title: Initial evidence for the link between activities and health: Associations between a balance of activities, functioning and serum levels of cytokines and C-reactive protein.
abstract: Growing evidence shows interrelations of psychological factors, neurological and immunological processes. Therefore, constructs like a balance of activities, the so called "occupational balance", could also have biological correlates. The aim of this study was to investigate potential associations between occupational balance, functioning, cytokines and C-reactive protein (CRP) in patients suffering from a chronic inflammatory disease like rheumatoid arthritis (RA) and healthy people. Moreover, we wanted to explore potential differences in gender and employment status. A descriptive study in patients with RA and healthy people was conducted using the Occupational Balance-Questionnaire (OB-Quest) and the Short-Form 36 Health Survey (SF-36). Serum levels of cytokines, such as interleukin 6 (IL-6) and 8 (IL-8), interferon alpha (INFα), tumour necrosis factor alpha (TNFα), rheumatoid factor (RF) and of CRP were measured. Descriptive statistics, as well as Mann-Whitney U tests and Spearmen's rank correlation coefficients (rs) were calculated. One-hundred-thirty-two patients with RA and 76 healthy people participated. Occupational balance was associated with functioning, cytokines and CRP. The strongest associations were identified in the unemployed healthy-people sample with cytokines and CRP being within the normal range. For example, the OB-Quest item challenging activities was associated with IL-8 (rs=-0.63, p=0.04) and the SF-36 sub-scale bodily pain was associated with IFNα (rs=-0.69, p=0.02). The items rest and sleep (rs=-0.71, p=0.01) and variety of different activities (rs=-0.74, p<0.01) correlated with the SF-36 sub-scale social functioning. Employed and unemployed people differed in their age and CRP levels. Additionally, gender differences were found in two OB-Quest items in that fewer women were able to adapt their activities to changing living conditions and fewer men were overstressed. In conclusion, we found preliminary biological evidence for the link between occupation and health in that the concepts encompassed in the construct of occupational balance were associated with functioning, cytokines and CRP.
authors.affiliation: IMC University of Applied Sciences, Department of Health Sciences, Bachelor Program Occupational Therapy, Piaristengasse 1, 3500 Krems, Austria; Medical University of Vienna, Department of Internal Medicine III, Division of Rheumatology, Währinger Gürtel 18-20, 1090 Vienna, Austria; Medical University of Vienna, Department of Pediatrics and Adolescent Medicine, Division of Neonatology, Pediatric Intensive Care and Neuropediatrics, Währinger Gürtel 18-20, 1090 Vienna, Austria. Electronic address: mona.duer@fh-krems.ac.at.
authors.forename: Mona
authors.initials: M
authors.lastname: Dür
authors.affiliation: Medical University of Vienna, Department of Internal Medicine III, Division of Rheumatology, Währinger Gürtel 18-20, 1090 Vienna, Austria; Ludwig Boltzmann Society, Cluster Rheumatology, Balneology and Rehabilitation, Nussdorfer Strasse 64, 1090 Vienna, Austria. Electronic address: guenter.steiner@meduniwien.ac.at.
authors.forename: Günter
authors.initials: G
authors.lastname: Steiner
authors.affiliation: University of Applied Sciences for Health Professions Upper Austria, Bachelor Program Occupational Therapy, Niedernharter Straße 20, 4020 Linz, Austria. Electronic address: michaela.stoffer@me.com.
authors.forename: Michaela Alexandra
authors.initials: MA
authors.lastname: Stoffer
authors.affiliation: Medical University of Vienna, Department of Physical Medicine and Rehabilitation, Währinger Gürtel 18-20, 1090 Vienna, Austria. Electronic address: pmr-office@meduniwien.ac.at.
authors.forename: Veronika
authors.initials: V
authors.lastname: Fialka-Moser
authors.affiliation: Medical University of Vienna, Department of Internal Medicine III, Division of Gender Medicine, Währinger Gürtel 18-20, 1090 Vienna, Austria. Electronic address: alexandra.kautzky-willer@meduniwien.ac.at.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Kautzky-Willer
authors.affiliation: Medical University of Vienna, Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Währinger Gürtel 18-20, 1090 Vienna, Austria. Electronic address: clemens.dejaco@meduniwien.ac.at.
authors.forename: Clemens
authors.initials: C
authors.lastname: Dejaco
authors.affiliation: Medical University of Vienna, Institute of Environmental Health, Kinderspitalgasse 15, 1090 Vienna, Austria. Electronic address: cem.ekmekcioglu@meduniwien.ac.at.
authors.forename: Cem
authors.initials: C
authors.lastname: Ekmekcioglu
authors.affiliation: Swiss Paraplegic Research ICF Unit, Guido A. Zäch Strasse 4, 6207 Nottwil, Switzerland. Electronic address: birgit.prodinger@paraplegie.ch.
authors.forename: Birgit
authors.initials: B
authors.lastname: Prodinger
authors.affiliation: Medical University of Vienna, Department of Internal Medicine III, Division of Rheumatology, Währinger Gürtel 18-20, 1090 Vienna, Austria. Electronic address: alexa.binder@gmail.com.
authors.forename: Alexa
authors.initials: A
authors.lastname: Binder
authors.affiliation: Medical University of Vienna, Department of Internal Medicine III, Division of Rheumatology, Währinger Gürtel 18-20, 1090 Vienna, Austria; Hospital Hietzing and Neurological Centre Rosenhügel, Wolkersbergenstraße 1, 1130 Vienna, Austria. Electronic address: josef.smolen@wienkav.at.
authors.forename: Josef
authors.initials: J
authors.lastname: Smolen
authors.affiliation: Medical University of Vienna, CeMSIIS-Center for Medical Statistics, Informatics and Intelligent Systems, Section for Outcomes Research, Spitalgasse 23, 1090 Vienna, Austria; Medical University of Vienna, Department of Internal Medicine III, Division of Rheumatology, Währinger Gürtel 18-20, 1090 Vienna, Austria; Ludwig Boltzmann Society, Cluster Rheumatology, Balneology and Rehabilitation, Nussdorfer Strasse 64, 1090 Vienna, Austria. Electronic address: tanja.stamm@meduniwien.ac.at.
authors.forename: Tanja Alexandra
authors.initials: TA
authors.lastname: Stamm
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000097:blood / Q000523:psychology; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism*; D016022:Case-Control Studies; D016207:Cytokines / Q000097:blood*; D004651:Employment; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged
chemical_list: D015415:Biomarkers; D016207:Cytokines; D002097:C-Reactive Protein
keywords: Autoimmune disease; Biomarker; Immunology; Inflammatory markers; Measure; Occupational balance; Occupational science; Psychoneuroimmunology