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Condensed Consolidated Statements Of Cash Flows - USD ($)
$ in Thousands
 3 Months Ended
Mar. 31, 2019
Mar. 31, 2018
Cash flows - operating activities:    
Net income including noncontrolling interests $ 72,410 $ 55,374
Adjustments to reconcile net income to net cash used in operating activities:    
Depreciation and amortization 10,585 9,711
Amortization of identifiable intangible assets 11,610 10,668
(Recovery of) provision for doubtful accounts (673) 1,135
Deferred income taxes 2,496 2,944
Excess tax benefits from share-based compensation (499) (716)
Equity income from unconsolidated entities (26) (41)
Non-cash share-based compensation expense 3,557 3,268
Distributions from unconsolidated entities 80 1,585
Other reconciling items 413 379
Changes in operating assets and liabilities, excluding the effect of businesses acquired (157,388) (143,394)
Net cash used in operating activities (57,435) (59,087)
Cash flows - investing activities:    
Payments for acquisitions of businesses, net of cash acquired (31,124) (2,689)
Proceeds from sale of property, plant and equipment 1,023 242
Purchase of property, plant and equipment (13,113) (6,588)
Investments in and advances to unconsolidated entities (794) (2,804)
Net cash used in investing activities (44,008) (11,839)
Cash flows - financing activities:    
Repayments of long-term debt and debt issuance costs (3,800) (3,800)
Repayments of finance lease liabilities (1,053) (372)
Dividends paid to stockholders (4,480) (4,704)
Repurchase of common stock 0 (34,485)
Taxes paid related to net share settlements of equity awards (3,735) (3,267)
Issuance of common stock under employee stock purchase plan 1,323 1,337
Payments for contingent consideration arrangements (23) 0
Distributions to noncontrolling interests (40) 0
Net cash used in financing activities (11,808) (45,291)
Effect of exchange rate changes on cash, cash equivalents and restricted cash 1,298 1,733
Decrease in cash, cash equivalents and restricted cash (111,953) (114,484)
Cash, cash equivalents and restricted cash at beginning of year (1) [1] 366,214 469,388
Cash, cash equivalents and restricted cash at end of period (2) [2] 254,261 354,904
Cash paid for:    
Interest 3,218 2,650
Income taxes $ 3,787 $ 2,741
[1] Includes $2.3 million and $2.0 million of restricted cash classified as “Prepaid expenses and other” in the Consolidated Balance Sheets as of December 31, 2018 and 2017, respectively.
[2] Includes $2.2 million and $2.5 million of restricted cash classified as “Prepaid expenses and other” in the Consolidated Balance Sheets as of March 31, 2019 and 2018, respectively.