Condensed Consolidated Statements of Cash Flows - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Cash flows from operating activities
Net loss	$ (18,600)	$ (5,983)
Adjustments to reconcile net loss to net cash provided by (used by) operating activities:
Depreciation and amortization	23,425	14,281
Amortization of debt issuance costs	1,191	1,088
Loss on extinguishment of debt and write-off of debt issuance costs	2,699	0
Share of net income from joint venture, net of cash dividends received	(269)	(831)
Compensation expense from issuance of share-based awards	873	1,256
Deferred income taxes	(4,373)	0
Other	182	347
Changes in operating assets and liabilities, net of acquisitions:
Accounts receivable	(13,963)	(9,433)
Inventories	(6,302)	(7,791)
Accounts payable	7,236	(296)
Income taxes receivable and payable, net	248	(613)
Other	4,941	7,001
Net cash used by operating activities	(2,712)	(974)
Cash flows from investing activities
Acquisition of property, plant and equipment	(14,073)	(11,860)
Proceeds from liquidation of short-term investment	8,000	0
Cash paid to acquire businesses, net of cash received	0	(14,676)
Cash paid for earnest money for Paragon Medical acquisition	0	(6,000)
Other	2,394	(282)
Net cash used by investing activities	(3,679)	(32,818)
Cash flows from financing activities
Cash paid for debt issuance or prepayment costs	(738)	0
Dividends paid	(2,947)	(1,931)
Proceeds from long-term debt	19,025	10,000
Repayment of long-term debt	(7,522)	(13,000)
Proceeds from (repayments of) short-term debt, net	1,982	(52)
Other	(924)	(1,278)
Net cash provided by (used by) financing activities	8,876	(6,261)
Effect of exchange rate changes on cash flows	(204)	562
Net change in cash and cash equivalents	2,281	(39,491)
Cash and cash equivalents at beginning of period	17,988	224,446
Cash and cash equivalents at end of period	20,269	184,955
Supplemental schedule of non-cash operating, investing and financing activities
Non-cash additions to property, plant and equipment	$ 4,071	$ 2,992