter analysis, bluish-green scrubs, a full-time internist, a well-known physician, a well-qualified nurse, a know-it-all attitude. The only exceptions are words that follow adverbs that end in –ly: an easily remembered rule.
Use with a two-thought compoundsocio-economic.
Use to designate dual heritageItalian-American, African-American.
Quotations — Periods and commas go within quotation marks; dashes, semicolons, question marks, and exclamation points go within the quotation marks when they apply to the quoted matter only. They go outside when they apply to the whole sentence.
For quotes within quotes, alternate between double quotation marks (“or”) and single marks (‘or’):
Example: She said, “I quote from his letter, ‘I agree with Kipling that “the female of the species is more deadly than the male” but the phenomenon is not an unchangeable law of nature,’ a remark he did not explain.”
Use three marks together if two quoted elements end at the same time:
Example: She said, “He told me, ‘I love you.’”
Semicolons — Use in a sentence to separate two complete and related thoughts: Dr. Smith went to Florida; it was her first vacation there. A semicolon is also used to clarify a series: The surgical team was made up of Dr. Jones, who has been with the hospital two years; and Dr. Johnson, who just transferred from an Atlanta hospital last month.
Think of a semicolon as a half pause but that connects two sentences that could grammatically stand on their own.

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