Okay, I think I’ve got it.
The first problem I had is I wasn’t setting my environment up properly to that +y was up.
I’ll be writing a tutorial shortly that will spawn a static image in the centre of the screen, but the main focus will be setting up the world, and view.
using Microsoft.Xna.Framework;
using Microsoft.Xna.Framework.Graphics;
using Microsoft.Xna.Framework.Input;
using System.Collections.Generic;
using tainicom.Aether.Physics2D.Dynamics;
namespace AetherTutorial001
{
  /// <summary>
  /// This is the main type for your game.
  /// </summary>
  public class Game1 : Game
  {
    GraphicsDeviceManager graphics;
    SpriteBatch spriteBatch;
    private BasicEffect _spriteBatchEffect;
    private World _world;
    private Matrix _projection;
    private Texture2D _texture;
    private Vector2 _origin;
    private Vector2 _scale;
    private Body _body;
    public Game1()
    {
      graphics = new GraphicsDeviceManager(this);
      Content.RootDirectory = "Content";
    }
    /// <summary>
    /// Allows the game to perform any initialization it needs to before starting to run.
    /// This is where it can query for any required services and load any non-graphic
    /// related content.  Calling base.Initialize will enumerate through any components
    /// and initialize them as well.
    /// </summary>
    protected override void Initialize()
    {
      // TODO: Add your initialization logic here
      base.Initialize();
    }
    /// <summary>
    /// LoadContent will be called once per game and is the place to load
    /// all of your content.
    /// </summary>
    protected override void LoadContent()
    {
      // Create a new SpriteBatch, which can be used to draw textures.
      spriteBatch = new SpriteBatch(GraphicsDevice);
      _spriteBatchEffect = new BasicEffect(graphics.GraphicsDevice);
      _spriteBatchEffect.TextureEnabled = true;
      _world = new World();
      _texture = Content.Load<Texture2D>("Square");
      _origin = new Vector2(_texture.Width / 2, _texture.Height / 2);
      _scale = new Vector2(1f, 1f);
      _body = _world.CreateRectangle(_scale.X, _scale.Y, 0.1f, new Vector2(0f, 0f));
      _body.BodyType = BodyType.Static;
    }
    /// <summary>
    /// UnloadContent will be called once per game and is the place to unload
    /// game-specific content.
    /// </summary>
    protected override void UnloadContent()
    {
      // TODO: Unload any non ContentManager content here
    }
    /// <summary>
    /// Allows the game to run logic such as updating the world,
    /// checking for collisions, gathering input, and playing audio.
    /// </summary>
    /// <param name="gameTime">Provides a snapshot of timing values.</param>
    protected override void Update(GameTime gameTime)
    {
      // update camera View Projection
      var vp = GraphicsDevice.Viewport;
      var cameraZoomFactor = 12.5f / vp.Width; // zoom out to about ~12.5 meters wide
      _projection = Matrix.CreateOrthographic(vp.Width * cameraZoomFactor, vp.Height * cameraZoomFactor, 0f, -1f);
      _world.Step((float)gameTime.ElapsedGameTime.TotalSeconds);
      base.Update(gameTime);
    }
    /// <summary>
    /// This is called when the game should draw itself.
    /// </summary>
    /// <param name="gameTime">Provides a snapshot of timing values.</param>
    protected override void Draw(GameTime gameTime)
    {
      GraphicsDevice.Clear(Color.CornflowerBlue);
      _spriteBatchEffect.Projection = _projection;
      spriteBatch.Begin(SpriteSortMode.Deferred, null, null, null, RasterizerState.CullClockwise, _spriteBatchEffect);
      spriteBatch.Draw(_texture, _body.Position, null, Color.White, _body.Rotation, _origin, _scale / new Vector2(_texture.Width, _texture.Height), SpriteEffects.FlipVertically, 0f);
      spriteBatch.End();
      base.Draw(gameTime);
    }
  }
}
I think the above is about as basic as I can get it. I’m going to debug it over the weekend to see if I can understand it more.
With everything being rotated, and using the smaller values for positions and such, my brain is a little mumbled right now!