(6)	Restructuring

We incurred $1,216, $4,846, and $1,545 of restructuring costs in the years ended December 31, 2011, 2010, and 2009, respectively, in restructuring and other expenses in our statements of operations.

Prior Year Initiatives

In 2008, we completed two restructuring initiatives to better align our costs with anticipated revenues going forward. The initiatives included personnel terminations from all parts of the organization as well as contract exit costs related to the abandonment of leased facilities. In 2009, we recorded a credit of $174 related to these restructuring initiatives as a result of updates to our estimated contract exit cost obligations.

In 2009, we completed a restructuring initiative to reduce our workforce by approximately 35 individuals. This action was taken concurrent with the acquisition of etrials based upon our assessment of ongoing personnel needs. As a result, we incurred $1,719 of severance and related costs in the third quarter of 2009.

In 2010, we committed to a restructuring initiative to materially reduce our workforce by approximately 125 individuals and exit certain facilities. In the second quarter of 2010, we exited each of our Bellevue, Washington; Milwaukee, Wisconsin and Hudson, Ohio facilities. This action was taken concurrent with the acquisition of AMICAS based upon our assessment of ongoing personnel needs. In the third quarter of 2010, we exited our New Brighton, Massachusetts facility as part of the plan for this initiative. We incurred $2,116 in severance and related costs, $2,225 in contract exit costs and $505 in relocation costs in 2010 associated with this initiative.

Third Quarter 2011 Initiative

On August 5, 2011, we committed to a restructuring initiative to reduce our workforce by approximately 30 individuals. This action was taken based upon our assessment of ongoing personnel needs. We anticipate we will incur $1,561 in expense related to this initiative by the end of the second quarter of 2012 and have incurred $1,167 in expense in 2011.

The following table shows the restructuring activity in the years ended December 31, 2011, 2010 and 2009:

	Employee Termination Costs			Lease & Contract Exit Costs			Relocation			Total
	Prior year initiatives
Balance at December 31, 2008	$	533		$	655		$	-		$	1,188
Charges to expense		1,719			(174	)		-			1,545
Payments		(1,641	)		(279	)		-			(1,920	)
Foreign exchange		51			15			-			66
Balance at December 31, 2009		662			217			-			879
Charges to expense		2,116			2,225			505			4,846
Payments		(2,339	)		(744	)		(463	)		(3,546	)
Foreign Exchange		10			-			-			10
Balance at December 31, 2010		449			1,698			42			2,189
Charges to expense		(30	)		104			(25	)		49
Payments		(104	)		(1,365	)		(17	)		(1,486	)
Foreign Exchange		(4	)		-			-			(4	)
Balance at December 31, 2011	$	311		$	437		$	-		$	748
		2011 Intiative
Balance at December 31, 2010	$	-		$	-			-		$	-
Charges to expense		1,167			-			-			1,167
Payments		(508	)		-			-			(508	)
Balance at December 31, 2011	$	659		$	-		$	-		$	659
		Total Initiatives
Balance at December 31, 2008	$	533		$	655		$	-		$	1,188
Charges to expense		1,719			(174	)		-			1,545
Payments		(1,641	)		(279	)		-			(1,920	)
Foreign Exchange		51			15			-			66
Balance at December 31, 2009		662			217			-			879
Charges to expense		2,116			2,225			505			4,846
Payments		(2,339	)		(744	)		(463	)		(3,546	)
Foreign Exchange		10			-			-			10
Balance at December 31, 2010		449			1,698			42			2,189
Charges to expense		1,137			104			(25	)		1,216
Payments		(612	)		(1,365	)		(17	)		(1,994	)
Foreign Exchange		(4	)		-			-			(4	)
Balance at December 31, 2011	$	970		$	437		$	-		$	1,407

As of December 31, 2011, the remaining balance of $1,407 is included in the restructuring accrual in current liabilities. We expect that the majority of the balance will be paid out by the end of the second quarter of 2012.