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      &lt;font style="FONT-FAMILY: Times New Roman, Times, serif; FONT-SIZE: 10pt"&gt;&lt;b&gt;(11)&amp;#160;&amp;#160;&amp;#160;&amp;#160;&amp;#160;&amp;#160;&amp;#160;

      &amp;#160; &amp;#160;Financial Instruments&lt;/b&gt;&lt;/font&gt;

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      &lt;font style="FONT-FAMILY: Times New Roman, Times, serif; FONT-SIZE: 10pt"&gt;The

      FASB issued ASC Topic 815, &lt;i&gt;Derivatives and Hedging&lt;/i&gt;,

      (&amp;#8220;ASC 815&amp;#8221;),&amp;#160;which establishes accounting

      and reporting standards for derivative instruments. ASC 815

      requires an entity to recognize all derivatives as either

      assets or liabilities and measure those instruments at fair

      value. Derivatives that do not qualify as a hedge must be

      adjusted to fair value in earnings. If the derivative does

      qualify as a hedge under ASC 815, changes in the fair value

      will either be offset against the change in fair value of the

      hedged assets, liabilities or firm commitments or recognized

      in accumulated other comprehensive income until the hedged

      item is recognized in earnings. The ineffective portion of a

      hedge&amp;#8217;s change in fair value will be immediately

      recognized in earnings.&lt;/font&gt;

    &lt;/p&gt;&lt;br/&gt;&lt;p style="TEXT-ALIGN: justify; LINE-HEIGHT: 1.25; TEXT-INDENT: 45pt; MARGIN: 0pt" id="PARA4754"&gt;

      &lt;font style="FONT-FAMILY: Times New Roman, Times, serif; FONT-SIZE: 10pt"&gt;In

      August 2008, in order to protect against interest rate

      exposure on its variable-rate debt, the Company entered into

      an interest rate swap to fix the interest rate applicable to

      certain of its variable-rate debt. The agreement swaps

      one-month LIBOR for a fixed interest rate of 4.36% with a

      notional amount of $4.8 million and $3.9 million as of

      December 31, 2012 and June 30, 2013, respectively. The

      Company did not meet the criteria for hedge accounting under

      ASC 815, thus the difference between its amortized cost and

      its fair value resulted in an unrealized gain at June 30,

      2012 and 2013 of $115,000 and $94,000 respectively, and such

      amount was reported in interest and other expenses, net on

      the accompanying Consolidated Statements of Comprehensive

      Loss.&lt;/font&gt;

    &lt;/p&gt;&lt;br/&gt;&lt;p style="TEXT-ALIGN: justify; LINE-HEIGHT: 1.25; TEXT-INDENT: 45pt; MARGIN: 0pt" id="PARA4756"&gt;

      &lt;font style="FONT-FAMILY: Times New Roman, Times, serif; FONT-SIZE: 10pt"&gt;In

      September 2012, in order to protect against foreign currency

      exposure on its Australian operations, the Company borrowed

      in Australian dollars under the Senior Secured Revolving

      Credit Facility as a hedge of its net investment in Australia

      related to the MedHealth acquisition. The Company had

      outstanding debt of approximately AUD$50.0 million that was

      designated as a hedge of its net investment in Australia as

      of December 31, 2012. This non-derivative net investment

      hedge was classified as long-term debt in the Company&amp;#8217;s

      Consolidated Balance Sheets. In accordance with ASC 815, the

      translation of this debt instrument designated as a net

      investment hedge is recorded in accumulated other

      comprehensive loss, offsetting the currency translation

      adjustment of the related net investment that is also

      recorded in accumulated other comprehensive loss. The AUD$

      denominated debt was paid off in full in the second quarter

      of 2013 and as of June 30, 2013, all outstanding debt under

      the Senior Secured Revolving Credit Facility is denominated

      in U.S. dollars.&lt;/font&gt;

    &lt;/p&gt;&lt;br/&gt;&lt;p style="TEXT-ALIGN: justify; LINE-HEIGHT: 1.25; TEXT-INDENT: 45pt; MARGIN: 0pt" id="PARA4758"&gt;

      &lt;font style="FONT-FAMILY: Times New Roman, Times, serif; FONT-SIZE: 10pt"&gt;In

      the second quarter of 2013, in order to protect against

      foreign currency exposure on its Australian operations, the

      Company entered into forward foreign currency contracts as a

      hedge of its net investment in Australia. The Company closed

      out the hedge position later in the second quarter of 2013

      and received $3.8 million in net proceeds. This amount was

      classified as accumulated other comprehensive&amp;#160;loss in

      the Company&amp;#8217;s Consolidated Balance Sheet, offsetting

      the currency translation adjustment of the related net

      investment that is also recorded in accumulated other

      comprehensive loss, and is reported net of the effect of

      income taxes.&lt;/font&gt;

    &lt;/p&gt;&lt;br/&gt;&lt;p style="TEXT-ALIGN: justify; LINE-HEIGHT: 1.25; TEXT-INDENT: 45pt; MARGIN: 0pt" id="PARA4760"&gt;

      &lt;font style="FONT-FAMILY: Times New Roman, Times, serif; FONT-SIZE: 10pt"&gt;The

      Company does not enter into derivative transactions for

      speculative purposes.&lt;/font&gt;

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