This shouldn't really be a surprise if you've played Oblivion, Fallout 3 or Fallout New Vegas before...I played this some more last night:
Terrible menu navigation system requres a mix of keystrokes and mouse clicks is a real PITA.
Even worse is the lack of any high-lighting of useable items. Games like this MUST have some kind of indication when you are near an item that you can use and as well a name flating above it is nice so you can determine if you actually want to pick it up or not. There is soooo much crap to pick up in this game and the only way to know if anything is useable is to move right beside it it and put the crosshairs on it. What idiot developer let this happen? I've checked the manual and also looked at a few online guides in an attempt to see if there is any switch I need to toggle to get "item high-light" mode active and I've found nothing. This really bugs me and I'm putting this on the shelf until there is a patch to include high-lighting.