IIRC items are for billing/breaking down the project (e.g. data prep, data load, implementation, post-implementation support (stuff that you want your customer to see)) and activities are how you break down your expenses and time for things you want to be able to see across multiple projects (e.g. traveling, client meetings, data work). They both really could be just about anything, really depends on what the business is and what needs to be tracked and reported on.