Note 6 - Accrued Expenses (Details) - Accrued Expenses - USD ($) $ in Thousands	Dec. 31, 2015	Dec. 31, 2014
Accrued Expenses [Abstract]
Accrued compensation and benefits	$ 13,266	$ 15,041
Accrued selling and professional fees	5,457	4,202
Accrued income, value added and other taxes	30,774	26,576
Accrued medical panel fees	7,598	4,391
Other accrued expenses	3,653	3,768
Totals	$ 60,748	$ 53,978