The health needs and experiences of rural residents are diverse. While common themes, such as limitation of access to health services are easily identified, also relevant is the diversity related to the geographic, social, economic and environmental factors that mould the character of a community. Rural people have poorer health outcomes, poorer health behaviours, and are more likely to experience the social determinants of health, particularly lower incomes, level of education and a higher proportion of First Nations’ populations (AIHW, 2019; Wakerman et al., 2017). This chapter employs a conceptual framework to assist in describing the complexity of rural health outcomes. The framework proposes that the interrelationships of six concepts can be used to interpret issues and scenarios in rural and remote health. These concepts are: geographical isolation, the rural locale and the social interactions of people in the local area, local health responses, broader health systems, broader social systems, and power relations. This chapter explores each of the six concepts in the framework to understand how public health measures at all levels can contribute to rural health outcomes.

There is an extensive vernacular conduct literature of the twelfth and thirteenth century that has barely been used by social historians. This is all the more surprising as it has a considerable amount to say on central social issues, not least gender. This chapter analyses what several conduct tracts have to say about just one such aspect, femininity, beginning with the earliest conduct tract of all, addressed to women by the aristocratic Occitan author Garin lo Brun in the first half of the twelfth century. We find that Garin and other authors, notably the prolific thirteenth-century social commentator Robert de Blois, described and defined an idealised superior woman: the preudefemm or biderbe wip who summed up in herself the contemporary gender expectations of the female of the twelfth and thirteenth centuries. Importantly, it is an ideal of femininity generated within lay society and not out of the Latin literature of the schools previously used for the purpose by scholars, tainted with clerical misogyny as it is. The result goes a long way to explain the potential and limits of the female agency recent gender scholarship has suggested was to be found in medieval society.

The defining feature of Western warfare in this period was knighthood. This was not because horseback warfare was in any way new in the Frankish lands, or even because the technology of the equipment and use of cavalry had changed in any radical sense, though it is generally assumed that the stirrup appeared as a feature of cavalry equipment at some time in the ninth or tenth century, thus allowing the saddle to become a more effective fighting platform. But the stirrup did not by any means create the knight. What the knight represented was a new social phenomenon which grew progressively more important as generations passed and read new meanings into the status and potential of knighthood.

MASTER ROGER of Howden may not have written the most attractive, witty and engaging chronicles of his life and times, but their importance is beyond any dispute. For thirty years he was a member of the most powerful court of twelfth-century Western Europe and knew its personalities and its lord well. He was a witness, and in a small way a participant, in several ecclesiastical causes celèbres in both England and Scotland. He was also, as we now know, a frequent traveler to distant lands in his master's interests and an avid observer of the cultures he found far from his native Yorkshire. His chronicles, begun in 1169 as a travel diary and journal of his days as a young Angevin courtier in the final months of the Becket debacle, eventually mutated into a much more ambitious general chronicle of his age, which included England's back story to the time of Bede. It is, however, another aspect of his life that is the business of this chapter, one that has yet to be properly explored, but which nonetheless has something to say about the life and work of Roger of Howden. This is its local context: the minster church of Howden of which he was the head; the Yorkshire landed society of the East Riding and Lower Ouse basin in which he was brought up and lived, and the ecclesiastical community of the diocese of York of which he was part. This is one of those aspects of Roger's biography which has not to date been selected as being particularly germane to reconstructing his life, but as our colleague and friend Richard Abels has warned us, the evidence a biographer selects does tend to form the overall picture in unintended ways.

We know Roger better now than ever. The first editor of his works, William Stubbs, another clergyman whose roots were in Yorkshire, certainly established some matters, if he obscured others. He observed but discounted the similarities between Roger's Chronica and the earlier work known as the Gesta regis Henrici et Ricardi. But between the 1950s and 1980s a debate finally and firmly concluded that the works were both Roger’s.

The systematic list covers all records for the period up to 31 December 2013. This appendix includes further noteworthy records for the period from 2014 until 2018. Records are drawn from the 2014 and 2015 Annual Reports for Nottinghamshire and the British Birds Rarities Reports for 2014, 2015, 2016 and 2017. A number of accepted, but as yet unpublished, records for 2016, 2017 and 2018 have also been included.

