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Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($)
$ in Thousands
 3 Months Ended
Mar. 31, 2018
Mar. 31, 2017
Cash flows from operating activities:    
Net income (loss) $ (5,983) $ 7,411
Adjustments to reconcile net income (loss) to net cash provided by (used by) operating activities:    
Depreciation and amortization of continuing operations 14,281 12,571
Depreciation and amortization of discontinued operations   3,009
Amortization of debt issuance costs 1,088 1,221
Share of net income from joint venture, net of cash dividends received (831) (1,693)
Compensation expense from issuance of share-based awards 1,256 1,152
Other 347 (207)
Changes in operating assets and liabilities:    
Accounts receivable (9,433) (19,332)
Inventories (7,791) (1,025)
Accounts payable (296) 1,394
Income taxes receivable (613) 5,899
Other 7,001 (5,459)
Net cash provided by (used by) operating activities (974) 4,941
Cash flows from investing activities:    
Acquisition of property, plant and equipment (11,860) (8,565)
Cash paid to acquire businesses, net of cash received (14,676)  
Cash paid for earnest money for Paragon Medical acquisition (Note 3) (6,000)  
Other (282) 295
Net cash provided by (used by) investing activities (32,818) (8,270)
Cash flows from financing activities:    
Dividends paid (1,931) (1,910)
Proceeds from long-term debt 10,000 14,000
Repayment of long-term debt (13,000) (1,437)
Repayments of short-term debt, net (52) (2,045)
Other (1,278) (316)
Net cash provided by (used by) financing activities (6,261) 8,292
Effect of exchange rate changes on cash flows 562 215
Net change in cash and cash equivalents (39,491) 5,178 [1]
Cash and cash equivalents at beginning of period 224,446 14,405 [2]
Cash and cash equivalents at end of period $ 184,955 $ 19,583
[1] Cash and cash equivalents includes $8.1 million of cash and cash equivalents that were included in current assets of discontinued operations as of December 31, 2016.
[2] Cash and cash equivalents includes $10.9 million of cash and cash equivalents that were included in current assets of discontinued operations as of March 31, 2017.