Records listed here include the first records of Pallid Harrier and Azorean Yellow-legged Gull for Nottinghamshire, and the first confirmed breeding records for Eurasian Bittern, Mediterranean Gull, Herring Gull, European Bee-eater and Bearded Tit.

Barnacle Goose Branta leucopsis

A skein of 40 Barnacle Geese which flew east at Kilvington Lakes on 24 November 2014 may have been wild birds.

Tundra Bean Goose Anser serrirostris

There were two additional reports in 2016 of three birds at Budby Pumping Station and at Girton on 17 January 2016 and of a lone bird at Bank End Road North on 26 December 2016 and in 2018 a single bird was seen at Budby Pumping Station on 9 December 2018.

Pink-footed Goose Anser brachyrhynchus

A bird at Lound on 5 June 2016 was the latest departing migrant ever recorded in Nottinghamshire.

Mute Swan Cygnus olor

A count of 291 birds at Netherfield Lagoons on 1 May 2016 is the highest ever site count in Nottinghamshire.

Whooper Swan Cygnus cygnus

On 22 March 2015, a total of 341 birds passed over Budby Common, 250 birds went north-west over Kilvington Lakes, 204 birds went north over Langford Lowfields and approximately 200 birds went northwest over Farnsfield. These are the highest ever site counts for the county.

A summering bird was seen at Newington South Quarry on 17 July 2015.

Egyptian Goose Alopochen aegyptiaca

A count of 29 birds at Attenborough NR on 2 September 2016 is the highest ever site count for Nottinghamshire.

Mandarin Duck Aix galericulata

A count of 209 birds at Welbeck Lakes on 11 November 2018 is the highest ever count for Nottinghamshire.

Garganey Spatula querquedula

A drake at Eakring Flash and Rufford CP from 23 December 2014 to 4 May 2015 was the first ever winter record for Nottinghamshire. What was probably the same bird was present through the winters of 2015/16 and 2016/17.

I am delighted to write a few words celebrating this long-awaited publication about the birds of our wonderful county.

As a long-standing member of Nottinghamshire Birdwatchers, I have always had such great pleasure in taking a breather from my hectic life to enjoy the peace of the countryside and, in particular, the birds that bring it alive.

Birds very much reflect our changing world. Who would have thought years ago you would have seen Common Buzzards over Trent Bridge whilst enjoying the cricket, or Little Egrets flying down the Trent on the way to a Nottingham Forest game? Recording these changes and trying to understand their meaning is the prime purpose of all county bird clubs, and this book is testament to the hard work and many hours in the field of hundreds of dedicated enthusiasts.

We all delight in Nottinghamshire's special breeding birds – Hawfinch, Honey-buzzard, European Nightjar and Woodlark come to mind – and the county is rightly famous for them, as it is for those very special rarities that sometimes appear, and the thrill they bring.

I was on the banks of the River Trent at Wilford with the many thousands who travelled to see England's first Cedar Waxwing back in March 1996 but sadly I failed to make it to join the throng to see Britain's first ever Redhead just over my constituency border at Gibsmere. A truly remarkable birding year.

Most important, I think, is the effort many people in the birdwatching community put in unheralded to preserve and nurture our natural environment for future generations. Working in partnership with the wildlife trusts, the RSPB, landowners and farmers, there is now a much greater understanding that a healthy environment benefits us all in so very many ways.

I think of the Barn Owl project in my constituency of Rushcliffe, which year after year – through the work of dedicated volunteers – rings over 100 chicks in over 150 boxes on farms across the constituency. The delight in seeing this magnificent bird is something we must ensure is preserved for the future.

Escapes

Several species that have been recorded in Nottinghamshire as deliberate or accidental releases. The majority of records listed here derive from Annual Reports for Nottinghamshire between 1943 and 2013. Most species have been recorded on a handful of occasions but six (Black Swan, Bar-headed Goose, Muscovy Duck, Wood Duck, Northern Bobwhite and Zebra Finch) have bred in the county on at least one occasion. Perhaps unsurprisingly many of these are wildfowl that have escaped from collections, or popular cage birds such as parrots or finches. There are also several raptors that were presumably lost falconers’ birds. A few, however, are decidedly bizarre, such as the first!

Darwin's (Lesser) Rhea Rhea pennata

One from 29 August 2001 onwards at Kinoulton.

West Indian Whistling Duck Dendrocygna arborea

One was present during November–December 1994, moving between Burton Meadows, Hoveringham and Shelford.

Fulvous Whistling Duck Dendrocygna bicolour

Two reports, both of singletons. One on 11 October 2003 at Cottam Power Station, and another at Hoveringham on 18 October 2003.

Wandering Whistling Duck Dendrocygna arcuata

Two were seen at Lound GP Complex on 20 May 2010.

Red-breasted Goose Branta ruficollis

There are two records, both of single birds. The first was at Hoveringham from 16–31 July 2004, and the second was at Attenborough NR from 22 March–2 April 2005.

Cackling Goose Branta hutchinsii

A small number of birds showing the characteristics of this species (or the smaller races of Canada Goose) were recorded between 1986 and 2007 at Beeston, Clumber Park, Girton and Lound. All records have referred to single birds.

Bar-headed Goose Anser indicus

This species has been recorded quite often since 1969, with regular reports of birds in the Trent and Idle Valleys and at sites in the Dukeries. A single pair bred at the Lound GP Complex in 1994, 1999 and 2000. However, there is little evidence of a consolidation of the feral population in the county and reports have tapered off in recent years, with no reports since 2011.

Emperor Goose Chen canagica

Single birds were reported in the Trent Valley from 1986–1988 and from 1996–2001. A further bird was then reported at Lound GP Complex in October 2003.

Complications arise more frequently during the first trimester than at any other stage of pregnancy. Most present with bleeding, pain, or both. Vaginal bleeding occurs in about 20% of clinically diagnosed pregnancies. It causes considerable anxiety for the woman and her partner. In the vast majority of cases, no intervention alters the outcome. The main aim of clinical management is a prompt and accurate diagnosis, with reassurance if the pregnancy is appropriately developed and viable, or appropriate intervention if not. This chapter focuses on the principles of diagnosis and management and three principal diagnoses: miscarriage, ectopic pregnancy, and gestational trophoblastic disease. The other differential diagnoses are shown in Table 5.1.

Wool and Wealth

Britain was perceived as a wealthy island in the eleventh century, and Scandinavian pirates and armies had been liberating that wealth to their own advantage for generations. The national land tax of pre-Conquest England was called the Danegeld for that very reason. England was far and away the economically dominant area of the archipelago in population, resources and markets. The fact that the English currency was so well monitored and exploited by the West Saxon monarchy was as much to the advantage of the kings themselves as to the merchants who needed a standard national currency in which to deal. Kings were also able to profit from imposing charges on trade at ports. Whether perception of England's great wealth matched reality is less clear. Were Vikings raiding England because it was so notoriously rich in silver and treasure, or was it because it was just a wealthier place than where they lived? There is a theory that it was the export of wool from England to the continent that produced a long-term beneficial balance of trade which attracted streams of silver into the islands and generated constant surpluses.

Reading these chapters will take you back among the ‘medieval’ people of Great Britain, and, if you've not met them before, I think you'll find they were not at all what you might expect from the use of that adjective.

Expectations on Women

The middle ages had its views on how each person should conduct him- or herself, and they were not as unrelenting or restrictive as some twentieth-century scholarship might suggest. It would be fair to say that acceptable male and female conduct was mostly understood by medieval people, rather than imposed. But correct conduct was a more central feature of medieval life than it is for us, and there were reasons for this. Not least was the fact that everyone who learned to read did so from the ages of seven to seventeen from standard Latin texts whose principal subject matter was conduct and morality. Medieval people were also constantly advised to look to the conduct of others: to admired characters in history and literature for clues as to what was moral or not. Proverbial sayings were collected and memorised for their moral content. And always, just as now, people were alert to the reactions – both positive and negative – of those around them to their choices and words. Men and women of any sensitivity were in a constant, silent dialogue between themselves and this ‘habitus’, testing what they did and said against how the world reacted to it. Since prosperity and opportunities depended on the degree of social success their behaviour attracted, this medieval fixation on conduct was a pragmatic one.